Hearing impairment and socioeconomic factors: a population-based survey of an urban locality in southern Brazil Deficiencia auditiva y factores socioeconómicos: estudio de base poblacional en una localidad urbana del sur de Brasil

OBJECTIVE: To provide the first population-based data on deafness and hearing impairment in Brazil. METHODS: In 2003, a cross-sectional household survey was conducted of 2 427 persons 4 years old and over. The study population was composed of 1 040 systematically chosen households in 40 randomly selected census tracts (dwelling clusters) in the city of Canoas, which is in the state of Rio Grande do Sul, in southern Brazil. Hearing function was evaluated in all subjects by both pure-tone audiometry and physical examination, using the World Health Organization Ear and Hearing Disorders Survey Protocol and definitions of hearing levels. The socioeconomic data that were gathered included the amount of schooling of all individuals tested and the income of the head of the household. RESULTS: It was found that 26.1% of the population studied showed some level of hearing impairment, and 6.8% (95% confidence interval (CI) = 5.5%-8.1%) were classified in the disabling hearing impairment group. The prevalence of moderate hearing loss was 5.4% (95% CI = 4.4%-6.4%); for severe hearing loss, 1.2% (95% CI = 0.7%-1.7%); and for profound hearing loss, 0.2% (95% CI = 0.03%-0.33%). The groups at higher risk for hearing loss were men (odds ratio (OR) = 1.54; 95% CI = 1.06-2.23); participants 60 years of age and over (OR = 12.55; 95% CI = 8.38-18.79); those with fewer years of formal schooling (OR = 3.92; 95% CI = 2.14-7.16); and those with lower income (OR = 1.56; 95% CI = 1.06-2.27). CONCLUSIONS: These results support advocacy by health policy planners and care providers for the prevention of deafness and hearing impairment. The findings could help build awareness in the community, in universities, and in government agencies of the health care needs that hearing problems create.OBJETIVO: Presentar los primeros datos de un estudio de base poblacional sobre sordera y deficiencia auditiva en Brasil. MÉTODOS: Se realizó una encuesta transversal de hogares en 2003 en la que participaron 2 427 personas de 4 años de edad o más. La población de estudio estuvo compuesta por 1 040 hogares escogidos de manera sistemática en 40 sectores censales (conglomerados de viviendas) escogidos al azar en la ciudad de Canoas, estado de Rio Grande do Sul, en el sur de Brasil. Se evaluó la función auditiva de los participantes mediante audiometría tonal liminar y examen físico, según el Protocolo para el Estudio de Trastornos Óticos y Auditivos y las definiciones de niveles auditivos, ambos de la Organización Mundial de la Salud. Entre los datos socioeconómicos colectados estaban los años de escolaridad de las personas estudiadas y los ingresos del jefe del hogar. RESULTADOS: Se encontró que 26,1% de la población estudiada mostró algún grado de deficiencia auditiva y 6,8% (intervalo de confianza de 95% [IC95%]: 5,5% a 8,1%) se clasificó en el grupo con deficiencia auditiva incapacitante. La prevalencia de pérdida auditiva moderada fue de 5,4% (IC95%: 4,4% a 6,4%); de pérdida auditiva grave, 1,2% (IC95%: 0,7% a 1,7%); y de pérdida auditiva profunda, 0,2% (IC95%: 0,03% a 0,33%). Los grupos en mayor riesgo de pérdida auditiva fueron los hombres (razón de posibilidades [odds ratio, OR] = 1,54; IC95%: 1,06 a 2,23); los participantes de 60 años de edad o más (OR = 12,55; IC95%: 8,38 a 18,79); los que tenían menos años de escolaridad formal (OR = 3,92; IC95%: 2,14 a 7,16); y los que tenían menores ingresos (OR = 1,56; IC95%: 1,06 a 2,27). CONCLUSIONES: Estos resultados respaldan las recomendaciones de los planificadores de políticas sanitarias y de los proveedores de servicios de salud sobre la prevención de la sordera y la deficiencia auditiva. Además, pueden contribuir a aumentar el nivel de conciencia de la comunidad, las universidades y las agencias gubernamentales acerca de las necesidades de atención sanitaria que generan los problemas auditivos

Efeito do exercício físico sobre o volume nasal Effects of physical exercise in nasal volume

A variação da permeabilidade nasal tem sido demonstrada usando-se várias técnicas de exame. As estruturas nasais geram uma resistência que representa cerca de 50% da resistência respiratória total. O exercício físico é um dos fatores que pode causar um efeito vasoconstritor sobre a mucosa nasal. OBJETIVO: O objetivo deste estudo é avaliar o grau de mudança do volume nasal após exercício físico e o tempo de retorno aos níveis basais. MATERIAIS E MÉTODOS: Dezenove indivíduos foram submetidos à realização de teste físico em bicicleta ergométrica. O volume nasal foi obtido através da rinometria acústica, realizada em repouso, após o fim do exercício físico, e nos minutos décimo e vigésimo de seu final. RESULTADOS: Os resultados rinométricos mostram um aumento estatisticamente significativo do volume nasal (p < 0,001). No vigésimo minuto o volume nasal estava próximo aos níveis de repouso. CONCLUSÃO: O exercício físico de modo geral aumenta significativamente o volume nasal. Entretanto, o aumento do volume nasal foi transitório, ocorrendo uma maior redução deste aumento nos primeiros dez minutos após o final do exercício. No vigésimo minuto após o fim do exercício físico, os valores do volume nasal retornam próximos aos valores de repouso.<br>The nasal permeability has been demonstrated using several exams. Nasal structures produces a resistance to the nasal air flux that represents over 50% of the total respiratory resistance. Physical exercises is a factor that brings a vasoconstrictor effect over nasal mucosa. AINS: Evaluate the improvement degree of nasal volume after aerobic physical exercises and time to return to previous levels. SUBJECTS AND METHODS: Nineteen heathly subjects were submitted to aerobic exercise in ergometric bike. The nasal volume was obtained by Acoustic Rhinometry perfomed in rest, after aerobic exercise, 10o and 20o minutes after the aerobic exercise. RESULTS: Rhynometrics results shows a statically and significant increase of nasal volume (p<0,001). The nasal volume, in twenty minutes, returns nearby the rest levels. CONCLUSIONS: Aerobic exercises, generally, increases the nasal volume. However, the increase of nasal volume was transitory, and occurs a major reduction of increase in the first ten minutes after the exercises ends, and perform a greater vasoconstrictor effect over nasal mucosa, Twenty minutes after the physical exercises finish, total nasal volume returns, closely, to the basal levels