Multidisciplinary assessment of patients with musical hallucinations, tinnitus and hearing loss.

BACKGROUND: Although auditory hallucinations are considered a psychopathological phenomenon, musical hallucinations have been reported in individuals without psychosis but with auditory symptoms (tinnitus and/or hearing loss). Thus, a possible different cognitive functioning may be involved in musical hallucinations. The aim of the study was to characterize patients with tinnitus and musical hallucinations through a multidisciplinary assessment, allowing a better understanding of these concomitant phenomena. SAMPLING AND METHODS: As this sample is rare to find, all consecutive patients with tinnitus, hearing loss and musical hallucinations were included over a 3-year period, excluding those unable to respond. All subjects underwent the following assessments: (1) otolaryngological and audiological assessment (physical examination and audiometry), (2) neurological assessment (cognition, electroencephalogram and imaging examination) and (3) psychiatric assessment (structured interview). RESULTS: A total of 16 patients were included (87.5% women; mean age 61.43 ± 15.99 years). The otolaryngological examination was normal in all cases, but audiometry revealed that the degree of hearing loss was severe to profound in 68.75% of participants. Neurological assessment showed electroencephalogram changes in only 17.6% of cases, while 25% presented with mild attention deficit and 43.75% had small foci of gliosis or ischemia on the imaging examination. Psychiatric assessment showed that 68.75% of cases had depression, 6.25% had anxiety disorder and 25% had no psychiatric conditions. CONCLUSIONS: Musical hallucinations were strongly associated with female elderly adults and with mood disorders. Thus, in contrast to common auditory hallucinations, patients with musical hallucinations associated with tinnitus and hearing loss should be offered a more multidisciplinary assessment.

Exsangüinação profilática de membros posteriores na síndrome de reperfusão estudo experimental / Hinder limb profilaticexsanguination in the reperfusion syndrome - experimental study

A síndrome de reperfusão é uma importante complicação da obstruçãoarterial aguda, podendo levar ao óbito. O objetivo desta pesquisa foi determinar ainfluência da exsangüinação na prevenção do desenvolvimento da Síndrome de Reperfusão em ratos.Utilizaram-se 36 ratos distribuídos em grupos controle e experimental. Os animaisforam submetidos à ligadura da aorta infra-renal. No grupo experimental tambémrealizava-se infusão arterial de solução fisiológica concomitantemente à exsangüinação venosa abaixo das ligaduras. Realizavam-se 3 coletas arteriais apóso início da reperfusão. No sangue, avaliaram-se o BE, HCO negativo, K positivo, uréia, creatininaeCPK. Nas 12 primeiras horas de reperfusão, 38,9 porcentagem dos ratos foram a óbito. O BE eo HCO negativo foram significantemente menores no grupo experimental (p < 0,05). A obs-trução arterial aguda aorto-ilíaca teve alta letalidade. A exsangüinação quando realizada com reperfusão controlada em curto período de tempo em ratos causoudesequilíbrios ácidos-básicos. A técnica proposta não preveniu o surgimento daSR...