Juliana Jandre Melo

PREVALÊNCIA DE QUEIXA DE ZUMBIDO E PROVÁVEIS ASSOCIAÇÕES COM PERDA AUDITIVA, DIABETES MELLITUS E HIPERTENSÃO ARTERIAL EM PESSOAS IDOSAS

PURPOSE: To assess the prevalence of tinnitus and possible association with hearing loss, diabetes mellitus and hypertension in elderly. METHODS: Cross-sectional study with individuals older than 60 years who underwent audiological evaluation (pure tone audiometry and history) and answered a comorbidity questionnaire. We evaluated 519 subjects of both genders with a median age of 69 years. Individuals who did not participate in the audiometric test were excluded, then totaling 498 subjects. We applied the appropriate statistical tests to analyze the tinnitus and associated factors. RESULTS: The prevalence of 42.77% of tinnitus was found, being 58.68% bilateral tinnitus and 41.31% unilateral tinnitus. There was a difference between tinnitus and hearing loss, but there was no difference between tinnitus and hypertension and between tinnitus and diabetes mellitus alone. CONCLUSION: The prevalence of tinnitus is significant in the elderly. There are differences between tinnitus and hearing loss, with association between the side affected by tinnitus and the side of hearing loss. Only the association of comorbidity of diabetes mellitus and hypertension is an independent risk factor for tinnitus.

Vertigem no idoso: relato de caso

BACKGROUND: to investigate the vertigo in elderly woman with several systemic commitments and evaluate treatment effectiveness for Benign Paroxysmal Positional Vertigo (BPPV). PROCEDURES: longitudinal clinical study of a female patient with vertigo submitted to speech and hearing therapy with vestibular habituation exercises. RESULTS: after six months the patient had clinical improvement. CONCLUSION: vestibular rehabilitation with vestibular habituation exercises showed effectiveness in the treatment of this patient with BPPV.

Avaliação docente em relação às novas tecnologias para a didática e atenção no ensino superior

Discute-se a importância da atencao no ensino/aprendizagem na universidade em conexao com as novas tecnologias, propondo-se de forma simples, o aprimoramento do desempenho do professor universitario em relacao a estas tecnologias, visando a melhoria da atencao do aluno no ensino superior.

Comparação da frequência de queixa de vertigem no idoso com e sem hipertensão arterial

INTRODUCAO: A presenca de sintomas otologicos associados a hipertensao e discutida ha decadas; entretanto, sua etiologia ainda permanece obscura. OBJETIVO: Comparar a frequencia de queixa de vertigem em pacientes idosos com e sem hipertensao arterial. METODO: Estudo prospectivo com 238 individuos. Foi aplicado um questionario para preenchimento sistematizado de dados para verificacao da hipertensao arterial e da vertigem baseado no protocolo para anamnese audiologica utilizada na rotina de atendimentos. RESULTADOS E DISCUSSAO: Houve uma proporcao maior de mulheres em ambos os grupos. Quanto a idade, houve media de idade semelhante entre o grupo entre os dois grupos. Quanto ao uso de medicamentos, todos faziam uso de algum tipo de medicamento de forma continua. Na populacao estudada com hipertensao arterial, 106 (90%) faziam uso de anti-hipertensivos. Dos 99 individuos que relataram vertigem 22 (15,15%) dos idosos faziam uso de antivertiginosos. No grupo de hipertensos 58 (23,8%) individuos relataram vertigem e no de nao hipertensos 41 (16%) individuos relataram vertigem. Nao houve significância entre a queixa de vertigem e a hipertensao arterial no grupo estudado, isto provavelmente por alguns criterios como a exclusao de individuos com enfermidades e uso de medicamentos capazes de produzir vertigem, que nao puderam ser evitados durante a execucao, pois a maioria deles tinha disturbios associados, situacao comum nos idosos. CONCLUSAO: Observou-se em idosos, com e sem hipertensao arterial, grande frequencia da queixa de vertigem, embora nao se tenha obtido relacao significativa entre a queixa de vertigem e hipertensao arterial na populacao estudada.

Prevalence of tinnitus in elderly individuals with and without history of occupational noise exposure

Summary Introduction: The various metabolic and circulatory alterations that are related to noise exposure may cause the onset of several symptoms, including tinnitus. Objective: The purpose of the study was to assess the prevalence of tinnitus complaints in elderly individuals with and without history of occupational noise exposure. Method: This prospective study was conducted in a sample population consisting of 502 individuals aged over 60 years, by anamnesis and audiological evaluation. The variables that were studied were the frequency of tinnitus and the history of occupational noise. Logistic regression was used to control for potential confusion or modifications caused by the effects of the other variables on the associations of interest. Results and Discussion: Tinnitus was reported in 50% of the cases, with tinnitus reported in 40% of the elderly individuals with history of occupational noise exposure, and in 43% of controls (elderly individuals without history of occupational noise exposure). A high frequency of tinnitus was detected in the population under investigation, but there were no statistically significant associations between the presence of tinnitus and history of occupational noise exposure. Conclusion: The results of this study may have occurred due to other factors such as the age of the individuals without history of occupational noise exposure.

Avaliação da manobra de reposicionamento de Epley em indivíduos com vertigem posicional paroxística benigna

PURPOSE: to evaluate the stabilometry parameters after Epleys maneuver in individuals with BPPV previously confirmed through Dix-Hallpike maneuver. METHODS: an experimental study which included patients with BPPV with positional nystagmus taking Dix-Hallpikes test and assessed in 2008, at the Multidisciplinary Vertigo Ambulatory, and who were also submitted to Epleys maneuver and assessed as for their postural balance through a stabilometry exam, both before and after such maneuver. RESULTS: the 13 female subjects with ages ranging from 15 to 78 years with previously confirmed BPPV, who were selected for the research, showed a significant statistically improvement regarding their postural balance after Epleys maneuver in all analyzed parameters as for both exams. CONCLUSION: in this research the Epleys maneuver was shown as a procedure of important intervention for improving the answers of postural balance in individuals with BPPV evaluated by the stabilometry.

Manobra de epley na vertigem posicional paroxística benigna: relato de série de casos

Introduction:  Benign paroxysmal positional vertigo (BPPV) is probably the most common cause of vertigo in women. Objective:  To report the result of Epleys maneuver when treating BPPV patients. Method:  Study of a series of 9-month-long cases of five female individuals aged between 46 and 64 with BPPV, who were submitted to Epleys maneuver at a scholar clinics, having the positive Dix-Hallpike maneuver at the first consultation as an inclusion criterion, and evaluations were repeated in a six and nine-month term. Results:  Only one Epleys maneuver, as the only therapeutic procedure, was enough to eliminate nystagmus and positional vertigo in 4 patients, who did not show a positive Dix-Hallpike maneuver in the two reevaluations performed. Only one patient showed BPPV in the first reevaluation of the study term, and nystagmus reoccurred in the second evaluation only. Conclusion:  Epleys repositioning maneuver proved to be a simple and effective BPPV treatment method for this studys patients at length.INTRODUCTION: Benign paroxysmal positional vertigo is probably the most common vertigo cause in women. OBJECTIVE: To mention the Epley manouvre in patients treatment benign paroxysmal positional vertigo. METHOD: Study of several longitudinaBnths of 05 individuals of female gender with age between 46 and 64 years old, with benign paroxysmal positional vertigo, submitted to Epley manouvre, in school clinic, having as inclusion criterion the positive Dix-Halpike manouvre in first session being reevaluated in a given period of time of 06 to 09 months. RESULTS: Just one Epley manouvre, as a single therapeutic procedure, was sufficient to abolish the nystagmus and the positioning vertigo in 04 patients that did not present the positive Dix-Halpike manouvre in the 02 effected reevaluations. Just one patient presented again the benign paroxysmal positional vertigo in the first reevaluation of study cycle, having the nystagmus recurrence only in the second evaluation. CONCLUSION: the repositioning of Epley manouvre showed to be a method treatment of benign paroxysmal positional vertigo simple and efficient in the course of studied patients.

RESULTADOS TIMPANOMÉTRICOS: LACTENTES DE SEIS MESES DE IDADE

PURPOSE: to check the timpanometric findings in six-month-old infants, who were exclusively and/or predominantly breast fed. METHODS: 46 six-month-old infants were studied. From this total, 30 (61.22%) of the infants were submitted exclusively to breast feeding during six months and 16 (34.78%) infants were not submitted to exclusive breast feeding. The infants were submitted to external acoustic meatho and eardrum inspection. RESULTS: there were statistically significant (p=0.0084) differences in the findings for timpanometry alterations in breast fed infants for a longer time period. Considering the infants gender related to breast feeding period, only the male infants presented statistically significant (p=0,0006) results related to normal tympanometric curve protection. Concerning other analyzed factors, it was possible to find a relation between exclusive breast feeding period and tympanometric alterations. CONCLUSION: despite other risk factors, exclusive breast feeding for a period of six months is the ideal way for breast feeding and it acts as an important factor to prevent tympanometric alterations. It is not necessary to insert other types of food before this period which has been recommended to be an ideal breast feeding period by the World Health Organization.

Interleukin‑1β gene polymorphism and hearing loss related to the history of occupational noise exposure in Brazilian elderly

Hearing loss is the most common sensory impairment in older people, and may have social and psychological consequences, such as social isolation, frustration and depression. Noise-induced hearing loss (NIHL) is an interaction of both genetic and environmental factors. Some studies have led to the identification of possible NIHL susceptibility genes. The aim of the present study was to investigate whether the polymorphism of the interleukin (IL)-1β gene at position + 3954 was associated with complaints of hearing loss due to occupational exposure. The sample was composed of elderly people with hearing loss (age ≥ 60 years) divided into two groups: 99 with occupational exposure to noise and 193 without exposure. Information on occupational exposure to noise was obtained through interviews using a semi-structured questionnaire. Hearing acuity was measured from 500 to 6000 Hz and the IL-1β genotype was obtained by the polymerase chain reaction- restriction fragment length polymorphism technique. Differences in allelic and genotypic frequencies, and the association between genotypic frequencies and complaints of hearing loss due to occupational exposure, were analyzed by the Chi-square test at the 5% significance level. Fifty-one percent of the elderly were homozygous for the ancestral allele (C), 17.2% were homozygous for the polymorphic allele (T) and 31.8% were heterozygous. The frequency was found to be 67-33% C to allele T. There was no significant association between polymorphism in gene IL-1β and hearing loss associated with occupational exposure (χ2 = 0.538; P = 0.676). No association was found with the polymorphism of the IL-1β +3954 C/T gene and hearing loss associated with the occupational noise exposure history.

Prevalência e associações da vertigem posicional paroxística benigna em idosos

PURPOSE:to determine the prevalence of benign paroxysmal positional vertigo and identify their associations in an elderly population.METHODS:a cross-sectional study in elderly patients evaluated by audiological evaluation, comorbidity questionnaireand Dix-Hallpike maneuver Were applied nonparametric tests: Chi-square and multivariate regression with a confidence interval of 95%.RESULTS:the final sample consisted of 494 individuals, with a median age of 69 (64.75 to 74.00) years. Observed prevalence of 23.9% of benign paroxysmal positional vertigo and 51.6% of neck pain and headache 37.9%. There was a statistically significant association between benign paroxysmal positional vertigo and neck pain, headache and gender in this population.CONCLUSION:it is concluded that this elderly population the prevalence of benign paroxysmal positional vertigo was 23.9% and the neck pain was 51.6% and there was a significant association between benign paroxysmal positional vertigo with neck pain and female gender.