Sex differences in rheumatoid arthritis: more than meets the eye...

Sex differences in the prevalence of autoimmune diseases such as rheumatoid arthritis (RA) are well described, but the literature is not as clear about sex differences in RA disease course and prognosis. A recent study from a very large cross-sectional international cohort demonstrated slightly worse levels of disease activity and function in female patients with RA, compared with men. These findings are discussed in the context of our evolving knowledge of sex differences in the expression of this prototypic autoimmune disease, both in terms of the actual disease activity level, the effects that the disease has on physical function, and our ability accurately to measure these aspects

Supplementary Material for: Hearing loss and cognitive function in early old age: comparing subjective and objective hearing measures

Introduction: Population-based research has consistently shown that people with hearing loss are at greater risk of cognitive impairment. We aimed to explore the cross-sectional association of both subjective and objective hearing measures with global and domain-specific cognitive function. We also examined the influence of hearing aid use on the relationship. Methods: A population-based sample (n=1105, 52% women) of 70-year-olds that were representative of the inhabitants of the city of Gothenburg, Sweden completed a detailed cognitive examination, pure-tone audiometry and a questionnaire regarding perceived hearing problems. A subsample (n=247, 52% women) also completed a test of speech-recognition-in-noise (SPRIN). Multiple linear regression analyses were conducted to explore the association of hearing with cognitive function adjusting for sex, education, cardiovascular factors, and tinnitus. Results: Global cognitive function was independently associated with the better ear pure-tone average across 0.5-4 kHz (PTA4, β=-0.13, 95% CI, -0.18, -0.07), the better ear SPRIN score (β=0.30, 95% CI, 0.19, 0.40), but not with the self-reported hearing measure (β=-0.02, 95% CI, -0.07, 0.03). Both verbally loaded and non-verbally loaded tasks, testing a variety of cognitive domains, contributed to the association. Hearing aid users had better global cognitive function than non-users with equivalent hearing ability. The difference was only significant in the mild hearing loss category. Discussion/Conclusion: In a population-based sample of 70-year-old persons without dementia, poorer hearing was associated with poorer global and domain-specific cognitive function, but only when hearing function was measured objectively and not when self-reported. The speech-in-noise measure showed the strongest association. This highlights the importance of including standardized hearing tests and controlling for hearing status in epidemiological geriatric research. More research is needed on the role that hearing aid use plays in relation to age-related cognitive declines

VEMP using a new low-frequency bone conduction transducer

Bo Håkansson,1 Karl-Johan Fredén Jansson,1 Tomas Tengstrand,2 Leif Johannsen,3 Måns Eeg-Olofsson,4 Cristina Rigato,1 Elisabeth Dahlström,4 Sabine Reinfeldt1 1Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden; 2Department of Audiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 3Ortofon A/S, Nakskov, Denmark; 4Department of Otolaryngology, Head and Neck Surgery, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Objective: A new prototype bone conduction (BC) transducer B250, with an emphasized low-frequency response, is evaluated in vestibular evoked myogenic potential (VEMP) investigations. The aim was to compare cervical (cVEMP) and ocular (oVEMP) responses using tone bursts at 250 and 500 Hz with BC stimulation using the B250 and the conventional B81 transducer and by using air conduction (AC) stimulation.Methods: Three normal subjects were investigated in a pilot study. BC stimulation was applied to the mastoids in cVEMP, and both mastoid and forehead in oVEMP investigations.Results: BC stimulation was found to reach VEMP thresholds at considerably lower hearing levels than in AC stimulation (30–40 dB lower oVEMP threshold at 250 Hz). Three or more cVEMP and oVEMP responses at consecutive 5 dB increasing mastoid stimulation levels were only obtained in all subjects using the B250 transducer at 250 Hz. Similar BC thresholds were obtained for both ipsilateral and contralateral mastoid stimulation. Forehead stimulation, if needed, may require a more powerful vibration output.Conclusion: Viable VEMP responses can be obtained at a considerably lower hearing level with BC stimulation than by AC stimulation. The cVEMP and oVEMP responses were similar when measured on one side and with the B250 attached to both ipsilateral and contralateral mastoids. Keywords: vestibular investigation, air conduction, bone conduction, VEMP, cVEMP, oVEM

VEMP using a new low-frequency bone conduction transducer [Erratum]

Håkansson B, Fredén Jansson KJ, Tengstrand T, et al. Med Devices (Auckl). 2018;11:301–312.On page 307, Table 1, there is an error in the placement of the lines in the “Average” column. All measured values in Table 1 are correct, but the lines to the right, showing how the conclusive values “39 dB” and “32 dB” were calculated, were erroneously scaled in the final preparation, and point to wrong values in their lower end. The correct placement of the lines is shown in the corrected version in this erratum.Read the original article