Zumbido e intolerância a sons : evidência e experiência de um grupo brasileiro

Introdução Zumbido e intolerância a sons são queixas frequentes e subjetivas que podem ter impacto na qualidade de vida do paciente. Objetivo Apresentar uma revisão dos principais pontos, inclusive conceitos, fisiopatologia, diagnóstico e abordagem do paciente com zumbido e sensibilidade a sons. Método Revisão da literatura com levantamento bibliográfico na base de dados da LILACS, SciELO, Pubmed e MEDLINE. Foram selecionados artigos e capítulos de livros sobre zumbido e sensibilidade a sons. Os diversos tópicos foram discutidos por um grupo de profissionais brasileiros e as conclusões, descritas. Resultado A prevalência de zumbido tem aumentado ao longo dos anos, muitas vezes associado a perda auditiva, fatores metabólicos e erros alimentares. A avaliação médica deve ser feita minuciosamente no sentido de orientar a solicitação de exames subsidiários. Os tratamentos disponíveis atualmente variam de medicamentos ao uso de sons com características específicas e técnicas de meditação, com resultados variáveis. Conclusão Foi apresentada uma revisão sobre os temas que permitindo ao leitor uma visão ampla da abordagem dos pacientes com zumbido e sensibilidade auditiva baseada em evidências científicas e experiência nacional.Introduction Tinnitus and sound intolerance are frequent and subjective complaints that may have an impact on a patient's quality of life. Objective To present a review of the salient points including concepts, pathophysiology, diagnosis and approach of the patient with tinnitus and sensitivity to sounds. Methods Literature review with bibliographic survey in LILACS, SciELO, Pubmed and MEDLINE database. Articles and book chapters on tinnitus and sound sensitivity were selected. The several topics were discussed by a group of Brazilian professionals and the conclusions were described. Results The prevalence of tinnitus has increased over the years, often associated with hearing loss, metabolic factors and inadequate diet. Medical evaluation should be performed carefully to guide the request of subsidiary exams. Currently available treatments range from medications to the use of sounds with specific characteristics and meditation techniques, with variable results. Conclusion A review on tinnitus and auditory sensitivity was presented, allowing the reader a broad view of the approach to these patients, based on scientific evidence and national experience

Tinnitus and Hyperacusis: a prevalence study and risk factors in children

A hiperacusia e o zumbido representam alterações na percepção dos sons, estando freqüentemente associados. Ambos refletem um estado de hiperatividade da via auditiva, gerado por alterações na plasticidade neuronal geralmente associadas à super estimulação ou deprivação sensorial. A hiperacusia refere-se a uma disfunção na percepção da intensidade de sons externos, o zumbido refere-se à percepção de um som interno que não tem uma fonte geradora externa. Afetam adultos e crianças e podem ocasionar limitações na qualidade de vida. Ainda são muito negligenciados por otorrinolaringologistas e pediatras, apesar da sua presença não ser incomum na infância. Delineamos um estudo populacional transversal randomizado entre crianças de 5 a 12 anos cujo objetivo principal foi estimar a prevalência da hiperacusia e do zumbido. O objetivo secundário foi avaliar a associação a possíveis fatores de risco e a causalidade entre os sintomas. Foram avaliadas 506 crianças em ambiente escolar. Os dados foram coletados por meio de questionário aos pais ou responsáveis, entrevista com as crianças, otoscopia e testes auditivos. A classificação dos resultados seguiu critérios previamente estabelecidos. Participaram 240 meninas (47,4%) e 266 meninos (52,6%), idade média 9.46 anos (DP= 2.09). Os limiares auditivos foram classificados como normais em 81%, disacusia de grau mínimo/leve em 14% e disacusia de grau moderado/ profundo em 4% das crianças. A prevalência da sensação de zumbido foi 37,5%, incômodo com zumbido 19,6% e hiperacusia 3,2%. Os fatores de risco foram analisados por um modelo de regressão multivariado. Em relação ao zumbido, os fatores associados foram: idade, gênero, perda auditiva, história de exposição aos sons e cinetose. Para a hiperacusia, o único fator de risco encontrado foi a perda auditiva leve na orelha esquerda. A presença de hiperacusia demonstrou ser o maior fator de risco associado ao incomodo com o zumbidoHyperacusis and tinnitus are altered states of sound perception and are frequently associated. Both reflect a hyperactivity of the auditory pathway as an expression of neural plasticity which is often triggered by over stimulation or deprivation of sensorial stimuli. Hyperacusis is a dysfunction on loudness perception of external sounds and tinnitus a perception of an internal sound without an external source. They might affect adults and children causing interference on quality of life. They are still neglected by otolaryngologysts and pediatricians. A prospective cross sectional study was designed to estimate tinnitus and hyperacusis prevalence and evaluate association to possible risk factors and causality among them. Children from 5 to 12 years of age were evaluated in the school environment. Data was collected searching parental information, children\'s interview, otoscopy and audiometric tests. The symptoms were classified according to previous established criteria. The final sample counted on 240 girls and 266 boys, mean age 9.46 (SD= 2.09). Hearing thresholds were classified as normal in 81%, minimum to mild hearing loss in 14% and moderate to profound hearing loss in 4% of the children. Prevalence of tinnitus sensation was found to be 37.5%, tinnitus suffering 19.6% and hyperacusis 3.2%. Age, gender, hearing loss, history of noise exposure and motion sickness were risk factors to tinnitus. Left ear hearing loss was a risk factor for hyperacusis. The presence of hyperacusis demonstrated to be the highest risk factor to tinnitus sufferin

Tinnitus and Hyperacusis: a prevalence study and risk factors in children

A hiperacusia e o zumbido representam alterações na percepção dos sons, estando freqüentemente associados. Ambos refletem um estado de hiperatividade da via auditiva, gerado por alterações na plasticidade neuronal geralmente associadas à super estimulação ou deprivação sensorial. A hiperacusia refere-se a uma disfunção na percepção da intensidade de sons externos, o zumbido refere-se à percepção de um som interno que não tem uma fonte geradora externa. Afetam adultos e crianças e podem ocasionar limitações na qualidade de vida. Ainda são muito negligenciados por otorrinolaringologistas e pediatras, apesar da sua presença não ser incomum na infância. Delineamos um estudo populacional transversal randomizado entre crianças de 5 a 12 anos cujo objetivo principal foi estimar a prevalência da hiperacusia e do zumbido. O objetivo secundário foi avaliar a associação a possíveis fatores de risco e a causalidade entre os sintomas. Foram avaliadas 506 crianças em ambiente escolar. Os dados foram coletados por meio de questionário aos pais ou responsáveis, entrevista com as crianças, otoscopia e testes auditivos. A classificação dos resultados seguiu critérios previamente estabelecidos. Participaram 240 meninas (47,4%) e 266 meninos (52,6%), idade média 9.46 anos (DP= 2.09). Os limiares auditivos foram classificados como normais em 81%, disacusia de grau mínimo/leve em 14% e disacusia de grau moderado/ profundo em 4% das crianças. A prevalência da sensação de zumbido foi 37,5%, incômodo com zumbido 19,6% e hiperacusia 3,2%. Os fatores de risco foram analisados por um modelo de regressão multivariado. Em relação ao zumbido, os fatores associados foram: idade, gênero, perda auditiva, história de exposição aos sons e cinetose. Para a hiperacusia, o único fator de risco encontrado foi a perda auditiva leve na orelha esquerda. A presença de hiperacusia demonstrou ser o maior fator de risco associado ao incomodo com o zumbidoHyperacusis and tinnitus are altered states of sound perception and are frequently associated. Both reflect a hyperactivity of the auditory pathway as an expression of neural plasticity which is often triggered by over stimulation or deprivation of sensorial stimuli. Hyperacusis is a dysfunction on loudness perception of external sounds and tinnitus a perception of an internal sound without an external source. They might affect adults and children causing interference on quality of life. They are still neglected by otolaryngologysts and pediatricians. A prospective cross sectional study was designed to estimate tinnitus and hyperacusis prevalence and evaluate association to possible risk factors and causality among them. Children from 5 to 12 years of age were evaluated in the school environment. Data was collected searching parental information, children\'s interview, otoscopy and audiometric tests. The symptoms were classified according to previous established criteria. The final sample counted on 240 girls and 266 boys, mean age 9.46 (SD= 2.09). Hearing thresholds were classified as normal in 81%, minimum to mild hearing loss in 14% and moderate to profound hearing loss in 4% of the children. Prevalence of tinnitus sensation was found to be 37.5%, tinnitus suffering 19.6% and hyperacusis 3.2%. Age, gender, hearing loss, history of noise exposure and motion sickness were risk factors to tinnitus. Left ear hearing loss was a risk factor for hyperacusis. The presence of hyperacusis demonstrated to be the highest risk factor to tinnitus sufferin

Tinnitus and sound intolerance: evidence and experience of a Brazilian group

<div><p>Abstract Introduction Tinnitus and sound intolerance are frequent and subjective complaints that may have an impact on a patient's quality of life. Objective To present a review of the salient points including concepts, pathophysiology, diagnosis and approach of the patient with tinnitus and sensitivity to sounds. Methods Literature review with bibliographic survey in LILACS, SciELO, Pubmed and MEDLINE database. Articles and book chapters on tinnitus and sound sensitivity were selected. The several topics were discussed by a group of Brazilian professionals and the conclusions were described. Results The prevalence of tinnitus has increased over the years, often associated with hearing loss, metabolic factors and inadequate diet. Medical evaluation should be performed carefully to guide the request of subsidiary exams. Currently available treatments range from medications to the use of sounds with specific characteristics and meditation techniques, with variable results. Conclusion A review on tinnitus and auditory sensitivity was presented, allowing the reader a broad view of the approach to these patients, based on scientific evidence and national experience.</p></div

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora

Growing knowledge: an overview of Seed Plant diversity in Brazil

Abstract An updated inventory of Brazilian seed plants is presented and offers important insights into the country's biodiversity. This work started in 2010, with the publication of the Plants and Fungi Catalogue, and has been updated since by more than 430 specialists working online. Brazil is home to 32,086 native Angiosperms and 23 native Gymnosperms, showing an increase of 3% in its species richness in relation to 2010. The Amazon Rainforest is the richest Brazilian biome for Gymnosperms, while the Atlantic Rainforest is the richest one for Angiosperms. There was a considerable increment in the number of species and endemism rates for biomes, except for the Amazon that showed a decrease of 2.5% of recorded endemics. However, well over half of Brazillian seed plant species (57.4%) is endemic to this territory. The proportion of life-forms varies among different biomes: trees are more expressive in the Amazon and Atlantic Rainforest biomes while herbs predominate in the Pampa, and lianas are more expressive in the Amazon, Atlantic Rainforest, and Pantanal. This compilation serves not only to quantify Brazilian biodiversity, but also to highlight areas where there information is lacking and to provide a framework for the challenge faced in conserving Brazil's unique and diverse flora