Programa de tamizaje universal e intervención precoz (PTUIP) en hipoacusia sensorioneural bilateral congénita: Tarea pendiente desde la perspectiva de políticas públicas de salud en Chile / Universal screening program and early intervention (uspei) in congenital bilateral sensorineural hearing loss in Chile

Congenital hearing loss is the total or partial inability to hear sounds through the ears. It is the most common disability in newborns in Chile and worldwide, and is a permanent condition. The direct impact on children who are not adequately diagnosed is the alteration in acquisition of language and cognitive skills and a decline in their social and school insertion, jeopardizing their professional and potentially productive life. Universal screening programs for hearing loss are essential for the diagnosis, since 50% of infants with hearing loss have no known risk factor. Screening before one month of age, confirmation before 3 months, and effective intervention before 6 months, allows the development of these children as if they had normal hearing. In Chile there is a selective program of screening for infants aged less than 32 weeks or 1,500 grams, as part of Explicit Health Guarantees, but it covers only 0.9% of newborns per year. Therefore, a large majority of children remain without diagnosis. The aim of this review is to compare the situation in Chile with other countries, raising the need to move towards a universal neonatal hearing loss screening program, and propose necessary conditions in terms of justification and implementation of a universal screening public policy.

[Universal screening program and early intervention (USPEI) in congenital bilateral sensorineural hearing loss in Chile]. / Programa de tamizaje universal e intervención precoz (PTUIP) en hipoacusia sensorioneural bilateral congénita: Tarea pendiente desde la perspectiva de políticas públicas de salud en Chile.

Congenital hearing loss is the total or partial inability to hear sounds through the ears. It is the most common disability in newborns in Chile and worldwide, and is a permanent condition. The direct impact on children who are not adequately diagnosed is the alteration in acquisition of language and cognitive skills and a decline in their social and school insertion, jeopardizing their professional and potentially productive life. Universal screening programs for hearing loss are essential for the diagnosis, since 50% of infants with hearing loss have no known risk factor. Screening before one month of age, confirmation before 3 months, and effective intervention before 6 months, allows the development of these children as if they had normal hearing. In Chile there is a selective program of screening for infants aged less than 32 weeks or 1,500 grams, as part of Explicit Health Guarantees, but it covers only 0.9% of newborns per year. Therefore, a large majority of children remain without diagnosis. The aim of this review is to compare the situation in Chile with other countries, raising the need to move towards a universal neonatal hearing loss screening program, and propose necessary conditions in terms of justification and implementation of a universal screening public policy.

Survey and data analysis of patients treated in a hearing aids grant program.

PURPOSE: To establish a profile of the patients treated in a Hearing Aids Grant Program of the Brazilian Ministry of Health, by analyzing the variables: age, sex, type and degree of hearing loss, number of aided patients, adaptation type (unilateral or bilateral), and adapted ear. METHODS: This is a descriptive observational study, retrospective in a cross-sectional perspective, which included patients treated between February 2006 and July 2010, totaling 1,572 individuals; RESULTS: Their ages ranged from 3 to 100 years, mostly elderly (52.8%), with no frequency difference between the sexes. The sensorineural (73.12%) and moderate (54.7%) hearing losses were the most frequent ones, except in children, in whom the degree found was more profound (45.3%). More than 99% of the patients were aided, 258 unilaterally and 1,302 bilaterally. CONCLUSION: Mostly patients presents 60 years old or more, with no frequency difference between the sexes. The sensorioneural and moderate hearing losses were the most frequent ones, except in children. More than 99% of the patients were aided and the conducts were defined based in the audiological diagnosis and patient's needs.

Congenital cytomegalovirus is the second most frequent cause of bilateral hearing loss in young French children.

OBJECTIVE: To estimate the prevalence of congenital cytomegalovirus (cCMV) among causes of bilateral hearing loss in young French children. STUDY DESIGN: Children <3 years old with hearing loss were prospectively included at their first visit to a referral center. Cytomegalovirus polymerase chain reaction was performed on dried blood spots from Guthrie cards. Medical records were reviewed. RESULTS: One hundred children with bilateral hearing loss were included at a median age of 15 months; the prevalence of cCMV was 8% (8/100) (95% CI, 2.7%-13.3%) in this population and 15.4% (8/52) in the subpopulation of children with profound bilateral hearing loss. Delayed neurodevelopment and brain abnormalities on computed tomography scan were found more often in children with cCMV than in children with hearing loss without cCMV (P = .027, P = .005). In 6 of 8 cCMV cases, cCMV infection had not been diagnosed before the study. CONCLUSIONS: In a comprehensive study of the causes of bilateral hearing loss in young French children, cCMV is the second most frequent cause of hearing loss after connexin mutations. It underlines that a majority of French children with hearing loss and cCMV are not diagnosed early and therefore may not benefit from early intervention including the possibility of neonatal antiviral treatment. These results make the case for promoting systematic cytomegalovirus screening in neonates with confirmed hearing loss identified through neonatal hearing screening.

Levantamento e análise de dados de pacientes atendidos em um programa de concessão de aparelhos de amplificação sonora individual / Survey and data analysis of patients treated in a hearing aids grant program

OBJETIVO: Traçar um perfil dos pacientes atendidos em um Programa de Concessão de aparelhos de amplificação sonora individual, do Ministério da Saúde, analisando-se as variáveis: faixa etária, gênero, tipo e grau da perda auditiva, número de pacientes adaptados, tipo de adaptação, se uni ou bilateral e a orelha adaptada. MÉTODOS: Trata-se de um estudo de levantamento e análise de dados, de caráter observacional descritivo, retrospectivo de corte transversal, no qual foram incluídos os pacientes atendidos no período de fevereiro de 2006 a julho de 2010, totalizando 1572 indivíduos. RESULTADOS: As idades variaram entre três e 100 anos, sendo em sua maioria idosos (52,8%), não existindo diferença de frequência entre os gêneros. As perdas auditivas do tipo neurossensorial (73,12%) e grau moderado (54,7%) foram as mais frequentes, exceto em crianças, em que o grau mais encontrado foi o profundo (45,3%). Foram adaptados mais de 99% dos pacientes, sendo 258 unilateralmente e 1302 bilateralmente. CONCLUSÃO: A maioria dos pacientes atendidos no Programa apresenta idade superior a 60 anos, não existindo diferença de frequência entre homens e mulheres. O tipo de perda auditiva neurossensorial e o grau moderado foram os mais frequentemente diagnosticados nos gêneros e faixas etárias estudadas, exceto em crianças. Observou-se que mais de 99% dos pacientes atendidos foram adaptados, sendo a conduta definida de acordo com seus diagnósticos audiológicos e necessidades.

PURPOSE: To establish a profile of the patients treated in a Hearing Aids Grant Program of the Brazilian Ministry of Health, by analyzing the variables: age, sex, type and degree of hearing loss, number of aided patients, adaptation type (unilateral or bilateral), and adapted ear. METHODS: This is a descriptive observational study, retrospective in a cross-sectional perspective, which included patients treated between February 2006 and July 2010, totaling 1,572 individuals; RESULTS: Their ages ranged from 3 to 100 years, mostly elderly (52.8%), with no frequency difference between the sexes. The sensorineural (73.12%) and moderate (54.7%) hearing losses were the most frequent ones, except in children, in whom the degree found was more profound (45.3%). More than 99% of the patients were aided, 258 unilaterally and 1,302 bilaterally. CONCLUSION: Mostly patients presents 60 years old or more, with no frequency difference between the sexes. The sensorioneural and moderate hearing losses were the most frequent ones, except in children. More than 99% of the patients were aided and the conducts were defined based in the audiological diagnosis and patient's needs.

Estimación del problema auditivo en México / Assessment of the hering problem in Mexico

Con el programa de detección de defectos auditivos efectuado con unidades móviles, atendimos 15,355 sujetos, durante el período de 1993-1997 en 26 comunidades del Distrito Federal y Área Metropolitana; y en 66 Centros Escolares de diferente nivel educativo. La valoración auditiva se realizó con métodos de rastreo "juguetes sonoros mexicanos" (en 33.3 por ciento), "prueba de un minuto" (en 15.2 por ciento) "Audioscope" (en 26.5 por ciento); y con audiometría tonal (en 25 por ciento). Se atendió prioritariamente a la población infantil. En menores de 3 años 11 meses de edad, valorados con "juguetes sonoros mexicanos", encontramos una tasa de sospecha de hipoacusia profunda bilateral de 1.17 por ciento para lactantes y de 0.75 por ciento para preescolares. A 2,333 escolares les fue aplicada la "prueba de un minuto" donde encontramos falla auditiva en el 21 por ciento; la audioscopía se realizo en 4,072 sujetos mayores de 4 años, en los que el 41 por ciento presentó falla auditiva en 25 y 40 dB, confirmada en el 4.12 por ciento con audiometría tonal. Al 25 por ciento se les realizó audiometría tonal, de estos el 20.15 por ciento tuvo algún tipo de pérdida auditiva. A 2,931 sujetos se les realizó timpanometría, el 29.81 por ciento presentó anormalidades que fueron menos frecuentes conforme aumentó la edad

Surdez ocupacional em trabalhadores industriais da regiäo metropolitana de Salvador, Bahia / Occupation deafness in industrialist workers of metropolitan region of Salvador, Bahia

O presente trabalho constitui-se no estudo de prevalência, realizado a partir de dados audiométricos referentes a 7.925 trabalhadores de 44 empresas industriais, de nove diferentes ramos de atividade. A prevalência de perda auditiva foi de 45,9 por cento, na populaçäo estudada. Em relaçäo à perda auditiva do tipo induzida pelo ruido (PAIR), somando as perdas bilaterais e unilaterais, observou-se prevalência de 35,7por cento. Para cada ramo, as prevalências foram as seguintes: 58,7 por cento no editorial/gráfico, 51,7 por cento no mecânico, 45,9 por cento no de bebidas, 42,3 por cento no químico//petroquímico, 35,8 por cento no metalúrgico, 33,5 por cento no siderúrgico, 29,3 por cento no de transportes, 28,0 por cento no de alimentos e 23,4 por cento no têxtil. Chamam a atençäo as altas prevalências de PAIR unilateral - 18 por cento dos trabalhadores avaliados. O presente estudo permitiu delinear quadro extremamente alarmante, dada a magnitude da prevalência de perda auditiva do tipo induzida pelo ruído, apontando a importância da implementaçäo, por parte das empresas, de Programas de Conservaçäo Auditiva

Achados audiológicos em indivíduos pós-meningite / Hearning findings in subjects after meningitis

Realizou-se estudo para verificar a ocorrência de indivíduos que apresentam perda auditiva por terem contraído meningite, bem como caracterizar a perda diagnosticada quanto ao tipo, ao grau e à configuraçäo audiométrica. Foram levantados 949 prontuários de pacientes atendidos em um centro de distúrbios da audiçäo, selecionados os que indicaram perda auditiva pós-meningite e realizada avaliaçäo audiológica a que foram submetidos os pacientes. Os resultados indicaram 6,2 por cento de ocorrência de perda auditiva devido à meningite. A característica dessa perda auditiva foi do tipo predominantemente neurossensorial, simétrica, linear e de grau profundo.