PubMed Health⌕ Search

Biomedical subjects

M C Tapia

Publications and source records attributed to M C Tapia.

12 recordsLinked to original sources

Tinnitus and Ménière's disease: characteristics and prognosis in a tinnitus clinic sample.

The aim of this study is to describe tinnitus epidemiological characteristics in Ménière's disease (MD), the prognosis and its interaction with other MD symptoms. It is a descriptive transversal study. One hundred two MD patients were referred to a tinnitus clinic. Tinnitus was evaluated according to psychoacoustical tinnitogram, visual analogue scale, and tinnitus handicap inventory (THI). All patients were diagnosed with definitive MD (following AAO-HNS' 95 criteria). Pitch was more commonly identified in low and medium frequencies. Psychoacoustical intensity was matched in 12.7 dB. The visual analogue scale showed a value of 7.1, while THI score reached an average of 49%. Compared with other aetiologies (acoustic trauma, otosclerosis), MD showed a statistical difference in tinnitus severity parameters (P<0.05). Tinnitus increased VAS and THI score as a function of duration and bilateral disease (P<0.01). We found a statistical association (P<0.05) between tinnitus intensity and worse hearing loss or hyperacusis, but it was not influenced by number of vertigo spells. Higher MD stage increased tinnitus intensity and handicap. Tinnitus in MD patients referred to our tinnitus clinic presents a high intensity and handicap levels and represents the most troublesome symptom. Severity is influenced by the longer duration of the disease, the bilateral affection, hearing impairment or hyperacusis and a higher MD stage.

Adolescent↗

[Auditory neuropathy].

INTRODUCTION: Auditory neuropathy is a type of neurosensorial hypoacusis that produces significant impairment in language comprehension. Etiologically, this neuropathy has been related to perinatal hypoxia, hyperbilirubinemia, metabolic disorders and degenerative entities that affect the auditory pathway. PATIENTS AND METHODS: We report five children with this disorder. Two of the children were referred for otorhinolaryngeal assessment after failing the neonatal hearing screening and one was referred because of a history of perinatal hypoxia. The two eldest children were referred because of schooling problems and language impairment. In all the children, auditory brainstem response, otoacoustic emissions, tympanometry stapedius reflex were examined and liminal and condition-orientation reflex audiometry were performed. After diagnosis, the children were followed-up for 3 consecutive years. RESULTS: In all five children, tympanogram and otoacoustic emissions were normal. The stapedius reflex and auditory brainstem responses with 80-90 dli stimuli were absent. Medium latency and conical and cognitive potentials were normal in the only child (aged 9 years) in whom they could be performed. In two children (aged 7 and 9 years), verbal discrimination was within the normal range for theft age. In all the children, audiometry revealed bilateral mild-to-moderate hypacusla, which did not change during follow up. CONCLUSIONS: Auditory neuropathy can be detected by the combined use of neonatal hearing screening techniques, auditory brainstem responses and otoacoustic emissions. Interest in the early identification and diagnosis of this disorder Is due to the clear benefit to language development secondary to the early treatment and rehabilitation of these children.

Age Factors↗

The migraine: benign paroxysmal vertigo of childhood complex.

The migraine--a benign paroxysmal vertigo of childhood complex is the most frequent etiology of pediatric dizziness, with an incidence of 34.7%. We present a series of 34 children in whom this entity was diagnosed. We describe the most important characteristics and discuss the possible etiological factors. We review the theories about a common pathophysiological origin for migraine, benign paroxysmal vertigo of childhood, and paroxysmal torticollis. Evolution of these entities confirms the idea of a common origin and a different vestibular symptomatology, depending on the age of the child experiencing dizziness.

Adolescent↗

A novel locus for non-syndromic sensorineural deafness (DFN6) maps to chromosome Xp22.

Non-syndromic X-linked deafness is highly heterogeneous. At least five different clinical forms have been described, but only two loci have been mapped. Here we report a Spanish family affected by a previously undescribed X-linked form of hearing impairment. Deafness is non-syndromic, sensorineural, and progressive. In affected males, the auditory impairment is first detected at school age, affecting mainly the high frequencies. Later it evolves to become severe to profound, involving all frequencies for adulthood. Carrier females manifest a moderate hearing impairment in the high frequencies, with the onset delayed to the fourth decade of life. Deafness was assumed to be X-linked dominant, with incomplete penetrance and variable expressivity in carrier females. The family was genotyped for a set of microsatellite markers evenly spaced at intervals of about 10 cM. We found evidence of linkage to markers in the Xp22 region (maximum lod score of 5.30 at theta = 0.000 for DXS8036 and for DXS8022). The position of the novel deafness locus (DFN6) was refined by haplotype analysis. Mapping of the breakpoints in two critical recombinants allowed us to define an interval for DFN6, delimited by DXS7108 on the distal side and by DXS7105 on the proximal side, and spanning a genetic distance of about 15 cM.

Audiometry, Pure-Tone↗

Etiological review of hirsutism in 250 patients.

Two hundred fifty women with hirsutism were studied, with a mean age of 25.5 years (ranging from 13 to 38 years). The evolution of hirsutism varied from 3 months to 13 years, being minimal in 82 patients (33%), mild to 101 (40%), moderate in 56 (23%) and severe in the remaining 11 women (4%). Polycystic ovary syndrome (PCOS) was diagnosed in 134 patients (53%), overweight or obesity in 45 (18%), late-onset adrenal hyperplasia in five (2%), ovarian tumor in two (0.8%), drug-induced hirsutism and Cushing's syndrome in one patient each (0.4%), and idiopathic hirsutism in 62 cases (25%). Among 67 patients with moderate or severe hirsutism, testosterone was elevated in 21 (31%). In 117 out of 206 (57%) cases polycystic ovaries were observed by ultrasound. Fifty-four patients were treated with a combination of 2 mg cyproterone acetate and 0.035 mg ethinyl estradiol, observing improvement of hirsutism in 32 patients (59%). It is concluded that PCOS is the most frequent cause of hirsutism, but an important proportion of cases without evident etiology remain classified as idiopathic hirsutism.

Adolescent↗

Selectivity of attenuation (i.e., gating) of somatosensory potentials during voluntary movement in humans.

Attenuation of somatosensory evoked potentials (SEPS) recorded from the scalp during voluntary movement occurs for specific combinations of the finger moved and the peripheral nerve stimulated. The cerebral potential component occurring at a latency of 27 msec (P27) evoked either by stimulation of median nerve at the wrist or by stimulation of 1st and 2nd digit nerves in the fingers were selectively attenuated during movement of 1st digit but were not altered during movement of 5th digit. By contrast, the cerebral P27 component evoked by stimulation of ulnar nerve at the wrist or by stimulation of 5th digital nerve were attenuated during movement of that digit but were not altered during movement of 1st digit. Gating of somatosensory activity is a selective phenomenon occurring when movement involves the areas being stimulated.

Electric Stimulation↗

Attenuation of auditory-evoked potentials during voluntary movement in man.

Long-latency auditory evoked potential (AEP) amplitudes were reduced during voluntary thumb movement. The cerebral component N100 did not change during the movement. By contrast, the cerebral potential P200 and N100-P200 amplitudes were attenuated during the motor task compared to control. This report cannot clearly distinguish if the attenuation obtained in the AEP during the performance of the movement is related to motor events in the cerebral cortex causing 'gating' or to other factors such as habituation or vigilance changes.

Auditory Threshold↗

Audiometric study of the neonate: impedance audiometry. Behavioural responses and brain stem audiometry.

The following clinical measurements of acoustic impedance were carried out successfully on 25 neonates. Average compliance was 0.48 cm3, with a range from 0.28 to 0.81 cm3. Tympanometry showed a high percentage of maximum compliance curves with positive pressures. In a notably high percentage, the stapedial reflex was combined with generalized body movements and was therefore considered a behavioural response. Behavioural responses of the child were also observed separately. Ipsilateral stimulation did not evoke a measurable stapedius reflex in any of the cases, but with contralateral stimulation some babies did show this reflex. The most intense behavioural responses occurred when white noise was used as the stimulus. Of the 25 children studied with impedance audiometry, 10 were evaluated audiologically by brain stem electric potentials. The latency of wave V was within the normal range in all the cases. Electric response audiometry could be a promising method for audiological evaluation of the neonate.

Acoustic Impedance Tests↗

[Disability evaluation in patients with tinnitus].

OBJECTIVES: Tinnitus handicap evaluation through Spanish validation of the Tinnitus Handicap Inventory. STUDY DESIGN: Spanish validation of the Tinnitus Handicap Inventory. PATIENTS: Eighty patients referred to our Tinnitus Unit in University Hospital, between September and December, 1999. OUTCOME MEASURES: The Spanish version of the THI was administered after translation and retrotranslation. Internal consistency and reliability were established. RESULTS: Spanish adaptation of the THI and its subscales (functional, emotional and catastrophic) showed a high reliability and internal consistency (Cronbach's alfa: 0.90). CONCLUSIONS: Spanish adaptation of the THI is valid, reliable and can be used in a clinical setting to quantify the impact of tinnitus on patient's quality of life.

Adult↗

[Auditory neuropathy in childhood].

The combination of transient otoacoustic emissions (TOAE) and auditory brainstem responses (ABR) permits us to identify a group of patients with auditory neuropathy. The clinical and therapeutic aspects of these patients are a challenge for otological practice. The patients underwent ENT, neurological, and otological examination using audiometry, tympanometry, stapedial reflex, OAE, or ABR, depending on the patient. TOAE and tympanograms were normal in all cases. The stapedial reflex and ABR were absent in all cases. Logoaudiometry showed a disproportionate decrease in speech comprehension in relation to each patient's audiogram. These audiograms revealed mild-to-moderate hearing loss. These findings suggest that the lesion is sensorineural with normal function of the external hair cells. However, we could not determine if the lesion lay in the internal hair cells, the eighth cranial nerves, or both sites. The causes of hearing loss were: hyperbilirubinemia, perinatal asphyxia, or idiopathic. All the patients were treated by a speech therapist: The results obtained with hearing aids vary. Successful speech rehabilitation depends on early treatment.

Area Under Curve↗

[Equilibrium disorders in childhood].

Dizziness and imbalance are uncommon in children, but often alarming for their families. A detailed interview and otoneurological examination are important for reaching a specific diagnosis and treatment. The purpose of our study was to obtain our own etiological, clinical and diagnostic statistics, and to review the major related pathologies. We report a series of 76 children with imbalance or dizziness as the presenting symptom. Paroxysmal benign vertigo of childhood was the most common pathology in our study, followed by vestibular neuronitis. Our findings were compared to those of other authors. Early diagnosis is emphasized as the most important factor for achieving an effective vestibular rehabilitation in children.

Adolescent↗