Kátia de Freitas Alvarenga

The Brazilian Portuguese Hearing in Noise Test

The hearing in noise test (HINT) is currently available in several languages (Nilsson et al., 1994). The similarity of the procedures and the resulting similarity of the test materials makes the measures obtained with the HINT comparable across languages. Individuals from both genders, in the age range of 18 50 years, with hearing thresholds 20 dB HL or better at the octave frequencies from 250 to 8000 Hz, for both ears, who were native speakers of the Portuguese spoken in Brazil participated in this study.

The universal newborn hearing screening in Brazil: From identification to intervention

OBJECTIVE The objective of the study is to investigate the results of the newborn hearing screening program carried out in a Public Hospital in Brazil, in the first 3 years regarding: (1) the prevalence of hearing impairment; (2) the influence of the universal hearing screening program on the age at which the diagnosis of hearing loss is defined; (3) the cost effectiveness of the program; (4) the outcomes, in terms of the age in which the hearing rehabilitation started. METHODS A descriptive study of the first 3 years after starting the universal newborn hearing screening in a Public Hospital of Bauru, São Paulo state, Brazil. The screening method consists of a two-stage screening approach with transient otoacoustic emissions (TOAE), conducted by an audiologist. If the outcome in the second-stage screening is REFER, the infant is submitted to diagnostic follow-up testing and intervention at the Audiology and Speech Pathology Clinic at the University of São Paulo, campus of Bauru. The evaluation of the costs of the universal newborn hearing screening program per each screened newborn (around 4000/year) was done based on a proposal by the National Center for Hearing Assessment and Management, of the Utah State University, United States of America. RESULTS 11,466 newborns were submitted to hearing screening, corresponding to 90.52% of the living newborns. The prevalence of sensorineural hearing loss was 0.96:1000. Of the 11 children with sensorineural hearing loss, eight children received hearing aids and five started the therapeutic process before the age of 1. Currently, four children between the ages of 11 months and 2 years old were submitted to cochlear implant surgery. The cost of hearing screening was US

Proposta para capacitação de agentes comunitários de saúde em saúde auditiv

7.00 and the annual cost of the universal newborn hearing screening program was US

Potencial cognitivo P300 em indivíduos com diabetes mellitus

26,940.47. CONCLUSION The hospital-based universal newborn hearing screening carried out through the Brazilian National Health System is viable, with promising results. However, in a country such as Brazil, which presents large socio-economic differences, the same type of analyses should be performed in several regions, so as to take into account specific aspects, to implement the newborn hearing screening along with the Public System.

Audiometria de alta freqüência: estudo com indivíduos audiologicamente normais

TEMA: capacitacao de agentes comunitarios de saude na area de saude auditiva. OBJETIVO: verificar a efetividade de um programa de capacitacao de agentes comunitarios de saude do Programa de Saude da Familia, na area de saude auditiva infantil. METODO: a casuistica constou de dois grupos: grupo A foi constituido por 31 agentes comunitarios de saude da cidade de Bauru e, grupo B, formado por 75 agentes comunitarios de saude de Sorocaba, ambos municipios do Estado de Sao Paulo. A capacitacao foi realizada por meio de aulas expositivas para os dois grupos, contudo para o grupo A foi utilizado uma apostila adaptada da World Health Organization (2006), para que os agentes comunitarios de saude pudessem acompanhar as atividades realizadas de forma interativa. A capacitacao abordou os temas: audicao e deficiencia auditiva, tipos, prevencao e causas da deficiencia auditiva, tecnicas de identificacao e diagnostico da deficiencia auditiva e aspectos gerais da deficiencia auditiva. Para validar a capacitacao foi aplicado um questionario pre e pos-capacitacao com perguntas sobre os assuntos que foram abordados no decorrer do curso, a fim de analisar a assimilacao do conteudo ministrado. RESULTADOS: a capacitacao foi efetiva, com aumento no escore total obtido nos questionarios pre e pos-capacitacao. CONCLUSOES: os resultados comprovam a eficacia do programa de capacitacao com utilizacao de material e abordagem interativa proposto para os agentes comunitarios de saude dos Programas de Saude da Familia.

Análise crítica de três protocolos de triagem auditiva neonatal

Diabetes Mellitus pode acarretar complicacoes nos olhos, rins, nervos cranianos, nervos perifericos, ouvidos, etc. A funcao cognitiva tambem parece estar prejudicada em individuos portadores de Diabetes Mellitus, visto que as estruturas corticais e subcorticais responsaveis por esta funcao estao prejudicadas em alguns pacientes dependentes de insulina. O potencial cognitivo P300 tem sido usado como um procedimento objetivo para avaliar a funcao cognitiva cerebral. OBJETIVO: Analisar a sensibilidade do potencial cognitivo P300 para detectar alteracoes no cortex auditivo decorrentes do Diabetes Mellitus. FORMA DE ESTUDO: coorte transversal. MATERIAL E METODO: Participaram deste estudo 16 individuos diabeticos de ambos os sexos, com idade variando de 7 a 71 anos, e 17 individuos nao-diabeticos equiparados quanto ao sexo, idade e limiar auditivo. Os procedimentos de avaliacao foram: Audiometria Tonal Liminar (ATL) e potencial cognitivo P300. No grupo diabetico foi realizada a medida do valor glicemico antes da realizacao do P300. RESULTADOS: Os resultados obtidos na ATL nao mostraram diferenca estatisticamente significante. Foi observado diferenca estatisticamente significante entre os grupos, quando analisado a latencia do componente P3, medido em Fz. Houve correlacao entre a glicemia e a latencia e amplitude do P300. CONCLUSAO: A pesquisa do potencial cognitivo P300 e um importante procedimento para prevenir e diagnosticar precocemente de alteracoes neurologicas em individuos com Diabetes Mellitus.

Potencial evocado auditivo de longa latência-P300 em indivíduos normais: valor do registro simultâneo em Fz e Cz

Recent research studies pointed to High-Frequency Audiometry (HFA) as a tool for early diagnosis of hearing impairment caused by the main etiological agents, such as aging, exposure to ototoxic drugs, and occupational noise. AIM: Although there are already several techniques developed for this assessment, some of them should not be applied to clinical routine, because of their lack of practicability and, sometimes, lack of reliable results. According to the literature, a suitable methodology for such assessment, as well as values indicated as normal reference, are still needed. STUDY DESIGN: Clinical prospective. MATERIAL AND METHOD: The present research study observed auditory thresholds in young and audiologically normal individual with HFA and assessed some variables that could have an influence upon the results. CONCLUSION: Based on the collected data, we were able to established values for mean, standard deviation and median, besides minimum and maximum values for each frequency, for the entire population. Statistical analyses did not identify significant differences between gender and the ears. Moreover, questions related to inter-and intra-individual variability are discussed.

Capacitação de agentes comunitários de saúde em saúde auditiva: efetividade da videoconferência

BACKGROUND: having knowledge about the validity of procedures for newborn hearing screening (NHS) is fundamental, once the purpose of these programs is to identify all newborns with hearing loss at an acceptable cost. AIM: to estimate the specificity and the false-positive rate of NHS protocols using transient evoked otoacoustic emissions (TEOAE) and automated auditory brainstem response (AABR). METHOD: participants were 200 newborns who were submitted to a hearing screening test between March and July 2006. Three protocols were analyzed: protocol 1, NHS was carried out in two steps using TEOAE; protocol 2, NHS was carried out in two steps using AABR; and protocol 3, NHS was carried out in one step, using the two procedures - testing with TEOAE followed by a retest with AABR for all the newborns who did not pass the TEOAE testing. RESULTS: although there was no statistically significant difference when comparing the referral rates to audiological diagnosis obtained in protocols using TEOAE and AABR, the protocol using TEOAE referred four times more newborns. Protocol 3 presented the highest referral rate, with a statistically significant difference when compared to protocols 1 and 2. CONCLUSIONS: the false-positive rate and consequently specificity were better for the protocol using AABR, followed respectively by the protocol using TEOAE and using both TEOAE and AABR.

Maturação do sistema auditivo central em crianças ouvintes normais

The P300 is and auditory Evoked Potential, called endogenous potential because it reflects the functional use the individual makes of the auditory stimulus, being highly dependent on cognitive skills; among them we list attention and auditory discrimination. It is a procedure of objective evaluation; however, one that depends on the examiners experience to detect wave peaks, and it is important to use recording methods that facilitate the response presence analysis and result interpretation. AIM: to analyze the P300 Long Latency Auditory Evoked Potential obtained through the use of two active electrodes positioned on Fz and Cz. MATERIALS AND METHODS: 330 individuals from both genders and age ranging between 7 and 34 years participated in this study, they all had normal hearing and did not have any risk factor for mental problems. RESULTS: Results show that there was no statistically significant difference for N2 and P3 latency and P3 amplitude as far as gender is concerned, nor correlation with the individuals age. There was a strong correlation of these measures with Fz and Cz electrode positioning. CONCLUSION: Fz and Cz active electrodes positioning can be considered one more resource to help in the P300 clinical analysis.

The maturational process of the auditory system in the first year of life characterized by brainstem auditory evoked potentials

BACKGROUND: training of Community Health Agents on hearing health through videoconference. AIM: to verify the effectiveness of a training program for community health agents, through videoconference, on child hearing health. METHOD: participants of the study were 50 professionals who were randomly divided in two groups: 31 community health agents were physically present in the training program and 19 participated via videoconference. Training was provided in eight hours, through classes and using specific material adapted from the Primary ear and hearing care training resource - basic, intermediate and advanced levels for both groups, simultaneously. Training was organized and evaluated according to a previous study. RESULTS: both groups presented a statistically significant difference when comparing pre and post training performances. However, for the group of community health agents who were physically present during the training program, this difference was higher not only when considering the final total scores but also when looking at the individual topics. CONCLUSION: videoconference was effective as a learning tool for the training of community health agents on child hearing health. However, this instrument should be used as a complementary material to the traditional form of training.