Hearing Loss at High Frequencies and Oxidative Stress: A New Paradigm for Different Etiologies

The clinical assessment of hearing loss has been transformed and revised in terms of interpreting the characteristics of patterns found in relation to the relative frequency of certain diseases. However, increasing the threshold to 4 kHz as a starting point for hearing loss has shown to be common to different diseases such as noise-induced hearing loss. In noise-induced hearing loss, for example, six mechanisms can be considered: conversion of sound pressure level into hearing level, vascular failure in the cochlear region responsible for hearing at 4 kHz, sound wave propagation velocity is very high and causes the displacement amplitude in the cochlear duct, the structure anatomy of the cochlea causes a collision of fluids in the first curve of the cochlea, characteristics of auricular pavilion resonance and external auditory canal, and sound attenuation of the acoustic reflex. It is hoped that this new paradigm for the different hearing losses will result in a different approach to the physiological changes that affect the auditory system in the form of high-frequency hearing loss. As such, preventing, treating, and avoiding exacerbations are possibilities to be investigated in order to guarantee efficient communication and quality of life for individuals

Dizziness associated with panic disorder and agoraphobia: case report and literature review

SummaryDizziness is one of the most frequent complaints in both primary and specialized medical care facilities. Many dizzy patients, without a known organic cause, considered as having idiopathic dizziness, may have a psychiatric disorder. Besides, even organic dizziness may cause or exacerbate latent psychiatric alterations. One of the most common disorders associated with dizziness is Panic Disorder with or without Agoraphobia. The aim of this paper is to report a patient’s case and make a literature review on the subjec

Childhood pemphigus vulgaris is a challenging diagnosis

Pemphigus Vulgaris (PV) is an uncommon autoimmune and blistering mucocutaneous disease. Childhood Pemphigus Vulgaris (CPV) is a pediatric variant of PV, which affects children below 12 years, being very rare among children under 10 years of age. CPV has similar clinical, histological, and immunological features as seen in PV in adults. The mucocutaneous clinical presentation is the most common in both age groups. Vesicles and erosions arising from the disease usually cause pain. A few CPV cases have been reported in the literature. This study reports a case of an 8-year-old male patient with oral lesions since the age of 3 years, and the diagnosis of pemphigus was achieved only 2 years after the appearance of the initial lesions. CPV remains a rare disease, making the diagnosis of this clinical case a challenge due to its age of onset and clinical features presented by the patient. Therefore, dentists and physicians should know how to differentiate CPV from other bullous autoimmune diseases more common in childhood

Hearing handicap in patients with chronic kidney disease: a study of the different classifications of the degree of hearing loss

Abstract Introduction: The association between hearing loss and chronic kidney disease and hemodialysis has been well documented. However, the classification used for the degree of loss may underestimate the actual diagnosis due to specific characteristics related to the most affected auditory frequencies. Furthermore, correlations of hearing loss and hemodialysis time with hearing handicap remain unknown in this population. Objective: To compare the results of Lloyd's and Kaplan's and The Bureau Internacional d'Audiophonologie classifications in chronic kidney disease patients, and to correlate the averages calculated by their formulas with hemodialysis time and the hearing handicap. Methods: This is an analytical, observational and cross-sectional study with 80 patients on hemodialysis. Tympanometry, speech audiometry, pure tone audiometry and interview of patients with hearing loss through Hearing Handicap Inventory for Adults. Cases were classified according to the degree of loss. The correlations of tone averages with hemodialysis time and the total scores of Hearing Handicap Inventory for Adults and its domains were verified. Results: 86 ears (53.75%) had hearing loss in at least one of the tonal averages in 48 patients who responded to Hearing Handicap Inventory for Adults. The Bureau Internacional d'Audiophonologie classification identified a greater number of cases (n = 52) with some degree of disability compared to Lloyd and Kaplan (n = 16). In the group with hemodialysis time of at least 2 years, there was weak but statistically significant correlation of The Bureau Internacional d'Audiophonologie classification average with hemodialysis time (r = 0.363). There were moderate correlations of average The Bureau Internacional d'Audiophonologie classification (r = 0.510) and tritone 2 (r = 0.470) with the total scores of Hearing Handicap Inventory for Adults and with its social domain. Conclusion: The Bureau Internacional d'Audiophonologie classification seems to be more appropriate than Lloyd's and Kaplan's for use in this population; its average showed correlations with hearing loss in patients with hemodialysis time ≥ 2 years and it exhibited moderate levels of correlation with the total score of Hearing Handicap Inventory for Adults and its social domain (r = 0.557 and r = 0.512)