Keila Alessandra Baraldi Knobel

Selective auditory attention and silence elicit auditory hallucination in a nonclinical sample

Introduction. Several investigations have shown that the occurrence of auditory hallucinations (AH) is not restricted to neuropsychiatric patients. The aim of this study is to analyse the effect of attention and sustained silence on the emergence of AH in a nonclinical sample. Methods. Sitting in a silent sound booth, 66 adults were studied under different attention demands and then where asked about their auditory perception. Results. While performing a Hanoi Tower in silence, 10.6% of the individuals had hallucination-like perceptions (music, voices, and others). This rate decreased to 6.0% during a visual attention task, but highly increased to 36.4% during auditory attention. Conclusions. Auditory hallucinations may occur in a nonclinical population in a silent environment. Concomitant auditory attention increases both the quantity and the quality of those perceptions.

Reabilitação vestibular em um hospital universitário

A Reabilitacao Vestibular visa melhorar o equilibrio global, a qualidade de vida e orientacao espacial dos pacientes com tontura. OBJETIVOS: Tracar o perfil dos pacientes atendidos no Ambulatorio de Reabilitacao Vestibular do Setor de Otoneurologia de um hospital universitario e verificar os resultados obtidos no periodo de novembro/2000 a dezembro/2004. MATERIAL E METODO: Levantamento de dados contidos nas fichas dos 93 pacientes submetidos a Reabilitacao Vestibular no periodo. FORMA DE ESTUDO: Clinico retrospectivo. RESULTADOS: A media etaria dos pacientes foi de 52,82 anos, 56 do sexo feminino e 37 do sexo masculino. O numero medio de atendimentos foi 4,3, sendo maior para os pacientes com disturbios otoneurologicos centrais (media de 5,9). Dentre os pacientes que concluiram o tratamento proposto, 37 (60,7%) obtiveram melhora significativa, 14 (22,9%) tiveram melhora parcial e 10 (16,4%) nao referiram beneficios significativos. Os pacientes que mais se beneficiaram com a Reabilitacao Vestibular tinham disturbios otoneurologicos perifericos. CONCLUSAO: A maior parte dos pacientes era do sexo feminino, com idade media de 52,8 anos. Cinquenta e um pacientes (83,6%) tiveram beneficio com a terapia confirmando a eficacia do tratamento.

Effectiveness of the Brazilian version of the Dangerous Decibels® educational program

Abstract Objective: To evaluate the effectiveness of a Brazilian version of the Dangerous Decibels® educational program in increasing students’ knowledge and positively changing their attitudes and intended behaviors related to NIHL prevention and to decrease exposures to loud sounds and the barriers related to hearing protective strategies (HPS). Design: This is a prospective longitudinal controlled study. Study sample: Third to fifth graders (n = 220) filled out a baseline questionnaire; participated in a 60 minutes Dangerous Decibels® classroom presentation; answered a follow-up questionnaire immediately after the presentation; worked with their teachers on an activity booklet about hearing health ten weeks later; and filled out a three-months follow-up questionnaire. Students that did not receive health hearing education served as a control group (n = 51). A mixed analysis of variance was performed, with time as the within-subjects independent variable, and the intervention as the between-subjects independent variable. Results: The study group exhibited significant short- and long-term improvements in knowledge, attitudes, and intended behavior related to NIHL and acoustic trauma prevention, and in decreased exposures to loud sounds and barriers to the use of hearing protective strategies. Conclusions: This study demonstrated the effectiveness of a Brazilian version of the Dangerous Decibels classroom program with an additional supplementary workbook intervention.

Knowledge, habits, preferences, and protective behavior in relation to loud sound exposures among Brazilian children

Abstract Objective: Identification of the beliefs and attitudes towards noise exposure and the risk of noise-induced hearing loss in Brazilian children. Design: Prospective cross-sectional study through interviews with children and their parents. Study sample: 753 children were selected and invited to participate. The final sample was 475 children and 404 parents. Results: In general, children disliked noisy places (67%). Although 87.4% of the children and 93.9% of the parents considered loud sounds damaging to the ears, children were poorly informed about hearing protection and did not have hearing protection devices. Children were mostly exposed to parties and concerts with loud music (51.9%), carnaval (Mardi Gras) parties (38.2%), firecrackers (36.8%), and loud music at home or in the car (33.1%), or from listening to loud music with earphones (17.3%). Compared to children from private schools, children from public schools had a greater preference for loud sounds and were less informed about hearing protection. Conclusions: Knowledge of hearing risk from loud sounds was not enough to prompt preventive behaviors, and adults exposed children to loud sounds.

Nível de desconforto para sensação de intensidade em indivíduos com audição normal

BACKGROUND Loudness Discomfort Level (LDL), a test used in the hearing aid fitting process, has also been recommended to evaluate patients with tinnitus and/or suspect of hyperacusis. AIM To determine LDL reference values for normal hearing individuals and to correlate the LDL to the Acoustic Reflex Threshold (ART). METHOD LDL was investigated in 64 normal hearing subjects, with ages between 18 and 25 years (53.1% female), in the frequency threshold of 0.5 to 8KHz and for speech (non-recorded, non-standardized connected discourse). Pulsate pure tones were presented for two seconds, with a one-second interval between each presentation. The initial stimulus intensity was at 50dB and was followed by ascending presentations, of 5dB each, until the subject referred initial discomfort with loudness. The testing procedure was performed separately in each ear, and was immediately repeated at the end of the test (test and retest situation). The choice of the ear that would start the testing procedure was alternated for each subject. After that contralateral acoustic reflexes ART were measured. The presence of the ART was indicated by a minimal needle deflection (larger than 0.05ml) on the emittance equipment. RESULTS Median varied from 86 to 98dBHL, with no statistically significant differences between gender (p > 0.11), between ears (p > 0.36) and between the test-retest situation (p > 0.34). The determination coefficients (r2) of the linear regression model revealed absence of correlation between log(LDL) and log(ART). CONCLUSION Normal hearing individuals have LDL between 86 and 98dBHL for all of the tested stimuli. Inter-subject differences and the good reproductivity suggest that the interpretation of the test should be cautious and analyzed considering the patients history. The test can be an useful instrument go follow-up patients. No correlation was found between LDL and ART.

Vestibular rehabilitation in a university hospital

UNLABELLED The aim of vestibular rehabilitation is to improve total balance, quality of life and spatial orientation of patients with dizziness. AIMS To determine the characteristics of the patients who underwent the Vestibular Rehabilitation program of the Neurotology Ward of a University Hospital, and to verify the results obtained between November/2000 and December/2004. MATERIALS AND METHODS analysis of 93 files from patients under Vestibular Rehabilitation during the studied period. STUDY DESIGN Retrospective clinical. RESULTS the mean age of patients was 52.82 years, 56 females and 37 males. The average number of therapy sessions was 4.3, higher for patients with central neurotological disorders (average of 5.9). Among the patients who concluded the treatment, 37 (60.7%) had significant improvement, 14 (22.9%) presented partial improvement and 10 (16.4%) did not report significant benefits. Patients with peripheral neurotological disorders were the ones who most benefited from Vestibular Rehabilitation. CONCLUSION Most of the patients were female, with a mean age of 52.8 years. Fifty one patients (83.6%) benefited from the therapy, confirming treatment efficacy.

R086: Attention and Silence Elicit Phantom Auditory Perceptions

graine headaches. Mutation analysis is under way. CONCLUSION: MRS with FP is possibly more common than diagnosed, has better prognosis than progressively worsening edematous form of MRS (different disease?), and is frequently associated with minor symptoms known to accompany MRS. The association with UNC-93B deficiency is to be determined. SIGNIFICANCE: 1. Clarifying the clinical picture of MRS with FP, the form of MRS that is rarely studied and reported in the literature. 2. From upcoming results, possible susceptibility to herpesvirus infection in MRS. SUPPORT: This study was partly supported by a grant from the Helsinki University Central Hospital Reasearch Fund.

Loudness discomfort level for normal hearing subjects: is it a reliable test?

Objectives: Loudness discomfort level (LDL) is usually used in patients with hearing loss during the hearing aid evaluation and fitting process. Recently, it has also been used to diagnose and follow-up patients with hypersensitivity to sound. As these patients may have normal hearing thresholds and there are no reference values established for this test, the objective of this study is to determine the range of values of LDL for normal listeners. Methods: The LDL was investigated in 64 normal listening young adults from 18 to 25 years old (34 females [53.1%] and 30 males [46.9%]). Both ears were evaluated in test and re-test situation for frequencies among 0.5 and 8 KHz. Pulsate pure tones were presented on ascendant way until the subject first complained of discomfort to the sound. Results: The median for all frequencies varied between 86 and 98 dBHL, with no differences between right and left ears nor on test and retest situation. Conclusion: The good reliability on test and re-test situation makes LDL a trustable test. However, the inter-subject differences pointed out in this study suggest that LDL should always be associated with a detailed anamnesis about hypersensitivity to sound before its interpretation.