Biomedical subjects

Clifford Qualls

Publications and source records attributed to Clifford Qualls.

At least 37 records · Page 2Linked to original sources

PubMed2005

Abortion education in medical schools: a national survey.

OBJECTIVE: This survey was performed to examine the inclusion and extent of abortion education in US medical schools. STUDY DESIGN: A 3-item confidential survey requesting information about abortion education throughout the 4 years of medical school was mailed to the OB-GYN clerkship directors of the 126 accredited US medical schools. RESULTS: Seventy-eight surveys were returned, for a response rate of 62%. Overall, 17% of clerkship directors reported no formal education about abortion either in the preclinical or clinical years. In the third-year OB-GYN rotation, 23% reported no formal education, whereas 32% offered a lecture specifically about abortion. While 45% of third-year rotations offered a clinical experience, participation was generally low. About half of schools offered a fourth-year reproductive health elective, but few students participated. CONCLUSION: Abortion education is limited in US medical schools. As an integral part of women's reproductive health services, abortion education deserves a place in the curricula of all medical schools.

Abortion, Induced↗

PubMed2005

The relationship between central corneal thickness-adjusted intraocular pressure and glaucomatous visual-field loss.

BACKGROUND: Although measurement of central corneal thickness (CCT) is increasingly becoming an important component of glaucoma risk analysis, significant controversy exists regarding the benefit of calculating a corrected intraocular pressure (IOP) value from measured IOP and CCT data. METHODS: Three hundred forty-four male subjects were identified from a VA eye clinic with one of the following clinical diagnoses: ocular hypertension (OHT), primary open-angle glaucoma (POAG), normal tension glaucoma (NTG), and normal tension glaucoma suspect (NTGS). Using one eye per subject, multivariate logistic regression and correlational analyses were performed to determine relationships between glaucomatous visual-field loss and several glaucoma risk factors, including adjusted IOP values. RESULTS: Multivariate logistic regression analysis did not identify CCT-adjusted IOP values as independent risk factors for development of either NTG or POAG-related glaucomatous visual-field loss. CCT, however, was found to be strongly associated with both NTG and POAG-related visual-field loss. Correlational analysis revealed a weak correlation between Ehlers-adjusted pre-treatment IOP and severity of POAG-related visual-field loss, but no other adjusted IOP values significantly correlated with severity of visual-field loss in either POAG or NTG. CONCLUSIONS: Our results suggest that adjusted IOP, as calculated using current algorithms, is not useful within glaucoma risk analysis, since adjusted IOP was unable to predict either presence or severity of glaucomatous visual-field loss in this study. CCT, conversely, was found to be a robust and independent predictor of glaucomatous visual-field loss. These findings, while supporting routine CCT measurements for all glaucoma suspects, do not support routine clinical computation of adjusted IOP values using current algorithms.

Aged↗

PubMed2005

Outcome of very low birth weight infants exposed to antenatal indomethacin for tocolysis.

OBJECTIVE: Beginning in October 1995, and for several years thereafter, our institution used indomethacin as a first-line tocolytic drug. Our purpose is to compare the outcomes of very low birth weight infants who were exposed to antenatal indomethacin with those who were not exposed to this therapy. STUDY DESIGN: We used our center's component of the NICHD Neonatal Research Network's Generic Data Base which recorded the outcomes of all live born infants weighing less than 1500 g over a 5-year period. We abstracted data concerning neonatal morbidity (death, Grades III to IV intraventricular hemorrhage (IVH), necrotizing enterocolitis and patent ductus arteriosus), as well as other factors including gestational age, birth weight, antenatal corticosteroid treatment and maternal hypertension or pre-eclampsia. Univariate analysis was performed using Fisher's exact test. Multivariate analysis using logistic regression was performed to control for confounding factors. RESULTS: A total of 85 infants who were exposed to antenatal indomethacin were compared to 464 infants who were not exposed to the drug. In the univariate analysis, antenatal indomethacin exposure was not associated with a significant increase in the incidence of necrotizing enterocolitis or patent ductus arteriosus. The incidence of Grades III to IV IVH was 17.9% in those infants exposed to antenatal indomethacin compared to 7.1% in the nonexposed infants (p=0.008). The incidence of neonatal death in the exposed infants was 27.7 versus 16.4 in the nonexposed infants (p=0.02). After controlling for antenatal corticosteroids, maternal pre-eclampsia, gestational age and birth weight, antenatal indomethacin was significantly associated with an increased incidence of IVH, but not neonatal death. CONCLUSION: Antenatal indomethacin was associated with significantly higher rates of IVH. Additional studies assessing the potential risks of indomethacin tocolysis are needed before it is used as a first-line tocolytic therapy.

Cause of Death↗

PubMed2004

Reduced area of the corpus callosum in posttraumatic stress disorder.

Magnetic resonance imaging (MRI) studies have revealed decreases in the mid-sagittal area of the corpus callosum (CC) in pediatric posttraumatic stress disorder (PTSD), but at present no data are available in adult PTSD patients. We have previously reported decreased whole-brain white matter (WM) volume in adults with PTSD and now report corpus callosum area from the same sample. MRI was used to obtain whole-brain images in 12 adult patients with PTSD and 10 matched controls. Total parenchyma (white matter plus gray matter [GM]) volume, mid-sagittal area of the CC and seven sub-regions of this structure were calculated. In PTSD patients, the total CC area, absolute and normalized to total brain parenchyma, was smaller compared with control values. Several absolute and normalized CC sub-regions were also smaller in PTSD patients: genu (region 2), mid-body (region 5) and isthmus (region 6). There was also a trend for the anterior mid-body (area 4) to be smaller in PTSD patients. No differences were found in the rostrum (region 1), rostral body (region 3) or splenium (region 7). Adult patients with PTSD had decreased CC area after correcting for total brain tissue, indicating that these differences are not attributable to generalized white matter atrophy. These findings are similar to previous results in children with PTSD and suggest specific changes in the CC.

Adult↗

PubMed2004

Reaction time and movement time after embryonic cell implantation in Parkinson disease.

BACKGROUND: Embryonic nigral cell implants are a novel treatment for Parkinson disease (PD). Reaction time (RT) and movement time (MT) analysis, validated quantitative measures of premovement neural processing and motor execution, can be used as objective physiological markers of motor performance in PD. OBJECTIVES: To gauge the change in motor performance in patients with PD who received implants, and to determine whether the physiological findings correlate with clinical outcome measures after transplantation. DESIGN: Double-blind, placebo-controlled trial. Patients Forty patients with levodopa-responsive, Hoehn and Yahr stage III or greater PD. INTERVENTIONS: Random assignment to embryonic tissue implants or placebo (sham) operation. MAIN OUTCOME MEASURES: Combined RT + MT scores measured preoperatively and at 4 and 12 months postoperatively in the "off" state. RESULTS: The difference in mean RT + MT scores between the sham and implant groups was statistically significant (P =.005) and was greatest in those 60 years or older (P =.003). Changes correlated with Unified Parkinson's Disease Rating Scale off scores at 4 (r = 0.87, P =.001) and 12 (r = 0.75, P =.01) months in those younger than 60 years. There was a significant deterioration in the sham surgery group at 12 months (P =.03) that was thought to be due to worsening in subjects 60 years and older (P<.001). CONCLUSIONS: The physiological measures detected significant changes in patients undergoing embryonic nigral cell implants and correlated directly with clinical outcome measures. Comprehensive analyses of RT paradigms can document subtle changes in motor performance over time, making them useful outcome measures in therapeutic trials of PD. These findings support further research into nigral cell implantation for PD.

Adult↗

PubMed2004

Slitlamp, specular, and light microscopic findings of human donor corneas after laser-assisted in situ keratomileusis.

OBJECTIVE: To examine slitlamp, specular, and light microscopic features of human donor corneas known to have undergone laser-assisted in situ keratomileusis (LASIK). METHODS: Twenty-six donor corneas known to have undergone LASIK prospectively underwent slitlamp examination with particular attention to the presence of a flap edge, as well as specular microscopy with particular attention to the presence of highly reflective particles in the stroma corresponding to the LASIK interface. Central endothelial cell density and pachymetery were obtained. They were compared with 26 control donor corneas without LASIK. Eleven LASIK donor corneas were processed for histology. Twenty-six donor corneas with no known prior keratorefractive surgery also underwent similar slitlamp examination and specular microscopy to serve as controls. RESULTS: Twelve (46%) of 26 LASIK donor corneas had an obvious flap edge, and 10 (39%) had a subtle flap edge by slitlamp examination. Four (15%) had infiltrates by slitlamp examination, of which 3 were confirmed by histopathologic examination. Highly reflective particles were seen by specular microscopy in the stroma of 23 (88%) of 26 LASIK donor corneas, but only 1 (4%) of 26 control donor corneas had a single highly reflective particle in the stroma (P<.001). The mean central endothelial cell counts were similar: 2138 cells/mm(2) in the LASIK group compared with 2250 cells/mm(2) in the controls (P =.39). Vacuolization and pyknosis of keratocytes was a consistent histopathologic finding after LASIK. Metallic particles at the interface were not detected by histology. CONCLUSIONS: Detection of a flap edge by slitlamp examination may detect at least half of the donor corneas that may have undergone LASIK. The detection of highly reflective stromal particles may form an effective basis for screening for LASIK donor corneas using specular microscopy and requires further study.

Adult↗

PubMed2004

Effect of topical bupivacaine on postoperative pain after laparoscopic tubal sterilization with Filshie clips.

OBJECTIVE: The purpose of this study was to evaluate postoperative pain after the administration of topical bupivacaine during laparoscopic sterilization with Filshie clips. STUDY DESIGN: Sixty-three women who underwent laparoscopic tubal sterilization with Filshie clips were assigned randomly to receive topical bupivacaine or placebo. Presence of pain, pain intensity, nausea, vomiting, timing of request for pain medication, and pain medication requirements were assessed postoperatively. RESULTS: Patient demographics were similar between the 2 groups. Topical bupivacaine decreased the incidence (P=.005) and intensity (P=.028) of postoperative pain at 30 minutes. No differences in incidence or severity of pain were seen at hospital discharge or on postoperative day 1. CONCLUSION: Topical bupivacaine that is applied to the fallopian tubes at the time of laparoscopic tubal sterilization with the Filshie clip decreases immediate postoperative pain.

Administration, Topical↗

PubMed2004

Sexual function after surgery for stress urinary incontinence and/or pelvic organ prolapse: a multicenter prospective study.

OBJECTIVE: The purpose of this study was to assess sexual function in women after surgery for stress urinary incontinence and/or pelvic organ prolapse (UI/POP) at 3 and 6 months with the Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire (PISQ). STUDY DESIGN: Of 269 eligible women participating in a trial of prophylactic antibiotic use with suprapubic catheters, 102 (37.9%) agreed to participate in a sexual function study. Women underwent a variety of anti-incontinence and reconstructive surgeries. Sexual function and urinary incontinence were assessed preoperatively and at 3 and 6 months postoperatively with the PISQ and Incontinence Impact Questionnaires (IIQ-7). Paired t tests compared changes over time. Logistic regression compared worsening PISQ vs other variables. Generalized McNemar's test compared individual questions pre- and postoperatively. Significance was set at P <.05. RESULTS: Mean age was 47.1 (23 to 85) years, and 64% of women were premenopausal. Seventy-five (74%) women completed questionnaires at 3 or 6 months. Sexual function scores declined after surgery despite improvement in IIQ-7 scores (PISQ=86 vs 78, P <.001; IIQ-7=52 vs 13, P <.001). Behavioral Emotive domain scores worsened at 3 to 6 months compared with preoperative scores, while the Physical domain improved (all P <.001). Worsening PISQ scores were independent of age, type of surgery, hysterectomy, complications, or hormonal status (logistic regression, all P <.05). CONCLUSION: Sexual function scores in women after surgery for UI/POP do not improve despite improvement of incontinence at 3 to 6 months after surgery.

Female↗

PubMed2004

A randomized, double-blind, placebo-controlled comparison of the effect of nitrofurantoin monohydrate macrocrystals on the development of urinary tract infections after surgery for pelvic organ prolapse and/or stress urinary incontinence with suprapubic catheterization.

OBJECTIVE: The purpose of this study was to determine if antibiotic prophylaxis with nitrofurantoin monohydrate macrocrystals (study drug) after pelvic organ prolapse and/or urinary incontinence surgery with suprapubic catheterization (SPC) decreases urinary tract infection (uti) compared with placebo in a randomized, double-blind, multicenter trial. STUDY DESIGN: Six centers participated in this study. After a negative preoperative urine culture, history, surgical and postoperative course, urine culture and symptoms at SPC removal, and at 6 to 8 weeks postoperative, any other UTI and adherence were recorded. To demonstrate a 50% decrease in the bacteruria rate from 20%, with 80% power and alpha of 0.05, 438 patients were required. Data were evaluated with Student t test and Fisher exact test. RESULTS: Of 449 patients enrolled, 211 randomized to study drug, and 224 randomized to placebo. No pre- or perioperative differences existed between groups (all P>.05). Antibiotic prophylaxis decreased positive urine cultures compared with placebo (46% vs 61%, P=.002), symptomatic UTI at SPC removal (7.2% vs 19.8%, P=.001), and any other symptomatic UTI 6 to 8 weeks postoperatively (18.9% vs 32.6%, P=.002). Antibiotic prophylaxis did not decrease symptomatic UTI at the 6- to 8-week postoperative visit (1.8% vs 5.4%, P=.10). CONCLUSION: Antibiotic prophylaxis with nitrofurantoin monohydrate macrocrystals decreases UTI compared with placebo after pelvic organ prolapse and/or urinary incontinence surgery with suprapubic catheterization.

Aged↗

PubMed2004

Incidence of and risk factors for residual posterior capsule opacification after cataract surgery.

PURPOSE: To evaluate the incidence of and determine the risk factors for residual posterior capsule opacification (PCO). SETTING: University of New Mexico Health Sciences Center and the Veterans Administration Medical Center, Albuquerque, New Mexico, USA. METHODS: This study evaluated 194 uneventful cataract surgeries. Immature cataracts were graded for nuclear sclerosis (NS), posterior subcapsular cataract (PSC), and anterior cortical spokes on a 1 to 4 scale. Preoperative Snellen best corrected visual acuity was converted to the logMAR scale. The posterior capsule was examined after polishing and was classified as clear or as having residual opacity. Those with residual capsule opacity were evaluated 6 weeks postoperatively for the presence of visually significant PCO. RESULTS: The incidence of residual capsule opacity was 23% (44 eyes). Seven (54%) of 13 eyes with white mature cataract had residual capsule opacity. In contrast, 37 (20%) of 181 eyes with immature cataract had residual capsule opacity (P = .01). In eyes with immature cataract, the mean preoperative logMAR acuity was +1.14 +/- 0.60 (SD) in the residual capsule opacity group and +0.73 +/- 0.46 in the clear group (P<.001). In eyes with immature cataract, the adjusted odds ratio for each increasing grade of NS was 2.3 and of PSC, 1.8 (P = .002 and P<.001, respectively). Eleven percent (5 eyes) of residual capsule opacities resulted in visually significant PCO 6 weeks postoperatively. All 5 opacities were centrally located at surgery. CONCLUSIONS: Results indicate that aggressive polishing of peripheral or adherent residual capsule opacities is not advisable as only 5 eyes with central residual capsule opacities developed visually significant PCO.

Aged↗

PubMed2004

Advanced glycation end products and oxidative stress are increased in chronic allograft nephropathy.

BACKGROUND: The histologic picture of chronic allograft nephropathy (CAN) resembles early arteriosclerotic lesion. Oxidative stress and advanced glycation end products (AGES) have been implicated in the pathogenesis of atherosclerosis and progression of renal disease. METHODS: The authors serially measured the plasma malonyldialdehyde (MDA), carbonyl protein (CP), pentosidine, and argpyramidine levels in 11 postrenal transplant patients with normal renal function (KPT) and 10 patients with biopsy proven CAN at 1, 3, 6, 9 through 12, and 18 through 24 months posttransplant. Data were also obtained in 16 controls and 13 patients with chronic renal failure (CRF). RESULTS: Although serum creatinine, MDA, CP, pentosidine, and argpyrimidine levels decreased during follow-up in KPT, it progressively increased in patients with CAN. The mean serum creatinine level was higher in patients with CRF (3.3 +/- 0.8 mg/dL [291.7 +/- 70.7 micromol/L]) and CAN (2.4 +/- 1.1 mg/dL [212.1 +/- 96.6 micromol/L]) than in controls (1.2 +/- 0.3 mg/dL [105.8 +/- 26.7 micromol/L]) and KPT patients (1.2 +/- 0.2 mg/dL [109.7 +/- 17.7 micromol/L]; P < 0.001). Markers of oxidative stress and AGEs measured at 18 to 24 months posttransplant in patients with CAN were higher than in KPT, controls, and CRF patients. MDA (nmol/mL) was significantly higher in patients with CAN (1.30 +/- 0.30) compared with controls (0.53 +/- 0.12), KPT (0.52 +/- 0.15), and CRF (0.74 +/- 0.27) groups (P < 0.001). Plasma CP (nmol/mg protein) in patients with CAN (4.3 +/- 1.00) was higher than in controls (1.90 +/- 0.69) and KPT (2.62 +/- 1.00) groups at the same time-point (P < 0.001), but comparable with CRF (2.69 +/- 1.20). Plasma pentosidine (pmol/micromol protein) level in patients with CAN (19.69 +/- 5.05) was higher compared with controls (2.49 +/- 0.86), CRF (13.10 +/- 3.68), and KPT (14.32 +/- 6.28) groups (P < 0.001). Plasma argpyrimidine (pmol/10 micromol protein) was higher in patients with CAN (123.8 +/- 17.9) compared with controls (4.81 +/- 1.91), CRF (56.92 +/- 29.67), and KPT (31.1 +/- 11.1; P < 0.001) groups. CONCLUSION: Oxidative stress and AGEs are increased in patients with CAN, which cannot be explained by the decline in renal function alone. Oxidative stress and AGEs may be one among the nonimmune mediators of CAN.

Adult↗

PubMed2004

Concentrations of surface-dust metals in Native American jewelry-making homes in Zuni Pueblo, New Mexico.

This pilot study was conducted to identify the metals used by home-based Native American jewelry makers, to quantify the metals in dust samples taken from jewelers' homes, and to compare these concentrations with background levels from control homes in which jewelry was not made. Participants were recruited from Zuni Pueblo, New Mexico. Surface dust samples were collected from the work and living areas of 20 jewelers' homes, and from the living areas of 20 control homes. Silver, copper, tin, boron, nickel, zinc, lead, and cadmium were significantly higher in work areas than in living areas of jewelry-making homes (p < or = 0.02). Silver, copper, nickel, and antimony were significantly higher in living areas of jewelers' homes compared with control homes (p < or = 0.04). Ventilation measures did not effectively reduce metal concentrations in jewelers' homes; concentrations in nonwork areas remained elevated.

Air Pollution, Indoor↗

PubMed2003

A short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12).

The aim of this study was to develop the short form of a condition-specific, reliable, validated and self-administered instrument to evaluate sexual function in women with pelvic organ prolapse and/or urinary incontinence. The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire -12 (PISQ-12) was developed from the data of 99 of 182 women surveyed to create the long form (PISQ-31). An additional 46 patients were recruited for further validation. All subsets regression analysis identified 12 items likely to predict PISQ-31 scores. Short form scores underwent correlation analysis with long form, Incontinence Impact Questionnaire - 7 (IIQ-7), Sexual History Form -12 (SHF-12) and Symptom Questionnaire (SQ) scores. Test-retest reliability was checked with a subset of 20 patients. All subsets regression analysis with R>0.92 identified 12 items that predicted PISQ-31 scores. Short form scores were highly correlated with long form scores ( R=0.75-0.95). Correlations of the PISQ-12 with SHF-12 ( R=-0.66 and -0.68) and IIQ-7 ( R=-0.38 and -0.54) scores were similar to correlation of the PISQ-31 with these other measures. Reliability was moderate to high, with weighted kappa values from 0.56 to 0.93. PISQ-12 scores were lower in patients with low sexual function as measured on the SHF-12 ( P <0.001), and lower in women with depression as measured on the SQ ( P <0.001). The PISQ-12 is a validated and reliable short form that evaluates sexual function in women with urinary incontinence and/or pelvic organ prolapse and predicts PISQ-31 scores. It is able to distinguish women with poor sexual function as measured on the SHF-12.

Female↗

PubMed2003

Immune response to hepatitis B vaccine in asthmatic children.

Asthma is a disease that demonstrates chronic Th2 lymphocyte-mediated pulmonary inflammation. We hypothesized that cytokines produced by asthmatic lung inflammation bias the immune response to antigens administered systemically toward a Th2 response, as assessed by serum IgE antibody and lymphocyte-secreted IL-4 and IL-5. We also hypothesized that treatment of asthmatic children with local anti-inflammatory agents reduces this cytokine-mediated Th2 influence. We systemically immunized groups of asthmatic children (n=29) who were participating in a long-term, randomized, placebo-controlled clinical trial of inhaled anti-inflammatory therapy (Childhood Asthma Management Program) and nonasthmatic children (n=12) with hepatitis B (Hep B) antigen, and examined their antigen-specific antibody and lymphocyte cytokine secretion profiles. The asthmatic population demonstrated an increased amount of Th2-mediated serum IgE anti-Hep B antibody, as compared to nonasthmatic children; but comparable amounts of IgG1, IgG2, IgG3, IgA, and IgM anti-Hep B antibody and lymphocyte IFNgamma, IL4, and IL5. There was no significant difference of antibody isotype or cytokine production between asthmatic subjects receiving treatment with budesonide or nedocromil, as compared to placebo. In conclusion, there is a subtle bias in responses to systemic immunization in children with asthma, but anti-inflammatory therapy does not affect this bias. The findings support the concept that the Th2 bias may be largely genetic. Importantly, we confirmed that children with asthma, including even those on inhaled corticosteroids, responded to Hep B immunization as well as did nonasthmatic children with the major isotypes of anti-Hep B antibody, suggesting that vaccine protection against hepatitis B is not influenced by inhaled steroid therapy.

Administration, Inhalation↗

PubMed2003

Emergency contraception: pharmacy access in Albuquerque, New Mexico.

OBJECTIVE: Emergency contraception could reduce the approximately 3 million unintended pregnancies that occur annually in the United States. Dedicated emergency contraception products may be particularly useful because instructions are easy to understand and simple to follow. However, they must be available within a few days to women who have had unprotected intercourse. The goal of this study was to investigate whether women presenting to pharmacies in a moderately sized metropolitan area with a prescription for Plan B or Preven could get it filled. METHODS: Two research assistants posed as women needing emergency contraception. They visited 89 pharmacies in Albuquerque, New Mexico, presenting a prescription for either Plan B or Preven. The assistants recorded the availability of the products in the pharmacies. When the product was not in stock, the research assistants asked pharmacy providers why the products were not carried. Fisher exact test was performed to compare categoric data. RESULTS: Plan B and Preven were in stock at only 19 visits (11%). Of the pharmacies that did not stock the products, 53% reported they could obtain Plan B or Preven within 24 hours. The most common reason cited by pharmacy providers for not stocking Plan B or Preven was the lack of prescriptions received for them (65%). CONCLUSION: Plan B and Preven were not in stock at the majority of pharmacies in a moderately sized metropolitan area. Lack of availability at the pharmacy constitutes a major barrier to emergency contraception access.

Contraceptives, Oral, Combined↗

PubMed2003

Abdominal hysterectomy for the enlarged myomatous uterus compared with vaginal hysterectomy with morcellation.

OBJECTIVE: The purpose of this study was to compare intraoperative and postoperative complications of abdominal hysterectomy for the enlarged, myomatous uterus with vaginal hysterectomy with morcellation. STUDY DESIGN: Medical records of 139 patients who underwent vaginal hysterectomy with morcellation and 244 patients who underwent total abdominal hysterectomy for an enlarged, myomatous uterus between August 1990 and July 2001 were reviewed. Uterine weights of >982 g were excluded because this was the largest uterus removed vaginally, which left 208 evaluable cases of total abdominal hysterectomy. The perioperative and postoperative course of the two groups was compared. The Student t test was used for continuous variables, and the Fisher exact test was used for binary or categoric data. RESULTS: There were no significant differences between the two groups in surgical or anesthetic risk factors (P>.05). Operative time was similar between the groups (P>.05). Length of hospital stay was increased significantly with total abdominal hysterectomy (mean, 3.9 days vs 2.6 days; P<.001). Perioperative complications were increased with the abdominal route (10% vs 25%, P<.001). CONCLUSION: In this large series, uterine morcellation at the time of vaginal hysterectomy is safe and facilitates the removal of moderately enlarged and well-supported uteri and is associated with decreased hospital stay and perioperative morbidity rate compared with the abdominal route.

Adult↗

PubMed2003

Validation of a Spanish version of the Pelvic Organ Prolapse Incontinence Sexual Questionnaire.

OBJECTIVE: To develop a validated Spanish version of the Pelvic Organ Prolapse Incontinence Sexual Questionnaire (PISQ). METHODS: The PISQ is a previously described validated and reliable questionnaire. We used a back-translation method to develop a Spanish-language version. Twenty-six bilingual patients with pelvic organ prolapse and/or urinary incontinence were randomized to complete either the original English version or the final Spanish version of the PISQ first, followed by the other questionnaire. Scores of the two versions were compared. Paired t test for total PISQ and its three domain scores and Wilcoxon signed rank test for each item assessed the bias between the two equivalent versions. Agreement between the two versions was assessed by weighted kappa statistics, with 95% confidence intervals for each item. P values of .05 or less were considered significant, and kappa values of .75 or greater were considered to indicate good agreement. RESULTS: English and Spanish versions demonstrated no differences for each of the factors and total scores (P = .15, .83, .28, and .56, respectively). Wilcoxon signed rank test demonstrated that one item was answered differently in the English and Spanish versions. Good agreement between Spanish and English versions in 30 of the 31 items was demonstrated by weighted kappa statistics. Overall, 72% of women scored both versions of the questionnaire equivalently. CONCLUSIONS: We have developed a validated and reliable Spanish questionnaire to evaluate sexual functioning in Spanish-speaking patients with pelvic organ prolapse and/or urinary incontinence.

Adult↗

PubMed2002

The APO E4 allele and cognition in New Mexico Hispanic elderly.

OBJECTIVE: To determine if the apolipoprotein E E4 (APO E4) allele is associated with cognitive performance in New Mexico Hispanic elderly. METHOD: We performed a cross-sectional survey of 105 community volunteers, aged 60 years and older, born in New Mexico, with both parents of Hispanic descent. Subjects were excluded for medical conditions that could influence cognitive performance. We also performed a longitudinal analysis on 18 participants who were re-tested over a 3-year interval. The main outcome measures for both the cross-sectional and longitudinal analysis were scores on 5 cognitive tests comparing subjects with the E4 allele to those without the E4 allele. RESULTS: The mean age was 69 years, with a range of 60 to 91. For the cross-sectional analysis, there were no significant differences between the 2 groups on the cognitive tests, although subjects with an E4 allele did not perform as well on color trails A (P=.09). In the longitudinal analysis we found that the variability of cognitive test scores tended to be higher in the E4 group on most cognitive measures. The time needed to complete color trails A (indicating slower performance) was significantly greater (P<.05) in the E4 group. For the total recall portion of the Fuld Object Memory test, the E4 group did not perform as well on follow-up (P=.08). CONCLUSION: We found no significant cross-sectional association between the APO E4 allele and cognitive performance. In our longitudinal analysis, the time needed to complete color trails A was significantly greater in the E4 group, and the E4 group did not perform as well on total recall.

Aged↗