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Objectives: Radiation-induced dermatitis (RD) is one of the most common toxicities in radiation therapy (RT) patients. Corticosteroids, immunosuppressants, and natural products (NPs) have been used as treatment. The objective was to evaluate the efficacy of a NPs-based cream (Alantel®) to reduce the incidence of RD in women with breast cancer undergoing RT treatment. Design: We conducted a controlled, randomized, double-blind clinical trial. Setting: Radiation Oncology Unit of the Reina Sofía Hospital and 5 Primary Care centers of the Cordoba and Guadalquivir Health District (Spain). Interventions: Patients assigned to the experimental group (GTA) were treated with Alantel, while those in the control group (GTE) were treated with a moisturizer and emollient cream. Main outcome measures: The primary outcome variable was the incidence of RD. RD-free time, duration of RD, quality of life, and product safety were also assessed. Results: Seventy patients were included in the study, 35 in the GTA and 35 in the GTE. The incidence of RD was lower in the GTA (71.4%) than in the GTE (91.4%) after 4 weeks of follow-up (RR = 0.78; NNT = 5; p < 0.031). The Skindex-29 questionnaire showed differences in the statement: "My skin condition makes it hard to work or do hobbies" (17.1% in the GTE vs. 2.9% in GTA; p = 0.024). Conclusions: The higher efficacy of Alantel® compared to the control cream in reducing the incidence of RD in women with breast cancer has been demonstrated.
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OBJECTIVES: We tested the effects of a weight-loss intervention encouraging energy-reduced MedDiet and physical activity (PA) in comparison to ad libitum MedDiet on COVID-19 incidence in older adults. DESIGN: Secondary analysis of PREDIMED-Plus, a prospective, ongoing, multicentre randomized controlled trial. SETTING: Community-dwelling, free-living participants in PREDIMED-Plus trial. PARTICIPANTS: 6,874 Spanish older adults (55-75 years, 49% women) with overweight/obesity and metabolic syndrome. INTERVENTION: Participants were randomised to Intervention (IG) or Control (CG) Group. IG received intensive behavioural intervention for weight loss with an energy-reduced MedDiet intervention and PA promotion. CG was encouraged to consume ad libitum MedDiet without PA recommendations. MEASUREMENTS: COVID-19 was ascertained by an independent Event Committee until December 31, 2021. COX regression models compared the effect of PREDIMED-Plus interventions on COVID-19 risk. RESULTS: Overall, 653 COVID-19 incident cases were documented (IG:317; CG:336) over a median (IQR) follow-up of 5.8 (1.3) years (inclusive of 4.0 (1.2) years before community transmission of COVID-19) in both groups. A significantly lowered risk of COVID-19 incidence was not evident in IG, compared to CG (fully-adjusted HR (95% CI): 0.96 (0.81,1.12)). CONCLUSIONS: There was no evidence to show that an intensive weight-loss intervention encouraging energy-reduced MedDiet and PA significantly lowered COVID-19 risk in older adults with overweight/obesity and metabolic syndrome in comparison to ad libitum MedDiet. Recommendations to improve adherence to MedDiet provided with or without lifestyle modification suggestions for weight loss may have similar effects in protecting against COVID-19 risk in older adults with high cardiovascular risks.
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COVID-19 , Doenças Cardiovasculares , Dieta Mediterrânea , Síndrome Metabólica , Humanos , Feminino , Idoso , Masculino , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/prevenção & controle , Síndrome Metabólica/complicações , Sobrepeso/complicações , Estudos Prospectivos , Doenças Cardiovasculares/etiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/complicações , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/terapia , Estilo de Vida , Redução de PesoRESUMO
BACKGROUND: This study evaluated the correlation between patient and clinician subjective voice analysis in a group of patients suffering from muscular tension dysphonia. This disease does not usually present with organic lesions, and voice analysis is crucial to evaluate it. METHODS: A retrospective study with 75 patients was performed. Correlation between grade, roughness, breathiness, asthenia and strain scale and voice handicap index-10 was analysed. Any possible influence of the type of muscular tension dysphonia on these two scales was studied. RESULTS: There are only a few studies that correlate voice handicap index-10 and the grade, roughness, breathiness, asthenia and strain scale; however, none of them are specific for patients suffering from muscular tension dysphonia. A moderate correlation (r = 0.56) was found. No influence of muscular tension dysphonia type on voice handicap index-10 score was found, but muscular tension dysphonia type 4 had worse grade, roughness, breathiness, asthenia and strain scale scores than other muscular tension dysphonia types. This could be explained if muscular tension dysphonia type 4 is considered to be the most severe form of this disease. CONCLUSION: The use of assessment scales based on the opinion of both the clinician and patient must be considered as complementary clinical tools in order to perform a complete assessment of dysphonia.
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Disfonia/diagnóstico , Disfonia/etiologia , Tono Muscular , Qualidade da Voz , Adulto , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Estudos Retrospectivos , Autoavaliação (Psicologia) , Índice de Gravidade de Doença , Inquéritos e QuestionáriosRESUMO
BACKGROUND & AIMS: The incidence of osteoporotic fractures is lower in countries in the Mediterranean basin. Virgin olive oil, a key component of the Mediterranean Diet (MDiet), with recognised beneficial effects on metabolism and cardiovascular health, may decrease the risk of osteoporotic fractures. The aim to this study was to explore the effect of chronic consumption of total olive oil and its varieties on the risk of osteoporosis-related fractures in a middle-aged and elderly Mediterranean population. METHODS: We included all participants (n = 870) recruited in the Reus (Spain) centre of the PREvención con DIeta MEDiterránea (PREDIMED) trial. Individuals, aged 55-80 years at high cardiovascular risk, were randomized to a MedDiet supplemented with extra-virgin olive oil, a MedDiet supplemented with nuts, or a low-fat diet. The present analysis was an observational cohort study nested in the trial. A validated food frequency questionnaire was used to assess dietary habits and olive oil consumption. Information on total osteoporotic fractures was obtained from a systematic review of medical records. The association between yearly repeated measurements of olive oil consumption and fracture risk was assessed by multivariate Cox proportional hazards. RESULTS: We documented 114 incident cases of osteoporosis-related fractures during a median follow-up of 8.9 years. Treatment allocation had no effect on fracture risk. Participants in the highest tertile of extra-virgin olive oil consumption had a 51% lower risk of fractures (HR:0.49; 95% CI:0.29-0.81. P for trend = 0.004) compared to those in the lowest tertile after adjusting for potential confounders. Total and common olive oil consumption was not associated with fracture risk. CONCLUSIONS: Higher consumption of extra-virgin olive oil is associated with a lower risk of osteoporosis-related fractures in middle-aged and elderly Mediterranean population at high cardiovascular risk.
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Azeite de Oliva/uso terapêutico , Fraturas por Osteoporose , Idoso , Dieta Mediterrânea , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fraturas por Osteoporose/dietoterapia , Fraturas por Osteoporose/epidemiologia , Fraturas por Osteoporose/prevenção & controleRESUMO
Human erythropoietin is mainly recognized for its hematopoietic function; however, by binding to its receptor (EpoR), it can activate different signaling pathways as STAT, PI3K, MAPK and RAS to increase cellular differentiation or provide neuroprotective effects, among others. A recombinant human erythropoietin variant with low glycosylation and without hematopoietic effect (EpoL) was purified from skimmed goat milk. Recombinant human erythropoietin (Epo) was obtained from CHO cell line and used as control to compare EpoL effects. Neuroprotection studies were performed in PC12 cells and rat hippocampal slices. Cells were pretreated during 1h with EpoL or Epo and exposed to oxidative agents (H2O2 or FCCP); cell viability was assayed at the end of the experiment by the MTT method. Hippocampal slices were exposed to 15min of oxygen and glucose deprivation (OGD) and the neuroprotective drugs EpoL or Epo were incubated for 2h post-OGD in re-oxygenated medium. Cell cultures stressed with oxidative agents, and pretreated with EpoL, showed neuroprotective effects of 30% at a concentration 10 times lower than that of Epo. Moreover, similar differences were observed in OGD ex vivo assays. Neuroprotection elicited by EpoL was lost when an antibody against EpoR was present, indicating that its effect is EpoR-dependent. In conclusion, our results suggest that EpoL has a more potent neuroprotective profile than Epo against oxidative stress, mediated by activation of EpoR, thus EpoL represents an important target to develop a potential biopharmaceutical to treat different central nervous system pathologies related to oxidative stress such as stroke or neurodegenerative diseases.
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Eritropoetina/farmacologia , Neurônios/efeitos dos fármacos , Fármacos Neuroprotetores/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Animais , Células CHO , Sobrevivência Celular/efeitos dos fármacos , Cricetulus , Eritropoetina/genética , Humanos , Neurônios/citologia , Neurônios/metabolismo , Fármacos Neuroprotetores/metabolismo , Células PC12 , Ratos , Receptores da Eritropoetina/metabolismo , Proteínas Recombinantes/genética , Proteínas Recombinantes/farmacologiaRESUMO
BACKGROUND: Otitis media with effusion (OME) is the most common cause of paediatric hearing loss. No single treatment has proved its effectiveness. There is a lack of evidence-based medicine studies in the area of homeopathy. METHOD: A prospective randomized, double blinded interventional placebo control study was conducted. Patients, from 2 months to 12 years, with OME diagnosed by pneumatic otoscopy (PNO) and tympanometry, were randomized into two groups. Both groups received aerosol therapy (mucolytics and corticosteroids). In addition, the experimental group (EG) received homeopathy (Agraphis nutans 5CH, Thuya Occidentalis 5CH, Kalium muriaticum 9CH and Arsenicum iodatum), and the placebo group (PG) placebo, both of them for 3 months. Patients were evaluated by PNO examination and tympanometry at baseline, at 45 and 90 days. RESULTS: 97 patients were enrolled. In the EG, 61.9% of individuals were cured (PNO went from negative in the 1st visit to positive in the 3rd visit) compared with 56.8% of patients treated with placebo. 4.8% of patients in the EG suffered a recurrence (positive PNO in the 2nd visit changed to negative in the 3rd visit) while 11.4% did in the PG. No significant difference was found. Adverse events were distributed similarly, except in the case of upper respiratory tract infections, which were less frequent in EG (3 vs. 13, p: 0.009). CONCLUSION: The homeopathic scheme used as adjuvant treatment cannot be claimed to be an effective treatment in children with OME. TRIAL REGISTRATION: EUDRACT number: 2011-006086-17, PROTOCOL code: 55005646.
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Homeopatia , Otite Média com Derrame/terapia , Fitoterapia , Thuja , Testes de Impedância Acústica , Adjuvantes Imunológicos/uso terapêutico , Corticosteroides/uso terapêutico , Criança , Pré-Escolar , Método Duplo-Cego , Feminino , Humanos , Masculino , Otite Média com Derrame/diagnóstico , Estudos Prospectivos , Recidiva , Resultado do TratamentoRESUMO
OBJECTIVES: The efficiency in the management of public resources is one of the main pillars of the welfare state. The objective of this work is to analyze the efficiency of the public resources that regional governments in Spain (Autonomous Communities (AC)) invest in health systems (HS). STUDY DESIGN: A dataset from of the Ministry of Health, Social Services and Equality of Spain has been used, which contains the most important indicators from the National HS. The following variables have been chosen in this study: the health care expenses per resident, the percentage of this investment that is forwarded to labour expenses, frequency of hospital care services, frequency of specialized external health care services and, primary health care services in medicine and nursing per resident. METHODS: To this end, Data Envelopment Analysis (DEA) is applied, which enables researchers and managers to obtain measurements of efficiency of the analyzed regions, and to propose corrective steps to achieve efficiency for inefficient HS. Moreover, the super-efficiency measurement is shown for a constant and a variable scale. RESULTS: The results show that there are three groups of AC, first a group composed by six HS that are globally efficient, a second group composed by eight HS that are globally inefficient, and a third group composed by three HS that are efficient in some terms and their efficiency can be improved. CONCLUSIONS: It is concluded that DEA is an appropriate method for evaluating efficiencies of health systems and giving the adjustments for the application of economic, social and organizational policies to improve their efficiencies.
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Eficiência Organizacional , Recursos em Saúde/estatística & dados numéricos , Governo Local , Programas Nacionais de Saúde/organização & administração , Humanos , Seguridade Social , EspanhaRESUMO
CONCLUSION: The comprehensive Hearing Preservation classification system presented in this paper is suitable for use for all cochlear implant users with measurable pre-operative residual hearing. If adopted as a universal reporting standard, as it was designed to be, it should prove highly beneficial by enabling future studies to quickly and easily compare the results of previous studies and meta-analyze their data. OBJECTIVES: To develop a comprehensive Hearing Preservation classification system suitable for use for all cochlear implant users with measurable pre-operative residual hearing. METHODS: The HEARRING group discussed and reviewed a number of different propositions of a HP classification systems and reviewed critical appraisals to develop a qualitative system in accordance with the prerequisites. RESULTS: The Hearing Preservation Classification System proposed herein fulfills the following necessary criteria: 1) classification is independent from users' initial hearing, 2) it is appropriate for all cochlear implant users with measurable pre-operative residual hearing, 3) it covers the whole range of pure tone average from 0 to 120 dB; 4) it is easy to use and easy to understand.
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Audiometria de Tons Puros , Limiar Auditivo , Implante Coclear , Implantes Cocleares , Consenso , HumanosRESUMO
OBJECTIVE: This study on patients undergoing surgery for vestibular schwannoma investigated tumour (i) the effect of pre-operative factors on tinnitus, (ii) the effect of translabyrinthine or hearing preservation surgical approaches on tinnitus, and (iii) the effect of postoperative tinnitus status on the patient's quality of life (QOL). METHODOLOGY: Seventy-nine patients who underwent vestibular schwannoma (VS) excision between 2001 and 2005 were selected. Postoperative tinnitus status was evaluated using a standard questionnaire for tinnitus, and QOL was measured using the Glasgow Benefit Inventory (GBI). RESULTS: Overall, 58% of patients noted tinnitus before tumour removal. Pre-operative tinnitus was not associated with age, gender, tumour size, or hearing thresholds. The total percentage of patients suffering postoperative tinnitus was 64%. Hearing preservation approaches showed no difference in terms of changes in tinnitus compared to the translabyrinthine approach. Twenty-one patients (30%) reported better QOL, 40 patients (56%) reported worse QOL, and 10 patients (14%) reported the same QOL. A significant association was found between tinnitus worsening as measured by GBI score and QOL. CONCLUSIONS: Most patients do not report significant changes in their tinnitus status after surgery. Tinnitus evolution is unpredictable and not related to the type of surgical approach. Thus, tinnitus should not be used as a criterion for selecting the surgical approach. Tinnitus worsening appears to influence QOL following surgery for VS.
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Neuroma Acústico/cirurgia , Procedimentos Cirúrgicos Otológicos/efeitos adversos , Qualidade de Vida , Zumbido/etiologia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Prognóstico , Estudos Retrospectivos , Inquéritos e Questionários , Zumbido/psicologia , Adulto JovemRESUMO
OBJECTIVE: To evaluate the quality of life (QOL) of hearing-impaired children fitted with either a cochlear implant and a hearing aid or bilateral hearing aids, and to compare their outcomes with those of normal-hearing peers. We also investigated the impact of demographic, clinical, and audiological results on QOL. METHODOLOGY: Cross-sectional study using a generic QOL questionnaire. Questionnaires were completed by children and their parents. Eighty-eight children were divided into three groups: bilateral deaf children with a cochlear implant and a contralateral hearing aid (bimodal group), bilateral deaf children with bilateral hearing aids (hearing aid group), and normal-hearing children. The Spanish version of the KINDLr test was used. Responses were correlated with demographic, clinical, and audiological data. RESULTS: The questionnaires revealed a high health-related QOL with a total self-rating score for the children and a proxy score for the parents of 75 or higher in five out of six domains. No significant difference was found in the QOL among the three groups. Additionally, there was no significant difference between the self-rating and the proxy total scores, and no significant association was found between the QOL and the variables of the study. CONCLUSION: Our results indicate a high level of QOL in hearing-impaired children and their families following treatment with either bilateral hearing aids or bimodal stimulation. Children and their parents reported a QOL similar to that of normal-hearing children.
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Implantes Cocleares , Auxiliares de Audição , Qualidade de Vida , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Crianças com Deficiência , Feminino , Humanos , Masculino , Satisfação do Paciente , Pessoas com Deficiência AuditivaRESUMO
Few data exist on the possible effects of pulp and paper effluent discharge on native fish populations in the Southern Hemisphere, relative to the research done in the Northern Hemisphere. The present research examined two native fish species (Trichomycterus areolatus and Percilia gillissi) for effects at both the molecular and individual level due to the discharge of effluent from a tertiary treated elemental chlorine-free pulp mill into a fluvial system in Central Chile over three seasons (February 2007, October 2007, January 2008). Different responses were observed between species and between sexes. There was an increase in the production of gonadal 17ß-estradiol in the females of both species but a drop in 11-ketotestosterone production in P. gillissi males. Female gonadal size was increased, especially during the summer period, with corresponding increases the frequency of advanced oocyte development, and in the oocyte diameter in both species. Hepatic ethoxyresorufin-O-deethylase (EROD) activity was elevated for both species downstream of the discharge point, although overall it was higher in P. gillissi than T. areolatus. Decreases in the frequency of smaller-sized fish for both species, as well as a drop in the size of the adults downstream of the discharge point, were observed. The present study is the first evidence of endocrine disruption in native freshwater fish associated with modern pulp mills in South America. This study establishes possible links in the reproductive alterations observed at the subindividual and individual levels that could explain the changes observed at the population level.
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Peixes-Gato/fisiologia , Disruptores Endócrinos/toxicidade , Resíduos Industriais/efeitos adversos , Perciformes/fisiologia , Poluentes Químicos da Água/toxicidade , Antagonistas de Receptores de Andrógenos/toxicidade , Animais , Chile , Citocromo P-450 CYP1A1/metabolismo , Monitoramento Ambiental , Estradiol/metabolismo , Feminino , Água Doce/química , Gônadas/efeitos dos fármacos , Gônadas/metabolismo , Fígado/efeitos dos fármacos , Masculino , Papel , Densidade Demográfica , Testosterona/análogos & derivados , Testosterona/metabolismoRESUMO
OBJECTIVE: To assess the long-term results and prognostic factors in patients who have undergone open cordectomy (OC) for the treatment of T(1a) glottic laryngeal carcinoma. METHODS: One hundred four epidermoid cancer patients operated from January 1989 through December 1999 were included in the study. Clinical parameters, postoperative complications, and postoperative stay were retrospectively evaluated in all cases. RESULTS: Mean survival for the patients included in the study was 61.5+/-24.8 months after the date of operation (range: 11-121 months). Ninety-four patients did not have recurrent tumor (90.4%). Local, regional and distant recurrence were linked with a statistical negative impact on survival rates (p<0.05). Only sero-hematoma was significantly related to local recurrence (p<0.05), whereas the remainder complications did not. None of the complications was associated with neck recurrence or distant metastasis (p>0.05). CONCLUSIONS: Open cordectomy is nowadays a valid technique for the surgical treatment of T(1a) glottic laryngeal carcinoma. Its results are comparable with those of other more recent techniques.
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Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/cirurgia , Neoplasias Laríngeas/mortalidade , Neoplasias Laríngeas/cirurgia , Prega Vocal/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Neoplasias Laríngeas/patologia , Laringectomia , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical , Recidiva Local de Neoplasia/mortalidade , Complicações Pós-Operatórias , Estudos RetrospectivosRESUMO
BACKGROUND: Sustained virological response rates of up to 52% have been obtained with peginterferon alpha2a (40 kDa) plus ribavirin in patients suffering from chronic hepatitis C genotype 1 in randomized-controlled trials. AIM: To assess early virological response and its clinical utility in predicting an sustained virological response in patients suffering from chronic hepatitis C genotype 1 in routine clinical practice in Spain. METHODS: Treatment-naïve patients received pegylated interferon alpha2a (40 kDa) 180 microg/week plus ribavirin 1000/1200 mg/day for 48 weeks, and were followed for a further 24 weeks. Overall, 475 patients received at least one dose of medication and were included in the efficacy population. RESULTS: The overall sustained virological response rate was 48%. Of those with week 12 virological data, 83% had an early virological response. The negative predictive value of an early virological response was 93%. CONCLUSION: If sustained virological response is the goal, a treatment-decision based on a 12-week evaluation during routine clinical practice is feasible.
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Antivirais/uso terapêutico , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/uso terapêutico , Polietilenoglicóis/uso terapêutico , Ribavirina/uso terapêutico , Adulto , Antivirais/farmacocinética , Quimioterapia Combinada , Feminino , Hepatite C Crônica/virologia , Humanos , Interferon alfa-2 , Interferon-alfa/farmacocinética , Masculino , Pessoa de Meia-Idade , Polietilenoglicóis/farmacocinética , Proteínas Recombinantes , Ribavirina/farmacocinética , Resultado do TratamentoRESUMO
INTRODUCTION: In this study we have analyzed (i) the audiometric frequencies more often affected in acoustic neuroma (AN), (ii) the percentage of patients presenting normal hearing and those with sudden hearing loss, (iii) if there is a correlation between tumor size and hearing loss, and (iv) the relationship between clinical and radiological parameters and audiological data. METHODS AND MATERIAL: Retrospective study of 81 patients undergoing surgical removal of a sporadic AN. RESULTS: The highest threshold in the tumor's ear was found at 8000 Hz, and the highest interaural difference at 4000 Hz. The percentage of patients presenting normal hearing and sudden hearing loss was 2.5% and 9%, respectively. No significant association was found between tumor size and hearing loss, preoperative facial palsy or Vth cranial nerve deficit. There was a significant association between the degree of hearing loss and Vth cranial nerve deficit, and between hearing loss and preoperative facial palsy. CONCLUSIONS: The association between hearing loss and Vth cranial nerve deficit, and between hearing loss and preoperative facial palsy is independent the size of the tumour.
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Perda Auditiva/etiologia , Neuroma Acústico/complicações , Neuroma Acústico/patologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Introducción: Hemos analizado: 1) las frecuencias audiométricas más afectadas en el neurinoma del acústico (NA), 2) el porcentaje de pacientes con audición normal y con sordera súbita; 3) si hay correlación entre el tamaño tumoral y la hipoacusia; y 4) la relación entre hallazgos clínicos, radiológicos y audiométricos. Material y métodos: Estudio retrospectivo de 81 pacientes intervenidos por NA. Resultados: El mayor umbral en el oído del tumor se encontró a 8000 Hz, y la mayor diferencia interaural a 4000 Hz. El porcentaje de pacientes con audición normal y con sordera súbita fue 2,5% y 9%, respectivamente. No encontramos asociación entre tamaño tumoral e hipoacusia, parálisis facial o alteración del V par. Hallamos asociación entre hipoacusia y alteración del V par, y entre hipoacusia y parálisis facial. Conclusiones: La relación entre hipoacusia y alteración del V par, y entre hipoacusia y parálisis facial es independiente del volumen tumoral
Introduction: In this study we have analyzed (i) the audiometric frequencies more often affected in acoustic neuroma (AN), (ii) the percentage of patients presenting normal hearing and those with sudden hearing loss, (iii) if there is a correlation between tumor size and hearing loss, and (iv) the relationship between clinical and radiological parameters and audiological data. Methods and Material: Retrospective study of 81 patients undergoing surgical removal of a sporadic AN. Results: The highest threshold in the tumor´s ear was found at 8000 Hz, and the highest interaural difference at 4000 Hz. The percentage of patients presenting normal hearing and sudden hearing loss was 2.5% and 9%, respectively. No significant association was found between tumor size and hearing loss, preoperative facial palsy or Vth cranial nerve deficit. There was a significant association between the degree of hearing loss and Vth cranial nerve deficit, and between hearing loss and preoperative facial palsy. Conclusions: The association between hearing loss and Vth cranial nerve deficit, and between hearing loss and preoperative facial palsy is independent the size of the tumour
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Masculino , Feminino , Adulto , Adolescente , Pessoa de Meia-Idade , Humanos , Neuroma Acústico/complicações , Neuroma Acústico/patologia , Perda Auditiva/etiologia , Estudos Retrospectivos , AudiometriaRESUMO
CONCLUSION: Telephone usage is a difficult challenge for cochlear implanted patients. A significant number of cochlear implanted patients are able to carry on a land-line or mobile telephone conversation. The telephone model may be a critical factor for telephone performance. OBJECTIVES: The goals of this study were to evaluate speech discrimination through land-line and mobile telephones in Combi40+ users, and to compare different mobile telephone models to find out which could be more advisable for them. PATIENTS AND METHODS: Eighteen Combi40+ implantees were tested with CID sentences and bisyllabic words presented through land-line and mobile telephones, in both quiet and noisy environments. RESULTS: Mean scores for telephonic speech discrimination were over 85% for CID sentences and 28-59% for bisyllabic words. The Siemens M55 was superior to the other mobile telephones tested.
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Telefone Celular , Implantes Cocleares , Percepção da Fala , Adolescente , Adulto , Idoso , Criança , Perda Auditiva , Humanos , Pessoa de Meia-Idade , Testes de Discriminação da FalaRESUMO
La elevada incidencia de problemas relacionados con la medicación en la población geriátrica ofrece unaoportunidad al farmacéutico para disminuir la morbilidad y el coste de los tratamientos farmacológicos. Larespuesta a esta demanda, en el ámbito sociosanitario de la Comunidad Valenciana, se plasmó en el Programade Atención Farmacéutica en centros sociosanitarios dependientes de la Dirección General de ServiciosSociales de la Conselleria de Bienestar Social.Este programa de atención farmacéutica sociosanitario, pionero en España, que se inició en el año 1990 enla Residencia Mixta de Carlet (Valencia), se realizó en coordinación con la Conselleria de Sanidad. Actualmente, el Programa de Atención Farmacéutica sociosanitario está implantado en Centros sociosanitarios Públicos y en Centros de Discapacitados Psíquicos, siendo cinco los Servicios de Farmacia ubicados en toda la Comunidad Valenciana, realizándose la dispensación de medicamentos en dosis unitarias.Desde el Servicio de Provisión y Asistencia Farmacéutica de la Dirección General de Farmacia y ProductosSanitarios de la Conselleria de Sanidad, se propone establecer un único modelo de Atención Farmacéuticaen Centros sociosanitarios, dando cobertura no sólo a los Centros de titularidad Pública sino también a losCentros de titularidad Privada. Dicho proyecto de futuro está basado en un análisis DAFO, donde se reflejanlas Debilidades, Amenazas, Fortalezas y Oportunidades del sistema
The high incidence of drug-related problems among the geriatric population provides an opportunity for thepharmacist to reduce the morbidity and costs associated with drug treatments. The response to this demand,in the social health care setting of the Community of Valencia, Spain, was reflected in the PharmaceuticalCare Program in the social health care centers under the General Social Services Administration of the SocialWelfare Department.This program of social health pharmaceutical care, a pioneering effort in Spain, initiated in 1990 at theResidencia Mixta in Carlet, Valencia, was carried out in cooperation with the Health Care Department. To date, the social health pharmaceutical care program has been introduced into public social health care centers and centers for the mentally handicapped. There are now five pharmacy services throughout the Community of Valencia that dispense medications in unit doses.The Pharmaceutical Care and Provision Service of the General Pharmacy and Health Care Products Administrationof the Health Care Department proposes to establish a single model for pharmaceutical care in social health care centers, providing coverage not only to public centers but to private centers as well. Thisprojection for the future is based on a SWOT analysis reflecting the strengths, weaknesses, opportunities and threats of the system (AU)
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Humanos , Assistência Farmacêutica/organização & administração , Modelos Organizacionais , Padrões de Prática Médica , Centros Comunitários de Saúde/organização & administração , Dose ÚnicaRESUMO
OBJECTIVE: To assess speech discrimination through line and mobile telephone in cochlear implanted patients. MATERIAL AND METHODS: Eighteen patients implanted with a Combi 40+ went through different speech discrimination tests with a line telephone and three mobile telephones, in quiet and noisy environment. RESULTS: Mean scores for telephonic speech discrimination were 84-92% using CID sentences, 27-58% using bisyllabic words in quiet environment and 15-41% using bisyllabic words in noisy environment. Among the mobile telephones tested, the Siemens M55 reached the best scores. CONCLUSIONS: Telephonic speech discrimination is achieved by a significant number of cochlear implanted patients. Certain mobile telephone models appear to be more advisable for these patients.
Assuntos
Implantes Cocleares , Percepção da Fala , Telefone , Estimulação Acústica/instrumentação , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Testes de Discriminação da Fala , Inquéritos e QuestionáriosRESUMO
Objetivo: Estudiar la discriminación verbal a través del teléfono fijo y móvil en pacientes con implante coclear. Material y métodos: Dieciocho pacientes implantados con un Combi 40+ fueron sometidos a pruebas de discriminación verbal a través de un teléfono fijo y tres modelos de móviles, tanto en silencio como en presencia de ruido. Resultados: La discriminación verbal telefónica media fue de 84-92% para frases CID, de 27-58% para palabras bisílabas en silencio y de 15-41% para palabras bisílabas en presencia de ruido. Delos modelos de telefonía móvil probados el Siemens M55 obtuvo los mejores resultados. Conclusiones: Un número significativo de pacientes implantados consiguen una buena discriminación verbal telefónica. Ciertos modelos de telefonía móvil parecen más recomendables para estos pacientes
Objective: To assess speech discrimination through line and mobile telephone in cochlear implanted patients. Material and Methods: Eighteen patients implanted with a Combi 40+ went through different speech discrimination tests with a line telephone and three mobile telephones, in quiet and noisy environment. Results: Mean scores for telephonic speech discrimination were 84-92% using CID sentences, 27-58% using bisyllabic words in quiet environment and 15-41% using bisyllabic words in noisy environment. Among the mobile telephones tested, the Siemens M55 reached the best scores. Conclusions: Telephonic speech discrimination is achieved by a significant number of cochlear implanted patients. Certain mobile telephone models appear to be more advisable for these patients