Formal auditory training in adult hearing aid users

INTRODUCTION: Individuals with sensorineural hearing loss are often able to regain some lost auditory function with the help of hearing aids. However, hearing aids are not able to overcome auditory distortions such as impaired frequency resolution and speech understanding in noisy environments. The coexistence of peripheral hearing loss and a central auditory deficit may contribute to patient dissatisfaction with amplification, even when audiological tests indicate nearly normal hearing thresholds. OBJECTIVE: This study was designed to validate the effects of a formal auditory training program in adult hearing aid users with mild to moderate sensorineural hearing loss. METHODS: Fourteen bilateral hearing aid users were divided into two groups: seven who received auditory training and seven who did not. The training program was designed to improve auditory closure, figure-to-ground for verbal and nonverbal sounds and temporal processing (frequency and duration of sounds). Pre- and post-training evaluations included measuring electrophysiological and behavioral auditory processing and administration of the Abbreviated Profile of Hearing Aid Benefit (APHAB) self-report scale. RESULTS: The post-training evaluation of the experimental group demonstrated a statistically significant reduction in P3 latency, improved performance in some of the behavioral auditory processing tests and higher hearing aid benefit in noisy situations (p-value < 0,05). No changes were noted for the control group (p-value <0,05). CONCLUSION: The results demonstrated that auditory training in adult hearing aid users can lead to a reduction in P3 latency, improvements in sound localization, memory for nonverbal sounds in sequence, auditory closure, figure-to-ground for verbal sounds and greater benefits in reverberant and noisy environments

Formal auditory training in elderly hearing aid users

It is of paramount importance to install hearing rehabilitation programs for the elderly. AIM: to check the efficacy of a forma auditory training program for elderly patients fitted with hearing aids for at least three months, by means of speech recognition tests and self-assessment questionnaires. METHODS: longitudinal contemporary cohort study. We selected 13 elderly hearing aid users, using intra-canal hearing aids in both ears, from both genders, with average age of 65.3 years. This group was randomly divided in Experiment Group and Control Group. The Experiment Group underwent seven formal auditory training sessions, aiming at stimulating their hearing skills for hearing closing, memory, attention, background figure and binaural integration. The participants were assessed by three behavioral tests and one self assessment questionnaire. RESULTS: The elderly from the Experiment Group had significantly better performance in the assessments after auditory training in comparison to the Control Group. conclusion: the formal auditory training program in a soundproof booth, associated with the use of hearing aids, improves speech recognition performance and reduces the perception of auditory handicap for the elderly who use intra-canal hearing aids.A implantação de programas de reabilitação para o deficiente auditivo idoso é de grande importância. OBJETIVO: Verificar a eficácia de um programa de treinamento auditivo formal em idosos que receberam próteses auditivas há no mínimo três meses, por meio de testes de reconhecimento de fala e questionário de auto-avaliação. MÉTODO: Estudo de coorte contemporânea longitudinal. Foram selecionados 13 idosos usuários de próteses auditivas intra-aurais em adaptação binaural, de ambos os sexos, com idade média de 65,30 anos. Este grupo foi subdividido aleatoriamente em Grupo Experimental e Grupo Controle, por meio de sorteio. O Grupo Experimental foi submetido a sete sessões de treinamento auditivo formal, visando estimular as habilidades auditivas de fechamento auditivo, memória, atenção, figura-fundo e integração binaural. Os participantes foram avaliados por três testes comportamentais e um questionário de auto-avaliação. RESULTADOS: Os idosos do Grupo Experimental apresentaram desempenho significantemente melhor nas avaliações após o treinamento auditivo e também em relação ao Grupo Controle. CONCLUSÃO: O programa de treinamento auditivo em cabina acústica, associado ao uso de próteses auditivas, melhora o desempenho das habilidades de reconhecimento de fala e reduz a percepção do handicap auditivo de idosos usuários de próteses auditivas intra-aurais.UNIFESP-EPMUNIFESP Departamento de FonoaudiologiaUNIFESP, EPMUNIFESP, Depto. de FonoaudiologiaSciEL

Development of the Brazilian Portuguese version of the dichotic sentence identification test (DSI)

PURPOSE: To develop the Brazilian Portuguese version of the dichotic sentence idenfication test (DSI). METHODS: The sentences used in the Portuguese version of DSI test were extracted from the Synthetic Sentece Identification (SSI) test in Portuguese. A method of combination was used in order to create 45 pairs of sentences, each pair corresponding to a test item. The items were divided into five groups, each group corresponding to a specific test condition. For this purpose, a computer program was designed in the Matlab 7.0 computing platform, using the Monte Carlo method, or the brute force method, for the distribution of items in each group. The sentences were edited, recorded and finalized; for manipulation of data it was used the CaKewalk Sonar 2.2 program. Finally, the Sound Forge program was used for finalization and standardization of the recording. RESULTS: As a result, a compact disc with six tracks was obtained to be used as part of the behavioral assessment of auditory processing, including the following tracks: calibration, practice, binaural integration, directed attention to the right and to the left ears. The use of the calibration and auditory training tracks is recommended for use in the rehabilitation of auditory processing disorders. CONCLUSION: The compact disc with the Brazilian Portuguese version of the DSI test consisted of six tracks: calibration, practice, binaural integration, directed attention to the right and to the left ears and auditory training.OBJETIVO: Elaborar a versão em Português Brasileiro do teste de identificação de sentenças dicóticas (DSI). MÉTODOS: As frases utilizadas na versão em Português do teste DSI foram extraídas do teste de identificação de sentenças sintéticas (SSI) em Português. Foi realizado um método de combinação onde formaram-se 45 pares de frases, sendo cada par de frases correspondente a um item de teste. Os itens foram distribuídos em cinco grupos, sendo que cada grupo corresponde a uma condição do teste. Para realizar essa disposição, criou-se um programa na plataforma computacional Matlab 7.0, que utilizou o método Monte Carlo ou método da força bruta para obter a distribuição dos itens em cada grupo. As frases foram editadas, gravadas e finalizadas; para a manipulação dos dados utilizou-se o programa CaKewalk Sonar 2.2. Para a finalização, acabamento e padronização da gravação utilizou-se o programa Sound Forge. RESULTADOS: Como resultado obteve-se um compact disc com seis faixas para serem aplicadas na avaliação comportamental do processamento auditivo, nas seguintes etapas: calibração, treino, integração binaural, escuta direcionada à direita e escuta direcionada à esquerda. Para o uso na reabilitação dos distúrbios do processamento auditivo recomenda-se o uso das faixas de calibração e de treinamento auditivo. CONCLUSÃO: O compact disc com a versão em Português Brasileiro do teste DSI constou de seis faixas: calibração, treino, integração binaural, escuta direcionada à direita, escuta direcionada à esquerda e treinamento auditivo.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Nuclear factor kB as a target for new drug development in myeloid malignancies.

The transcription nuclear factor k B (NF-kB) can intervene in oncogenesis through to its capacity to regulate the expression of a large number of genes that regulate apoptosis, cell proliferation and differentiation as well as inflammation, angiogenesis and tumor migration. Impaired NF-kB activity has been demonstrated not only in solid cancers but also in various types of hematologic malignancies including acute myeloid leukemia, chronic myelogenous leukemia and in a subset of myelodysplastic syndromes. The underlying mechanisms, illustrated in the text and although quite diverse in different diseases, provide the rationale for new therapeutic strategies combining different NF-kB or proteasome inhibitors. It has, therefore, been proposed that inhibition of NF-kB could be an adjuvant therapy for cancer and many phase I/II clinical studies are ongoing with different inhibitors. This review highlights the in vitro and in vivo results of NF-kB inhibition in myeloid malignancies

Creación de un Centro de Nutrición Integral: Nutrition & Coaching Well-being / Wellness Center

Este trabajo de investigación busca resolver una problemática que está en niveles alarmantes en el Perú: el sobrepeso y la obesidad. Danma es un centro de nutrición especializado en coaching nutricional que cuenta además con endocrinología y talleres de nutrición. Estudios demuestran que el coaching nutricional aumenta la adherencia dietoterapéutica y los resultados obtenidos sean sostenibles en el tiempo. Luego del análisis del macroentorno y la investigación de mercado, el negocio está dirigido a Empresari@s y Ejecutiv@s entre 25-50 años de NSE A y B que residen en zona 7 de Lima Metropolitana y se caracteriza por brindar factores determinantes de éxito: un servicio que cumple con altos de estándares de calidad como es la puntualidad, la atención en horario flexible y por profesionales altamente competentes y actualizados. Además de estar ubicado estratégicamente entre los distritos de San Isidro y San Borja y, con ayuda de una fuerte publicidad, principalmente en redes sociales, Danma se dará a conocer como el único centro de nutrición especializado en coaching nutricional que no sólo practica lo que promueve sino además es un lugar que busca la transformación personal a nivel físico y mental y lleva a adoptar una nueva forma de vivir y ser feliz. Será necesario una inversión de S/. 329,725 donde el 55% será financiado y lo restante por inversionistas. El análisis financiero arrojó un VAN de S/. 722,901 soles en un periodo de cinco años y un TIR de 55% con un COK de 11.8%, concluyendo ser a nivel económico un proyecto viable y rentable.This research work seeks to solve a problem that is at alarming levels in Peru: overweight and obesity. Danma is a nutrition center specialized in nutritional coaching that also has endocrinology and nutrition workshops. Studies show that nutritional coaching increases dietary adherence and the results obtained are sustainable over time. After analyzing the macroenvironment and market research, the business is aimed at Business men and Executives between 25-50 years of SEL A and B who reside in 7 zone of Metropolitan Lima and is characterized by providing determining factors for success: a service that meets high standards of quality such as punctuality, flexible hours and by highly competent and updated professionals. In addition to being strategically located between the districts of San Isidro and San Borja and, with the help of a strong publicity, mainly in social networks, Danma will be known as the only nutrition center specialized in nutritional coaching that, not only practices what it promotes, but it is also a place that seeks personal transformation on a physical and mental level and leads to adopting a new way of living and being happy. An investment of S/. 329,725 where 55% will be financed and the rest by investors. The financial analysis showed a Net Present Value (NPV) of S/. 722,901 soles and an Internal Rate of Return (IRR) of 55% with an Opportunity Cost of Capital (OCC) of 11.8%, concluding being an economically, viable and cost effectiveness project.Tesi

Aurora kinase inhibitors: which role in the treatment of chronic myelogenous leukemia patients resistant to imatinib?

At present, there are no compounds in clinical development in the field of chronic myeloid leukemia (CML) or Philadelphia-positive (Ph+) acute lymphoblastic leukemia (ALL) that have been documented to harbor significant activity against the imatinib-resistant T315I mutation. Recent reports on the pre-clinical activity of some emerging tyrosine kinase inhibitors such as ON012380, VX-680 and PHA-739358 promise possible clinical efficacy against this specific Bcr-Abl mutant form. Here, we focus on the role of aurora kinase inhibitor VX-680 and PHA-739358 in blocking the leukemogenic pathways driven by wild-type and T315I-Bcr-Abl in CML or Ph+ ALL by reviewing recent research evidence. We also discuss the possibility of employing aurora kinase inhibitors as a promising new therapeutic approach in the treatment of CML and Ph+ ALL patients resistant to first and second generation TK inhibitors

Translation and adaptation of the ABEL: Auditory Behavior in Everyday Life questionnaire into Brazilian Portuguese

PURPOSE: To translate and adapt the ABEL - Auditory Behavior in Everyday Life - questionnaire into Brazilian Portuguese, and to establish the profile of auditory behavior in a group of children who use hearing aids. METHODS: The ABEL questionnaire was translated and back translated. This version was compared to the original version regarding semantic equivalence, generating a new version in Portuguese. After that, 31 parents of children fitted with hearing aids answered an anamnesis and the Portuguese version of the ABEL questionnaire. The scores obtained were related to the variables investigated in the anamnesis. RESULTS: Differences were found in the analysis of the aural-oral score for the variables degree of hearing loss and time of daily use of the hearing aid: children with milder degrees of hearing loss and/or children who use the hearing aid for longer periods showed better performances. There were also differences in total and auditory awareness scores for the variable time of daily use of the hearing aid, indicating that children who user their hearing aids for longer periods daily showed better performances. CONCLUSION: There was consistency between the versions generated during the translation of the questionnaire, allowing the formulation of its final version in Portuguese. Children with lower degrees of hearing loss and/or who use their hearing aids for longer periods have their daily activities less affected by the hearing loss. The ABEL questionnaire is an appropriate instrument to detail the development of auditory behaviors in children who use hearing aids.OBJETIVO: Traduzir e adaptar o questionário ABEL - Auditory Behavior in Everyday Life - para o Português Brasileiro e estabelecer o perfil do comportamento auditivo de crianças usuárias de aparelhos de amplificação sonora individual (AASI) por meio de sua aplicação. MÉTODOS: Foi realizada a tradução do questionário ABEL, seguida pela retrotradução. Esta versão foi comparada à original em relação à equivalência semântica, sendo gerada uma nova versão em Português. A partir disso, foram entrevistados 31 pais de crianças adaptadas com AASI. Todos responderam a uma anamnese e à versão em Português do questionário ABEL. Os escores obtidos na aplicação do instrumento foram relacionados às variáveis investigadas na anamnese. RESULTADOS: A análise do escore oral-aural revelou diferenças segundo as variáveis grau de perda auditiva e tempo de uso diário dos AASI, sendo que crianças com menores graus de perda e/ou que fazem uso dos AASI por mais tempo apresentam melhor desempenho. Em relação ao escore total e ao escore de consciência auditiva, houve diferenças segundo o tempo de uso diário dos AASI, indicando melhor desempenho daquelas que fazem uso dos AASI por mais tempo. CONCLUSÃO: Há coerência entre as versões geradas nas etapas de tradução do questionário, possibilitando a formulação de sua versão em Português. Crianças com menores graus de perda auditiva e/ou que referem maior tempo de uso diário de AASI têm suas atividades diárias menos comprometidas pela perda auditiva. O questionário ABEL é um instrumento apropriado para detalhar o desenvolvimento dos comportamentos auditivos de crianças usuárias de AASI.Universidade Federal de São Paulo (UNIFESP) Departamento de Fonoaudiologia Programa de Pós-Graduação (Doutorado) em Distúrbios da Comunicação HumanaUniversidade Federal de São Paulo (UNIFESP) Departamento de FonoaudiologiaUNIFESP, Depto. de Fonoaudiologia Programa de Pós-Graduação (Doutorado) em Distúrbios da Comunicação HumanaUNIFESP, Depto. de FonoaudiologiaSciEL

Detection and genotyping of human Papillomavirus in urine samples from unvaccinated male and female adolescents in Italy

The introduction of vaccination against Human Papillomavirus (HPV) in adolescent girls in 2006 has focused virological surveillance on this age group. As few studies have evaluated HPV infections in young populations, further data are needed in order to improve and extend prophylactic policy and to monitor epidemiological changes. The present study aimed at evaluating overall and type-specific HPV prevalence in both female and male adolescents in Italy. HPV DNA detection and genotyping was performed on urine samples collected from 870 unvaccinated adolescents (369 females, 501 males, 11-18 years of age) in five cities in Italy. Following DNA extraction by means of a commercial kit (NucliSENS®-miniMAG®, bioMérieux), the L1 gene fragment was PCR amplified and genotyped by restriction fragment length polymorphism analysis. HPV DNA was detected in 1.5% of all samples, and in 3% and 0.4% of samples from females and males, respectively. In approximately 70% of HPV DNA positive adolescents, the infection was due to a single genotype, with 88.9% of genotypes belonging to the HR-clade. The only two HPV-positive boys (14 and 18 years old) had HPV-70 genotype. Only one of the 11 HPV-infected girls was in the 11-14 age-group. HPV prevalence was 4.2% in girls aged 15-18 years and 60% of infections were due to vaccine types HPV-16 or HPV-6/-11. This is one of the few studies, the first conducted in Italy, on HPV infection in adolescents. Urine testing is the easier way of detecting HPV infection in younger populations. Our data revealed a very low HPV prevalence, and no infections were observed in the 12-year-old vaccine target population. The majority of infections were seen in females aged 15-18 years. Overall, more than 50% and 30% of the potentially persistent HPV infections detected in this group could have been prevented by the quadrivalent and the bivalent vaccines, respectively