Author Interviews, Geriatrics, Hearing Loss, JAMA / 28.08.2020
Cochlear Implants May Be Superior to Hearing Aids for Some Older Adults
MedicalResearch.com Interview with:
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Dr. Wick[/caption]
Cameron C. Wick, MD
Assistant Professor, Otology/Neurotology
Washington University School of Medicine
St. Louis, MO
MedicalResearch.com: What do you see as the primary message of your findings for the general public?
Response: Older adults not satisfied with their hearing aids achieved clinically meaningful improvement in both hearing and quality of life with a cochlear implant compared to an optimized bilateral hearing aid condition.
MedicalResearch.com: Do you see your findings as changing the way older adults with hearing loss are managed?
Response: Yes and partially because this study is unique in its design and the outcomes that were measured. Specifically the study is a prospective, multicenter clinical trial conducted at 13 locations across the United States. All patients were setup with a 30-day optimized hearing aid experience before cochlear implantation (context: sometimes hearing aids are not appropriately optimized so baseline testing may not reflect the "best" that hearing aids can do). This study assesses both hearing data as well as quality of life data before and 6-months after cochlear implantation. After implantation patients were tested in both the unilateral (cochlear implant alone) and bimodal (cochlear implant plus hearing aid in the opposite ear) conditions. My paper is a subanalysis of adults 65 years and older (range 65 - 91 years) enrolled in the clinical trial. The principal investigator of the clinical trial is Dr. Craig Buchman. Dr. Buchman and myself are at Washington University in St. Louis which was the lead center for the clinical trial.
The findings of the study are meaningful because they demonstrate clear superiority of cochlear implants over hearing aids in many key areas, such as understanding speech, hearing in background noise, and ability to communicate. Hearing loss, which becomes more prevalent as we age, can negatively impact communication leading to social isolation, depression, frustration, and possibly cognitive decline. This study highlights that if patients are not satisfied with their hearing aid performance then they should be referred to a center that can evaluate for cochlear implantation. Cochlear implant indications have evolved considerably since they were first FDA approved in 1984. This study emphasizes that patients do not have to be profoundly deaf to experience significant hearing and social benefits from cochlear implants. Also, it demonstrates that cochlear implant surgery is well tolerated even as adults age and acquire other health ailments.
Dr. Wick[/caption]
Cameron C. Wick, MD
Assistant Professor, Otology/Neurotology
Washington University School of Medicine
St. Louis, MO
MedicalResearch.com: What do you see as the primary message of your findings for the general public?
Response: Older adults not satisfied with their hearing aids achieved clinically meaningful improvement in both hearing and quality of life with a cochlear implant compared to an optimized bilateral hearing aid condition.
MedicalResearch.com: Do you see your findings as changing the way older adults with hearing loss are managed?
Response: Yes and partially because this study is unique in its design and the outcomes that were measured. Specifically the study is a prospective, multicenter clinical trial conducted at 13 locations across the United States. All patients were setup with a 30-day optimized hearing aid experience before cochlear implantation (context: sometimes hearing aids are not appropriately optimized so baseline testing may not reflect the "best" that hearing aids can do). This study assesses both hearing data as well as quality of life data before and 6-months after cochlear implantation. After implantation patients were tested in both the unilateral (cochlear implant alone) and bimodal (cochlear implant plus hearing aid in the opposite ear) conditions. My paper is a subanalysis of adults 65 years and older (range 65 - 91 years) enrolled in the clinical trial. The principal investigator of the clinical trial is Dr. Craig Buchman. Dr. Buchman and myself are at Washington University in St. Louis which was the lead center for the clinical trial.
The findings of the study are meaningful because they demonstrate clear superiority of cochlear implants over hearing aids in many key areas, such as understanding speech, hearing in background noise, and ability to communicate. Hearing loss, which becomes more prevalent as we age, can negatively impact communication leading to social isolation, depression, frustration, and possibly cognitive decline. This study highlights that if patients are not satisfied with their hearing aid performance then they should be referred to a center that can evaluate for cochlear implantation. Cochlear implant indications have evolved considerably since they were first FDA approved in 1984. This study emphasizes that patients do not have to be profoundly deaf to experience significant hearing and social benefits from cochlear implants. Also, it demonstrates that cochlear implant surgery is well tolerated even as adults age and acquire other health ailments. 
Dr. Jimenez[/caption]
Monik Carmen Jimenez, Sc.D
Assistant Professor of Medicine
Brigham and Women's Hospital
MedicalResearch.com: What is the background for this study?
Response: We wanted to get a comprehensive picture of the epidemiology of COVID-19 in carceral facilities that included jails and was not restricted solely to prisons. We utilized publicly available data collected in Massachusetts, pursuant to a court order. These data included prison and jail systems and were used to calculate rates of confirmed cases of COVID-19 and testing rates among incarcerated individuals. We were also able to compare those to changes in the population size within each system.
Dr. Reyes Gil[/caption]
Dr. Walline[/caption]
Jeffrey J. Walline, OD PhD
Associate Dean for Research
The Ohio State University
Columbus, OH 43210-1240
MedicalResearch.com: What is the background for this study?
Response: Greater amounts of nearsightedness are related to higher risks of sight-threatening complications in adulthood, so anything we can do to slow the progression of nearsightedness in childhood can have meaningful benefits in the future.
As the prevalence of nearsightedness increases worldwide and affects approximately 1/3 of the people in the United States, a treatment that provides clear vision AND slows the progression of nearsightedness can have a profound effect.
Dr. Heald-Sargent[/caption]
Taylor Heald-Sargent, M.D., Ph.D.
Ann & Robert H. Lurie Children’s Hospital
Chicago
MedicalResearch.com: What is the background for this study?
Response: Given the ongoing debate around the ability of children to transmit SARS-CoV-2, we noticed that our clinical data could address one of the prevalent assumptions. Some people postulated that the reason children have less severe infections with SARS-CoV-2 is because they are not able to replicate virus as much as adults and therefore may not transmit as readily. 
Dr. Jensen[/caption]
Majken K. Jensen, Ph.D.
Adjunct Professor of Nutrition
Harvard T.H. Chan School of Public Health &
Professor in the Department of Public Health
University of Copenhagen, Copenhagen, Denmark
MedicalResearch.com: What is the background for this study?
Response: Alzheimer’s disease and other dementias are highly prevalent conditions. According to the Alzheimer’s Association, 50 million people are currently living with Alzheimer’s disease or other dementias worldwide. Lower apolipoprotein E in plasma is a risk factor for dementia, but the underlying biological mechanisms are not fully understood. Thus, we investigated the role of apolipoprotein E overall and in lipoproteins with distinct metabolic functions in relation to cognitive function and dementia risk..
Dr. Brantley[/caption]
Erin Brantley, PhD, MPH
Senior Research Associate
Department of Health Policy and Management
Milken Institute School of Public Health
Preferred pronouns: she/her/hers
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We looked at what happened when work requirements for the Supplemental Nutrition Assistance Program Participation, or SNAP, were turned on in many places after the Great Recession.
We found large drops in participation in SNAP benefits due to work requirements, and that black recipients were more likely to lose benefits than white recipients. We think this is driven by the fact that black workers face higher unemployment rates than white workers, and work requirement policies do not take this into account.
We also found that some people who report having disabilities lost benefits, even though the intent of work requirements is that they apply to people without disabilities. ![MedicalResearch.com Interview with: Dr Herman Anne Service de Dermatologie Cliniques Universitaires Saint-Luc Avenue Hippocrate, 10 1200 Bruxelle MedicalResearch.com: What is the background for this study? Response: In the context of the COVID-19 pandemic, several cases of acro-located lesions (on foot or hands) suggestive of chilblains have been reported and were possibly related to COVID-19. We wanted to determine if chilblains, observed in many patients recently referred to our department, are indicative of COVID-19. MedicalResearch.com: Would you briefly explain what is meant by chilblains? Response: Chilblains are frequent cold induced inflammatory lesions. Chilblains are typically seen in winter and occur after repeated exposure to cold temperatures. Clinical presentation includes erythema and swelling on toes and/or digits followed by red-purple macules or patches. However, given the large number of patients affected, and the exceptionally high outdoor temperatures for the spring season over the past month and at the time of case-observation, cold-exposure seemed unlikely. These lesions were, therefore, suspected to be associated with COVID-19. However, to date, no study has proven a pathological link between these lesions and COVID-19. MedicalResearch.com: What are the main findings? Response: In our series of 31 patients who recently developed chilblains, negative nasopharyngeal swabs and the absence of anti-SARS-CoV-2 blood immunoglobulin (Ig)M and IgG antibodies in all patients included in your study suggested that these patients had not been infected with COVID-19. These lesions appeared not to be directly related to COVID-19. MedicalResearch.com: What should readers take away from your report? Response: One hypothesis points to an indirect consequence of the COVID-19 pandemic due to imposed community containment and lockdown measures. Indeed, all patients in this study had either been working from home or were home-schooled since the beginning of containment measures in Belgium (March 11, 2020) or were temporarily unemployed. As a result of containment measures, the majority (64.5%) of patients reported a decrease in their physical activity and significantly more time spent in sedentary positions in front of screens. Most of the patients declared that they remained barefoot or in socks most of the day. All these lifestyle changes can be considered as risk factors for developing chilblains. Therefore, it seems plausible that containment, through its collateral effects, may induce chilblains. Interestingly also, the mean BMI of the patients included was relatively low, suggesting that thin people may be more at risk of developing chilblains. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: During the current pandemic, several reports have suggested a possible link between cutaneous manifestations including aural lesions such as chilblains, and COVID-19, however, only few patients were tested for SARS-CoV-2 by RT-PCR and no serologic tests were performed. Therefore, reliable testings (RT-PCR and serologic testing) are essential to confirm a potential association with COVID-19. Citation: Herman A, Peeters C, Verroken A, et al. Evaluation of Chilblains as a Manifestation of the COVID-19 Pandemic. JAMA Dermatol. Published online June 25, 2020. doi:10.1001/jamadermatol.2020.2368 https://jamanetwork.com/journals/jamadermatology/fullarticle/2767774 [subscribe] Last Modified: [last-modified] The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.](https://medicalresearch.com/wp-content/uploads/2020/06/chilblain-example-dermnet-nz.jpg)
