Miringoplastia : análise dos resultados cirúrgicos para avaliação de seu aprendizado em serviço universitário

Orientadores: Carlos Eduardo Barrionuevo, João Jairney ManigliaDissertação (mestrado) - Universidade Federal do Parana, Setor de Ciencias da SaudeResumo: Num estudo retrospectivo de 101 timpanoplastias protocoladas, realizadas de 1972 a 1990, no serviço de Otorrinolaringologia do Hospital de Clinicas da Universidade Federal do Paraná, foram comparados os resultados obtidos (quanto a pega de enxertos e audiometria) no primeiro trimestre, quando o ato operatório é predominantemente do preceptor, com os do quarto trimestre, quando o ato operatório, ainda que sob supervisão, é realizado predominantemente pelo residente, numa avaliação critica do aprendizado cirúrgico no Serviço Universitário citado. Paralelamente, foram avaliados outros dados de interesse menor parai este trabalho, tais como: predominância de sexo e lado operado, procedência dos pacientes, etiologia e localização das perfurações, relação entre o sucesso cirúrgico (pega de enxerto e audiometria) e: faixa etária (pré-adolescentes e adultos), presença de patologia no ouvido contralateral, reoperações ou não e tempo de avaliação pós-operatório.Abstract: This study is a critical evaluation of the surgical training in otology at the University Hospital of the Universidade Federal do Paraná. The protocols of 101 tympanoplasties from 1972 to 1990 were reviewed. The results of the first quarter of the year in relation to graft take and post-operative audiometry, were compared with those of the last. In the first quarter of the year surgeries were predominantely performed by the preceptor, and in the last, the majority of surgeries was performed by the resident, although under the preceptor's supervision. In addition, other elements of secondaryimportance were annalyzed as: sex predominance and side of surgery, patients's origin, etiology and local of perforation, the relationship between surgical success (graft take and hearing result), age (pre-adolescents and adults), contralateral ear pathology, second surgery and post-operative evaluation time

Intensive Olfactory Training in Post-COVID Patients: A Randomized Multicenter Clinical Trial

Introduction: Olfactory dysfunction (OD) is one of the most reported symptoms of COVID -19. Previous studies have identified olfactory training (OT) as an important treatment for postinfectious OD, but little is known about its effect after SARS-CoV-2 infection and how it can be optimized. Objective: To assess whether OT can be optimized if performed intensively, with more fragrances over a shorter period in patients with persistent OD after COVID -19. Also, to determine the presence of other variables related to OD and treatment response in this population. Method: This multicenter randomized clinical trial recruited 80 patients with persistent OD with previous COVID-19 for less than three months. The patients were divided into two groups, who received treatment with 4 and 8 essences over four weeks. Subjective assessments and the University of Pennsylvania Smell Identification Test (UPSIT) were performed before and after treatment. Results: A significant improvement in olfaction was measured subjectively and on UPSIT in both groups, but without significant differences between groups. In addition, the presence of olfactory fluctuation was associated with higher UPSIT scores. Conclusion: These data suggest that intensifying the training by increasing the number of essences for 4 weeks does not show superiority over the classical method. Moreover, a fluctuating olfactory ability seems to be related to a better score in the UPSIT

Miringoplastia : análise dos resultados cirúrgicos para avaliação de seu aprendizado em serviço universitário

Orientadores: Carlos Eduardo Barrionuevo, João Jairney ManigliaDissertação (mestrado) - Universidade Federal do Parana, Setor de Ciencias da SaudeResumo: Num estudo retrospectivo de 101 timpanoplastias protocoladas, realizadas de 1972 a 1990, no serviço de Otorrinolaringologia do Hospital de Clinicas da Universidade Federal do Paraná, foram comparados os resultados obtidos (quanto a pega de enxertos e audiometria) no primeiro trimestre, quando o ato operatório é predominantemente do preceptor, com os do quarto trimestre, quando o ato operatório, ainda que sob supervisão, é realizado predominantemente pelo residente, numa avaliação critica do aprendizado cirúrgico no Serviço Universitário citado. Paralelamente, foram avaliados outros dados de interesse menor parai este trabalho, tais como: predominância de sexo e lado operado, procedência dos pacientes, etiologia e localização das perfurações, relação entre o sucesso cirúrgico (pega de enxerto e audiometria) e: faixa etária (pré-adolescentes e adultos), presença de patologia no ouvido contralateral, reoperações ou não e tempo de avaliação pós-operatório.Abstract: This study is a critical evaluation of the surgical training in otology at the University Hospital of the Universidade Federal do Paraná. The protocols of 101 tympanoplasties from 1972 to 1990 were reviewed. The results of the first quarter of the year in relation to graft take and post-operative audiometry, were compared with those of the last. In the first quarter of the year surgeries were predominantely performed by the preceptor, and in the last, the majority of surgeries was performed by the resident, although under the preceptor's supervision. In addition, other elements of secondaryimportance were annalyzed as: sex predominance and side of surgery, patients's origin, etiology and local of perforation, the relationship between surgical success (graft take and hearing result), age (pre-adolescents and adults), contralateral ear pathology, second surgery and post-operative evaluation time

Efeitos do ruído de impacto na audição de militares Effects of impact noise on the hearing of military personnel

A prática de tiro é uma atividade que expõe o policial militar ao ruído de impacto, o que pode causar efeitos irreversíveis na audição. OBJETIVO: Avaliar o conhecimento sobre o ruído e os efeitos do ruído de impacto entre policiais militares que fazem prática de tiro. FORMA DE ESTUDO: Caso controle retrospectivo. MATERIAL E MÉTODO: Participaram 115 militares, sendo 65 expostos ao ruído de impacto e 50 não expostos. Foi realizada a avaliação do nível de ruído das armas de fogo, aplicado um questionário, realizada audiometria tonal limiar e teste de emissões otoacústicas transiente e produto de distorção. RESULTADOS: O nível médio de ruído foi de 125Db (C), a maioria (78%) acredita que o ruído pode causar perda auditiva, 92,3% utilizam protetor auricular nas práticas de tiro, mas grande parte (32,3%) nunca recebeu orientação quanto ao seu uso, o sintoma mais referido foi o zumbido (23%) e 25% dos expostos apresenta perda auditiva sugestiva de induzida por ruído. Houve diferença significativa entre os grupos em relação às alterações auditivas. CONCLUSÃO: Os militares expostos ao tiro são mais suscetíveis a desenvolver perdas auditivas. Há necessidade do desenvolvimento de Programas de Preservação Auditiva nesta população.<br>Shooting is an activity that exposes military personnel to noise impact, which may cause irreversible effects on hearing. OBJECTIVE: To evaluate impact noise on the hearing of military personnel that practice shooting. STUDY DESIGN: A case-control retrospective study. METHODS: 115 military personnel were enrolled; 65 had been exposed to impact noise and 50 were non-exposed. Firearm noise levels were evaluated, subjects answered a questionnaire and underwent threshold tonal audiometry and otoacoustic emissions testing. RESULTS: The average noise level was 125dB(C). Most subjects (78%) believe that noise may cause hearing loss; nearly all (92.3%) used ear noise protectors while shooting, but most (32.3%) had never received guidance for using this equipment. There were significant differences between the two groups in relation to changes suggesting impact noise-induced hearing loss. CONCLUSION: The differences between groups show that noise-exposed military personnel are more likely to develop hearing loss. The goal of a hearing conservation program for this population should be to preserve hearing and educate these individuals about the importance of using hearing protection correctly

Efeitos do ruído na audição de trabalhadores de lavanderia hospitalar

Objetivo caracterizar o perfil auditivo de trabalhadores de uma lavanderia hospitalar. M&#233;todo estudo transversal, realizado numa lavanderia de um hospital p&#250;blico em Curitiba-PR, com 95 trabalhadores de ambos os sexos, m&#233;dia de idade de 38,23. Realizou-se an&#225;lise dos documentos do Programa de Controle M&#233;dico e Sa&#250;de Ocupacional e do Programa de Preven&#231;&#227;o de Riscos Ambientais da lavanderia, mensura&#231;&#227;o do ru&#237;do, avalia&#231;&#227;o auditiva com aplica&#231;&#227;o de anamnese, audiometria tonal limiar, imit&#226;ncia ac&#250;stica e teste de emiss&#245;es otoac&#250;sticas evocadas por est&#237;mulo transiente. Analisou-se os audiogramas por crit&#233;rios cl&#237;nico e ocupacionais (Norma Regulamentadora 7). Resultados os n&#237;veis de ru&#237;do encontrados foram de 77,0 a 99,0 dB(A), houve 37,89% audiogramas alterados, destes 18,94% com caracter&#237;sticas sugestivas de Perda Auditiva Induzida por Ru&#237;do, principalmente entre os dobradores de roupas. O teste de Emiss&#245;es Otoac&#250;sticas Evocadas por Est&#237;mulo Transiente demonstrou aus&#234;ncia de respostas em 13 sujeitos com aus&#234;ncia de emiss&#245;es em alguma das orelhas. Conclus&#227;o a lavanderia &#233; um local de risco para a perda auditiva. Desse modo, medidas preventivas, por meio de Programas de Preserva&#231;&#227;o Auditiva, devem ser adotadas

Auditory Effects of Exposure to Noise and Solvents: A Comparative Study

Introduction Industry workers are exposed to different environmental risk agents that, when combined, may potentiate risks to hearing. Objective To evaluate the effects of the combined exposure to noise and solvents on hearing in workers. Methods A transversal retrospective cohort study was performed through documentary analysis of an industry. The sample (n&#8201;=&#8201;198) was divided into four groups: the noise group (NG), exposed only to noise; the noise and solvents group (NSG), exposed to noise and solvents; the noise control group and noise and solvents control group (CNS), no exposure. Results The NG showed 16.66% of cases suggestive of bilateral noise-induced hearing loss and NSG showed 5.26%. The NG and NSG had worse thresholds than their respective control groups. Females were less susceptible to noise than males; however, when simultaneously exposed to solvents, hearing was affected in a similar way, resulting in significant differences (p&#8201;<&#8201;0.05). The 40- to 49-year-old age group was significantly worse (p&#8201;<&#8201;0.05) in the auditory thresholds in the NSG compared with the CNS. Conclusion The results observed in this study indicate that simultaneous exposure to noise and solvents can damage the peripheral auditory system