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Biomedical subjects

R Chmiel

Publications and source records attributed to R Chmiel.

At least 19 recordsLinked to original sources
PubMed1998

Comparison of performance with frequency transposition hearing aids and conventional hearing aids.

Four experienced hearing aid users were evaluated using a frequency transposition (TranSonic) hearing system. Following a trial period, the Abbreviated Profile of Hearing Aid Performance (APHAB) and a variety of speech audiometric measures were used to compare the frequency transposition fitting with each subject's conventional hearing aids. A single-subject study design with a series of repeated measures permitted statistical analysis of differences in performance with the various amplification strategies. Two of the four subjects demonstrated statistically significant benefit with the frequency transposition device. Results show the efficacy of frequency transposition in improving speech understanding and quality of life in some individuals with severe-to-profound hearing loss. Overall, results suggest the need for evaluating the benefit of frequency transposition on an individual basis.

Acoustic Stimulation↗
PubMed1997

Unsuccessful use of binaural amplification by an elderly person.

An elderly person who preferred and performed better with monaural than with binaural amplification was extensively studied, both audiologically and neuropsychologically, in search of an explanation for the phenomenon. Particular emphasis was placed on the study of dichotic speech perception, both behaviorally and electrophysiologically. Results suggest that age-related changes in interhemispheric transfer of auditory input via corpus callosum may underlie the preference for monaural amplification. Implications for the evaluation of amplification potential in elderly persons are discussed.

Age Factors↗
PubMed1997

Electrophysiologic indices of Stroop and Garner interference reveal linguistic influences on auditory and visual processing.

The purpose of this study was to examine linguistic influences on the auditory and visual processing of words both behaviorally and electrophysiologically. Our task yielded measures of the effect of irrelevant semantic content (Stroop interference) and of the effect of irrelevant linguistic variability (Garner interference). The behavioral results allow us to assess whether the linguistic and nonlinguistic dimensions of verbal stimuli are processed dependently or independently. The electrophysiologic results allow us to determine where any processing interactions are arising, particularly regarding perceptual versus postperceptual underpinnings, and to evaluate the similarity and dissimilarity between the two interference effects. Results show pronounced Stroop and Garner interference both behaviorally and electrophysiologically, indicating linguistic influences on auditory and visual processing. Subjects could not ignore the irrelevant linguistic dimension and attend selectively to the physical dimension of either spoken or written words. The results indicate that the physical and linguistic dimensions of words are not processed independently. With regard to the stage of processing underlying the interference effects, our results suggest that both Stroop and Garner interference involve multiple stages of processing. The two interference effects are not duplicate measures, however, and different electrophysiologic signatures were observed. Stroop interference is characterized by perceptual and postperceptual components. Similar electrophysiologic patterns within the auditory and visual modalities suggest that each interference effect is tapping similar processes for spoken and written stimuli.

Adult↗
PubMed1997

Factor analytic structure of auditory impairment in elderly persons.

The audiometric and self-assessed handicap data of 180 elderly persons with presbyacusic-type hearing impairment were submitted to principal components analysis in order to study the factor structure underlying auditory processing. Audiometric data included pure-tone threshold sensitivity, speech understanding scores for monosyllabic words without competition, synthetic sentences within competition, and dichotic synthetic sentence identification. The Hearing Handicap Inventory for the Elderly (HHIE) was used to quantify self-assessed handicap both by the subjects and by their significant others. Six factors emerged from the analysis: (1) low-frequency sensitivity loss, (2) high-frequency sensitivity loss, (3) general speech understanding ability, (4) self-assessed handicap, (5) the central processing of left ear input, and (6) the central processing of right ear input. Five conclusions are highlighted: (1) degree of hearing sensitivity loss, which determines speech audibility, remains a key concept in understanding the speech understanding problems of elderly persons; (2) low-frequency and high-frequency sensitivity loss emerge as separate factors; (3) a factor of general speech understanding ability, not strongly related to audibility, is confirmed; (4) the central processing of right and left ear verbal inputs emerge as separate factors; and (5) perceived auditory handicap emerges as a separate factor, apparently not strongly related to either audibility, general speech understanding, or the central processing of verbal input.

Acoustic Impedance Tests↗
PubMed1997

Comparison of performance with frequency transposition hearing aids and conventional hearing aids.

Four experienced hearing aid users were evaluated using a frequency transposition (TranSonic) hearing system. Following a trial period, the Abbreviated Profile of Hearing Aid Performance (APHAB) and a variety of speech audiometric measures were used to compare the frequency transposition fitting with each subject's conventional hearing aids. A single-subject study design with a series of repeated measures permitted statistical analysis of differences in performance with the various amplification strategies. Two of the four subjects demonstrated statistically significant benefit with the frequency transposition device. Results show the efficacy of frequency transposition in improving speech understanding and quality of life in some individuals with severe-to-profound hearing loss. Overall, results suggest the need for evaluating the benefit of frequency transposition on an individual basis.

Adult↗
PubMed1996

Comparison of conventional amplification and an assistive listening device in elderly persons.

OBJECTIVE: To assess the impact of personal amplification systems on quality of life of elderly persons and to compare conventional hearing aid with assistive listening device. DESIGN: Audiologic, neuropsychologic, and quality-of-life measures were prospectively administered to 180 elderly, hearing-impaired persons before and after randomized 6 wk trials of four treatment conditions-a no-amplification condition and three different types of amplification: 1) conventional hearing aid, 2) assistive listening device, and 3) a combination of the two systems. All subjects volunteered to participate in a study comparing different amplification systems and were paid for their participation. RESULTS: Both self-perceived handicap and speech understanding were improved significantly by all three amplification systems. There were no significant group differences between new users and previous users of amplification in self-assessed handicap after amplification use. Anecdotally, subjects preferred the sound quality of the assistive listening device, but an overwhelming majority (97.3%) still chose the conventional aid for use in daily living. CONCLUSIONS: Results affirm the significant impact of amplification on the quality of life of elderly persons. The strong preference for the conventional hearing aid in everyday use undoubtedly reflects the fact that elderly users usually are not willing to endure the difficulties associated with the use of remote-microphone systems.

Adult↗
PubMed1996

Hearing aid use, central auditory disorder, and hearing handicap in elderly persons.

We compared self-reported handicap (Hearing Handicap Inventory for the Elderly, HHIE) scores before and after a 6-week period of hearing aid use in subjects drawn from a pool of 115 elderly persons with hearing impairment. Study patients (PTs) were divided into two categories according to whether scores on a dichotic listening test (Dichotic Sentence Identification Test, DSI) were normal or abnormal. In a subgroup of 63 persons who had not previously used amplification, subjects in the two DSI categories showed equivalent average HHIE scores. After 6 weeks of first-time hearing aid use, there was a significant improvement in average HHIE scores, but only in the DSI-normal category. In the subgroup with dichotic deficits (DSI-abnormal group), average HHIE scores did not change significantly after hearing aid use. In a subgroup of 89 PTs, we compared the self-assessed HHIE scores of the PTs with the HHIE scores rated by their significant others (SOs). In both DSI categories, the average handicap, as judged by the subject's SO, was significantly greater than the handicap as judged by the PT. In addition, both ratings reflected significant improvement after hearing aid use. It was the case, however, that improvement consequent on amplification was significantly smaller for subjects in the DSI-abnormal category. Finally, we show, in the entire pool of 115 PTs, that the effect of practice on the HHIE score is not sufficient to explain the improvement after amplification. Results affirm both the positive value of amplification and the negative impact of central auditory deficit as they affect the HHIE scores of the elderly hearing-impaired person.

Aged↗
PubMed1995

Quantifying improvement with amplification.

We employed a nonparametric measure, the randomization test, to evaluate, statistically, a variety of speech understanding measures used to quantify the efficacy of different intervention strategies in five clinical patients. The flexibility of the approach was demonstrated by comparing monaural with binaural amplification, a conventional aid with an assistive listening device, and a cochlear implant alone versus a cochlear implant supplemented by visual cues. The randomization test allows statistical analysis of differences in performance at the level of the individual subject. This approach may be useful in addressing accountability when recommending a specific intervention strategy for a particular hearing-impaired individual.

Adolescent↗
PubMed1995

Dichotic listening, event-related potentials, and interhemispheric transfer in the elderly.

OBJECTIVE: To determine the basis for the large, age-related asymmetries in dichotic listening performance scores reported by Jerger et al. (1994). DESIGN: Behavioral and electrophysiologic responses to dichotic listening tasks in both verbal and nonverbal paradigms were obtain in four groups of subjects: young adults with normal hearing, elderly persons with presbyacusis, elderly persons with presbyacusis and marked dichotic deficits, and patients with lesions of the corpus callosum. RESULTS: In comparison with the young group the two elderly groups showed an increasing left-ear deficit on the verbal task, and an increasing right-ear deficit on the nonverbal paradigm. The pattern of results obtained in the elderly persons with marked dichotic deficits was similar to the pattern of results in the group with callosal lesions. CONCLUSIONS: With age, there may be a significant loss of efficiency of interhemispheric transfer of auditory information through the corpus callosum. Such age-related deficit might have important implications for the effective use of binaural information by elderly person.

Adolescent↗
PubMed1995

Hearing impairment in older adults: new concepts.

OBJECTIVE: To review present information about the epidemiology, etiologies, pathogenesis, evaluation, and quality of life aspects of hearing loss and to present an approach to rehabilitation for hearing loss in older adults. DESIGN: A survey of recent findings on the problem of hearing loss in older adults, efficacy of intervention with amplification, and new developments in intervention strategies. CONCLUSIONS: The complex nature of hearing problems in older adults involves changes in the auditory periphery as well as in the central mechanisms for processing sound input. These changes affect the social and emotional impact of the hearing disorder. The importance of understanding the many implications of hearing loss on quality of life is emphasized. Both older adults and immediate family members need information and advice about the consequences of age-related hearing loss. The physician has a key role in helping them to overcome negative attitudes toward a hearing handicap. For most older persons, hearing aids alleviate many of the handicaps of hearing impairment. For some older persons who do not benefit adequately from conventional hearing aids, assistive listening devices may be helpful. Many old persons and their relatives are reluctant to confront the reality of hearing handicap and try to hide the fact that they need sound amplification. One important future direction is to foster acceptance of hearing loss and to support the more open use of amplification systems.

Aged↗
PubMed1994

Effects of age and gender on dichotic sentence identification.

There is converging evidence that aging causes a progressive decline in the central processing of speech and that this decline is greater for left-ear than for right-ear input. In the present paper we investigated, by means of a dichotic sentence identification paradigm, some parameters of the "left-ear effect." We analyzed the clinical records of 356 individuals, 203 males and 153 females, to whom the Dichotic Sentence Identification (DSI) Test had been administered as part of routine audiometric assessment. Subjects ranged in age from 9 to 91 yr. The DSI test was always carried out in two modes: free report (FR) and directed report (DR). In the FR mode the subject reported what was heard in both ears. In the DR mode the subject reported only what was heard in one precued ear. In half of the trials the right ear was precued, in the other half the left ear was precued. Findings confirm a progressively larger right-ear advantage, or left-ear deficit, with increasing age. We document this effect in both the FR and DR modes, then demonstrate that the effects cannot be attributed to interaural asymmetries in threshold sensitivity. Comparison of male and female data suggest a gender difference in the effect of age on the left-ear deficit. Males show a larger effect then females in both modes of test administration. Finally, we propose a model of dichotic listening performance that attempts to explain ear asymmetry as the linear combination of an auditory/structural component and a task-related/cognitive component. We then show how these hypothetical components change with age in the present sample.

Adolescent↗
PubMed1993

Some factors affecting assessment of hearing handicap in the elderly.

In 42 elderly hearing-impaired persons we compared the patient's self-assessment of hearing handicap with the assessment made by the patient's significant other. In general, patients tended to rate themselves as less handicapped than did their significant others. The difference was not affected by degree of loss but was affected by slope of loss and by the presence of central auditory processing deficit. Results support the value of the handicap assessment by the significant other in understanding the communication problems of the elderly patient.

Adult↗
PubMed1993

Gender affects audiometric shape in presbyacusis.

A review of large-scale surveys of hearing over the past 50 years reveals a "gender-reversal" phenomenon in the average audiograms of the elderly. Above 1 kHz males show greater average loss than females, but below 1 kHz females show greater average loss than males. The effect increases with both age and degree of hearing loss. The difference is present whether or not the elderly persons complain of a hearing problem and remains after persons with a history of noise exposure are excluded from the analysis. A possible explanation, based on the greater likelihood of cardiovascular disease in the elderly female, is considered.

Aged↗
PubMed1993

Case studies in binaural interference: converging evidence from behavioral and electrophysiologic measures.

We present four case reports of elderly hearing-impaired persons demonstrating a binaural interference effect. Performance measures were poorer when stimulation was binaural than when it was monaural. In the first case the effect is shown for aided speech recognition scores. In the second case it is shown in topographic brain maps of the middle-latency auditory evoked potential. In the third and fourth cases it is shown for both aided speech recognition and the middle-latency response. The effect may be analogous to the phenomenon of binocular rivalry in the visual domain.

Acoustic Stimulation↗
PubMed1992

Non-dilated urinary tract obstruction.

OBJECTIVE: To describe the occurrence of obstructive uropathy in the absence of dilatation of the urinary tract. CLINICAL FEATURES: Five cases of non-dilated obstructive nephropathy are described. All patients were uraemic on presentation. Obstruction was caused by retroperitoneal malignancy in two patients and uric acid lithiasis in the remaining three. All patients had at least one ultrasound examination. Isotope renography and computed tomography were performed in three and four patients respectively. None of these imaging techniques suggested obstruction in any of the cases. Radionuclide scans were characterised by unusually poor perfusion and parenchymal phase images. INTERVENTION AND OUTCOME: An immediate diuresis and a rapid return of normal renal function occurred after relief of the obstruction in all cases. CONCLUSION: The absence of dilatation in obstructive nephropathy is uncommon but may be responsible for delayed diagnosis and management of a readily treatable cause of acute renal failure.

Aged↗
PubMed1992

Identification of the site of severe colon bleeding by technetium-labeled red-cell scan.

In cases of severe colon bleeding, it is more important to know the site than the cause, in case surgery is required. Technetium-labeled red-cell scan (TLRCS) is known to identify the site of bleeding at the rate of 0.1 ml per minute or more. The aim of this retrospective study was to see whether TLRCS was a reliable indicator of the site of severe colon bleeding. A retrospective study was made of patients investigated in this way for acute, severe colon bleeding at St. Vincent's Hospital, Melbourne, from 1984 to 1988 (five years). TLRCS identified the site of bleeding in less than half of the cases but correctly identified the site in all nine patients in whom bleeding was so severe as to require emergency surgery, avoiding total colectomy in eight cases.

Aged↗
PubMed1989

Speech tracking in the evaluation of a multichannel cochlear prosthesis.

Individual speech tracking data were analyzed in relation to other variables in 11 adult users of the Nucleus multichannel cochlear implant. Patients were categorized according to postoperative speech tracking results. The resultant groups could also be differentiated on the basis of postoperative MAC scores, surgeon's rating of overall success, and duration of deafness before implantation. The speech tracking paradigm appears to be a useful technique for the evaluation of performance with a cochlear prosthesis.

Adult↗