Social hearing measured with the Performance Inventory for Profound and Severe Loss: a comparison between adult multichannel cochlear implant patients and users of acoustical hearing aids

The objective of this study was to investigate social hearing in successful users of multichannel cochlear implants (CIs) and to compare the scores with those of a group of hearing-impaired adults using acoustical hearing aids (HAs). Out of 88 patients who had undergone surgery, 75 CI users with a mean age of 55 years and a mean pre-operative hearing level of 113dB in the better ear were compared with 59 users of acoustical HAs with a mean age of 56 years and a mean hearing level of 82dB in the better ear. Seven CI patients were non-users and were excluded from the study. The Performance Inventory for Profound and Severe Loss, a questionnaire that measures different aspects of hearing handicap, was used. The CI group scored significantly better than the HA group in three of six evaluated categories, measuring subjective intensity of sounds, speech with visual cues, and response to auditory failure. Awareness of environmental sounds, speech with no visual cues and personal reactions did not differ significantly. The group of successful CI users scored higher on a self-report measure than did a group of users of acoustical HAs with moderate- severe-profound deafness. The best CI users scored better than the best HA users, and the worst CI users scored worse than the worst HA users.     

Circulating YKL‐40 in myelofibrosis a potential novel biomarker of disease activity and the inflammatory state

Chronic myeloproliferative neoplasms (MPN), encompassing essential thrombocythaemia (ET), polycythaemia vera (PV) and myelofibrosis (PMF), are featured by a chronic inflammatory state which is pronounced in myelofibrosis The value of YKL‐40 as a biomarker of disease burden has been demonstrated in several different diseases, including cancer, diabetes mellitus and cardiovascular diseases. A state of chronic inflammation is shared by them all, YKL‐40 also being involved in the severity of chronic endothelial inflammation, which today is considered of crucial importance for the development of atherosclerosis. The MPNs being cancers with a heavy burden of cardiovascular diseases we hypothesised that circulating YKL‐40 might reflect the inflammatory process and potentially serve as a novel disease marker. Using ELISA, we measured YKL‐40 in 15 patients with ET, 16 patients with PV, 17 patients with PMF and 30 healthy controls. YKL‐40 was significantly elevated in PMF vs. control subjects, PMF levels median 43 ng/mL vs. controls median 28 ng/mL, P = 0.033. An increase from ET over PV may reflect the integrated impact of disease processes in MPNs.     

A large-scale genome-wide gene expression analysis in peripheral blood identifies very few differentially expressed genes related to antidepressant treatment and response in patients with major depressive disorder

A better understanding of the biological factors underlying antidepressant treatment in patients with major depressive disorder (MDD) is needed. We perform gene expression analyses and explore sources of variability in peripheral blood related to antidepressant treatment and treatment response in patients suffering from recurrent MDD at baseline and after 8 weeks of treatment. The study includes 281 patients, which were randomized to 8 weeks of treatment with vortioxetine (N = 184) or placebo (N = 97). To our knowledge, this is the largest dataset including both gene expression in blood and placebo-controlled treatment response measured by a clinical scale in a randomized clinical trial. We identified three novel genes whose RNA expression levels at baseline and week 8 are significantly (FDR < 0.05) associated with treatment response after 8 weeks of treatment. Among these genes were SOCS3 (FDR = 0.0039) and PROK2 (FDR = 0.0028), which have previously both been linked to depression. Downregulation of these genes was associated with poorer treatment response. We did not identify any genes that were differentially expressed between placebo and vortioxetine groups at week 8 or between baseline and week 8 of treatment. Nor did we replicate any genes identified in previous peripheral blood gene expression studies examining treatment response. Analysis of genome-wide expression variability showed that type of treatment and treatment response explains very little of the variance, a median of <0.0001% and 0.05% in gene expression across all genes, respectively. Given the relatively large size of the study, the limited findings suggest that peripheral blood gene expression might not be the best approach to explore the biological factors underlying antidepressant treatment.Subject terms: Predictive markers, Depression     

Non-response for health-related quality of life outcomes in ICU patients: A systematic review of the reporting in randomised trials

Background

Health-related quality of life (HRQoL) is frequently assessed in randomised clinical trials (RCTs) in the intensive care unit (ICU), but data are limited regarding the proportions of patients without responses or not surviving to HRQoL follow-up and the handling of this. We aimed to describe the extent and pattern of missing HRQoL data in intensive care trials and describe how these data and deaths were handled statistically.

Methods

We conducted a systematic review and meta-analysis following a published protocol. We searched PubMed, EMBASE, CINAHL and Cochrane Library for RCTs involving adult ICU patients reporting HRQoL as an outcome and excluded RCTs unobtainable in full text. We performed risk of bias assessment independently and in duplicate.

Results

We included 196 outcomes from 88 RCTs published in the years 2002–2022; the numbers of patients alive and eligible to respond HRQoL were reported in 76% of trials. At follow-up, median 27% (interquartile range 14%–39%) of patients had died, and median 20% (9%–38%) of survivors did not respond across outcomes. Analyses of 80% of outcomes were restricted to complete cases only. The handling of non-survivors in analyses were reported for 46% of outcomes, with 26% of all outcomes reported as including non-survivors (using the value zero or the worst possible score).

Conclusion

For HRQoL outcomes in ICU trials, we found that mortality at time of follow-up was high and non-response among survivors frequent. The reporting and statistical handling of these issues were insufficient, which may have biased results.     

Effect of electric toothbrush on residents' oral hygiene: a randomized clinical trial in nursing homes

A single‐blinded, randomized controlled clinical trial was performed to investigate the effect of electric toothbrushes (ET) compared with manual toothbrushes (MT) on residents in nursing homes and to evaluate the caregiver's opinion on ET. A sample of 180 nursing‐home residents were given either a new ET or a new MT. Oral examinations were performed to measure dental hygiene, using the Oral Hygiene Index‐Simplified (OHI‐S). Both groups received the same instructions for use. After 2 months participants were re‐examined. Questionnaires were then sent to their caregivers. Participants' mean age was 86.1 ± 7.7 yr, and the mean number of remaining teeth was 20 ± 5.6. No specific intervention effect was found for ET. Both groups showed identical improvements in the OHI‐S, from 1.27 ± 0.63 at baseline (the mean value for all participants) to 1.01 ± 0.53 after 2 months. Of 152 caregivers who responded to the questionnaire, the majority evaluated ET to be beneficial and less time‐consuming compared with MT, also for demented residents. In a frail population, no difference is found in the effect of ET compared with MT. However, the ET appears to be a useful aid for residents who receive assistance with dental hygiene.     

Visual loss after use of intraocular silicone oil associated with thinning of inner retinal layers

Purpose: To investigate the incidence and cause of severe visual loss following use and removal of intraocular silicone oil (SiO) after uncomplicated vitrectomy and SiO injection for primary rhegmatogenous retinal detachment (RRD). Methods: Consecutive case series of 216 patients operated with vitrectomy for primary RRD in 2004–2005. In 162 eyes, SiO (5500 centiStoke) had been used as intravitreal tamponade and in 54 eyes gas (perflouropropane, C₃F₈) had been used. Following chart review, we identified 16 eyes in 16 patients (nine SiO eyes, seven gas eyes) with macula‐on and documented visual acuity ≥6/12 before surgery, where SiO had been removed, cataract surgery performed and no re‐detachment had occurred. Examinations included best‐corrected visual acuity (BCVA) and high‐definition optical coherence tomography (OCT) of the macular area. Results: Preoperative characteristics were identical between SiO and gas eyes. Postoperative BCVA was significantly worse in SiO eyes (>6/24) compared to gas eyes (>6/7.5), p = 0.005. Three of 9 (33%) SiO eyes had final BCVA ≤6/60 and 67% had final BCVA ≤6/12. No gas eyes had final BCVA <6/9. Macular OCT revealed thinning of inner retinal layers in SiO‐operated eyes (5148 pixels) compared to gas‐operated eyes (6897 pixels), p < 0.002. No other visually significant structural differences were found. Conclusion: Severe visual loss after SiO use was observed in 1/3 of patients with otherwise good visual potential. The visual loss was associated with a significant reduction in inner retinal thickness indicating neuronal cell loss in the macular area as a possible explanation.