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C Aguilar

Publications and source records attributed to C Aguilar.

106 records · Page 6Linked to original sources
PubMed1990

Quality-of-life changes and hearing impairment. A randomized trial.

OBJECTIVE: To assess whether hearing aids improve the quality of life of elderly persons with hearing loss. SETTING: Primary care clinics at a Bureau of Veterans Affairs hospital. PATIENTS: One hundred and ninety-four elderly veterans who were identified as being hearing impaired from a screening survey involving 771 consecutive clinic patients. Of the original 194, 188 (97%) completed the trial. INTERVENTION: Subjects were randomly assigned to either receive a hearing aid (n = 95) or join a waiting list (n = 99). MAIN ENDPOINTS: A comprehensive battery of disease-specific and generic quality-of-life measures were administered at baseline, 6 weeks, and 4 months. MEASUREMENTS AND MAIN RESULTS: Persons assigned to the two groups were similar in age, ethnicity, education, marital status, occupation, and comorbid diseases. At baseline, 82% of subjects reported adverse effects on quality of life due to hearing impairment, and 24% were depressed. At follow-up, a significant change in score improvements for social and emotional function (34.0; 95% CI, 27.3 to 40.8; P less than 0.0001), communication function (24.2; CI, 17.2 to 31.2; P less than 0.0001), cognitive function (0.28; CI, 0.08 to 0.48; P = 0.008), and depression (0.80; CI, 0.09 to 1.51; P = 0.03) was seen in subjects who received hearing aids compared with those assigned to the waiting list. Six drop-outs (three per group), no crossovers, and no significant changes in cointerventions were seen. Average, self-reported, daily aid use in the hearing aid group was 8 hours. CONCLUSION: Hearing loss is associated with important adverse effects on the quality of life of elderly persons, effects which are reversible with hearing aids.

Aged↗
PubMed1990

A critical reevaluation of the Quantified Denver Scale of Communication Function.

The Quantified Denver Scale of Communication Function (QDS) is a 25 item questionnaire developed to measure communication difficulties in adults with hearing impairment. This study reassessed the constructs, reliability, and validity of the scale, and developed a 5 item short version. The QDS was administered to 238 elderly individuals (137 with and 101 without hearing loss). Factor analysis using this sample identified only two subscale constructs as opposed to four originally proposed constructs. The validity of the new revised two-construct model was verified by four independent investigators who labeled the two constructs as measuring self isolation and communication function. The internal reliability of the revised scale was 0.97 and of both construct subscales was 0.95. Overall test-retest reliability was 0.73. Validity examined by comparing the revised scale with another well-known handicap measure, the Hearing Handicap Inventory for the Elderly, was adequate: overall scale correlations were 0.73 and subscale correlations ranged from 0.64 to 0.72. The accuracy of the revised QDS for discriminating between individuals with and without hearing loss was 73%. Stepwise discriminant analysis generated a 5 item short version scale which contained two questions from the long communication subscale and three from the long self-isolation subscale. The accuracy of the short QDS was 74%. We conclude that the revised QDS is a reliable and valid scale that can be used to assess self isolation and communication function in elderly individuals with hearing loss, and that a new 5 item short version performs as well as the original 25 item scale.

Aged↗
PubMed1990

Discriminating and responsiveness abilities of two hearing handicap scales.

Several scales exist for screening handicap and assessing rehabilitation in elderly individuals with hearing loss. There are few comparative studies, however, to suggest which scales perform best. Using receiver-operating curves and responsiveness indices, we examined the relative discriminating ability and sensitivity to detect change of four scales: a long and short version of the Hearing Handicap Inventory in the Elderly (HHIE-L, HHIE-S), and a long and short version of the Revised Quantified Denver Scale of Communication Function (RQDS-L, RQDS-S). All scales were administered to 137 elderly veterans with hearing loss and 101 elderly veterans without hearing loss. Follow-up testing to determine relative ability to detect change was assessed in hearing impaired individuals only after they had used a hearing aid for 4 months. Discriminative accuracy for correctly identifying individuals with hearing loss were: HHIE-L 78%, HHIE-S 79%, RQDS-L 73%, and RQDS-S 74%. Overall differences between the HHIE-S and the RQDS-S were not statistically significant (p = 0.06). True positive results were greater with the HHIE-S compared to the RQDS-S (p = 0.03). Responsiveness indices were: HHIE-L 1.78, HHIE-S 1.86, RQDS-L 1.04, and RQDS-S 1.07. Differences between the HHIE-S and the RQDS-S were statistically significant (p less than 0.05). We conclude short versions of the HHIE and RQDS are as accurate and sensitive for detecting change as long versions, and the HHIE-S is a superior versatile instrument for screening and assessing rehabilitation in elderly individuals with hearing impairment.

Aged↗
PubMed1990

Association between hearing impairment and the quality of life of elderly individuals.

Hearing impairment is one of the most common chronic health problems of elderly Americans. Although adverse effects on quality of life are thought to be considerable, they have not been rigorously evaluated. This study was designed to identify the types and extent of dysfunction experienced by elderly individuals with hearing loss, and to define the most appropriate measures for assessing this dysfunction. Elderly male veterans attending a primary care clinic were screened for hearing loss and had their quality of life assessed with a comprehensive battery of disease-specific and generic measures. Of 472 people who had their hearing tested, 106 had hearing loss. Hearing loss was associated with significant emotional (P = .0001), social (P = .0001), and communication (P = .02) dysfunction. Most individuals (66%) perceived these dysfunctions as severe handicaps even though audiologic loss revealed only mild to moderate impairment (pure tone average loss, 27-55 dB). Adverse effects were best detected with disease-specific rather than generic functional status measures. We conclude that hearing impairment is associated with important adverse effects on the quality of life of elderly individuals, and that these effects are perceived as severe handicaps even by individuals with only mild to moderate degrees of hearing loss.

Activities of Daily Living↗
PubMed1988

Relative efficacy of vasodilator therapy in chronic congestive heart failure. Implications of randomized trials.

We examined existing evidence concerning the relative efficacy of various vasodilator agents in chronic congestive heart failure. Only randomized placebo-controlled trials with clinical end points and treatment durations of four weeks or more were selected from an exhaustive search of the English-language medical literature. Twenty-eight trials involving 1976 patients were found. Treatment durations of the trials varied from one month to two years. Patients with symptomatic heart failure despite digitalis and diuretic therapy were studied; most were middle-aged men and approximately half had coronary artery disease. Results of the trials were appraised by three independent observers, and mortality and functional status outcomes were pooled in a meta-analysis. All vasodilator agents except hydralazine hydrochloride were associated with improvements in functional status. Angiotensin converting-enzyme inhibitors were the only agents associated with both decreased mortality (odds ratio, 0.51; 95% confidence interval, 0.34 to 0.75) and improved functional status (odds ratio, 4.53; 95% confidence interval, 3.46 to 5.92). The optimal timing for initiation of these agents was not established.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1988

Manganese oxidation in pH and O2 microenvironments produced by phytoplankton.

Pure cultures of Chlorella sp. catalyzed the oxidation of soluble Mn(II) to particulate, extracellular, manganic oxides. Manganese oxidation was dependent on photosynthetic activity: no oxidation was observed in the dark when cells were grown heterotrophically on glucose, or in the light when photosystem II was inhibited by the addition of DCMU. Manganates were not formed when media were buffered below pH 8.0, suggesting that an important driving force for manganese oxidation was the high pH resulting from photosynthesis. Field studies with minielectrodes in Oneida Lake, New York, demonstrated steep gradients of O2 and pH and the presence of particulate manganic oxides associated with pelagic aggregates of the cyanobacterium Microcystis sp. The manganese oxidation reaction apparently occurs only when photosynthesizing algae are present as dense populations that can generate microenvironments of high (>9.0) pH, either as aggregates in the pelagic zone or concentrated cell cultures in the laboratory. A large-scale transition from soluble to particulate manganese was measured in the surface waters of Oneida Lake throughout summer 1986. Removal of Mn(II) was correlated with the presence of aggregate-forming cyanobacteria that oxidize Mn(II) by the mechanism described above.

Chlorella↗
PubMed1985

Adenosine triphosphatase activities in plasma liver membranes of rats treated with DDT and toxaphene.

The effect of exposure to chlorinated insecticides (DDT and toxaphene) on Na+,K+-ATPase, Mg2+-ATPase and Ca2+-ATPase activities of the plasma membrane of hepatocytes was determined. Acute treatment with DDT (200 mg per kg body weight) or toxaphene (110 mg per kg body weight) produced a significant decrease in Na+,K+-ATPase activity (80% and 85%, respectively) 24 h after treatment. DDT also produced a 30% decrease in Mg2+-ATPase and Ca2+-ATPase activity, but toxaphene treatment did not modify these enzymes. The effect of exposure to daily doses of DDT (30 mg per kg body weight) or toxaphene (16.5 mg per kg body weight) for a period of 3.5 months was also studied. Animals were sacrificed at 15-day intervals and results showed that Na+,K+-ATPase activity decreased 80% from the beginning of each treatment and the activity remained low throughout the treatment period. DDT, but not toxaphene, also led to a decrease in Mg2+-ATPase (20%) and Ca2+-ATPase (35%) activity. The low values observed from the beginning remained low throughout the treatment period. We believe that the general mechanism of ATPase inhibition by organochloride compounds could be the result of its interaction with membrane lipid components, although some differences could arise from differences in their spatial structure.

Adenosine Triphosphatases↗
PubMed1983

Megacolon at high altitude.

Megacolon occurs frequently in high altitude areas. This report describes observations made in 60 cases seen in La Paz, Bolivia (3,600 meters above sea level). Motility of both the large and small bowel was found to be increased and the feces had a low pH. No histologic abnormalities were noted in the nervous plexus or smooth muscle. It is assumed that megacolon in these circumstances is acquired and not congenital.

Altitude↗
PubMed1982

[Digestive changes in cholecystectomized patients].

An important number of cholecystectomized patients after some years of complete well-being, begin complaining of symptoms such as periodic diarrhea or constipation, abdominal pain, regurgitation, vomiting, etc. The purpose of this study is to try to identify an alteration or lesion in the stomach or colon in cholecystectomized patients of more than five years standing, which may be causing the aforementioned condition. The forty patients under observation, free of biliary tract post-operative lesions, were subjected to: hemogram, amylasemia, either infusion cholangiograph or ERCP, fecal parasitological-tests, upper digestive and colon X Ray series, esophagus, stomach and duodenal endoscopy with biopsies. Additionally, ten underwent a colonoscopy which also included biopsy. The result of the radiological, amylasemia and hemogram studies was normal in all cases. The parasitological tests were negative. In every case, a moderate to severe superficial, chronic gastritis was found as well as minor histopathological alterations in the colon mucosa. The presence of bile in both duodenum and colon in interdigestive periods, alterations in the enterohepatic circulation as well as in the biliary composition itself, are suggested as the possible causes of the patients symptoms.

Adult↗
PubMedDate not supplied

Interference in the quantitation of methylated arsenic species in human urine.

The aim of this paper is to report on the presence of chemical interferences in the quantitation of methylated arsenic species in human urine when using a method based on selective volatile arsine species generation, chromatographic separation, and hydride generation atomic absorption spectrometry (HGAAS) detection. An abnormal profile of methylated arsenic species characterized by the absence of the peak corresponding to dimethylarsinic acid (DMA) was observed in urine from some individuals exposed to arsenic via drinking water and living in rural communities of northwestern Argentina. The absence of this peak persisted even after the addition of known amounts of DMA to the samples. However, the DMA peak appeared after urine digestion with hydrochloric acid (2M). Samples showing interferences were provided by individuals who had mate consumption and coca-leaf chewing habits. Because the relative proportions of methylated arsenic species present in urine have been used to evaluate the efficiency of the methylation process, interferences in the formation or detection of methylarsines may cause underestimation of As exposure and also lead to erroneous conclusions about relative biomethylation efficiencies. Therefore, we recommend that urine samples should be digested with 2M HCl before performing speciation analysis using HGAA techniques. Further studies on the impact of this type of interferences on other arsenic speciation methods are also required.

Adolescent↗
PubMedDate not supplied

[Scheduled autotransfusion in orthopedic surgery].

We report the results of a programmed autotransfusion protocol applied to 22 patients undergoing orthopedic surgery. The number of extractions depended on the surgical needs and on the scheduled time for surgery. Among the total amount of blood used in this study, 81.7% corresponded to the volume previously given by the patient. This volume was sufficient for autologous transfusion in 17 patients. The remaining 18.3% of volume corresponded to homologous blood. We compared the hematologic data obtained at the beginning of the protocol and at the immediate pre and postoperative phase. We found statistical differences among hemoglobin levels, hematocrit, mean corpuscular hemoglobin, and mean corpuscular volume. We conclude that programmed autotransfusion constitutes an ideal method to compensate blood losses during surgery. This method may be the future for hemotransfusion in programmed surgery.

Adolescent↗