Angela Ribas

Reabilitação vestibular em idosos com Parkinson

ABSTRACTPurpose: to check the effectiveness of vestibular rehabilitation exercises (RV) by means of an evaluationof a pre and post application of the Dizziness Handicap Inventory (DHI) questionnaire (Brazilian version). Methods: eight patients were evaluated (three female and five male), in the age group varying from 48to 71, referred from the Parana Association of Parkinson to the Otoneurological Laboratory of TuiutiUniversity of Parana. The patients were divided in two groups and submitted to the following procedures:anamnesis, otorhinolaryngological evaluation, vestibular evaluation through vectoelectronystagmography(VENG) and an application of DHI questionnaire (Brazilian version) before and after RV, using Cawthorneand Cooksey (group A) and Herdman (group B) protocols. Results : a) regarding the otoneurologicalcomplaints referred to in the anamnesis, the prevalence of dizziness (100.0%), trembling (100.0%) anddeviation during walking (75.0%) were observed; b) In the vestibular exam, all patients (100.0%) presentedalterations, with the largest incidence being the deficient peripheral vestibular syndromes (62.5%); c)There was significant improvement of the functional (p = 0,020470) and emotional (p = 0,013631)aspects after accomplishing the RV exercises using the Cawthorne and Cooksey protocol and of theemotional aspect (p=0,007316) using Herdman protocol.

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 Students 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.

A relação entre o envelhecimento e a habilidade de escuta dicótica em indivíduos com mais de 50 anos

OBJECTIVE: To study the dichotic listening ability of a group of individuals over 50 years old and to verify the relationship between auditory processing, aging and hearing loss. METHOD: 40 individuals aged from 50 to 83 years were evaluated, subdivided into group A (normal listeners), group B (individuals with normal audition for their age) and group C (individuals with hearing loss). The following procedures were performed: anamnesis, otological inspection, audiological exams and evaluation of auditory processing by the administration of the dichotic tests of alternate disyllables and digits. RESULTS: A disorder of auditory processing was verified in all the groups evaluated; the degree of alteration was more important in group C; in all groups the most affected auditory ability was selective attention. CONCLUSION: It was observed that the aging progress is a susceptible factor for alterations of auditory processing, especially for dichotic listening in view of the fact that this can still receive influences from peripheral auditory losses.

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

OBJETIVO: Avaliar a qualidade de vida de um grupo de idosos presbiacusicos apos a protetizacao e comparar os resultados com um grupo de idosos normouvintes. METODO: Estudo clinico descritivo transversal, do qual participaram 51 individuos, de ambos os generos, divididos em dois grupos: grupo estudo, formado por 36 presbiacusicos, com idade media de 73 anos, e usuarios de protese auditiva (minimo de seis meses de uso); grupo controle, formado por 15 idosos normouvintes, com idade media de 69 anos. Foi aplicado o questionario WHOQOL-bref, e os dados relativos aos quatro dominios abrangidos (fisico, psicologico, meio ambiente e relacoes sociais) foram analisados e comparados entre os grupos. RESULTADOS: Qualitativamente, todos os sujeitos presbiacusicos declararam que sua vida melhorou depois da adaptacao da protese, porem os escores do WHOQOL-breaf revelaram: em relacao ao dominio fisico, nao houve diferenca significativa entre as respostas dos dois grupos, certamente porque o avanco da idade traz no seu bojo uma serie de limitacoes; nos demais dominios, houve diferenca estatisticamente significante entre os grupos, sendo que no grupo de presbiacusicos a qualidade de vida foi pior. Tal fato permite inferir que, no grupo de presbiacusicos, apesar do uso da protese, as limitacoes impostas pela idade continuam comprometendo a autoestima, as relacoes interpessoais e o convivio social. CONCLUSAO: Nos dois grupos, a idade representa limitacoes no que se refere a qualidade de vida. No grupo com presbiacusia, foi possivel verificar melhoria da percepcao auditiva, porem a melhora da qualidade de vida geral desses individuos depende de outros fatores que podem nao ter relacao com a perda de audicao, 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

INTRODUCTION : Presbycusis or hearing loss caused by aging can generate communicative psychological and social problems in the elderly, with profound impacts on their social and family life. OBJECTIVE: This study aimed to analyze the perception of a group of seniors about their hearing handicap before and after using a hearing aid. METHODS: A questionnaire was administered to 29 elderly coming from a private hospital in the city of Curitiba, Brazil. In this study the elderly responded to questions regarding the emotional consequences caused by hearing loss and about the social effects of this loss. The questionnaire was completed prior to placing the hearing aid and in a second stage, after one or two years of use. RESULTS: We found significant differences between the average handicap before and after using the device (p=0.0000). Thus there was significant decrease of hearing handicap after hearing aid use in the study group. CONCLUSION: It was found that the elderly generally made good use of hearing aids after a year of use, which had a positive impact on the quality of life and perception of their auditory handicap before and after use of the prosthesis.

Comparação dos resultados do limiar de detectabilidade de voz por meio de material gravado e a viva voz

PURPOSE: to compare the results of the test referred to as voice detection lower thresholds, using a previously-recorded list of trisyllabic words and in live voice in individuals with flat configuration audiogram. METHODS: 60 subjects (120 ears) took part in the study, each with an audiometric exam within normal patterns and tonal audiometry at a flat configuration, without auditory incidents, in the age group going from 20 to 30. The test was given with a live voice and with recorded material, in an acoustically-managed booth, by means of an AC40 audiometer and with the aid of a linked CD player. RESULTS: voice detection lower thresholds were found to be 10 dB better than the tritonal average in 35 ears (57% of the sample) when accomplished by live voice and in 10 ears (17%) when accomplished by recorded material; and were found to be 5 dB worse than the tritonal average in one ear (3%) when accomplished by live voice and in 23 ears (38%) by recorded material. CONCLUSION: a) when using recorded material for the establishment of LDV in flat configuration curves, one should consider intensity levels equal to the tritonal average or 5 dB lower as standards of normality and b) a difference was revealed between the results obtained with recorded material and those from live voices, demonstrating the importance of using recorded tests for determining lower auditory thresholds in logoaudiometry.

Childhood Hearing Health: Educating for Prevention of Hearing Loss

Introduction The presence of noise in our society has attracted the attention of health professionals, including speech-language pathologists, who have been charged along with educators with developing hearing conservation programs in schools. Objective To describe the results of three strategies for awareness and hearing preservation in first to fourth grades in public elementary schools. Methods The level of environmental noise in classrooms was assessed, and 638 elementary school students from first to fourth grades, 5 to 10 years of age, were audiologically evaluated. After the evaluations, educational activities were presented to children and educators. Results The noise level in the classroom ranged from 71.8 to 94.8 A-weighted decibels. The environment of the classroom was found to promote sound reverberation, which hinders communication. Thirty-two students (5.1%) presented hearing alterations. Conclusion The application of strategies for a hearing conservation program at the school showed that noise is present in the room, and hearing loss, sometimes silent, affects schoolchildren. Students and teachers were aware that hearing problems can be prevented. Avoiding exposure to noise and improving the acoustics in classrooms are essential.

Level of User Satisfaction with Hearing Aids and Environment: The International Outcome Inventory for Hearing Aids

Introduction The main function of hearing is to enable oral communication. Hearing loss impairs communication skills. Objective To evaluate the level of user satisfaction with hearing aids. Methods This is a cross-sectional group study comprising 108 subjects (56% men and 44% women). The average age of the subjects was 77 years. These subjects had been recently fitted with their hearing aids and showed sensorineural (90%) and mixed (10%) hearing loss as determined via the Questionnaire International Outcome Inventory for Hearing Aids Outcome Inventory (IOI-HA), which determined the benefit and satisfaction obtained by sound amplification. Results The hearing aids improved the quality of life of 52.78% of the patients, which was revealed by their high scores (mean = 27.3). The relationship of the user with the environment was significantly better (p < 0.001) than that of the user with the hearing aid. Conclusion IOI-HA is a simple and easy-to-use tool. Based on the results of this study, we can show a high degree of satisfaction with their hearing aids in the majority of the participants, which improved the quality of life.

Caracterização dos limiares auditivos de odontólogos numa população da cidade de Curitiba - PR, Brasil

Introduction: The dentists are exposed to noise in their work place, being likely to develop of hearing loss neurosensory with induced characteristics by noise. Objective: Analyze the hearing thresholds from dentists characterizing them according to gender, age and time of service. Method: The form of the study is cross-section (or sectional), prospective, that analyzed the hearing thresholds from 115 dentists, through tone audiometry of 500 Hz to 8000 Hz by airway or bone conduction. Were analyzed the tonal hearing thresholds from the group of dentists by gender, regarding the age and time of service and applied statistical procedures for the edition of data. Results: Were observed average tonal hearing thresholds with configuration from acoustic notch, being more accentuated in the male gender. There is sensorineural hearing loss in 28 (24,34%) dentists, 8 (14,54%) between female gender and 20 (33,33%) between the male gender, the proportion of subjects with altered hearing is significantly bigger in the male gender (p = 0,0208). The tonal hearing thresholds for the male gender shown to be worse than in the females when analyzed by age and time of service, but the men were older and with more time of service than the women. Conclusion: The dentists presented sensorineural hearing loss with acoustic notch (being more present in the male gender) with worsening of hearing and time of service, especially after 21 years of work.

Hormones and Auditory Perception: Study of Dichotic Listening in Women during the Menstrual Cycle

Introduction  Dichotic listening refers to the ability to hear different sounds presented to each ear simultaneously. Objective  The aim of the present study was to assess dichotic listening in women throughout the menstrual cycle. Methods  The volunteers who met the eligibility criteria participated in a dichotic listening assessment composed of three tests: 1) staggered spondaic word test; 2) dichotic digits test; and 3) consonant-vowel test. The female participants were tested during two different phases of the menstrual cycle: the follicular (days 11 to 13) and luteal (days 23 to 26) phases. The phases were confirmed by measuring serum levels of the hormone estradiol. Results  A total of 20 volunteers aged 18 to 49 years participated in the study (9 females and 11 males). In test 1, only the right ear of females showed better performance during the follicular phase (high estrogen levels), compared with the luteal phase (low estrogen levels); in test 2, there were no significant differences for any of the groups; and in test 3, both males and females showed significantly better performance in their right ear compared with their left ear. Conclusion  The better performance of females during the follicular phase of the cycle may indicate that estrogen levels might have an influence on dichotic listening in women.