RESUMO
INTRODUCTION: To evaluate the therapeutic response and the rheologic and immunological characteristics in subjects bearing of rapidly progressive sensorineural hearing loss (RPSHL). PATIENTS AND METHODS: A comparative prospective study on three groups of damaged ears treated with piracetam (n=29), corticosteroids (n=32) and plabcebo (n=25). Hearing loss and recovery level, whole blood filterability (WBF) and a Western-blot (WB) to anticochlear antibodies were evaluated. RESULTS: Recovery average was 20,8 +/- 55,9% in the first group, with progressive of deafness in the rest (p<0,01). WB did not show differences among groups. The higher WBF at the end of therapy was detected on group 1 (20,36 +/- 2,54 Vs 18,42 +/- 3,42 microl/seg on group 3; p<0,05). Moreover, it impaired only on those treated with piracetam, with statistically significative differences over the other two groups. CONCLUSIONS: We detected alterations on WBF in patients with RPSHL that justify the use of rheoactive measures as a pathophysiological therapy.
Assuntos
Corticosteroides/uso terapêutico , Perda Auditiva Neurossensorial/tratamento farmacológico , Piracetam/uso terapêutico , Adulto , Viscosidade Sanguínea , Progressão da Doença , Método Duplo-Cego , Feminino , Perda Auditiva Neurossensorial/sangue , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de TempoRESUMO
We developed a two year follow-up in thirteen subjects bearing of fluctuant sensorineural hearing loss measuring their blood filterability (BF) and making a correlation to appearance of deafness episodes. We could observe a decrease on BF in all patients when they felt a hearing loss. When they recovered the hearing level, BF increased too. The use of reoactive techniques to avoid these decreases on BF in fluctuant deafness could potentially prevent or improve them.
Assuntos
Cóclea/irrigação sanguínea , Cóclea/fisiopatologia , Perda Auditiva Neurossensorial/fisiopatologia , Audiometria de Tons Puros/métodos , Perda Auditiva Neurossensorial/diagnóstico , Hemodinâmica/fisiologia , Hemofiltração/instrumentação , Humanos , Índice de Gravidade de DoençaRESUMO
INTRODUCTION: Wide studies and substantial controversies build on utilization of actual mobile phones and appearance of systemic disorders or even tumours, but there is no knowledge about an eventual involvement on early hearing loss. PATIENTS AND METHODS: In a group of three hundred and twenty-three healthy and normoacoustic volunteers who were usual costumers of mobile phones an audiometric evaluation was made at the beginnig of its use and three years later, inquiring about the periods of time per day and year employed on direct contacts with phone. A healthy and normoacoustic control group of non users was studied too. RESULTS: Cases carried out 24.3 +/- 8.2 active contacts, reaching 50.4 +/- 27.8 days of mobile phone employment in three years. Audiometric curve was similar in cases and controls at the beginning of the study. After this follow-up, cases showed an increase on hearing threshold between 1 and 5 dB HL more than controls in speech tones (p<0.001). Moreover, there was a trend to correlate time of phone use to hearing impairment, but this finding did not result statistically significative. CONCLUSIONS: Frequent management of mobile phones in a middle period of time allows to detect a mild hearing loss, but the cause of this disorder keeps unclear.
Assuntos
Telefone Celular , Campos Eletromagnéticos/efeitos adversos , Audição , Adulto , Audiometria de Tons Puros , Feminino , Humanos , MasculinoRESUMO
OBJECTIVE: To evaluate the influence of different otoscopic findings on body thermometry in children using an infra-red tympanic thermometer. PATIENTS AND METHODS: Body temperature was measured on healthy right and left ear canals with Thermoscan systems. Moreover, it was determined on children with altered otoscopy, companng to normal contralateral ear. To assess its diagnostic fiability, accuracy ratios were calculated in different temperatures. RESULTS: Temperature measured bilaterally did not offer differences, and intra/interassay variation ratios were always less than 0.34%. Acute otitis externa increased tympanic thermometry a mean of 0.36 degrees C (p < 0.001), and cerumen and previously radical surgery decreased a mean of 0.62 and 0.53 degrees C, respectively (p < 0.001). CONCLUSIONS: The conditions mentioned before modify body thermometry if measured by infra-red tympanic thermometer. So, this system must be avoided in these circumstances. Otitis media, fluid in middle ear, tympanic perforation and ventilation tubes did not modify thermometric results.
Assuntos
Termômetros , Criança , Pré-Escolar , Orelha Média , Feminino , Humanos , Raios Infravermelhos , Masculino , Análise de Regressão , Reprodutibilidade dos TestesRESUMO
We report two cases of sudden deafness which appeared during vaso-occlusive crisis of a sickle cell anaemia (homozygous form of disease) and a sickle cell trait (heterozygous form) in two males aged sixteen and twenty-two, respectively. A high erythrocyte aggregability and low deformability were proved in both young men. Although hearing disorders have been reported in this disease, a sudden onset is not common. The treatment used was useful in the removal of painful crisis and infections, but deafness did not improve in either of then.
Assuntos
Anemia Falciforme/complicações , Surdez/etiologia , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Súbita/etiologia , Traço Falciforme/complicações , Dor Abdominal/etiologia , Adolescente , Adulto , Medicina Aeroespacial , Anemia Falciforme/sangue , Viscosidade Sanguínea , Hipóxia Celular , Surdez/fisiopatologia , Agregação Eritrocítica , Deformação Eritrocítica , Necrose da Cabeça do Fêmur/etiologia , Perda Auditiva Neurossensorial/fisiopatologia , Perda Auditiva Súbita/fisiopatologia , Humanos , Hipóxia/complicações , Masculino , Osteomielite/complicações , Traço Falciforme/sangue , Infecções Estafilocócicas/complicaçõesRESUMO
We show two atypical Cogan's syndrome cases in forty-seven and fifty-six years old individuals. Characteristical symptoms of the syndrome were detected in both (interstitial keratitis, sensorineural deafness and vestibular dysfunction), but they could be considered as unusual because of the association of systematic symptoms and an onset with hearing loss. In both cases there was an increase in erythrosedimentation rate and immunoglobulins levels, as well as high titles for rheumatoid factor and non-specific autoantibodies. By means of a Western-blot technique, several chochlear antibodies with distinct molecular weight were detected, but the 68 KD appeared in both. Metil-prednisolone treatment did not avoid ocular and auditive reactivation in ne of the patients.
Assuntos
Perda Auditiva/diagnóstico , Ceratite/diagnóstico , Vertigem/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SíndromeRESUMO
We present a case of Cogan's syndrome (interstitial keratitis, rapidly evolving sensorineural hearing loss and vestibular dysfunction) in a 12-year-old girl. Diagnosis was made by clinical and audiologic examination as well as by nonspecific laboratory findings (increased erythrosedimentation rate and positive IgA and IgM rheumatoid factor titers and antineutrophil cytoplasmic autoantibodies). Detection of specific autoantibodies against cochlear antigenic epitopes with a molecular weight of 68 kDa by Western-blot assay confirmed an organ-specific autoimmune mechanism. Therapy with deflazacort 1 mg/kg per day 3 three weeks decreasing progressively thereafter was successful and the patient remains symptom-free.