Luciana Lozza de Moraes Marchiori

Hipertensão como fator associado à perda auditiva

OBJETIVO: Identificar possivel associacao entre hipertensao arterial e perda auditiva. Foi realizado um estudo do tipo caso-controle nao pareado, na Universidade Norte do Parana, no Sul do Brasil. MATERIAL E METODO: 154 casos e 154 controles, de ambos os sexos com idade variando de 45 a 64 anos foram incluidos na pesquisa apos o calculo da amostra. A hipertensao foi verificada por medicao da pressao arterial e de questionario sistematizado sobre hipertensao e uso de medicamentos para pressao arterial. A audicao foi avaliada por audiometria e anamnese audiologica. A tecnica de regressao logistica nao-condicional foi utilizada com o objetivo de controlar a possivel acao de confusao ou modificacao de efeito exercida por outras variaveis sobre as associacoes de interesse. RESULTADOS : Pode-se verificar que existe associacao significativa entre hipertensao arterial e presenca de perda auditiva e que a perda auditiva observada nesta populacao sugere que a hipertensao arterial age como fator de aceleracao da degeneracao do aparelho auditivo proveniente da idade. CONCLUSOES: Os resultados da presente pesquisa, atraves da constatacao da associacao entre hipertensao e perda auditiva, servirao de base a uma integracao entre cardiologistas, nefrologistas, otorrinolaringologistas, fonoaudiologos e outros profissionais da area de com alteracoes provenientes da hipertensao.

Hypertension as a factor associated with hearing loss

AIM To identify likely association between blood hypertension and hearing loss. DESIGN A non-paired case-control study. SETTING Institutional work carried out at Universidade Norte do Paraná, in South Brazil. MATERIAL AND METHOD 154 cases and 154 controls, both genders, aged 45 to 64, included in the research after sample estimation. METHODOLOGY Hypertension was verified through blood pressure readings and by a systematized questionnaire about hypertension and the use of medication for blood pressure. Hearing was assessed through tonal threshold audiometrics and audiologic anamneses. Non-conditional logistic regression was used in order to control likely confusion or modification of effect of other variables on interest associations. RESULTS There is a significant association between blood hypertension and hearing loss. Hearing loss in the population under study suggests that hypertension is an accelerating factor of degeneration of the hearing apparatus due to aging. CONCLUSIONS The results in this research, through evidence of association between blood hypertension and hearing loss, can allow for an integrated work of cardiologists, nephrologists, otorhinolaryngologists, audiologists and other health professionals concerned with alterations caused by blood hypertension.

Diabetes mellitus: prevalência de alterações auditivas

Although the presence of otologic symptoms associated with diabetes mellitus (DM) have been discussed for six decades, its etiology still remains obscure. Since the association between DM and hearing loss is still a matter of debate, the goal of this paper was to verify the prevalence of hearing loss in patients with DM. Therefore we studied the genesis of DM by a case-control protocol, where pure tone and impedance audiometry were employed. The hearing acuity in 97.2% of the patients with DM showed sensorioneural hearing loss, mainly for high frequencies. We conclude that there was a direct association between DM and hearing loss, mainly for high frequencies.

Análise das respostas obtidas por potenciais evocados auditivos de estado estável em indivíduos normais

Introducao: Potenciais evocados auditivos de estado estavel sao respostas eletrofisiologicas a tons continuos, modulados em amplitude que podem ser registradas por eletrodios de superficie e permitem uma avaliacao mais detalhada e objetiva da audicao, devido a seletividade de frequencias e objetividade na analise das respostas. Objetivo: Averiguar se esta nova tecnica, que esta sendo introduzida no Brasil, e realmente confiavel e eficiente para ser incluida na rotina de avaliacao audiometrica objetiva. Forma de estudo: clinico prospectivo. Material e Metodo: analisar as respostas dos potenciais auditivos de estado estavel, nas frequencias de 500, 1000, 2000 e 4000Hz, obtidas em um grupo composto por 25 individuos adultos, com idades entre 21 e 40 anos, sem queixas auditivas e com limiares psicoacusticos entre 0 e 15dB NA. Resultados: As respostas evocadas dos potenciais de estado estavel no dominio da frequencia foram facilmente detectadas, atraves de procedimentos matematicos, entre 20 e 40dB NA em todos os individuos, em pelo menos seis das oito frequencias pesquisadas, correspondente a 97% de um total de 200 respostas esperadas. Uma grande concentracao (85%) destas respostas foi obtida ate 30dB NA, das quais: 80% em 500Hz; 84% em 1KHz; 90% em 2KHz e 86% na frequencia de 4KHz. Conclusao: Os resultados mostraram-se compativeis com os estudos realizados por pesquisadores de outros paises, isto e, uma aproximacao de 15 a 20dB NA dos limiares psicoacusticos. Foram confirmadas tambem as principais vantagens sobre os outros metodos de avaliacao auditiva eletrofisiologica: a objetividade da analise dos registros e a seletividade de frequencia das respostas dos potenciais evocados auditivos de estado estavel, fazendo supor que, em breve, esta tecnica assumira um papel de destaque na audiometria objetiva.

Signs and symptoms of Temporomandibular Disorders in the elderly

PURPOSE To perform a systematic review of the literature on questionnaires to assess the benefits of using hearing aids in children. METHODS A literature search was conducted in the data-bases Web of Science and Virtual Health Library (BIREME). The selection criteria included: title consistent with the purpose of this review; participants necessarily being children using hearing aids; and questionnaires to assess the benefits and satisfaction. RESULTS More evidence was found in studies that used the scale Parents Evaluation of Aural/Oral Performance of Children (PEACH), making it possibly the most consistent scale on the subjective evaluation of the use of amplification in children. CONCLUSION There is a paucity of studies with this approach; however, the results showed the importance of researches in this area, which turns the subject into an important field of research.PURPOSE This study investigated the prevalence of Temporomandibular Disorders (TMD) in the elderly and its association with palpation of the temporomandibular joint (TMJ), masticatory and cervical muscles as well as the presence of headache and joint noises. METHODS The sample consisted of 200 elderly of both genders (mean age: 69.2±5.7 years). The clinical evaluation of TMD signs and symptoms was divided into three stages: an anamnestic questionnaire, a TMJ evaluation, and a muscular examination. The results were analyzed through descriptive statistics as well as using χ2 and the tendency tests. RESULTS The presence of TMD was observed in 61% of the sample (mild: 43.5%, moderate: 13%, severe: 4.5%). A significantly greater prevalence of TMD was found for females (72.4%) compared with that for men (41.1%) (p<0.0001). Additionally, a significant association among TMD severity and palpation of the TMJ (p=0.0168), of masticatory muscles (p<0.0001), and of cervical muscles (p<0.0001) was verified. Also, there was a significant association between the frequency of headaches and the presence of TMD (p=0.0001). The association between the presence of joint noises and sensitivity to TMJ palpation was not significant. CONCLUSION The elderly presented high TMD prevalence, mostly in females, with mild severity and related to TMJ and masticatory/cervical muscles palpation. Thus, the accomplishment of a detailed clinical examination to investigate the presence of such disorders is essential and it must not be neglected during the treatment of elderly patients.

Zumbido: possível associação com alterações cervicais em idosos

INTRODUCAO: O zumbido e um sintoma prevalente e de alto impacto na qualidade de vida do paciente idoso. A presenca de cervicalgia e alteracoes na coluna cervical sao comuns em pacientes com queixa de zumbido. OBJETIVO: Avaliar a prevalencia do zumbido e cervicalgia em um grupo de idosos e verificar a possivel associacao entre zumbido, cervicalgia e restricao de amplitude de movimento cervical. METODO: Estudo transversal retrospectivo com avaliacao da amplitude de movimento cervical atraves de goniometria e do zumbido e da cervicalgia atraves da aplicacao de questionario padronizado. RESULTADOS: A amostra foi constituida por 147 individuos, com idade media de 69,22 anos sendo 61,90% mulheres. Desses individuos, 42,85% apresentaram queixa de zumbido 51% dos individuos relataram queixa de dor cervical. Nao houve associacao entre zumbido e dor cervical e nem associacao entre zumbido e restricao de amplitude de movimento cervical. CONCLUSAO: Embora nao tenha sido constatada associacao entre zumbido e dor cervical e entre zumbido e restricao de amplitude de movimento, observou-se grande prevalencia de queixa de zumbido, de cervicalgia e de diminuicao na amplitude de movimento cervical na populacao de idosos. Os resultados da presente pesquisa, por meio da constatacao desta grande prevalencia do zumbido em toda a populacao de estudo, servirao de base a uma integracao entre profissionais da area de saude envolvidos com tais alteracoes.

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.

Effectiveness of a vestibular rehabilitation protocol to improve the health-related quality of life and postural balance in patients with vertigo

Introduction Dizziness can be characterized as a balance disorder that causes discomfort, leading to several functional limitations. Currently, vestibular rehabilitation has been highlighted as a possible treatment. Objective Analyze the effects of completing a vestibular rehabilitation treatment protocol on quality of life and postural balance in patients with vestibular complaints, as well as to compare these effects between the patients taking or not taking antivertigo drugs. Methods A nonrandomized controlled trial was performed with 20 patients previously diagnosed with vestibular diseases. Information regarding vertigo symptoms, quality of life as assessed through the Dizziness Handicap Inventory, visual analog scale of dizziness, and stabilometry using force platform was collected. Patients were treated for 12 weeks by a custom protocol. The sample was divided into two groups according to the use (medicated group, n = 9) or not (control group, n = 11) of antivertigo drugs. Results There was improvement in quality of life (p < 0.001) and intensity of dizziness (p = 0.003) with the intervention. An improvement of postural balance was observed through functional tests. However, no statistically significant difference was noted in stabilometry. When both groups were compared, no statistically significant differences between the variations of the variables analyzed were found in the re-evaluation session. Conclusion Quality of life and postural balance are improved with intervention. However, this improvement is not associated with pharmacologic treatment.

Association between complaints of dizziness and hypertension in non-institutionalized elders

Summary Introduction: Advancing age increases the risk for a number of chronic diseases. Hypertension and dizziness are highly prevalent in the elderly population and represent major health problems. Objective: To verify the association between complaints of dizziness and the presence of hypertension in non-institutionalized elders. Method: This was a prospective cross-sectional cohort study of the elderly population of Londrina, Paraná in terms of aging and longevity. The required sample size was calculated, and subjects e” 60 years of age of both genders were selected at random. Data were collected using a questionnaire covering socio-demographic information and self-reported cases of hypertension and dizziness. Statistical analysis was performed using the chi-square test with p d” 0.05 as the level of significance. Results: The study included 493 elderly subjects, of whom 257 (52.1%) complained of dizziness and 308 (62.5%) reported a diagnosis of arterial systemic hypertension. Dizziness was significantly associated with hypertension (χ2 = 6.26, p = 0.01) and female sex. Conclusions: Hypertension and dizziness were both highly prevalent and were significantly associated, showing the great need for investments in preventive measures.

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.