Prevalência de perda auditiva e vulnerabilidade a saúde em crianças de 25 a 36 meses: uma análise da distribuição espacial

RESUMO Objetivo Analisar a associação entre perda auditiva e a vulnerabilidade à saúde em crianças na faixa etária de 25 a 36 meses. Método Estudo observacional analítico do tipo transversal realizado por meio da triagem auditiva infantil em nove creches. A triagem constou de anamnese, meatoscopia, timpanometria, emissões otoacústicas transientes e audiometria tonal limiar. Para cada exame realizado foi estabelecido o critério de “passa” e “falha”. Os endereços residenciais das crianças foram georreferenciados e foi construído mapa coroplético da distribuição espacial, considerando o Índice de Vulnerabilidade à Saúde (IVS). Foi realizada análise de associação entre o IVS com as variáveis sexo, exames audiológicos e regional de domicílio por meio dos testes Qui-quadrado de Pearson, e Exato de Fisher. Resultados Foram avaliadas 95 crianças de ambos os sexos, destas, 44,7% apresentaram alteração em pelo menos um dos exames realizados, sendo encaminhadas para avaliação otorrinolaringológica e auditiva. Das alterações observadas 36,9% ocorreram na timpanometria e 7,8% nas emissões otoacústicas transientes. Dentre crianças encaminhadas para avaliação, 9,7% apresentaram diagnóstico de perda auditiva do tipo condutiva, 13,6% resultados dentro da normalidade e 21,4% não compareceram para reavaliação. Das crianças que apresentaram o diagnóstico final de perda auditiva do tipo condutiva (9,7%), 1,9% foi classificado como IVS de risco baixo e 6,8% como IVS de risco médio. Houve significância estatística entre IVS e o local de residência da criança. Conclusão Não houve associação com significância estatística entre alteração auditiva e IVS, entretanto foi possível observar que 77,7% das crianças com diagnóstico de perda auditiva residiam em setores censitários de risco médio do IVS

Avaliação anatomofuncional das lesões benignas da laringe por meio da videolaringoscopia digital de alta velocidade

Exportado OPUSMade available in DSpace on 2019-08-12T14:42:09Z (GMT). No. of bitstreams: 1 disserta__o_ci_ncias_fonoaudiologicas_renata_c_cordeiro_d_oliveira_.pdf: 1583652 bytes, checksum: 85a44e074ce2ce2b419c41923a22bbb1 (MD5) Previous issue date: 4Introdução: As medidas objetivas da vibração das pregas vocais foram introduzidas na laringologia por meio da videolaringoscopia de alta velocidade, que permite a visualização dos verdadeiros períodos de vibração das pregas vocais à fonação. Considerado um novo e poderoso instrumento para investigar a dinâmica das pregas vocais, ela fornece informações essenciais para o diagnóstico clínico de uma forma eficaz, visual e quantitativa. É capaz de detectar pequenas assimetrias dinâmicas entre as pregas vocais; diferenças no coeficiente de abertura glótica; propagação lateral das ondas mucosa e movimentos da margem superior da borda livre da prega vocal. Os resultados da videolaringoscopia de alta velocidade podem possibilitar o diagnóstico diferencial de alterações benignas, ainda pouco estudadas, como os nódulos e cistos epidermóides, lesões mais prevalentes na clínica laringológica. Objetivo: Analisar e comparar o padrão vibratório das pregas vocais e as características das alterações, de mulheres com nódulos e cistos de pregas vocais, por meio da videolaringoscopia de alta velocidade. Métodos: Trata-se de um estudo transversal, que realizado no município de Belo Horizonte MG. Os participantes foram recrutados no consultório de otorrinolaringologia de uma clínica privada. Foram selecionados 60 sujeitos com idade variando entre 18 anos e 45 anos do sexo feminino, sendo o critério de inclusão o diagnóstico otorrinolaringológico de nódulo ou cisto em pregas vocais. Foram compostos três grupos de estudo, 20 mulheres sem alterações laríngeas formando o grupo controle (Grupo1), 20 mulheres com diagnóstico de nódulos vocais formando o Grupo 2 e 20 mulheres com diagnóstico de cisto de prega vocal formando o Grupo 3. Posteriormente foram encaminhados para realização da videolaringoscopia de alta velocidade para análise e comparação das imagens laríngeas utilizando parâmetros quimográficos e de área glotal, por meio de software KIPS®. Resultados: na análise da área glotal foi encontrada maior abertura mínima no ponto médio da glote nos pacientes com cistos corroborando com a maior rigidez encontrada na cobertura das pregas vocais com essas lesões, o que pode levar a maior área mínima e menores valores na abertura máxima no ponto médio da glote desses indivíduos. Com a videoquimografia foi possível à análise da abertura máxima e média e amplitude das pregas vocais no qual pacientes com lesões laríngeas apresentaram valores menores aos encontrados em pregas vocais sem alterações. Na comparação entre os grupos na região das alterações, os cistos apresentaram menores valores da abertura média que os nódulos, podendo-se inferir que esta lesão apresenta maior rigidez na onda mucosa. Apesar de não ter encontrado diferença estatística em relação à amplitude dos cistos quando comparado aos nódulos, estes apresentaram maiores valores. Conclusão: A análise dos parâmetros da videolaringoscopia digital de alta velocidade evidencia que os nódulos e cistos das pregas vocais aumentam as áreas glóticas mínimas e diminuem a amplitude da abertura das pregas vocais.Introduction: Objective measures of vocal fold vibration were introduced in laryngology through high-speed videolaryngoscopy, which allows the visualization of the true periods of vocal fold vibration in phonation. Considered a powerful new instrument for investigating vocal fold dynamics, it provides essential information for clinical diagnosis in an effective, visual and quantitative way. It is able to detect small dynamic asymmetries between the vocal folds; differences in the glottic opening coefficient; lateral propagation of the mucosal waves and movements of the upper margin of the free edge of the vocal fold. The results of high speed videolaryngoscopy may allow the differential diagnosis of benign changes, as yet little studied, such as nodules and cysts, prevalent in the laryngological clinic. Objective: To analyze and compare vocal fold vibration pattern and the characteristics of women with vocal fold cysts and nodules using high speed videolaryngoscopy. Method: This is a cross-sectional clinical study, carried out in the city of Belo Horizonte - MG. Participants will be recruited at the otolaryngology clinic of a private clinic. A total of 60 subjects were selected, with ages varying between 18 and 45 years old, being the criterion of inclusion the otorhinolaryngological diagnosis by videolaryngoscopy of the nodule or cyst in vocal folds. Three study groups were composed of 20 women without laryngeal changes forming the control group 1, 20 women with diagnosis of vocal nodules forming Group 2 and 20 women with diagnosis of vocal fold cyst forming Group 3. Subsequently, they were referred for high-speed videolaryngoscopy for analysis and comparison of laryngeal images using kymography and glottal area parameters, using specific software. Results: in the analysis of the glottal area a greater minimum opening was found in the midpoint of the glottis in patients with cysts corroborating with the higher stiffness found in the vocal fold cover with these changes, which may lead to a greater minimum area and smaller values at maximum aperture in the point of the glottis of these individuals. With videokymography, it was possible to analyze the maximum and mean opening and amplitude of vocal folds in which patients with laryngeal lesions presented lower values than those found in vocal folds without alterations. In the comparison between the lesions, the cysts presented lower values of the mean opening than the nodules, and it can be inferred that this changes presents a greater rigidity in the mucosal wave. Although there was no statistical difference in relation to the cysts amplitude when compared to the nodules, they had higher values. Research with larger samples could show a statistical difference. Conclusion: Analysis of the parameters of high-speed digital videolaryngoscopy shows that vocal fold nodules and cysts increase glottic areas and decrease the vocal fold opening amplitude

Hypacusis and Tinnitus Associated to Otosyphilis

Introduction: Both congenital and acquired syphilis may cause cochleovestibular dysfunction. In the literature, the neurosensorial hearing loss, tinnitus and unbalance have been described in the secondary and tertiary syphilis. Objective: The objective of this work was to emphasize the need for etiologic identification for treatment and control of individuals with cochleovestibular symptoms. Case Report: We described the case of a patient, aged 64 years, black, with complaints of slow and progressive diminishing of auditory accuracy since about 12 years ago, associated with tinnitus and occasional unbalances. In the laboratorial and audiometric evaluation, after exclusion of other related causes, we came to the additional diagnosis of otosyphilis. Final Comments: Syphilis must always be taken into account in patients with cochleovestibular complications, irrespectively of the age range, whether or not belonging to risk groups, and the number of partners of each patient. The etiological diagnosis is very important for the control and treatment of such patients

Late otoneurologic manifestations of Chiari I malformation

Introduction: Chiari malformation (CM) belongs to an anomaly group comprised of the structures in the cranial-cerebellar-medullary junctions. Type I (CM I) is characterized by the descent of the cerebellar tonsils and the medial portion of the lower cerebellar lobe through the cervical spinal canal. In literature, motor, sensorial and autonomous manifestations have been described. It is mostly found in women. Its prevalence is hard to determine, since there are many asymptomatic cases, hence, making the epidemiologic information scarce. Objective: The objective of this work was to report a Chiari I malformation case in a 66-year-old female patient. Case report: Authors report a Chiari I malformation case in a 66-year-old female patient, showing tinnitus, hearing loss and occipital headache symptoms. Final Comments: Chiari I's diagnostic hypothesis must be based on the patient's complaints, clinical and image examinations, and since the prevalence of this disease is difficult to determine, there can be diagnoses in rare age groups

Galvanic vestibular stimulation to improve postural instability, voluntary attention, and quality of life in Parkinson's disease patients

ABSTRACT Galvanic vestibular stimulation (GVS) influences body balance and has proved to be useful to improve patients’ mood, quality of life, and cognitive skills. This study aimed to present three cases of patients with Parkinson’s disease and postural instability who had been submitted to GVS to improve their balance, by assessing the impact of this intervention on their cognition, mood, and quality of life. Patients were assessed before and after GVS sessions concerning P300 latency and scores on the 15-item Geriatric Depression Scale (GDS-15) and the 39-item quality-of-life Parkinson’s Disease Questionnaire (PDQ-39). The three patients’ P300 latency improved, possibly indicating improved attention. Their PDQ-39 score also improved, possibly indicating a positive impact on their quality of life. Their GDS-15 score did not change before and after the intervention. None of the patients had any intervention side effects. This three-case experimental pilot study has shown that GVS is a safe method, possibly useful to improve attention and, therefore, the quality of life of patients presented with Parkinson’s disease

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data