Effect of Tinnitus on Sleep Quality and Insomnia

Introduction  Tinnitus is a conscious perception of a sound resulting from abnormal activity within the nervous system. A relevant percentage of tinnitus patients report symptoms severe enough to significantly affect quality of life, including sleep disorders. Objective  To analyze the sleep quality, insomnia, daytime sleepiness, and risk of obstructive sleep apnea (OSA) in participants with tinnitus. Methods  The sample comprised 18 adults and older adults aged between 18 and 85 years old (mean age = 58.7 ± 17.5 years old), females and males, with complaint of continuous tinnitus for > 1 month. The instruments used were the Tinnitus Handicap Inventory (THI) questionnaire, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the STOP-Bang questionnaire. Results  By means of the THI questionnaire, the tinnitus severity degree reported by most participants was mild (27.8%) and moderate (27.8%), having a positive (r = 0.582) and significant (0.011) correlation to sleep quality, measured by means of the Pittsburgh questionnaire. There was a positive correlation between the Insomnia Severity Index and tinnitus handicap (r = 0.499; p  = 0.035). A total of 72.2% of the participants self-assessed their sleep quality as poor, in addition to moderate insomnia (27.8%), although there is low risk of OSA (66.7%), without complaints of excessive daytime sleepiness (72.2%). Conclusion  Subjects with tinnitus complaint self-rated their sleep quality as poor. Moreover, the higher the reported tinnitus handicap, the greater the symptoms of insomnia. There was no influence of tinnitus in relation to daytime sleepiness and no relationship between the severity of tinnitus and the risk of OSA.

Translation, adaptation, and cross-cultural validation into Brazilian portuguese of the hearing protection assessment questionnaire (HPA)

PURPOSE

The aim of the present study is to translate, adapt, and cross-culturally validate the Brazilian Portuguese version of the questionnaire Hearing Protection Assessment Questionnaire (HPA).

METHODS

The original instrument, developed in English, seeks to assess barriers and supports related to the use of hearing protection devices (HPD), as well as workers' knowledge, habits and attitudes towards occupational noise. The translation, adaptation, and cross-cultural validation of the questionnaire consisted of five steps: Translation of the questionnaire from English to Portuguese; 2) Reverse translation from Portuguese to English; 3) Analysis of the instrument by three experts in the field; 4) Pre-test of the questionnaire with ten workers; 5) Application of the instrument to 509 workers in a meatpacking industry after the pre-employment medical exam.

RESULTS

The results indicate the construction and content validity of the Brazilian Portuguese version for use with a working population and its internal consistency.

CONCLUSION

This study resulted in the translation, cultural adaptation, and validation of the Hearing Protection Assessment Questionnaire (HPA), in order to be used to assess the use of individual hearing protection in the occupational field, called Hearing Protection Assessment Questionnaire (HPA).

Evaluation of the Dangerous Decibels Brazil Program in Workers Exposed to Noise

Introduction

Noise-induced hearing loss can be avoided by taking preventive measures.

Objective

To assess the effectiveness of the Brazilian version of the Dangerous Decibels® program for noise-exposed workers, using the ecological model as an educational intervention plan.

Method

Non-randomized interventional study with a quantitative, experimental trial design, conducted at a meatpacking company. The participants were divided into two groups—the first one (n = 132, divided into 6 subgroups) received the Dangerous Decibels® Brazil educational intervention (DDBEI) adapted to workers while the second group (n = 138, divided into 5 subgroups) received a conventional educational intervention (CEI). The interventions lasted 50 min. The Hearing Protection Assessment Questionnaire (HPA-5) was administered before and after the interventions. The five dimensions (attitude, behavior, knowledge, supports, and barriers) were compared using the Student’s t-test for paired data (<0.05).

Results

After both the DDBEI and CEI training, workers improved significantly in barriers, supports, knowledge, attitudes, and behavior around noise. By chance, the CEI group scored lower in all measures than the DDBEI group before training, and though both groups improved, the difference was maintained after training.

Conclusion

The Brazilian version of the Dangerous Decibels® program for noise-exposed workers was effective, influencing positively the factors at different levels of the ecological model. Though the DDBEI was no more effective than the CEI, the CEI participants began at much lower levels, so the effectiveness of the DDBEI may have been underestimated.

Hearing impairment among workers and satisfaction with the use of hearing aids

BACKGROUND: Hearing problems can have adverse effects on an individual’s job performance, as well as on unemployment or underemployment and increased risk of stress-related sick leave. OBJECTIVE: To investigate hearing impairment among workers and satisfaction with the use of hearing aids. METHODS: Cross-sectional study with workers who are hearing aid users. Subjects underwent pure tone audiometry and answered the Hearing Handicap Inventory for Adults and the Satisfaction with Amplification in Daily Life questionnaires. RESULTS: Participants were 36 workers between 36 and 75 years old, with an average age of 53.47 years, 52.7% male and 47.3% female. There was a mild to moderate hearing handicap perception, with worse results for women in the emotional domain. As hearing loss increased, workers’ frustration increased when talking to coworkers. Everyone was satisfied with the use of their hearing aids. Satisfaction increased with increasing age and decreased with increasing hearing loss. The greater the frustration when talking to co-workers, the lower the overall satisfaction with hearing aid use; the lower the satisfaction with the competence of the professional who assisted in adapting the hearing aid; the lower the satisfaction in environments with background noise and overall worse personal image. The worse the attitudes and emotional responses of workers regarding their hearing impairment, the lower the overall satisfaction with the hearing aid. CONCLUSIONS: Despite the use of hearing aids, workers perceive having a hearing impairment, especially women. As hearing loss and frustration in talking with co-workers increased, satisfaction decreased.

Findings on the Central Auditory Functions of Endemic Disease Control Agents

This study aimed to assess the central auditory functions of endemic disease control agents. This cross-sectional cohort study comprised two groups: the exposed group, with 38 male endemic disease control agents with simultaneous occupational noise and pesticide exposure; and the control group, with 18 age- and sex-matched workers without occupational noise and/or pesticide exposure. All participants underwent pure-tone audiometry, brainstem auditory evoked potentials, dichotic digits test, and transient-evoked otoacoustic emissions suppression effect. There was a significant inter-group difference in waves III and V absolute latencies, and interpeak I-III and I-V latencies bilaterally, with worse results found in the exposed group. Abnormal dichotic digits test results occurred more often in the exposed group, with a significant association between pesticide- and noise-exposure and the abnormal results (p = 0.0099). The transient-evoked otoacoustic emissions with suppression effect did not yield significant inter-group differences. It was concluded that pesticide and noise exposure induce harmful effects on the central auditory functions, particularly on the brainstem and figure-ground speech-sound auditory skills.

The Use of Exergames in the Neurorehabilitation of People with Parkinson Disease: The Impact on Daily Life

Introduction  Parkinson disease (PD) is a progressive degeneration characterized by motor disorders, such as tremor, bradykinesia, stiffness and postural instability. Objective  To evaluate the independence, confidence and balance in the development of daily activities in patients with PD before and after rehabilitation. Methods  A descriptive, retrospective cross-sectional study was carried out with 16 patients (mean 57.6 ± 18.7 years), submitted to anamnesis, otolaryngological evaluation and vestibular assessment. The Vestibular Disorders Activities of Daily Living (VADL) and the Activities-Specific Balance Confidence (ABC) scales were applied before and after rehabilitation with virtual reality. Results  a) The instrumental subscale of the questionnaire showed statistically significant result ( p  = 0.022; 95% CI 1.21; 2.21) between the first and second assessments; b) The correlation between the questionnaires showed statistically significant result in the ambulation subscale ( p  = 0.011; 95% CI -0.85; -0.17) first and ( p  = 0.002, 95% CI -0.88; -0.31) second assessments, and the functional subscale was only verified in the second assessment ( p  = 0.011, 95% CI -0.85; -0.17); and c) The patients presented clinical improvement in the final assessment after rehabilitation with significant result for the tightrope walk ( p  = 0.034, 95% CI -12.5; -0.3) and ski slalom games ( p  = 0.005, 95% CI -34.8; -6.6). Conclusions  Our results showed that the VADL and ABC questionnaires, applied before and after rehabilitation, were important tools to measure the independence, confidence and balance while developing daily activities. The VADL and ABC questionnaires may effectively contribute to quantify the effect of the applied therapeutics and, consequently, its impact on the quality of life of patients with PD.

Noise exposure and effects on hearing in Brazilian fishermen

BACKGROUND

Several health conditions among professional fishermen have been reported. Among the risks to the health of fishermen, it should be noted that high noise levels cause hearing loss and general health problems.

OBJECTIVE

to investigate the effects of exposure to occupational noise on hearing in professional fishermen at the main large-scale commercial fishing center in Brazil.

METHODS

A cross-sectional study, 466 Brazilian commercial fishermen participated in the study, all males, ages range 18-67 years. A total of 15 vessels were included in the study. The first phase involved assessment of the sound pressure levels (SPLs) in the vessels, the second phase involved the use of a questionnaire and audiological assessment.

RESULTS

Most compartments registered SPLs greater than 80 dBA and the noisiest compartment was the engine-room, where the vessel pilot works. Among the fishermen, tinnitus was the most commonly reported symptom (48.63%). A higher prevalence of hearing loss was observed in engine-room keepers. Longer the length of time in service, and consequently, exposure to noise (in years), were associated with higher auditory thresholds.

CONCLUSION

the tolerance limits to noise exposure were exceeded according to legislation. Fishing activities are associated with noise-induced hearing loss, with the risk increasing with the length of service.

Brainstem Auditory Evoked Potentials in infants aged 1 to 24 months during a hearing health care service

OBJECTIVES

Assessing infants' hearing is of utmost importance, as hearing at this phase is required for the development of oral language. Through hearing, human beings are capable of developing communication. The Brainstem Auditory Evoked Potentials are an indispensable test to diagnose deafness in infants. This study aimed to analyze the results of the Brainstem Auditory Evoked Potentials in children with risk factors for hearing loss.

METHODS

This cross-sectional study analyzed the Brainstem Auditory Evoked Potentials in 123 infants aged 1 to 24 months at a hearing health care service. The Vivosonic Integrity V500 equipment, which enabled the child to be awake while the testing was carried out, was used in this study. The data were compared by gestational age and sex, according to the standards suggested in the equipment handbook.

RESULTS

A significant difference was verified for age ranges 4 to 6 months, 13 to 15 months (waves I and V), and 7 to 9 months (wave V). The lower values in absolute wave latencies were comparable to data from the equipment handbook, justifying the need for standardization of the screening process.

CONCLUSION

There are some differences between the standards in the equipment handbook and those observed in our study. These results will serve as a reference for the standardization of the equipment used in the hearing health care service.

Qualidade de vida de surdos usuários de Libras no Sul do Brasil

O objetivo deste estudo foi investigar a qualidade de vida (QV) de surdos usuários da Língua Brasileira de Sinais que vivem no sul do Brasil, por meio do WHOQOL-Bref, e analisar os fatores que influenciam uma qualidade de vida mais favorável a esta parcela da população. Trata-se de um estudo transversal de natureza quantitativa, cuja coleta de dados se deu por meio da aplicação do questionário WHOQOL-Bref e de um questionário de caracterização da amostra. Participaram 60 surdos usuários de Libras moradores da região Sul do Brasil. Utilizou-se análise estatística por meio de métodos de estatística descritiva e métodos inferenciais considerando-se o nível de significância de 0,05 (5%). Os resultados apontaram que a média do escore total do WHOOQL-Bref foi de 43,3%. O domínio com maior escore foi o de relações sociais (64,31%) e o de menor escore o meio ambiente (54,77%). Os participantes surdos com nível maior de escolaridade e que se percebem proficientes no uso da língua portuguesa tiveram melhores escores de qualidade de vida. O compromisso com a QV da população brasileira, incluindo, a parcela surda, foco deste trabalho, pressupõe a formulação e o cumprimento de políticas públicas que visem o desenvolvimento de ações afirmativas direcionadas a superar condições de desigualdade e exclusão dessas pessoas, a fim de auxiliá-las a eliminar as barreiras que impedem ou dificultam sua participação na sociedade.

Hearing prevention program: how speech-language pathologists and audiologists work in the occupational health area

ABSTRACT Objective: to characterize speech-language pathologists/audiologists and their interventions in the occupational health area, regarding the Hearing Prevention Program (HPP). Methods: a cross-sectional, quantitative study with 74 speech-language pathologists/audiologists from several regions of Brazil, working in the areas of Occupational Health and Audiology. The participants answered a questionnaire on their professional and educational profile, as well as on their work related to the HCP components. For data analysis, statistical procedures were used (Chi-Square Test and the test of difference in proportions, at the significance level of 0.05 - 5%), in relation to the variables of gender, age, job position, time since their graduation and academic training in occupational safety and health. Results: the speech-language pathologists/audiologists, mostly women, who reported performing the HPP, were older than 30 years, had specific postgraduate courses, but still had doubts about the Program implementation, they worked for companies with over 1,000 employees, disregarding their employment status, performing interventions, such as: hearing management and guidance on the correct use of ear protectors. Conclusion: a high number of speech-language pathologists in the Occupational Health area have not developed a complete hearing conservation program to this date.

Benign rolandic epilepsy of childhood and central auditory processing disorder: A noncasual neurophysiological association

PURPOSE

The purpose of this study was to demonstrate the association between benign rolandic epilepsy of childhood (BREC) and central auditory processing disorders (CAPDs) and to test the hypothesis that an early onset of BREC could be associated with more cases of CAPD.

METHOD

This study has a retrospective cross-sectional design conducted from January 2006 to January 2016 including 93 patients with BREC and without intellectual disability, dyslexia, and attention-deficit hyperactivity disorders. All patients were evaluated for central auditory processing (CAP), and its presence or absence was compared with age of seizure onset.

RESULTS

In all patients, audiometric test results were normal, and in 43 cases (46.2%), CAPD was detected. There was no significant statistical difference in the mean age of seizure onset.

CONCLUSION

A significant proportion of children with BREC will have a diagnosis of CAPD at school age.

The importance of central auditory evaluation in Friedreich's ataxia

Objective To assess central auditory function in Friedreich's ataxia. Methods A cross-sectional, retrospective study was carried out. Thirty patients underwent the anamnesis, otorhinolaryngology examination, pure tone audiometry, acoustic immittance measures and brainstem auditory evoked potential (BAEP) assessments. Results The observed alterations were: 43.3% in the pure tone audiometry, bilateral in 36.7%; 56.6% in the BAEP test, bilateral in 50%; and 46.6% in the acoustic immittance test. There was a significant difference (p < 0.05) in the comparison between the tests performed. Conclusion In the audiological screening, there was a prevalence of the descending audiometric configuration at the frequency of 4kHz, and absence of the acoustic reflex at the same frequency. In the BAEP test, there was a prevalence of an increase of the latencies in waves I, III and V, and in the intervals of interpeaks I-III, I-V and III-V. In 13.3% of the patients, wave V was absent, and all waves were absent in 3.3% of patients.

Otoneurological findings prevalent in hereditary ataxias

Objective To describe and compare the vestibular findings most evident among the hereditary ataxias, as well as correlate their clinical features with the nervous structures affected in this disease. Methods Seventy-five patients were evaluated and underwent a case history, otorhinolaryngological and vestibular assessments. Results Clinically, the patients commonly had symptoms of gait disturbances (67.1%), dizziness (47.3%), dysarthria (46%) and dysphagia (36.8%). In vestibular testing, alterations were predominantly evident in caloric testing (79%), testing for saccadic dysmetria (51%) and rotational chair testing (47%). The presence of alterations occurred in 87% of these patients. A majority of the alterations were from central vestibular dysfunction (69.3%). Conclusion This underscores the importance of the contribution of topodiagnostic labyrinthine evaluations for neurodegenerative diseases as, in most cases, the initial symptoms are otoneurological; and these evaluations should also be included in the selection of procedures to be performed in clinical and therapeutic monitoring.

Speech-language pathology assessment for tracheal decannulation in patients suffering from traumatic brain injury

Purpose

To describe the effect of Speech-Language Pathology (SLP) management on the tracheal decannulation process in patients with traumatic brain injury (TBI).

Methods

Prospective controlled clinical study. Two groups of patients with TBI confirmed by computed axial tomography were included in the study group (G1) and control group (G2) composed of 30 individuals each, with 25 (83.3%) male and 5 (16.7%) female individuals in both groups. Patients' age ranged from 18 to 53 years old - mean age was 32 years. A SPL assessment tool was developed for tracheostomized patients with TBI, composed of investigation of awareness level, cognition and swallowing (annex 1) and conduct. G1 underwent the assessment proposed by the study, and G2 was assessed by retrospective analysis of medical records without SLP evaluation. In this population, the variables time with tracheostomy and total days of hospitalization were the measurement markers for the effect of SLP conduct with this instrument.

Results

It was verified that G1 presented mean reduction of 4.2 days with tracheostomy and of 4.4 days in length of hospital stay when compared to G2. However, these figures are not statistically significant (p = 0.2031).

Conclusion

The group that was evaluated and received the SLP conduct proposed in the instrument presented a reduction in the time of permanence with tracheostomy, as well as in hospital stay.

CARACTERÍSTICAS PERINATAIS DE CRIANÇAS COM TRANSTORNO DO ESPECTRO AUTISTA

Objective:

To analyze perinatal features of children with autism spectrum disorder (ASD).

Methods:

Retrospective review of the medical records of 75 children with ASD, between January 2008 and January 2015. Inclusion criteria were diagnosis of ASD based on DSM-5 criteria, and the informed consent form signed by the person who is legally responsible. The exclusion criterion was missing on the medical record. The variables analyzed were maternal age, prematurity (gestational age under 37 weeks), low birth weight (<2,500 g), and perinatal asphyxia (5^th minute Apgar score <7). Data were analyzed using the difference between proportions test, being significant p<0.05.

Results:

Seventy-five patients were included. Maternal age ranged from 21.4 to 38.6 years (29.8±4.1 years). Premature birth occurred in 14 (18.7%) patients, perinatal asphyxia in 6 (8.0%), and low birth weight in 32 (42.6%) patients. The prevalence of prematurity, low birth weight, and perinatal asphyxia among the children in our study was higher than the general prevalence of these conditions among all live births in our country, region, and state, which are, respectively, 11.5, 2.3, and 8.5% in Brazil; 11.0, 2.2, and 8.5% in Southern Brazil; and 10.5, 2.0, and 8.4% in the state of Paraná.

Conclusions:

Our findings show a higher prevalence of prematurity, low birth weight, and perinatal asphyxia among children with ASD. Some limitations are the retrospective study design, and the small sample size. Large prospective studies are needed to clarify the possible association between perinatal complications and ASD.

The Importance of Labyrinthine Examination in the Prognosis and Therapy for Balance in Spinocerebellar Ataxia

INTRODUCTION

Spinocerebellar ataxias (SCAs) are a heterogeneous group of neurodegenerative diseases that are characterized by the presence of progressive cerebellar ataxia.

OBJECTIVE

Identify vestibular disorders and demonstrate the importance of labyrinthine examination in the prognosis and therapy for balance in patients with SCAs.

MATERIALS AND METHODS

The study had a retrospective cross-sectional design and evaluated 57 patients, mean age of 41.6 years and standard deviation of 13 years. Patients underwent the following procedures: anamnesis, ENT examination and vestibular exam using electronystagmography (ENG).

RESULTS

The most frequent complaints were gait imbalance (71.9%), dysarthria (49.1%), dizziness (43.8%) and dysphagia (36.8%). 84.2% of the tests showed alterations. The most common tests with alterations were the caloric test (78.9%), slow saccades (61.4%) and the rotating chair test (49.1%).

CONCLUSION

The clinical history of the patient and oculomotor alterations in the labyrinthine examination provide sufficient information for the proper use of virtual rehabilitation protocols in the treatment of imbalance, making it the most effective therapy method. It was evident that changes in ENG are related to the severity of the SCA or the clinical stage of the disease. The labyrinthine examination proved to be an important concomitant tool to clinical and genetic study.

Atores profissionais e estudantes de teatro: aspectos vocais relacionados à prática

RESUMO Objetivo: identificar e comparar, em atores profissionais e estudantes de teatro, os aspectos relacionados à prática profissional, ao uso profissional da voz, hábitos e cuidados vocais, hábitos de saúde e condições ambientais no trabalho. Métodos: participaram 60 sujeitos de ambos os sexos, subdivididos em 2 grupos: Grupo Profissional - atores profissionais de teatro e Grupo Alunos - alunos de teatro sem experiência profissional teatral. Ambos os grupos responderam a um questionário que abordou aspectos relacionados à prática profissional, à voz, hábitos vocais, de saúde, condições ambientais e cuidados vocais. Resultados: os indivíduos do Grupo Profissional apresentaram maior ocorrência de rouquidão; maior ocorrência dos hábitos de usar a voz profissional quando está gripado, em posturas corporais e com respiração inadequadas, gritar, e permanecer em local com mofo ou pouca ventilação, fechado e empoeirado, e realizar ensaio em local diferente do local do espetáculo. O hábito de saúde de ingerir bebidas geladas foi maior no Grupo Alunos. O número de sujeitos que não possuem dificuldade em cena e que realizam aquecimento vocal é significantemente maior no Grupo Profissional. O tipo de aquecimento realizado significantemente mais pelo Grupo Profissional foi som de "s", respiração costo-diafragmática, som basal e vogais. Conclusão: constatou-se que ambos os grupos realizam hábitos prejudiciais e estão expostos a ambiente de trabalho inadequado para saúde vocal. Estes dados apontam a necessidade de ações de saúde vocal, a fim de minimizar o risco de alterações vocais nos profissionais e preparar os estudantes para o aumento da demanda vocal.

Occurrence of tinnitus and other auditory symptoms among musicians playing different instruments

INTRODUCTION

Tinnitus is one of the most reported auditory symptoms among musicians and can negatively influence their ability to work, sometimes even more severely than hearing loss.

OBJECTIVES

To analyze the occurrence of tinnitus and other auditory symptoms in musicians who play different instruments.

METHODS

One hundred musicians participated by answering a questionnaire on instrument played, practice time with the instrument, occurrence of tinnitus, hearing difficulties, and intolerance to loud sounds. The symptoms were analyzed in relation to gender, musical instrument, and time of experience using statistical tests such as the Chi-squared test and Difference in Proportions test at a significance level of 0.05 as well as finding the Prevalence Ratio.

RESULTS

Tinnitus was the most frequent symptom among musicians, especially among those who play amplified instruments. There was an association between tinnitus and hearing difficulty, and between instrument experience time and intolerance to loud sounds. The proportion of musicians with occasional tinnitus was high among those with less than 15 years of musical practice, and 4.53 times more prevalent in those with more than 15 years of experience.

CONCLUSION

The presence of auditory symptoms, especially tinnitus, among musicians reinforces the need for implementation of hearing conservation programs for this profession.

Tinnitus and temporomandibular disorders: the knowledge of professionals for primary health care in the city of Curitiba

INTRODUCTION

The high prevalence of temporomandibular disorders and tinnitus along with the negative effects on the quality of life of affected individuals makes this association a matter of public health.

OBJECTIVE

To assess the knowledge of primary health care professionals about the interrelationship between temporomandibular disorders and tinnitus.

MATERIALS AND METHODS

This was a quantitative cross-sectional study, using a structured, self-administered questionnaire for a group of 54 dental surgeons. The statistical analysis used involved descriptive analyses through absolute and relative frequency distributions.

RESULTS

The results showed that the professionals do not, as a routine, examine the temporomandibular joints and masticatory muscles during physical examination. In addition, there was a low percentage of correct answers on questions that assess knowledge.

CONCLUSIONS

There is a need to inform dentists about the interrelationship between temporomandibular disorders and tinnitus. Furthermore, there is a need to encourage managers to establish teaching and learning tools that support and strengthen the role of dentists in primary health care. In this way, routine visits might minimize these disorders, and thus contribute to the quality of life of the population.

The effect of preweaning and postweaning housing on the behaviour of the laboratory mouse (Mus musculus)

Standard housing for laboratory mice severely restricts natural behaviour and the control that the animal has over its environment. Providing the cage with objects is a method that has been used to both increase environmental complexity, promote the performance of natural behaviour and provide greater controllability for the animal. This method of furnishing cages has mostly been studied in adult animals, and little is known about the influence that the preweaning environment has on the behaviour of mice as adults. This study aimed to investigate the effects on mice behaviour of preweaning and postweaning housing environment.

In this experiment, 64 pairs of animals of the strain C57BL/6J were used. Half of the animals were born and reared until weaning in standard cages and the other half in cages twice the size of the standard and furnished with nesting material, a cardboard tube, a PVC nest box and a wooden chewblock. After weaning, half the animals in each group were changed to the other type of cage, whereas the other half remained in the same environment; in both cases they were kept in single-sex pairs of littermates. Behaviour during the dark, active period was studied through video recordings.

We found no main effects of preweaning environment on behaviour; however, mice moved from furnished to standard cages at weaning showed a decrease in inactive behaviour at four weeks of age. Mice housed after weaning in standard cages spent less time inactive, and more time engaging in activities like feeding and drinking, self-grooming and allogrooming. A sex difference was also found, in that females showed a greater performance of exploratory behaviour as well as a greater prevalence of stereotypies. The use of different objects and locations within the furnished cage was also analysed at both ages. Results show that at eight weeks of age mice spent more time at the top of the cage, and that the use of the nest box (although not for resting) increased between four and eight weeks. Mice were found to use the nest box as a nesting site/sleeping place only at age four weeks, whereas they always used the nesting material for sleeping.

Neurotological Findings at a Health Unit for Adults with Cervicalgia

Introduction The cervical spine is a flexible link between the sensory platform of the skull and torso. The fundamental principle of its operation is due to the balance between muscle strength and flexibility, and any dysfunction of this balance causes neck pain, known as cervicalgia.

Objective The objective of this study is to analyze the most prevalent neurotological findings in adults with neck pain.

Method A cross-sectional study in which 33 adults from 50 to 83 years of age with neck pain were evaluated and underwent the following procedures: anamnesis, as well as ENT, audiological, and vestibular exams.

Results The most evident neurotological symptoms were dizziness (75.7%), tinnitus, neck cracking, tingling in the extremities, and auditory problems (36.3% for each). The most frequently reported clinical symptoms were related to cardiovascular (69.7%), endocrine-metabolic (48.5%), and rheumatic (30.3%) systems. In the audiological assessment, 30 subjects (91.0%) presented hearing impairment in at least one ear, with sensorineural impairment being the most prevalent (88.0%). In the vestibular assessment, there were alterations in 13 subjects (39.0%) found in the caloric test. There was a prevalence of alterations in the peripheral vestibular system with a predominance of irritative peripheral vestibular dysfunction.

Conclusion Neurotological complaints were frequent in this population, verifying the importance of these tests in the dysfunctions of the cervical region or the craniocervical junction.

Otoneurological Abnormalities in Patients with Friedreich's Ataxia

Introduction Friedreich's ataxia is a neurodegenerative disease and progressive by nature. It has autosomal recessive inheritance and early onset in most cases. Nystagmus and hearing loss (in some cases) make up some of the common symptoms seen in this disorder.

Objective The objective of this study is to examine vestibular disorders in patients with Friedreich ataxia.

Methods We conducted a retrospective cross-sectional study. We evaluated 30 patients with ages ranging from six to 72 years (mean age of 38.6 ( ±  14.7). The patients underwent the following procedures: anamnesis, ENT, and vestibular evaluations.

Results Clinically, the patients commonly had symptoms of incoordination of movement (66.7%), gait disturbances (56.7%), and dizziness (50%). In vestibular testing, alterations were predominantly evident under caloric testing (73.4%), gaze nystagmus testing (50.1%), rotational chair testing (36.7%), and optokinetic nystagmus testing (33.4%). The presence of alterations occurred under examination in 90% of subjects, with the majority occurring in those with central vestibular dysfunction (70% of the examinations).

Conclusion The most evident neurotological symptoms were incoordination of movement, gait disturbances, and dizziness. Alterations in vestibular examinations occurred in 90% of patients, mostly in the caloric test, with a predominance of deficient central vestibular system dysfunction.

Otoneurological symptoms in Brazilian fishermen exposed over a long period to carbon monoxide and noise

Fishing, one of the oldest productive activities, is an important sector of the Brazilian economy as well as the world economy. To evaluate the vestibular behavior in population of fishermen. It was realized as a retrospective and cross-sectional study. Thirty fishermen [mean age 49.5 (± 8.5) years] whose age ranged from 33 years to 67 years were submitted to anamnesis, otorhinolaryngological evaluation, and vestibular examination through the electronystagmography (ENG). The most evident otoneurological symptoms were: Tinnitus (66.7%), dizziness (63.3%), and hearing loss (53.3%). The most evident clinical symptoms were: Fatigue (36.7%), anxiety (23.3%), and depression (16.7%). There were alterations in the vestibular examination of 13 (43.3%) fishermen in the caloric test. There was a prevalence of alteration in the peripheral vestibular system and there was a major frequency of the peripheral vestibular irritative syndrome (30.0%).

CONCLUSION

The otoneurological complaints were frequent in the population studied that verifies the importance of allowing labyrinth examinations and the need for adopting preventive measures related to noise exposure to carbon monoxide (CO), since they can cause and/enhance various manifestations of labyrinthine vestibular impairment that can affect the quality of life of these workers.

TESTES ESTATÍSTICOS E ANÁLISE MULTIVARIADA NA DETERMINAÇÃO DOS MODOS DE FALHA MONITORADOS PELOS INSTRUMENTOS EM BLOCOS DE CONCRETO DA BARRAGEM DE ITAIPU

Monitorar uma barragem requer, além de inspeções visuais, métodos tecnológicos que permitem uma avaliação mais precisa do comportamento de uma estrutura. Em uma estrutura de concreto que compõe uma barragem Vários instrumentos devem ser instalados de tal maneira que permitam leituras que avalie se a estrutura está em boas condições ou não, normalmente cada instrumento está destinado a coletar dados sobre características individuais da estrutura, possibilitando o diagnóstico de anomalias. O objetivo desse artigo é utilizar a instrumentação instalada em um bloco da barragem de Itaipu, para determinar modos de falhas possíveis de serem monitorados sem uma avaliação individual de cada instrumento. O método baseia-se no trabalho apresentado em XXX SNGB – Seminário Nacional de Grandes Barragens realizado em Foz do Iguaçu, que com o auxilio da análise fatorial, foi desenvolvido um método para determinação dos modos da falha possíveis de serem monitorados e de suas regiões críticas. Esse método será agora aplicado em um bloco chave de Itaipu, que é altamente instrumentado. Pretende-se, com essa aplicação obter resultados que comprove a eficiência desse método.

Newborn physiological responses to noise in the neonatal unit

INTRODUCTION

The incorporation of technologies in the care of infants has contributed to increased survival; however, this has turned neonatal unit into a noisy environment.

OBJECTIVE

To evaluate the physiological and functional effects resulting from the exposure to noise on low-weight newborns in incubators in a neonatal unit.

METHODS

Prospective, observational, quantitative, exploratory, descriptive study. The adopted statistical method included tables of frequency, descriptive statistics, and Student's t-test, with a 0.05 level of significance. As data collection tools, the environmental noise and the noise inside of the incubator were evaluated, and the Assessment of Preterm Infant Behavior scale was used to assess premature newborn behavior and projected specifically to document the neurobehavioral functioning of preterm infants. The data collection occurred from September of 2012 to April of 2013; 61 low-weight newborns admitted in the neonatal unit and in incubators were observed.

RESULTS

Significant differences in the variables heart rate and oxygen saturation were noted when newborns were exposed to noise.

CONCLUSION

Low-weight neonates in incubators present physiological alterations when facing discomfort caused by environmental noise in neonatal units.

Perception of hearing protectors by workers that participate in hearing preservation programs: a preliminary study

PURPOSE: To evaluate and compare the workers' perception of comfort and use aspects regarding two types of hearing protectors (shell and earplug), in three units from a lumbering company, with different implantation times for Hearing Preservation Programs.METHODS: This is a cross-sectional study comparing 440 workers' perception of hearing protectors, from three companies in Paraná State (Brazil), with different times for Hearing Preservation Programs. Two closed questionnaires were applied (9 and 10 questions, respectively), with a scale of answers varying from 1 to 5 (Likert's scale) regarding the perception of the comfort of hearing protectors. Then, audiometry results were analyzed.RESULTS: About 17.5% presented audiogram examinations with alterations. With regard to the questionnaire about the comfort perception, the importance of noise attenuation (mean of 4.25) was the most relevant aspect, followed by communication possibility (mean of 4.15). In the protector assessment, Unit A with more Hearing Preservation Program time presented better scores for both the worker's perception of important aspects regarding hearing protector and for the assessment of the used hearing protector. There was a significant difference on communication difficulty with the use of a hearing protector among workers with normal and altered audiograms (p=0.0371). With regard to the global comfort in the comparison of workers using the shell-type hearing protector with those using insert-type hearing protectors, there was no difference (p=0.2264), irrespective of the type of the unit.CONCLUSION: In general, the unit workers presented a good perception of the important aspects about the hearing protection use of both types of hearing protectors.

Relationship between Otolaryngologic Complaints and Systemic Comorbidities Observed in a Group of Hearing Aid Users

Introduction Optimization of the selection, adaptation, and benefit of hearing aids is necessary to characterize and manage hearing loss, user expectations, otolaryngologic symptoms, and systemic comorbidities. Objective To compare the occurrence of otologic complaints, systemic diseases, and effective use of hearing aids in men and women with deafness. Methods Patients from a Unified Health System-accredited hearing health service, who reported problems in adapting to their hearing aids, were evaluated by a physician and audiologist. An anamnesis, ENT evaluation, and audiological evaluation were performed. Results During the data collection period, 278 subjects came in for follow-up visits; of these, 61 (21%) reported otologic or operational problems with their equipment. The most prevalent type of hearing loss was basocochlear, a characteristic of presbycusis, in both men and women; the most frequently reported comorbidities were hypercholesterolemia (more significant in women) and hypertension (more significant in men). Fourteen subjects reported using their device discontinuously, with no significant difference between genders; the reasons for discontinuation of use were itching and ringing, with more complaints from women. Conclusion The incidence of systemic and audiological complaints is high in this population. These patients should be evaluated thoroughly, as resolutions of these complaints can contribute to improving the quality of life and assist in the process of hearing aid fitting.

Central auditory processing in patients with spinocerebellar ataxia

BACKGROUND

Autosomal dominant spinocerebellar ataxias (SCAs) are a group of rare and heterogeneous neurodegenerative diseases characterized by the presence of progressive cerebellar ataxia. Although the symptomatology of SCAs is well known, information regarding central auditory functioning in these patients is lacking. Therefore, we assessed the central auditory processing disorders (CAPD) in patients with different subtypes of SCA.

METHODS

In a retrospective cross-sectional study, we subjected 43 patients with SCAs to otorhinolaryngological, audiological, Brainstem Auditory Evoked Potential (BAEP) and acoustic immittance evaluations as well as CAPD tests, namely the Standard Spondaic Word (SSW) and the Random Gap Detection Test (RGDT).

RESULTS

Most patients (83.7%) reported an imbalance when walking; many reported difficulty speaking (48.8%), dizziness (41.8%), and dysphagia (39.5%). In the audiometric test, 14/43 patients (32.5%) presented alterations, including 4/12 patients with SCA3 (33.3%), 1/8 patients with SCA2 (12.5%), 1/1 patient with SCA4 (100%), 1/1 patient with SCA6 (100%), 1/1 patient with SCA7 (100%), 3/6 patients with SCA10 (50%), and 3/14 patients with an undetermined type of SCA (21.4%). In the BAEP test, 20/43 patients (46.5%) presented alterations (11.6% na orelha esquerda e 34.9% bilateralmente), including 7/12 patients with SCA3 (58.3%), 5/8 patients with SCA2 (62.5%), 1/1 patient with SCA4 (100%), 1/1 patient with SCA6 (100%), 1/1 patient with SCA7 (100%), 4/6 patients with SCA10 (66.7%), and 2/14 patients with an undetermined type of SCA (14.2%). In the SSW, 22/40 patients (55%) presented alterations (2.5% in the right ear, 15% in the left ear, and 37.5% bilaterally), including 6/10 patients (60%) with SCA3, 3/8 (37.5%) with SCA2, 1/1 (100%) with SCA4, 1/1 (100%) with SCA6, 1/1 (100%) with SCA7, 4/5 (80%) with SCA10, and 8/14 (57.1%) with an undetermined type SCA. For the RGDT, 30/40 patients (75%) presented alterations, including 8/10 (80%) with SCA3, 6/8 (75%) with SCA2, 1/1 (100%) with SCA4, 1/1 (100%) with SCA6, 1/1 (100%) with SCA7, 4/5 (80%) with SCA10, and 9/14 (64.3%) with an undetermined type of SCA. In immittance testing, 19/43 patients (44.1%) presented alterations, including 6/12 (50%) with SCA3, 4/8 (50%) with SCA2, 1/1 (100%) with SCA4, 1/1 (100%) with SCA6, 1/1 (100%) with SCA7, 2/6 (33.3%) with SCA10, and 4/14 (28.6%) with an undetermined type of SCA.

CONCLUSIONS

A majority of patients exhibited SSW test deficits, with a predominance of bilateralism, and three-fourths had impaired RGDT performance, pointing to difficulties with binaural integration and temporal resolution. Assessment of CAPD is important for therapeutic follow ups in patients with SCA.

Clinical and fiberoptic endoscopic assessment of swallowing in patients with chronic obstructive pulmonary disease

Introduction: Chronic obstructive pulmonary disease is characterized by progressive and partially reversible obstruction of pulmonary airflow.

Aim: To characterize swallowing in patients with chronic obstructive pulmonary disease and correlate the findings with the degree chronic obstructive pulmonary disease, heart and respiratory rate, oxygen saturation, and smoking.

Method: We conducted a prospective cohort study of 19 patients (12 men and 7 women; age range, 50–85 years) with confirmed medical diagnosis of chronic obstructive pulmonary disease. This study was performed in 2 stages (clinical evaluation and functional assessment using nasolaryngofibroscopy) on the same day. During both stages, vital signs were checked by medical personnel.

Results: Clinical evaluation of swallowing in all patients showed the clinical signs of cough. The findings of nasolaryngofibroscopy highlighted subsequent intraoral escape in 5 patients (26.5%). No patient had tracheal aspiration. There was no association of subsequent intraoral escape with degree of chronic obstructive pulmonary disease, heart and respiratory rate, oxygen saturation, or smoking.

Conclusion: In patients with chronic obstructive pulmonary disease, there was a prevalence of oral dysphagia upon swallowing and nasolaryngofibroscopy highlighted the finding of subsequent intraoral escape. There was no correlation between intraoral escape and the degree of chronic obstructive pulmonary disease, heart and respiratory rate, oxygen saturation, or smoking.

Vestibular findings in military band musicians

Introduction Exposure to music is the subject of many studies because it is related to an individual's professional and social activities. Objectives Evaluate the vestibular behavior in military band musicians. Methods A retrospective cross-sectional study was performed. Nineteen musicians with ages ranging from 21 to 46 years were evaluated (average = 33.7 years and standard deviation = 7.2 years). They underwent anamnesis and vestibular and otolaryngologic evaluation through vectoelectronystagmography. Results The most evident otoneurologic symptoms in the anamnesis were tinnitus (84.2%), hearing difficulties (47.3%), dizziness (36.8%), headache (26.3%), intolerance to intense sounds (21.0%), and earache (15.7%). Seven musicians (37.0%) showed vestibular abnormality, which occurred in the caloric test. The abnormality was more prevalent in the peripheral vestibular system, and there was a predominance of irritative peripheral vestibular disorders. Conclusion The alteration in vestibular exam occurred in the caloric test (37.0%). There were changes in the prevalence of peripheral vestibular system with a predominance of irritative vestibular dysfunction. Dizziness was the most significant symptom for the vestibular test in correlation with neurotologic symptoms. The present study made it possible to verify the importance of the labyrinthine test, which demonstrates that this population should be better studied because the systematic exposure to high sound pressure levels may cause major vestibular alterations.

Acoustic characteristics of the metallic voice quality

PURPOSE

To characterize the fundamental frequency and the frequency of the formants F1, F2, F3, and F4 from vocal emissions of amateur singers with metallic voice quality.

METHODS

There were 60 amateur female singers aged between 18 and 60 years old; 30 women with metallic voice quality forming the study group (SG) and 30 women without such a vocal quality forming control group (CG). The sample was selected through voice screening confirmed by reviewers after reaching a consensus. Regarding data collection, sustained vowel emissions in usual tone and at two predetermined frequencies, by which the values of F0 and frequency of the formants F1, F2, F3, and F4 were obtained, were recorded and analyzed.

RESULTS

Comparing the emissions in usual tone, no difference for F0 was found, but the values of the formants F2, F3, and F4 were higher in the SG. In the preestablished tones, there was a difference between the two groups in the formants F3 and F4 for both tones.

CONCLUSION

It is possible to characterize metallic voice quality as a normal fundamental frequency, with increasing frequency of the F2 formant, and values of frequencies of formants F2, F3, and F4 higher when compared to the CG.

Alterações da linguagem escrita de escolares em fase de alfabetização na visão de professores

OBJETIVOS:o objetivo geral deste estudo é caracterizar, a partir das respostas oferecidas pelos professores, as alterações de aprendizagem que julgam estar presentes nos alunos e identificar as queixas referentes à escrita frequentemente detectadas pelos professores.MÉTODOS:trata-se de um estudo individuado transversal seccional quantitativo. Participaram da pesquisa 21 professores que lecionam no ciclo de alfabetização (1º ao 3º ano) nas escolas de Cajati/SP, sendo sete do primeiro ano, seis do segundo ano e oito do terceiro ano. Estes participantes foram subdivididos em dois grupos: G1 - início do ciclo de alfabetização (1º e 2º ano) e G2 - final do processo de alfabetização (3º ano). Foi aplicado um questionário formulado pela autora e respondidos pelos professores. Utilizou-se o teste de Fisher como instrumento estatístico.RESULTADOS:mediante os achados, verificou-se diferença na proporção do histórico de alterações de linguagem anterior à escolarização, sendo maior no ano escolar final. Da compreensão do contexto dos textos com facilidade, relacionada ao ano frequentado pelos alunos é maior entre os escolares dos anos iniciais e a proporção dos escolares que expressam as ideias por meio da escrita é significantemente maior (0,0389) entre os alunos do período da tarde.CONCLUSÃO:o atraso na aquisição da linguagem pode prejudicar o processo de alfabetização que inclui a habilidade pragmática e a função expressiva.

Presynaptic adenosine A2A receptors dampen cannabinoid CB1 receptor-mediated inhibition of corticostriatal glutamatergic transmission

BACKGROUND AND PURPOSE

Both cannabinoid CB1 and adenosine A2A receptors (CB1 receptors and A2A receptors) control synaptic transmission at corticostriatal synapses, with great therapeutic importance for neurological and psychiatric disorders. A postsynaptic CB1 -A2A receptor interaction has already been elucidated, but the presynaptic A2A receptor-mediated control of presynaptic neuromodulation by CB1 receptors remains to be defined. Because the corticostriatal terminals provide the major input to the basal ganglia, understanding the interactive nature of converging neuromodulation on them will provide us with novel powerful tools to understand the physiology of corticostriatal synaptic transmission and interpret changes associated with pathological conditions.

EXPERIMENTAL APPROACH

Pharmacological manipulation of CB1 and A2A receptors was carried out in brain nerve terminals isolated from rats and mice, using flow synaptometry, immunoprecipitation, radioligand binding, ATP and glutamate release measurement. Whole-cell patch-clamp recordings were made in horizontal corticostriatal slices.

KEY RESULTS

Flow synaptometry showed that A2A receptors were extensively co-localized with CB1 receptor-immunopositive corticostriatal terminals and A2A receptors co-immunoprecipitated CB1 receptors in these purified terminals. A2A receptor activation decreased CB1 receptor radioligand binding and decreased the CB1 receptor-mediated inhibition of high-K(+) -evoked glutamate release in corticostriatal terminals. Accordingly, A2A receptor activation prevented CB1 receptor-mediated paired-pulse facilitation and attenuated the CB1 receptor-mediated inhibition of synaptic transmission in glutamatergic synapses of corticostriatal slices.

CONCLUSIONS AND IMPLICATIONS

Activation of presynaptic A2A receptors dampened CB1 receptor-mediated inhibition of corticostriatal terminals. This constitutes a thus far unrecognized mechanism to modulate the potent CB1 receptor-mediated presynaptic inhibition, allowing frequency-dependent enhancement of synaptic efficacy at corticostriatal synapses.

Study of evoked otoacoustic emissions and suppression effect on workers exposed to pesticides and noise

PURPOSE

To analyze the findings for Evoked Otoacoustic Emissions (EOEA) and suppression effect in workers with normal hearing exposed to pesticides and noise .

METHODS

The sample consisted of 55 participants with normal hearing, with ages ranging from 18 to 35 years, divided into two groups: one group exposed to noise and pesticides (GRA) and a control group (CG). The GRA was composed of 25 participants exposed to a representative average level of daily occupational noise exposure of 86 dBA and organophosphate-type pesticides, whereas the GC was composed of 30 participants who were not exposed to noise or pesticides. All participants underwent Transient Evoked Otoacoustic Emissions (TEOAE) and Distortion Product Otoacoustic Emissions (DPOAE) examinations and research of the suppression effect.

RESULTS

The findings revealed differences between the results of TEOAE and DPOAE exams between GRA and GC groups. GRA participants showed worse results in EOAE findings. Regarding the suppression effect, lesser effects were observed in the GRA.

CONCLUSION

The results suggest that the study of EOAE and suppression effect can be used in early identification of hearing damage to workers simultaneously exposed to pesticides and noise.

Qualidade de vida: comparando resultados em idosos com e sem presbiacusia

OBJETIVO: Avaliar a qualidade de vida de um grupo de idosos presbiacúsicos após a protetização e comparar os resultados com um grupo de idosos normouvintes. MÉTODO: Estudo clínico descritivo transversal, do qual participaram 51 indivíduos, de ambos os gêneros, divididos em dois grupos: grupo estudo, formado por 36 presbiacúsicos, com idade média de 73 anos, e usuários de prótese auditiva (mínimo de seis meses de uso); grupo controle, formado por 15 idosos normouvintes, com idade média de 69 anos. Foi aplicado o questionário WHOQOL-bref, e os dados relativos aos quatro domínios abrangidos (físico, psicológico, meio ambiente e relações sociais) foram analisados e comparados entre os grupos. RESULTADOS: Qualitativamente, todos os sujeitos presbiacúsicos declararam que sua vida melhorou depois da adaptação da prótese, porém os escores do WHOQOL-breaf revelaram: em relação ao domínio físico, não houve diferença significativa entre as respostas dos dois grupos, certamente porque o avanço da idade traz no seu bojo uma série de limitações; nos demais domínios, houve diferença estatisticamente significante entre os grupos, sendo que no grupo de presbiacúsicos a qualidade de vida foi pior. Tal fato permite inferir que, no grupo de presbiacúsicos, apesar do uso da prótese, as limitações impostas pela idade continuam comprometendo a autoestima, as relações interpessoais e o convívio social. CONCLUSÃO: Nos dois grupos, a idade representa limitações no que se refere à qualidade de vida. No grupo com presbiacusia, foi possível verificar melhoria da percepção auditiva, porém a melhora da qualidade de vida geral desses indivíduos depende de outros fatores que podem não ter relação com a perda de audição, quando comparado com o grupo normouvinte.

Análise da percepção de um grupo de idosos a respeito de seu handicap auditivo antes e após o uso do aparelho auditivo

INTRODUÇÃO: A presbiacusia, ou perda auditiva causada pelo envelhecimento, pode gerar dificuldades comunicativas, psicológicas e sociais nos indivíduos idosos, com impactos profundos em sua vida social e familiar. OBJETIVO: Este estudo visou analisar a percepção de um grupo de idosos a respeito de seu handicap auditivo antes e após o uso do aparelho auditivo. MÉTODOS: Foi aplicado um questionário a 29 idosos oriundos de um hospital particular da cidade de Curitiba, PR. Neste estudo, os idosos responderam a perguntas referentes às consequências emocionais causadas pela perda auditiva e sobre os efeitos sociais dessa perda. O questionário foi respondido antes da colocação do aparelho auditivo e, em um segundo momento, após um ou dois anos de uso. RESULTADOS: Verificou-se a existência de diferenças significativas entre os handicaps médios antes e após a protetização (p=0,0000). Desta forma, houve diminuição significativa do handicap auditivo após uso da prótese auditiva no grupo estudado. CONCLUSÃO: Constatou-se que os idosos obtiveram bom aproveitamento geral da prótese auditiva após um ano de sua utilização, o que gerou impacto positivo na qualidade de vida e na percepção do seu handicap auditivo antes e depois do uso da prótese.

Audiological evaluation in spinocerebellar ataxia

PURPOSE

To describe the audiological and electrophysiological results in patients with spinocerebellar ataxia (SCA).

METHODS

Retrospective and cross-sectional studies were performed. Forty-three patients were assessed using the following procedures: anamnesis and otolaryngologic exam, pure tone audiometry, acoustic immittance measures and brainstem auditory evoked potential (BAEP).

RESULTS

Patients showed gait abnormality (83.7%), speech disorder (48.8%), dizziness (41.8%) and dysphagia (39.5%). Hearing loss was referred in 27.9% of the cases; in the audiometric exams, 14 patients (32.5%) presented disorders; in SCA 3, 33.3%; in SCA 2, 12.5%; in SCA 4, 100.0%; in SCA 6, 100.0%; in SCA 7, 100.0%; in SCA 10, 50.0%; and in undetermined SCA, 21.4%. In BAEP, 20 patients (46.5%) were abnormal, being 58.3% in SCA 3, 62.5% in SCA 2, 100.0% in SCA 6, 100.0% in SCA 7, 66.7% in SCA 10 and 14.2% in undetermined SCA. While in acoustic immittance, 19 patients (44.1%) presented disorders, being 50.0% in SCA 3, 50.0% in SCA 2, 100.0% in SCA 4, 100.0% in SCA 6, 100.0% in SCA 7, 33.3% in SCA 10 and 28.5% in undetermined SCA.

CONCLUSION

The most evident abnormalities in the audiological evaluation were the predominance of the down-sloping audiometric configuration beginning at 4 kHz bilaterally and the bilateral absence of acoustic reflex at the frequencies of 3 and 4 kHz. In the electrophysiological evaluation, 50% of the patients showed abnormalities with prevalence of an increase of the latency of waves I, II and V and of the interval in the interpeaks I-III, I-V and III-V.

Avaliação do conforto do protetor auditivo individual numa intervenção para prevenção de perdas auditivas

OBJETIVO: analisar o conforto do protetor auditivo individual como parte de uma intervenção para prevenção de perdas auditivas em trabalhadores expostos a elevados níveis de ruído, por meio da utilização de um questionário de avaliação de conforto. MÉTODO: realizou-se análise dos documentos da empresa, investigação do ruído e uso de protetor auditivo individual anterior, seleção do protetor auditivo individual, atividades educativas, aplicação de questionário e realização audiometrias. A população foi composta de 20 trabalhadores expostos a ruído acima de 80 dB(A). Os trabalhadores utilizaram protetores tipo inserção e concha, cada um durante 15 dias e responderam ao questionário de avaliação do conforto em duas ocasiões. RESULTADOS: dentre os participantes 85% eram homens e 15% mulheres, idade média 35 anos. O Índice de Conforto do protetor tipo inserção foi 4,6 e concha 6,1, com tempo médio de utilização de 6 horas 40 minutos. Dentre as razões negativas ao uso do equipamento destacaram-se: interferência com a comunicação (20%), diminuição da audição (10%) e não sentir necessidadede usar (10%). CONCLUSÃO: os protetores auriculares estudados tiveram seus escores cotados em níveis aceitáveis, sendo considerados ambos confortáveis. Contudo, existiu uma diferença significante no Índice de Conforto entre protetores de diferentes tipos (inserção e concha). Com isso, pôde-se concluir que, o protetor auditivo individual tipo concha foi considerado o mais confortável e melhor aceito pela população estudada.

Achados audiológicos em pacientes submetidos ao transplante renal

OBJETIVO: Investigar o comportamento auditivo de pacientes com insuficiência renal crônica submetidos ao transplante renal. MÉTODOS: Foram avaliados 30 pacientes, 10 do gênero feminino e 20 do gênero masculino, na faixa etária de 13 a 26 anos (média de idade 16,97 anos). Os sujeitos foram submetidos a anamnese, avaliação otorrinolaringológica, avaliação audiológica convencional e de altas frequências, medidas de imitância acústica e avaliação do processamento auditivo central. Para os resultados da audiometria de altas frequências foi utilizado um grupo controle. RESULTADOS: Os sujeitos não apresentaram queixas auditivas na anamnese. Os resultados da audiometria convencional demonstraram predomínio da normalidade; na audiometria de altas frequências, os pacientes apresentaram resultados piores do que os sujeitos do grupo controle. Na imitanciometria houve predomínio de curva tipo A bilateral. Na avaliação do processamento auditivo central, 14 sujeitos (46,67%) apresentaram resultados alterados no Staggered Spondaic Word Test (SSW). Houve diferença significativa entre a variável idade e o resultado da audiometria tonal limiar: quanto maior a idade, menor a sensibilidade auditiva nos limiares de 250 Hz a 8 kHz. Houve relação entre o tipo de doador (cadáver ou vivo) e o resultado do teste SSW: os índices de resultados alterados foram maiores quando o doador era cadáver, em comparação com casos de doador vivo. CONCLUSÃO: Houve alterações na avaliação audiológica convencional e de altas frequências e no processamento auditivo central de sujeitos com insuficiência renal crônica submetidos ao transplante renal, sugerindo a necessidade de orientação à equipe envolvida quanto aos cuidados, prevenção e identificação precoce de acometimentos audiológicos.

Tinnitus in adolescents and its relation to the use of personal sound systems

INTRODUCTION

References to recreational exposure to high sound pressure levels (SPL) and the risk of hearing loss and sensation of tinnitus has increased in the adolescent population.

OBJECTIVE

To identify the occurrence of tinnitus in adolescents who use personal sound systems (PSS).

MATERIAL AND METHODS

This was a descriptive cross-sectional study, using a sample of 153 normal-hearing adolescent students. Participants answered a self-adaministered questionnaire containing open and closed questions, addressing information regarding sound habits with the use of PSS and symptoms associated with this practice.

RESULTS

The occurrence of a habit of using PSS was 93%. Comparing the exposed and unexposed groups, the incidence of tinnitus was 40% and 33% respectively, and 22% reported the occurrence of tinnitus induced by the use of PSS. There was no significant difference for the presence of tinnitus depending on the degree of exposure.

CONCLUSION

Although no relation between the use of PSS with tinnitus has been observed, the prevalence of symptoms of up to 40%, including noise-induced episodes, reinforces the possibility of subclinical hearing loss induced by high NPS and, because of the irreversible nature of these losses, the urgency of educational and regulatory measures to reverse these habits and attitudes.

Vestibular findings in autosomal recessive ataxia

OBJECTIVE

This study aims to examine vestibular disorders in patients with recessive spinocerebellar ataxia.

DESIGN

A retrospective cross-sectional study was conducted. The patients underwent the following procedures: case history, ENT and vestibular evaluations.

STUDY SAMPLE

The tests were performed in 19 patients ranging from 6 to 63 years of age (mean age of 36.7).

RESULTS

Clinically, the patients commonly had symptoms of dizziness (57.8%), lack of coordination of movement with imbalance when walking (52.6%), and headaches (42.1%). In vestibular testing, alterations were predominantly evident under caloric testing (73.5%), rotational chair testing, and testing for gaze and optokinetic nystagmus (36.8%). The presence of alterations occurred under examination in 89.5% of these patients, 100% occurred in subjects with Friedreich's ataxia and 84.6% for subjects with indeterminate recessive spinocerebellar ataxia, with the majority occurring in those with central vestibular dysfunction, 57.9% of the examinations.

CONCLUSION

The most evident neurotological symptoms were dizziness, lack of coordination of movement, and imbalance when walking. Alterations in vestibular examinations occurred in 89.5% of patients, mostly in the caloric test, with a predominance of deficient central vestibular system dysfunction. This underscores the importance of the contribution of topodiagnostic labyrinthine evaluations for neurodegenerative diseases.

Limiares auditivos em músicos militares: convencionais e altas frequências

OBJETIVO: Analisar e caracterizar os limiares auditivos tonais entre 500 Hz e 16.000 Hz de músicos profissionais, integrantes de uma banda militar. MÉTODOS: Realizou-se um estudo de coorte histórico, que comparou um grupo de 50 músicos profissionais (banda militar) com um grupo sem histórico de exposição profissional a som intenso (44 sujeitos); e homogêneos (p<0,05) em relação ao gênero (masculino) e à idade (em torno de 35 anos). Foram realizados exames de audiometria tonal limiar convencional e de altas frequências (de 9.000 a 16.000 Hz). RESULTADOS: A exposição à música desencadeou alterações auditivas permanentes. Quanto aos limiares auditivos convencionais, no grupo exposto encontrou-se 32% dos músicos com alterações auditivas neurossensoriais e no grupo não exposto encontrou-se 2,27%. Os sujeitos expostos à música tiveram 14,54 vezes mais risco de adquirir alterações auditivas neurossensoriais do que o grupo não exposto. Após 20 anos de exposição à música foram observadas pioras significativas nos limiares auditivos, principalmente nas altas frequências, e ocorreram diferenças entre os grupos a partir de 30 anos de idade. CONCLUSÃO: A exposição à música desencadeou alterações auditivas permanentes, evidenciando diferenças em relação ao grupo não exposto à música, registradas na avaliação audiológica convencional e em altas frequências.

Vestibular dysfunction in adolescents and young adults after kidney transplant

INTRODUCTION

Chronic kidney disease is a slowly progressive disease that causes irreversible loss of renal function and is considered a public health problem worldwide.

OBJECTIVE

To evaluate the vestibular behavior in patients with chronic kidney disease undergoing renal transplantation.

METHODS

A retrospective cross-sectional study was performed. Thirty patients were evaluated, 33.3% female and 66.7% male (mean age 16.9 (± 3.6) years old). Patients underwent the following procedures: anamnesis, ENT (ear, nose, and throat) evaluation and vestibular evaluation.

RESULTS

The patients reported dizziness when they were on dialysis. 50% the patients showed an abnormality in the vestibular test, which occurred in the caloric test. The abnormality was more prevalent in the peripheral vestibular system and there was a predominance of deficit peripheral vestibular disorders.

CONCLUSION

The dizziness was the most significant symptom for the vestibular test in correlation with neurotological symptoms. Alteration in the vestibular exam occurred in the caloric test, there was a prevalence of alterations for the peripheral vestibular system with a predominance of deficit vestibular dysfunction. We emphasize the need to show professionals involved in patients with chronic kidney disease, those undergoing renal transplant and dialitic treatment the importance of prevention and early identification of otoneurological involvement.

Effects of sleep deprivation on central auditory processing

BACKGROUND

Sleep deprivation is extremely common in contemporary society, and is considered to be a frequent cause of behavioral disorders, mood, alertness, and cognitive performance. Although the impacts of sleep deprivation have been studied extensively in various experimental paradigms, very few studies have addressed the impact of sleep deprivation on central auditory processing (CAP). Therefore, we examined the impact of sleep deprivation on CAP, for which there is sparse information. In the present study, thirty healthy adult volunteers (17 females and 13 males, aged 30.75±7.14 years) were subjected to a pure tone audiometry test, a speech recognition threshold test, a speech recognition task, the Staggered Spondaic Word Test (SSWT), and the Random Gap Detection Test (RGDT). Baseline (BSL) performance was compared to performance after 24 hours of being sleep deprived (24hSD) using the Student's t test.

RESULTS

Mean RGDT score was elevated in the 24hSD condition (8.0±2.9 ms) relative to the BSL condition for the whole cohort (6.4±2.8 ms; p=0.0005), for males (p=0.0066), and for females (p=0.0208). Sleep deprivation reduced SSWT scores for the whole cohort in both ears [(right: BSL, 98.4%±1.8% vs. SD, 94.2%±6.3%. p=0.0005)(left: BSL, 96.7%±3.1% vs. SD, 92.1%±6.1%, p<0.0001)]. These effects were evident within both gender subgroups [(right: males, p=0.0080; females, p=0.0143)(left: males, p=0.0076; females: p=0.0010).

CONCLUSION

Sleep deprivation impairs RGDT and SSWT performance. These findings confirm that sleep deprivation has central effects that may impair performance in other areas of life.

A disciplina de Libras no contexto de formação acadêmica em fonoaudiologia

OBJETIVO: analisar a inserção da disciplina de Libras em cursos nacionais de graduação em Fonoaudiologia, enfocando carga horária, período em que é ofertada, a natureza/estrutura da mesma; bem como, a avaliação de graduandos quanto à contribuição de tal disciplina na sua formação acadêmica e nas relações estabelecidas com sujeitos surdos. MÉTODO: foi aplicado um questionário a 240 acadêmicos de sete cursos de graduação em Fonoaudiologia, ofertados em Instituições de Ensino nacionais. Para tanto, adotou-se como critério de inclusão, acadêmicos que já tivessem cumprido a carga horária total da disciplina de Libras. O questionário foi respondido por escrito nas dependências dos cursos. Os resultados, analisados quantitativamente, foram organizados e apresentados em tabelas de frequências absolutas e relativas. RESULTADOS: os achados demonstram que se por um lado dentre os acadêmicos predomina a visão de que a carga horária destinada à referida disciplina é insuficiente, por outro existe uma conscientização por parte dos mesmos quanto à importância e à necessidade da formação em Libras. CONCLUSÃO: a partir de tal estudo pode-se evidenciar a necessidade do aprofundamento de discussões no contexto fonoaudiológico acerca da formação acadêmica voltada a Libras, bem como a definição de critérios e parâmetros que garantam um ensino de qualidade em torno de tal conteúdo. Esse estudo aponta para a necessidade do implemento de pesquisas que ofereçam elementos para o avanço na formação acadêmica fonoaudiológica voltada ao referido conteúdo, bem como, contribuam para a avanço de práticas fonoaudiológicas bilíngues, clínicas e educacionais, dirigidas a sujeitos surdos.

Disfonia infantil: hábitos prejudiciais à voz dos pais interferem na saúde vocal de seus filhos?

OBJETIVO: verificar hábitos prejudiciais à voz referidos por crianças disfônicas e por seus respectivos pais e mães e compará-los com dados obtidos de um grupo controle, constituído por crianças sem alterações vocais e seus respectivos pais e mães. MÉTODO: investigou-se 28 crianças disfônicas, com idade entre 6 e 12 anos e seus pais (Grupo de Estudo - GE) e 22 crianças sem alterações vocais, com a mesma faixa etária, e seus respectivos pais (Grupo Controle - GC). As vozes foram classificadas em "alteradas" e "não alteradas" por meio de análise perceptivo-auditiva com amostra da fala espontânea.Todos responderam a um questionário sobre fatores prejudiciais à voz. Para análise dos resultados foram aplicados os testes de comparação de duas proporções (p<0,05). RESULTADOS: verificou-se que as crianças do GE apresentaram significantemente mais os hábitos: falar com esforço, falar sem descansar e imitar vozes. Os pais do GE relataram significantemente mais hábitos de: pigarrear, gritar, falar junto com os outros, além de viver em ambiente de fumantes. As mães do GE apresentaram significantemente mais hábitos de: falar com esforço, falar em ambiente ruidoso e falar muito rápido. Viver em ambiente familiar ruidoso foi significantemente mais relatado por crianças, pais e mães do GE quando comparados aos do GC. CONCLUSÃO: independentemente de fatores que possam justificar a disfonia, crianças disfônicas e seus pais e mães relataram maior ocorrência de hábitos prejudiciais à voz e viver em ambiente familiar ruidoso do que crianças sem alterações vocais e seus respectivos pais e mães.

Relação de escolaridade, faixa etária e profissão de mães com a oferta de chupeta e mamadeira a seus filhos

OBJETIVO: avaliar a relação do grau de escolaridade, faixa etária e a profissão das mães com a oferta de chupeta e mamadeira a seus filhos MÉTODO: participaram deste estudo 190 mães de crianças entre 0 e 10 anos de idade, com idades de 20 a 45 anos que responderam a um questionário com questões fechadas a respeito de profissão, nível de escolaridade e uso de chupeta e mamadeira de seus filhos RESULTADOS: não foi observada diferença significante entre o grau de escolaridade quanto ao uso de chupeta (p= 0,915). O uso de mamadeira foi significantemente maior nos filhos de mães com ensino superior (p= 0,0124). Não houve diferença significante quanto à faixa etária das mães e a presença desses hábitos nos filhos (chupeta: p=0,427; mamadeira: p=0,427); e, entre mães que trabalham em casa e que trabalham fora de casa (chupeta: p=0,061; mamadeira: p=0,798). Não houve diferença entre mães que trabalham na área da saúde e em outras áreas (chupeta: p=0,339; mamadeira: p=0,455) CONCLUSÃO: as mães com nível superior de escolaridade oferecem significantemente mais mamadeira aos seus filhos, o que não ocorreu quanto ao uso de chupeta. Não foi observada diferença significante quanto ao uso de chupeta e mamadeira em relação à faixa etária e profissão de mães.