RESUMEN
Resumen Introducción: Se estima que hasta un 30% de la población mayor de 65 años presenta hipoacusia. Una intervención validada para la hipoacusia en adultos mayores es el uso de audífonos, pero el problema es que hasta un 50% de los adultos mayores no los utiliza. Objetivo: Estimar la adherencia al uso de audífonos en adultos mayores beneficiarios del programa GES de "Hipoacusia bilateral en mayores de 65 años que requieran audífonos" en un hospital en Santiago, Chile. Material y Método: Se utilizó la rama control de un ensayo clínico aleatorizado para estimar la adherencia al uso de audífono con cuestionarios validados y estructurados, por encuestadores entrenados que acudieron a los tres, seis, nueve y doce meses desde la intervención al domicilio de los beneficiarios del programa. Resultados: Se incluyeron 101 adultos mayores. El promedio de edad fue 76,3 años. Al analizar la adherencia considerando un criterio de uso del audífono mayor a 8 h al día, cada día, durante las últimas dos semanas, la adherencia a 3 meses fue un 56,8%, a 6 meses un 62,6%, a 9 meses un 63,2% y a 12 meses un 54,5%. Al analizar considerando uso entre 4-8 h/diarias, la adherencia del período fue entre 73,8% y 87,3%. Según el cuestionario del Dr. Yueh, la adherencia a 3 meses fue un 64,7%, a 6 meses un 63,9%, a 9 meses un 73,7% y a 12 meses un 67,8%. Conclusión: Los resultados del presente análisis muestran una excelente adherencia al uso del audífono en Chile, lo que representa una cifra positiva respecto a la efectividad de la política pública.
Abstract Introduction: It is estimated that up to 30% of the population over 65 years of age present hearing loss. A validated intervention for hearing loss in older adults is the use of hearing aids, but the problem is that up to 50% of older adults do not use them. Aim: To estimate the hearing aid adherence in elderly population with hearing loss who are beneficiaries of the GES program "Bilateral hearing loss in people over 65 who require hearing aids" in a hospital in Santiago, Chile. Material and Method: The control arm of a randomized clinical trial was used to estimate adherence to hearing aid with validated and structured questionnaires, by trained interviewers who visited the beneficiaries of the program at three, six, nine and twelve months posterior to the intervention. Results: 101 older adults were included. The average age was 76.3 years. When analyzing adherence as "use for more than 8 hours a day during the last two weeks", adherence at 3 months was 56.8%, at 6 months 62.6%, at 9 months 63.2%, and at 12 months 54.5%. When analyzing considering use between 4-8 h/day, the adherence during the follow-up was between 73.8% and 87.3%. According to Dr. Yueh's questionnaire, adherence at 3 months was 64.7%, at 6 months 63.9%, at 9 months 73.7%, and at 12 months 67.8%. Conclusion: The results of the present analysis show an excellent adherence to hearing aids in a group of Chilean population, which represents a positive outcome regarding the effectiveness of this particular public policy.
RESUMEN
Laryngeal squamous cell carcinoma (LSCC) is a highly disabling disease to the patient, affecting speech, swallowing and respiratory skills. Smoking and alcohol abuse are principal risk factors linked to this disease. Genetic factors can be involved in carcinogenesis by controlling the cell cycle, cell survival, angiogenesis, and invasiveness. Single nucleotide polymorphisms (SNPs) involving specific genes could modulate the risk of LSCC related to known carcinogens by modifying cellular responses, but not all genetic associations are known. In a case-control study, we assess the associations between cyclooxygenase-2 (COX2), epidermal growth factor (EGF), EGF receptor (EGFR), and tumor suppressor P53 SNPs on the risk of LSCC development in the Chilean population. A total of 85 LSCC patients and 95 healthy volunteers were recruited. SNPs genotype were analyzed from genomic DNA by Polymerase Chain Reaction (PCR)-Restriction Fragment Length Polymorphism (RFLP) and associations were estimated by odds ratios (ORs) using unconditional logistic regressions. A significant association between COX2 and TP53 SNP and LSCC risk was found, with an OR = 3.27 for COX2 c.-1329A>G (rs689466) SNP, and an OR = 1.94 for TP53 c.215C>G, Pro72Arg (rs1042522) SNP. These findings suggest that COX2 c.-1329A>G and TP53 c.215C>G (Pro72Arg) SNPs may be risk factors for LSCC. Through this research, we identify two low penetrance genetic variants that may be evaluated as novel biomarkers for this disease, in South American Mestizo populations.
Asunto(s)
Biomarcadores de Tumor/genética , Predisposición Genética a la Enfermedad , Neoplasias Laríngeas/genética , Carcinoma de Células Escamosas de Cabeza y Cuello/genética , Anciano , Consumo de Bebidas Alcohólicas/epidemiología , Estudios de Casos y Controles , Chile/epidemiología , Fumar Cigarrillos/epidemiología , Ciclooxigenasa 2/genética , Factor de Crecimiento Epidérmico/genética , Receptores ErbB/genética , Femenino , Humanos , Neoplasias Laríngeas/epidemiología , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Factores de Riesgo , Carcinoma de Células Escamosas de Cabeza y Cuello/epidemiología , Proteína p53 Supresora de Tumor/genéticaRESUMEN
Introducción: La hipoacusia es una condición prevalente en adultos mayores. Sin embargo, la baja adherencia al uso del audífono representa una realidad. Objetivo: Evaluar la utilidad de un programa de intervención para mejorar adherencia en pacientes con hipoacusia mayores de 65 años usuarios de audífono. Material y método: Ensayo clínico aprobado por Comité de Ética. Se incluyeron pacientes beneficiarios del GES de hipoacusia. Se evaluó adherencia al audífono en un corte a 6 meses. Resultados: Fueron evaluados 180 pacientes, correspondiendo a 90 pacientes control y 90 intervenidos. La adherencia global al uso del audífono fue de 78%. No hubo diferencia en los grupos por sexo, edad, ni grado de hipoacusia. El promedio de horas diarias de uso en el grupo control fue de 6,9 horas, comparado con el del grupo intervenido que fue 9,6 horas (p <0,0001). Hubo una asociación significativa entre la intervención y la regularidad del uso del audífono, con 80% de pacientes que lo usaban regularmente en el grupo intervenido contra el 8,9% en el grupo control (p <0,001). Discusión: La intervención implementada ha demostrado excelentes resultados preliminares en términos de tiempo de uso del audífono, por lo que sería de utilidad implementaria como parte de la política GES y difundir su uso.
Introduction: Hearing loss is a prevalent condition in elderly population. However, the low adherence to hearing aids is a fact. Aim: To evaluate the utility of a standardized counselling program in elderly patients with hearing loss. Material and methods: A clinical trial was carried out, approved by the Hospital ethics committee. Patients with 65years and older with hearing loss were included. We assessed adherence at a follow-up of 6 months. Results: 180 patients were evaluated, corresponding to 90 control and 90 rehabilitated patients. The overall adherence of hearing aids use was 78%. There was no difference in sex, age, and level of hearing loss between groups. The average daily hours of use in the control group was 6.9 hours, compared with the 9.6 hours in the intervention group (p <0.0001). There was a significant association between the intervention and regular hearing aid use, with 80% of patients who used it regularly in the intervention group compared with 8.9% in the control group (p <0.001). Discussion: The intervention implemented has shown excellent preliminary results in terms of time of use of the hearing aid. It would be useful to include this intervention in the hearing loss national public policy.