Ana Claudia Fiorini

Estudo da audição e da qualidade de vida em motoristas de caminhão

PURPOSE: to study hearing in relation to the quality of life in truck drivers. METHODS: an inquiring transversal epidemiological study was realized in 75 truck drivers, who answered to anamnesis and filled the World Health Organization questionnaire on quality of life - WHOQOL-bref, and underwent pure tone and speech audiometry. Noise induced hearing loss (NIHL) was classified, according to Fiorinis (1994) criterion. RESULTS: out of 75 evaluated audiograms, 50 subjects (66.7%) showed normal hearing (Group 1) and 25 subjects (33.3%) showed altered audiograms, being 20 (80.0%) classified as suggestive of NIHL (Group 2) and 5 (20,0%) were suggestive of other causes (Group 3). There was an association and/or dependence between groups and age (p=0,007) and between groups and years in the profession (p = 0.049). In Group 1 - Normal, there were statistically significant correlations for the domains: Physical x Psychological (p<0.001), Social x Physical (p<0.001), Environment x Physical (p<0.001), Psychological x Social (p=0,002), Psychological x Environment (p=0,001) and Environment x Social (p<0.001). In the Group 2 - Suggestive of NIHL, the correlations were: Physical x Psychological (p=0.002), Psychological x Social (p<0.001), Psychological x Environment (p=0.005) and Environment x Social p= (0.026). CONCLUSION: the prevalence of hearing disorders, suggesting NIHL, was 28.6% in this professional category, but the quality of life was not related to the audiogram results.

Effects of environmental and organizational factors on the health of shiftworkers of a printing company.

This study explored the effects of environmental and organizational stressors on the health of shiftworkers in a printing company (n = 124). A questionnaire was used to gather data on work history, organizational factors, psychosocial characteristics, medical history, present health, occupational and non-occupational exposures, and lifestyle factors. The perception of environmental and organizational conditions was associated (P < 0.05) with chronic back pain (odds ratio [OR], 1.29), varicose veins (OR, 1.35), allergic rhinitis (OR, 1.27), depression (OR, 1.45), and gastritis (OR, 1.15). Anxiety scores were associated with allergic rhinitis (OR, 1.14) and skin allergy (OR, 1.09). Shiftwork was a significant risk factor for conjunctivitis (OR, 3.68), depression (OR, 0.23), cardiac arrhythmia (OR, 7.13), and gastritis (OR, 4.38). Other associations included tenure and chronic back pain (OR, 4.89), toluene exposure and skin allergy (OR, 3.76), worksite and conjunctivitis (OR, 7.0), and worksite and dermatitis (OR, 1.24 to 4.95). The number of hours of exercise per week was associated with varicose veins (OR, 4.33), and alcohol intake was associated with cardiac arrhythmia (OR, 6.74).

Pop-rock musicians: assessment of their satisfaction provided by hearing protectors.

UNLABELLED Pop-rock musicians are at risk of developing hearing loss and other symptoms related to amplified music. AIM The aim of the present study was to assess the satisfaction provided by the use of hearing protection in pop-rock musicians. STUDY DESIGN Contemporary cohort study. MATERIALS AND METHODS A study of 23 male pop-rock musicians, aged between 25 to 45 years. After audiological evaluation (pure tone audiometry, middle ear analysis, TEOAE and DPOAE) hearing protective devices were provided to be used for three months. After that musicians answered a satisfaction assessment questionnaire. RESULTS The prevalence of hearing loss was of 21.7%. The most common complaints about the hearing protectors were: autophonia, pressure in the ears, interference in high frequencies perception and full time use of the hearing protector during concerts. There was a positive correlation between a reduction in tinnitus after the use of the HPD with the following complaints: tinnitus after beginning the career (p= 0.044), discomfort with the sound intensity in the work place (p= 0.009) and intolerance to loud sound (p= 0.029). CONCLUSIONS There was a high prevalence of hearing loss and a positive tendency towards the use of the ear protector device among the sample population.

Incômodo causado pelo ruído a uma população de bombeiros

PURPOSE: To identify annoyance caused by occupational and urban noises and auditory health complaints of a group of firefighters from a corporation in Santo Andre (SP), Brazil. METHODS: A cross-sectional epidemiological study was carried out with a population of 72 firefighters from the 8th Brigade: 28 firefighters from the administrative section, 20 from the occurrence center and 24 from the operational call center. It was used a protocol which consisted of 57 questions regarding personal data, auditory and non-auditory complaints and annoyance. A sound mapping from the surrounding area was also carried out. RESULTS: The sound pressure levels in the firefighter corporation area exceeded 67 dB (A), reaching more than 82 dB (A) at the main avenue. Most of the subjects (83.3%) reported noisy routine at work, and urban noise was reported as the major source of annoyance. When evaluated separately by performance section, the highest occurrences of complaints were for urban noise (73.9%), firefighter vehicle noise (68%) and telephone noise (38.2%), for the administrative section, operational call center and occurrence center, respectively. CONCLUSION: The firefighters interviewed, besides being exposed to noises deriving from work activities, like vehicles, walk-talk radios and telephones, are liable to consequences from urban noise, which disturbs work activities and also causes health problems.

Efeito de supressão das emissões otoacústicas evocadas por estímulo transiente em lactentes de risco para perda auditiva nascidos pré-termo

PURPOSE: to study the occurrence and magnitude of the transient otoacoustic emissions suppression in pre-term infants with high risk for hearing loss. METHODS: the study was carried out in 15 pre-term infants. The used equipment was ILO USB II V6 Clinical OAE Software from Ododynamics. The used stimulation was linear clicks displayed at the intensity of 60 dB pe SPL (± 5). The contralateral noise (white noise) was set at 60 dB SPL (± 5). RESULTS: From 15 infants, only one did not show bilateral suppression. Suppression effect was shown on 93.3% of the subjects, being 71.4% for both ears and 28.6% for only one ear. The results showed that there was a significant statistical difference between the right and left ears. We could not observe significant differences when actual and gestational age were analyzed. The baby boys showed higher responses when compared to baby girls. CONCLUSIONS: most of the studied population showed OAE suppression effect. White noise was found in the contralateral ear, and reduced the response level of the transient otoacoustic emissions, demonstrating the participation of the efferent system. The responses were different considering the side of the ear, being higher on the right ear and for boys.

Caracterização dos níveis de pressão sonora em academias de ginástica e queixas apresentadas por seus professores

Aim: The present study aims at identifying auditory and health complaints of fitness instructors in fitness centers in Curitiba, and to evaluate the sound pressure levels (SPL) produced in fitness classes. SPL measurements were made following ABNT recommendations (Brazilian Technical Norms and Regulations Association - Norm 10151) and revealed levels that ranged from 73.9 to 94.2 dBA. Study design: Prospective clinical randomized. Material and method: 32 fitness instructors answered a questionnaire about their most frequent complaints related to SPL. Results: The most frequent complaints were: tinnitus (24%); ear fullness (15%) and poor concentration (15%). The classes in which sound pressure levels were investigated were: Step, Body Pump and Aerofitness. Conclusion: The results of the present research suggested the presence of high sound pressure levels in 66% of the evaluated classes.

Satisfação de idosos com os aparelhos de amplificação sonora individual nos primeiros seis meses de uso

PURPOSE: To analyze the hearing aid satisfaction after one, three and six months of use. METHODS: Longitudinal study with 22 elderly individuals who participated in a selection and adaptation process for sound amplification devices in a high complexity health service. The study was carried out at the institution on the day of hearing aid fitting and on the follow-up appointments after one, three and six months of fitting. The data is part of the application of the Satisfaction with Amplification in Daily Life (SADL) questionnaire. In order to assess the consistency of the items composing the positive effects category of the SADL survey after one, three and six months of hearing aid use, the Cronbachs coefficient alpha was used. RESULTS: There were improvements to the SADL scores in the period between the first use of the hearing aid and the following six months. Cronbachs coefficient alpha was calculated excluding questions 9 and 10, simultaneously. The coefficient values were 0.75 after a month, 0.69 after three months, and 0.81 after six months. Questions 9 (Do you feel more confident when you use hearing aids?) and 10 (The sounds that you hear with your hearing aids are normal?) created inconsistency in the assessment after one and three months of amplification use. CONCLUSION: The results obtained with the SADL indicate a high level of satisfaction. The averages for positive effects, negative effects, and global score were different after one, three and six months of hearing aid use.

Cardiac abnormalities in Parkinson’s disease and Parkinsonism

OBJECTIVES Though there is increasing evidence for primary cardiac disease in Parkinsons disease (PD) and Parkinsonism (PS), this evidence is hardly included in the general management of these patients. METHODS Literature review. RESULTS PD is one of the most common age-related neurodegenerative disorders. Epidemiological studies have shown that PD is accompanied by high rates of premature death compared with the general population. In general, death in PD/PS is usually caused by determinant factors such as pneumonia, cerebrovascular, and cardiovascular disease. There is a significant body of literature demonstrating involvement of the heart in PD/PS. Cardiac involvement in PD/PS includes cardiac autonomic dysfunction, cardiomyopathy, coronary heart disease, arrhythmias, conduction defects, and sudden cardiac death (SCD), and sudden unexpected death in Parkinsons disease (SUDPAR). CONCLUSIONS Cardiac abnormalities found in PD/PS are manifold but the most prominent is cardiac autonomic dysfunction. The frequency of coronary heart disease in PD is a matter of debate. Only rarely reported in PD/PS are cardiomyopathies, arrhythmias, and sudden cardiac death, and SUDPAR. It is particularly recommended that PD/PS patients are more intensively investigated cardiologically as soon as the diagnosis is established. Early recognition of cardiac involvement is important for preventing SCD and SUDPAR.

The study of attenuation levels and the comfort of earplugs

Introduction: This study aimed to analyze and compare four different types of earplugs, divided into premolded plugs and foam plug models, in relation to the level of attenuation, comfort, and the size of the external acoustic meatus (EAM) in an attempt to identify how these variables influence the choice of specific hearing protection devices (HPDs). Materials and Methods: A cross-sectional observational study was performed in a sample of 49 participants, oriented toward the ideal placement of four HPDs, two premolded and two foam plugs (3M™). The procedures included otoscopy, EAM diameter measurement using an otometer, EAM volume measurement via an acoustic impedance test, and the obtainment of the bilateral personal attenuation rating (PAR) for each HPD using the E-A-Rfit™ Validation System (3M™). The Bipolar Comfort Rating Scale (BCRS) instrument was applied twice for each individual: once after the evaluations with the premolded HPDs and again after the evaluations with the foam plug HPDs. Then, each participant was asked which was his/her favorite protector. Results: The volume of the EAM was not directly related to the diameter of the EAM. The attenuation did not interfere with the HPD preference, and the PAR of the foam plug was significantly higher regardless of the preferred HPD. Regarding the BCRS, the variables “Placement,” “Complexity,” and “Occlusion Effect” had higher scores for premolded HPDs and had a direct relationship with the type of preferred HPD. Conclusion: Attention to the use of HPDs should be personalized, taking into account the needs of each individual, considering not only the attenuation, but also the user’s reported well-being.

TK2-related mitochondrial disorder is not restricted to the skeletal muscle

With interest we read the article by Wang et al. about the clinical and molecular spectrum of human thymidine-kinase-2-(TK2)-related disease [1]. We have the following comments and concerns. Though TK2 mutations predominantly manifest in the skeletal muscle, also the brain, eyes, heart, and liver can be affected [1]. Cerebral manifestations of TK2 mutations include cognitive impairment, epilepsy, loss of motor skills, developmental delay, motor development delay, feeding difficulties, muscle hypotonia, leucoencephalopathy, cerebral atrophy, cortical laminar necrosis, and cerebellar neuronal degeneration [2–4]. Since some of these manifestations may be also attributable to myopathy (e.g. hypotonia, respiratory insufficiency), it is often difficult to differentiate if a particular feature is attributable to affection of either the one or other organ, or both. Thus, we should know if all included patients underwent cerebral imaging to assess to which degree the phenotype was attributable to cerebral involvement. So called “liver enzymes” may not only derive from the liver but may occur in other organs as well. Regarding transaminases GOT and GPT, and LDH, they are also produced in the muscle and may reflect rather muscle destruction than liver disease. Thus, we should be informed if there were morphological or structural liver abnormalities or other indications, such as hyperammonemia and liver failure [5], or death from liver failure, demonstrating that the liver was indeed an organ clinically affected in TK2-disease. Recently, the phenotypic spectrum of TK2 mutations has been extended by the description of a female TK2 carrier manifesting with lethal hypertrophic cardiomyopathy [4]. Cardiac involvement became clinically apparent by the age of 13months and progressed to severe heart failure by the age of 22months [4]. It would be of value to mention if the 11 newly detected TK2 carriers were prospectively investigated for cardiac disease. In summary, the genotypic and phenotypic spectrum of TK2 mutations is broader than so far anticipated. Conflict of interests