Luciene da Cruz Fernandes

Sensorineural hearing loss in children with sickle cell anemia and its association with endothelial dysfunction

ABSTRACT Objectives: To investigate the prevalence of sensorineural hearing loss (SNHL) in children and adolescents with sickle cell anemia (SCA) and its association with endothelial dysfunction (ED). Methods: Fifty-two participants with stable SCA and 44 apparently healthy (AA genotype) participants aged 6–18 years were evaluated for pure tone audiometry and endothelial function using ultrasonographic imaging of the brachial artery to assess flow-mediated dilation (FMD). Laboratory analysis of the lipid profile and C-reactive protein levels was performed. Results: In the SCA group, 15 (28.8%) patients presented with SNHL. The FMD values were reduced in the SCA with SNHL group compared with the SCA without SNHL and healthy groups. Logistic regression analysis showed that FMD was associated with SNHL independent of the lipid profile and SCA characteristics (odds ratio [95% confidence interval] = 0.614 [0.440–0.858]; p = 0.004). Discussion: SNHL is a common complication in SCA; furthermore, this study identified a significant association between ED and SNHL. Damage to the vascular endothelium because of inflammation in SCA reduced blood flow in the inner ear. Thus, this circulatory disorder culminates in vaso-occlusive process and induces auditory disorders, such as SNHL.

HIPOTIREOIDISMO CONGÊNITO COMO FATOR DE RISCO PARA OS TRANSTORNOS DO PROCESSAMENTO AUDITIVO CENTRAL

ABSTRACT Objective: To investigate the presence of central auditory processing disorder symptoms in children with congenital hypothyroidism. Methods: An exploratory, descriptive, cross-sectional study of 112 patients with congenital hypothyroidism aged ≥5 years old. An interview was held with the parents/caregivers at the time of the medical consultation. Patients with other medical conditions were excluded. As a research instrument, the structured protocol of anamnesis was used to evaluate the auditory processing routinely used by audiologists. For statistical analysis, the chi-square test was used. Results: Sex distribution was similar in both boys and girls (girls: 53.3%). The most prevalent phenotypic form of congenital hypothyroidism was no dysgenesis (88.4%), and 65.3% of the children had an episode of irregular serum thyroid-stimulating hormone (TSH) levels. Among the manifestations of the most frequent central auditory processing disorder symptoms, problems were reported with regard to cognitive functions, as they related to hearing, such as figure-background ability (83.0%), auditory attention (75.9%) and auditory memory (33.0%). Complaints related to school performance were reported in 62.3% of the cases. Conclusions: The data obtained show a high frequency of lag symptoms in cognitive functions related to central auditory processing, particularly with regard to auditory attention, figure-background ability and auditory memory in patients with congenital hypothyroidism.

Avaliação quantitativa da produção ambulatorial em saúde auditiva no município de Salvador-Bahia no período de 2004 a 2016

Introducao : a saude auditiva no Brasil ganhou impulso com a implantacao da Politica Nacional de Atencao a Saude Auditiva (PNASA), em 2004, gerando melhorias para a assistencia ao deficiente auditivo. Essa politica ficou vigente ate o ano de 2011, quando foi instituido o Plano Nacional dos Direitos da Pessoa com Deficiencia – Plano Viver sem Limite (PVSL), mudando o cenario brasileiro no cuidado a pessoa com deficiencia, no qual a assistencia ao deficiente auditivo havia sido incluida. Objetivos : avaliar a producao ambulatorial em saude auditiva e os recursos financeiros investidos nessa producao nos anos de 2004 a 2016, no municipio de Salvador-Bahia e verificar o impacto da revogacao da PNASA e implantacao do PVSL no tempo sobre a producao ambulatorial em saude auditiva e recursos financeiros investidos nessa producao no municipio de Salvador. Metodologia : estudo ecologico realizado atraves de dados secundarios de dominio publico provenientes do Sistema de Informacoes Ambulatoriais do SUS (SIA/SUS). Foi realizada analise descritiva dos dados por meio do tamanho do efeito, media, desvio padrao, valor minimo e maximo, frequencia relativa e frequencia absoluta. Resultados : verificou-se crescimento da producao ambulatorial e dos recursos financeiros investidos no ano de 2004 a 2016. Observou-se, tambem, que a revogacao da PNASA e instituicao do PVSL ocasionou grande efeito na producao ambulatorial e nos recursos financeiros. Conclusao : foi possivel constatar que as mudancas no cenario da saude auditiva no Brasil geraram evolucao dos servicos, podendo ser constatado pela crescente producao ambulatorial e aumento dos investimentos financeiros ao longo dos anos

Mechanisms involved in hearing disorders of thyroid ontogeny: a literature review

Endocochlear, retrocochlear and/or central origin hearing damage may be related to the absence of appropriate levels of thyroid hormone during morphogenesis and/or auditory system development. Hearing disorders related to the thyroid are not well studied, despite speculation on the pathophysiological mechanisms. The objective of this review was to characterize the main pathophysiological mechanisms of congenital hypothyroidism and to evaluate the relationship with central and peripheral hearing disorders. We conducted a literature review using the databases MedLine, LILACS, Cochrane Library, SciELO, Institute for Scientific Information (ISI), Embase, and Science Direct between July and September on 2016. We identified the studies that address hearing disorder mechanisms on the congenital hypothyroidism. Congenital hypothyroidism may have clinical and subclinical manifestations that affect the auditory system and may be a potential risk factor for hearing impairment. Hearing impairment can severely impact quality-of-life, which emphasizes the importance of monitoring and evaluating hearing during the clinical routine of these patients.