16 research outputs found
Primeiro relato de ototoxicidade pelo antimoniato de meglumina
Introdução: Antimoniais pentavalentes são os fármacos de primeira escolha no tratamento da leishmaniose tegumentar. Dados de ototoxicidade relacionados a tais fármacos são escassos na literatura, o que nos levou a desenvolver um estudo de funções cócleo-vestibulares. Relato de caso: Relatamos caso de paciente masculino de 78 anos com leishmaniose tegumentar, que apresentou aumento significativo dos limiares auditivos com zumbido e tontura rotatória grave durante o tratamento com antimoniato de meglumina. Os sintomas pioraram até duas semanas após a interrupção do tratamento. Conclusão: Tontura e zumbido já tinham sido associados ao antimoniato de meglumina. Entretanto, este é o primeiro caso bem documentado de toxicidade cócleo-vestibular relacionado ao antimoniato de meglumina.Introduction: Pentavalent antimonials are the first drug of choice in the treatment of tegumentary leishmaniasis. Data on ototoxicity related with such drugs is scarcely available in literature, leading us to develop a study on cochleovestibular functions. Case Report: A case of a tegumentary leishmaniasis patient, a 78-year-old man who presented a substantial increase in auditory threshold with tinnitus and severe rotatory dizziness during the treatment with meglumine antimoniate, is reported. These symptoms worsened in two weeks after treatment was interrupted. Conclusion: Dizziness and tinnitus had already been related to meglumine antimoniate. However, this is the first well documented case of cochlear-vestibular toxicity related to meglumine antimoniate
Estudo da orelha média na forma mucosa de Leishmaniose Tegumentar Americana
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Previous issue date: 2012Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Em aproximadamente 90% das lesões mucosas de LTA o nariz é o único sítio envolvido. As orelhas normalmente não são envolvidas na leishmaniose mucosa, embora o envolvimento mucoso da nasofaringe possa afetar o orifício da tuba de Eustáquio provocando o aparecimento de otite média com efusão nas formas mais avançadas de leishmaniose mucosa. Caso a otite média não seja identificada e conduzida de forma adequada, o paciente pode ficar com seqüelas otológicas e audiológicas de difícil recuperação. Este estudo objetivou avaliar as funções da orelha média dos pacientes com forma mucosa de LTA para verificar a freqüência de disfunção tubária/otite média com efusão e descrever os fatores a elas associadas. Foi realizado um estudo prospectivo e longitudinal nos pacientes com Leishmaniose Mucosa ou Cutâneo-mucosa, atendidos no Instituto Nacional de Infectologia Evandro Chagas na Fundação Oswaldo Cruz, a partir de 2008. Os pacientes foram submetidos às avaliações otorrinolaringológica e fonoaudiológica nas consultas prétratamento e até um mês após a conclusão do tratamento ou até a normalização das alterações, composta de: questionário de avaliação de alterações auditivas e de queixas otorrinolaringológicas; avaliação endoscópica das mucosas laríngea, faríngea, oral e nasal; avaliação otoscópica; audiometria tonal, audiometria vocal, impedanciometria. Foram descritas as freqüências simples das variáveis categóricas e as medidas de tendência central e dispersão das variáveis quantitativas contínuas As freqüências de otite média foram comparadas entre as diferentes localizações de lesões mucosas por LTA por teste para proporção do tipo qui-quadrado. Foram incluídos 17 pacientes, sendo 15 do sexo masculino (88,2%) e dois do sexo feminino (11,8%). A idade variou de 30 a 77 anos, com média de 52,7 anos. Quatro pacientes (23,5%) apresentaram curva B ou C no exame imitânciométrico, sendo que destes, dois (11,8%) apresentavam retração de membrana timpânica e um (5,9%) curva audiométrica do tipo condutiva. No pós-tratamento, dos quatro pacientes com alteração de orelha média no pré-tratamento, um manteve curva C (25%), dois normalizaram e um não teve seu último exame realizado, porém apresentava normalização do padrão condutivo de sua audiometria. A ausência de alteração da tuba auditiva em 75% dos casos nos alerta para que outros mecanismos que não o obstrutivo pelo processo inflamatório da LTA estejam envolvidos na etiopatogenia da OME decorrente da LM. Estes resultados tornam visíveis a importância da realização de avaliação otoscópica e de exames audiométricos e imitanciométricos antes e após o tratamento de pacientes com leishmaniose mucosa.In approximately 90% mucosal lesions of ATL, the nose is the only site affected. The ears are usually not involved in mucosal leishmaniasis, although involvement of the mucous nasopharynx may affect the orifice of the eustachian tube leading to the onset of otitis media with effusion in more advanced forms of mucosal leishmaniasis. If otitis media is not identified and managed appropriately, the patient can stay with otological and audiologic sequel of difficult recovery. The objective of the study was to verify the frequency of tube dysfunction / otitis media with effusion and describe the factors associated with them. A prospective and longitudinal study in patients with cutaneous leishmaniasis or mucosa-mucosa treated in the Institute Evandro Chagas Clinical Research at the Oswaldo Cruz Foundation, from 2008. Patients were submitted to otorhinolaryngological and audiological evaluations in pre-treatment and up to one month after completion of treatment or until normalization of the changes, composed of: a survey assessment of hearing and of these complaints, endoscopic evaluation laryngeal mucosa, oropharyngeal and nasal; otoscopy, pure tone audiometry, speech audiometry, impedance We will describe the simple frequencies of categorical variables and measures of central tendency and dispersion of continuous quantitative variables. The frequency of otitis media will be compared between different locations mucosa lesions by ATL ratio test to chi-square type. Expected to be differences of frequency of otitis media and / or hearing impairment related to the location of the damaged mucosa of ATL and its time evolution. We included 17 patients, 15 males (88.2%) and two females (11.8%). The age ranged from 30 to 77 years, mean 52.7 years. Four patients (23.5%) showed curve B or C on immittance examination, and of these, two (11.8%) had tympanic membrane retraction, and one (5.9%) the conductive audiometric curve. In the post-treatment of four patients with abnormal middle ear before treatment, one remained a curve C (25%), two normalized and one did not have his last examination, but had normalization of their conductive pattern audiometry. One patient also started to present normal otoscopy after treatment. The lack of change in the Eustachian tube in 75% of cases warns that mechanisms other than the obstruction by inflammation of the ATL is involved in the pathogenesis of OME due to ML. These results become apparent the importance of otoscopy and performing audiometric tests immittance thresholds before and after treatment of patients with mucosal leishmaniasis
Evaluation of voice disorders in patients with active laryngeal tuberculosis
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Previous issue date: 2015Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Vigilância em Leishmanioses. Rio de Janeiro, RJ, Brasil / Federal University of Rio de Janeiro. Department of Speech Pathology. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Vigilância em Leishmanioses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Vigilância em Leishmanioses. Rio de Janeiro, RJ, Brasil.Federal University of Rio de Janeiro. Rio de Janeiro, RJ, Brazil.Federal University of Rio de Janeiro. Department of Speech Pathology. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Vigilância em Leishmanioses Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Vigilância em Leishmanioses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Vigilância em Leishmanioses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Vigilância em Leishmanioses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Vigilância em Leishmanioses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Micobacterioses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Vigilância em Leishmanioses. Rio de Janeiro, RJ, Brasil / Federal University of Rio de Janeiro. Department of Otorhinolaryngology and Ophthalmology. Rio de Janeiro, RJ, Brazil.Introduction: Laryngeal tuberculosis (LTB) is the most frequent larynx granulomatous disease. In general
there is lung involvement, but in an important proportion of cases you can find LTB without pulmonary disease. The lesions observed in LTB, such as ulceration and fibrosis, can interfere in the process of voice production. The involvement of the mucous lining of the vocal folds can change their flexibility and, consequently, change voice quality, and the main symptom is dysphonia present in almost 90% of cases. Objective: To describe the anatomical characteristics and voice quality in LTB patients. Material and Method: A descriptive cross-sectional study was conducted with 24 patients. Result: The most frequently affected sites were vocal folds in 87.5% patients, vestibular folds in 66.7%, epiglottis in 41.7%, arytenoid in 50%, aryepiglottic folds in 33.3%, and interarytenoid region in 33.3% patients. We found 95.8% cases of dysphonia. The voice acoustic analysis
showed 58.3% cases of Jitter alterations, 83.3% of Shimmer and 70.8% of GNE. Conclusion: Voice disorders found in active laryngeal tuberculosis are similar to those reported after clinical healing of the disease, suggesting that sequelae and vocal adjustments may install during the active phase of the disease, negatively impacting the process of vocal quality reestablishment
Degree of voice perturbation in the GRBASI<sup>*</sup> scale in 24 patients with laryngeal tuberculosis, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, 2014.
<p>n- number.</p><p>*GRBASI scale.</p><p>G—hoarseness, R—roughness B—breathiness; A—asthenia; S—strain</p><p>Degree of voice perturbation in the GRBASI<sup><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0126876#t002fn002" target="_blank">*</a></sup> scale in 24 patients with laryngeal tuberculosis, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, 2014.</p
Videolaryngoscopy images and diagrams of phonation deviation in 3 patients with laryngeal tuberculosis, Evandro Chagas, National Institute of Infectious Diseases, Brazil, 2014.
<p>*(A) epiglottis with granular appearance with amputation of the edges with uninjured vocal folds (B) phonatory deviation diagram from the normal range (C) granulous infiltrate of the vallecula, necronis area of the epiglottis, infiltration of aryepiglottic folds and arytenoid, precluding visualization of the vocal folds (D) phonatory deviation diagram from the normal range (E) presence of infiltration and hyperemia of the arytenoid, left vocal fold and left vestibular fold (F) phonatory deviation diagram from the normal range.</p
Clinical and vocal characteristics of 24 patients with active laryngeal tuberculosis, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, 2014.
<p><sup><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0126876#t001fn001" target="_blank">*</a></sup>M- male; F- female</p><p>Clinical and vocal characteristics of 24 patients with active laryngeal tuberculosis, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, 2014.</p
Good response to pentamidine isethionate in a case of Mucosal Leishmaniasis caused by Leishmania (Viannia) braziliensis that was difficult to treat: Case Report
Abstract In Brazil, meglumine antimoniate is the first drug of choice for mucosal leishmaniasis treatment followed by amphotericin B and pentamidine isethionate. We report the case of a patient with severe mucosal lesions caused by Leishmania (Viannia) braziliensis that were difficult to treat. Over a 14-year period, the patient showed low adherence and three treatment attempts with meglumine antimoniate failed. Additionally, there was an unsatisfactory response to liposomal amphotericin B and nephrotoxicity when using amphotericin B deoxycholate that persisted after new treatment attempt with liposomal amphotericin B. Finally, healing was achieved with pentamidine isethionate and maintained during nine months of monitoring
First report on ototoxicity of meglumine antitoniate
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Previous issue date: 2014FAPERJ, CNPqFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Departamento de Otorrino e Oftalmologia. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Universidade Federal do Estado do Rio de Janeiro. Rio de Janeiro, RJ, BrasilUniversidade Federal do Rio de Janeiro. Departamento de Otorrino e Oftalmologia. Rio de Janeiro, RJ, BrasilUniversidade Federal do Rio de Janeiro. Departamento de Otorrino e Oftalmologia. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Departamento de Otorrino e Oftalmologia. Rio de Janeiro, RJ, Brasil /Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Departamento de Otorrino e Oftalmologia. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, BrasilPentavalent antimonials are the first drug of choice in the treatment of tegumentary leishmaniasis. Data on ototoxicity related with such drugs is scarcely available in literature, leading us to develop a study on cochleovestibular functions. Case Report: A case of a tegumentary leishmaniasis patient, a 78-year-old man who presented a substantial increase in auditory threshold with tinnitus and severe rotatory dizziness during the treatment with meglumine antimoniate, is reported. These symptoms worsened in two weeks after treatment was interrupted. Conclusion: Dizziness and tinnitus had already been related to meglumine antimoniate. However, this is the first well documented case of cochlear-vestibular toxicity related to meglumine antimoniate
Alterations in evoked otoacoustic emissions by the use of meglumine antimoniate in American tegumentary leishmaniasis patients
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Previous issue date: 2017Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Federal University of Rio de Janeiro. Faculty of Medicine. Department of Otorhinolaryngology and Ophthalmology. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Federal University of Rio de Janeiro. Faculty of Medicine. Department of Otorhinolaryngology and Ophthalmology. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Federal University of Rio de Janeiro. Faculty of Medicine. Department of Otorhinolaryngology and Ophthalmology. Rio de Janeiro, RJ, Brazil.Federal University of the State of the Rio de Janeiro. Faculty of Medicine. Department of Otorhinolaryngology. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Brazilian National Council for Scientific and Technological Development. Brasilia, DF, Brazil / Carlos Chagas Filho Foundation for Research Support of the state of Rio de Janeiro. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Federal University of Rio de Janeiro. Faculty of Medicine. Department of Otorhinolaryngology and Ophthalmology. Rio de Janeiro, RJ, Brazil / Carlos Chagas Filho Foundation for Research Support of the state of Rio de Janeiro. Rio de Janeiro, RJ, Brazil / New University of Lisbon. Hygiene and Tropical Medicine Institute. Lisbon, Portugal.Tegumentary Leishmaniasis (TL) is a neglected, non-contagious, infectious disease, caused by different protozoa species of the Leishmania genus that affects skin and mucous membranes. Meglumine Antimoniate (MA), the first drug of choice for TL treatment in Brazil, has already been associated with cochlear toxicity, which is defined as damages of the cochlea caused by exposure to chemical substances, resulting in reversible or irreversible hearing loss. Auditory monitoring for cochlear toxicity aims at the early detection of auditory disorders, enabling, when possible, hearing to be preserved or an early auditory rehabilitation. Although otoacoustic emissions (OAEs) are used in this monitoring, there is no consensus on the criteria that define cochlear toxicity by this examination. The objective of this study was to describe the characteristics of the OAEs in cochlear toxicity monitoring in TL patients using MA