The use of high-frequency audiometry increases the diagnosis of asymptomatic hearing loss in pediatric patients treated with cisplatin-based chemotherapy.

BACKGROUND: Cisplatin may cause permanent cochlear damage by changing cochlear frequency selectivity and can lead to irreversible sensorineural hearing loss. High-frequency audiometry (HFA) is able to assess hearing frequencies above 8,000 Hz; hence, it has been considered a high-quality method to monitor and diagnose early and asymptomatic signs of ototoxicity in patients receiving cisplatin. PROCEDURE: Forty-two pediatric patients were evaluated for hearing loss induced by cisplatin utilizing HFA, and its diagnostic efficacy was compared to that of standard pure-tone audiometry and distortion-product otoacoustic emissions (DPOAEs). The patient population consisted of those who signed an informed consent form and had received cisplatin chemotherapy between 1991 and 2008 at the Hospital de Clínicas de Porto Alegre Pediatric Unit, Brazil. RESULTS: Forty-two patients were evaluated. The median age at study assessment was 14.5 years (range 4-37 years). Hearing loss was detected in 24 patients (57%) at conventional frequencies. Alterations of DPOAEs were found in 64% of evaluated patients and hearing loss was observed in 36 patients (86%) when high-frequency test was added. The mean cisplatin dose was significantly higher (P = 0.046) for patients with hearing impairment at conventional frequencies. CONCLUSION: The results suggest that HFA is more effective than pure-tone audiometry and DPOAEs in detecting hearing loss, particularly at higher frequencies. It may be a useful tool for testing new otoprotective agents, beside serving as an early diagnostic method for detecting hearing impairment.

The Influence of Seasonal Temperature Variation on Blood Pressure Behavior

Abstract Background: Hypertension in Brazil affects 32.5% of the population, accounting for 50% of deaths due to cardiovascular disease. The correct measurement and interpretation of blood pressure are essential for attaining an adequate disease diagnosis and management. Objective: To verify the correlation between the seasonal temperature variation during 2016 and blood pressure variation in 902 patients of a private Cardiology Service in the city of Porto Alegre/RS. Method: A total of 902 ambulatory blood pressure monitoring (ABPM) results were analyzed in 2016. Pearson's Correlation Coefficient was used to correlate blood pressure levels with the values of temperature and relative air humidity; the Kolmogorov-Smirnov and Shapiro-Wilk tests were adopted for significance values, assuming an alpha error < 0.05 and a 95% confidence interval. The Analysis of Variance compared the 902 ABPM results with the continuous variables obtained for this study. Results: No statistically significant differences were found when the blood pressure values obtained from the 902 ABPM results were correlated with the minimum, mean and maximum values of temperature and relative air humidity, and also when each of the continuous variables obtained for this study were compared with these same pressure measurements. Conclusion: Despite the great variation in temperature and relative air humidity throughout the year in the region, there was no significant influence on the systemic arterial pressure in the study population. New comparative studies in the same population with different thermal variations may provide further clarification on this subject.