Hearing Thresholds at High Frequencies: Age as a Predictor of Values.

Introduction The audiological evaluation has the main objective of determining the integrity of the auditory system. Pure tone audiometry is a standardized behavioral procedure that aims to investigate auditory thresholds to describe auditory sensitivity. Despite being recognized since the mid-1960s, high frequency audiometry is still little used and explored in clinical practice, and its use is more considered as an audiological monitoring tool or as a research tool. Objective To analyze the audiological thresholds of high frequency audiometry in normal hearing individuals, and to verify the predictive capacity of age in the auditory thresholds of high frequency audiometry. Methods This is a retrospective, cross-sectional, and quantitative study that was approved by the Research Ethics Committee under number 5.039.583/21. The procedures were: clinical evaluation, pure tone audiometry, acoustic immittance measurements, and high frequency audiometry. All data collected from the exams were tabulated in an Excel spreadsheet and analyzed using appropriate statistical tests in the Statistical Package Social Sciences software. Results A total of 980 medical records were analyzed. The right and left ears presented similar tonal hearing thresholds for the frequencies of 12 kHz and 16 kHz. The threshold variance of 29.8% in the 12 kHz frequency can be explained by the variance of age, while, for the frequency of 16 kHz, this percentage is of 46.4%. Conclusion For 12 kHz hearing thresholds, an increase of 1 year leads to a 0.66 dBHL increase in hearing threshold. For 16 kHz hearing thresholds, an increase of 1 year leads to a 1.02 dBHL increase in hearing threshold.

Hearing Thresholds at High Frequencies: Age as a Predictor of Values

Abstract Introduction The audiological evaluation has the main objective of determining the integrity of the auditory system. Pure tone audiometry is a standardized behavioral procedure that aims to investigate auditory thresholds to describe auditory sensitivity. Despite being recognized since the mid-1960s, high frequency audiometry is still little used and explored in clinical practice, and its use is more considered as an audiological monitoring tool or as a research tool. Objective To analyze the audiological thresholds of high frequency audiometry in normal hearing individuals, and to verify the predictive capacity of age in the auditory thresholds of high frequency audiometry. Methods This is a retrospective, cross-sectional, and quantitative study that was approved by the Research Ethics Committee under number 5.039.583/21. The procedures were: clinical evaluation, pure tone audiometry, acoustic immittance measurements, and high frequency audiometry. All data collected from the exams were tabulated in an Excel spreadsheet and analyzed using appropriate statistical tests in the Statistical Package Social Sciences software. Results A total of 980 medical records were analyzed. The right and left ears presented similar tonal hearing thresholds for the frequencies of 12 kHz and 16 kHz. The threshold variance of 29.8% in the 12 kHz frequency can be explained by the variance of age, while, for the frequency of 16 kHz, this percentage is of 46.4%. Conclusion For 12 kHz hearing thresholds, an increase of 1 year leads to a 0.66 dBHL increase in hearing threshold. For 16 kHz hearing thresholds, an increase of 1 year leads to a 1.02 dBHL increase in hearing threshold.

Experience of tinnitus in adults who have severe-to-profound hearing loss: A scoping review.

Background: Tinnitus is defined as the subjective perception of sound in the absence of an external stimulus, and tinnitus disorder becomes relevant when it is associated with emotional distress, cognitive dysfunction, and/or autonomic arousal. Hearing loss is recognized as the main risk factor for the pathogenesis of tinnitus. However, clinical guidelines for tinnitus disorder provide little direction for those who have severe-to-profound hearing loss including those who are pre-lingually Deaf. The aim of this scoping review was to catalogue what is known from the existing literature regarding the experience and management of tinnitus in adults who have a severe-to-profound hearing loss. Summary: A scoping review was conducted following the Preferred Reporting Item for Systematic Reviews and Meta-analysis extension for Scoping Reviews. Records were included if they reported an evaluation of tinnitus in adults who had severe-to-profound hearing loss. The online databases Ovid (MEDLINE, EMBASE and PsycINFO), CINAHL, ProQuest, Scopus, and Google Scholar were searched using the search terms 'tinnitus' (as a MESH term) and 'deaf' OR 'profound hearing loss. Thirty-five records met the inclusion criteria for this review and were cataloged according to three major themes: Impact of tinnitus in deaf adults; Primary treatment of tinnitus in deaf adults; and Cochlear implant studies where tinnitus was a secondary outcome. Tinnitus symptom severity was assessed before and after intervention using tinnitus validated questionnaires in 29 records, with six further records using other assessment tools to measure tinnitus severity. Participants using cochlear implants were included in 30 studies. Medication, repetitive transcranial magnetic stimulation (rTMS), electrical promontory stimulation, and behavioral self-control therapy were each reported in single records. Key messages: This scoping review cataloged the experience, assessment, and treatment of tinnitus in adults who have severe-to-profound hearing loss. It is shown that there is very limited research reported in this field. Although this review included many records, most focused on the provision of cochlear implants for severe-to-profound hearing loss, with assessment and measurement of tinnitus as a baseline or secondary outcome. Largely missing in the literature are empirical studies that seek firstly to understand the nature of the experience of tinnitus by people with no or little residual access to external sound.

Um resgate de si: itinerário terapêutico de um caso de adoecimento mental relacionado ao trabalho / Rescuing yourself: therapeutic itinerary of a case of work-related mental illness

Este artigo apresenta uma reflexão sobre o processo de reabilitação de adoecimento mental relacionado ao trabalho por meio da reconstituição do Itinerário Terapêutico de uma trabalhadora, evidenciando a importância dos serviços públicos de saúde. Mesmo diante do expressivo aumento dos casos de adoecimento mental e das evidências de relação com as condições e formas de organização do trabalho, raramente as situações laborais são consideradas nas avaliações dos serviços de saúde. Mesmo com o atual contexto de desmonte da saúde pública, existem exemplos de atuações exitosas, como a que discutimos aqui. Por meio de entrevista semidirigida com uma trabalhadora e construção do Itinerário Terapêutico, buscou-se compreender seu processo de adoecimento mental, a relação com o trabalho e o percurso de reabilitação. Os resultados demonstram a importância do entendimento do trabalho como determinante de saúde, da elaboração de projetos terapêuticos singulares e da atenção integral, revelando que a articulação em rede, o estabelecimento de vínculo e a busca pelo protagonismo do usuário são essenciais na atenção à saúde mental relacionada ao trabalho.

This article presents a reflection on the process of rehabilitation of work-related mental illness through the reconstitution of a worker's Therapeutic Itinerary, highlighting the importance of public health services. Even in the face of significant increase in cases of mental illness and evidence of a relationship with the conditions and forms of work organization, work situations are rarely considered in the assessments of health services. However, despite the current context of dismantling the public health system, there are examples of successful actions, such as the one we discussed here. Through a semi-directed interview with a worker and construction of the Therapeutic Itinerary, we sought to understand her mental illness process, the relationship with work and the path of rehabilitation. The results demonstrate the importance of understanding work as determinant of health, the development of unique therapeutic projects and comprehensive care, revealing that networking, establishing a bond and seeking the protagonism of the user are essential in work-related mental health care.

Profile and prevalence of people with tinnitus: a health survey. / Perfil e prevalência de pessoas com zumbido: inquérito em serviço de saúde.

PURPOSE: To estimate the prevalence and characterize the health profile, and tinnitus complaint, of the adult population of a health district in Campinas, in the State of São Paulo. METHODS: A in-service survey was conducted in all health centers in the district with a random approach to the adult population seeking care at the unit. The sample consisted of 1,720 people, including 1,569 subjects who agreed to participate in the survey and answered a questionnaire including questions on general health and tinnitus. Two regression models were performed according to the variables and a 5% significance level was was adopted for the statistical analysis. RESULTS: 496 people reported tinnitus, representing a prevalence of 31.6%. Most of the sample was female, had at least one chronic disease and made continuous use of some medication. Respondents reported hearing complaints and the most common type of tinnitus was reported as unilateral, intermittent and acute. The regression models performed showed a higher chance of tinnitus with advancing age and with the occurrence of diabetes and thyroid disorder. CONCLUSION: Tinnitus is related to the occurrence of chronic diseases and advancing age, may cause discomfort and is a reason for seeking treatment. Further population studies are required in different contexts in the Brazilian scenario.

OBJETIVO: Estimar a prevalência e caracterizar o perfil de saúde, e a queixa de zumbido, da população adulta de um distrito de saúde do município de Campinas, no estado de São Paulo. MÉTODO: Foi realizado um inquérito em serviço em todos os centros de saúde do distrito com abordagem aleatória da população adulta que entrasse na unidade. A amostra contou com 1.720 pessoas, sendo que 1.569 concordaram em participar da pesquisa e responderam a um questionário contendo perguntas de saúde em geral e sobre zumbido. Para a análise estatística, foram realizados dois modelos de regressão de acordo com as variáveis e o nível de significância considerado foi igual a 5%. RESULTADOS: 496 pessoas referiram queixa de zumbido, configurando uma prevalência de 31,6%. A maioria da amostra pertence ao gênero feminino, tem pelo menos uma doença crônica e faz uso contínuo de alguma medicação. Os entrevistados relataram queixa auditiva e o zumbido mais referido foi unilateral, intermitente e agudo. Nos modelos de regressão realizados, observou-se maior chance de zumbido com o avançar da idade e com a ocorrência de diabetes e alteração de tireoide. CONCLUSÃO: O zumbido apresenta relação com a ocorrência de doenças crônicas e o avançar da idade, tem potencial de gerar incômodo para o indivíduo e é motivo para a busca por tratamento nos serviços de saúde. São necessários mais estudos populacionais em diferentes contextos no cenário brasileiro.

Perfil e prevalência de pessoas com zumbido: inquérito em serviço de saúde / Profile and prevalence of people with tinnitus: a health survey

RESUMO Objetivo Estimar a prevalência e caracterizar o perfil de saúde, e a queixa de zumbido, da população adulta de um distrito de saúde do município de Campinas, no estado de São Paulo. Método Foi realizado um inquérito em serviço em todos os centros de saúde do distrito com abordagem aleatória da população adulta que entrasse na unidade. A amostra contou com 1.720 pessoas, sendo que 1.569 concordaram em participar da pesquisa e responderam a um questionário contendo perguntas de saúde em geral e sobre zumbido. Para a análise estatística, foram realizados dois modelos de regressão de acordo com as variáveis e o nível de significância considerado foi igual a 5%. Resultados 496 pessoas referiram queixa de zumbido, configurando uma prevalência de 31,6%. A maioria da amostra pertence ao gênero feminino, tem pelo menos uma doença crônica e faz uso contínuo de alguma medicação. Os entrevistados relataram queixa auditiva e o zumbido mais referido foi unilateral, intermitente e agudo. Nos modelos de regressão realizados, observou-se maior chance de zumbido com o avançar da idade e com a ocorrência de diabetes e alteração de tireoide. Conclusão O zumbido apresenta relação com a ocorrência de doenças crônicas e o avançar da idade, tem potencial de gerar incômodo para o indivíduo e é motivo para a busca por tratamento nos serviços de saúde. São necessários mais estudos populacionais em diferentes contextos no cenário brasileiro.

Abstract: Purpose To estimate the prevalence and characterize the health profile, and tinnitus complaint, of the adult population of a health district in Campinas, in the State of São Paulo. Methods A in-service survey was conducted in all health centers in the district with a random approach to the adult population seeking care at the unit. The sample consisted of 1,720 people, including 1,569 subjects who agreed to participate in the survey and answered a questionnaire including questions on general health and tinnitus. Two regression models were performed according to the variables and a 5% significance level was was adopted for the statistical analysis. Results 496 people reported tinnitus, representing a prevalence of 31.6%. Most of the sample was female, had at least one chronic disease and made continuous use of some medication. Respondents reported hearing complaints and the most common type of tinnitus was reported as unilateral, intermittent and acute. The regression models performed showed a higher chance of tinnitus with advancing age and with the occurrence of diabetes and thyroid disorder. Conclusion Tinnitus is related to the occurrence of chronic diseases and advancing age, may cause discomfort and is a reason for seeking treatment. Further population studies are required in different contexts in the Brazilian scenario.

Zumbido e atenção básica: uma revisão de literatura / Tinnitus and primary health care: a literature review / Acúfeno y atención primaria: una revisión de la literatura

Introdução: O zumbido teve um aumento significativo de sua prevalência na última década e, conhecidamente, pode ter impacto negativo na qualidade de vida de seu portador. No entanto, ainda é pouco explorado no contexto da atenção básica. Objetivo: Evidenciar a escassez de literatura que aborde o zumbido no âmbito da atenção básica. Método: Foi realizada uma revisão de literatura, utilizando as bases de dado PubMed, Bireme, SciELO, Web of Science, Medline e Cochrane Library. Foram considerados os artigos publicados em inglês, português e espanhol e que abordassem o zumbido no contexto específico da atenção básica. Resultados: Foram encontrados 33 artigos, sendo que 10 cumpriram os critérios de inclusão. Os trabalhos selecionados evidenciam o impacto do zumbido na vida do indivíduo, a importância de sua abordagem na atenção básica, a necessidade da capacitação dos profissionais envolvidos na linha de cuidado e a relevância de se ter uma equipe multiprofissional. Conclusão: O zumbido é fator relevante no cuidado, sendo necessário fortalecer ações relacionadas na atenção básica e ampliar os estudos nesta área específica.

Introduction: Tinnitus has had a significant increase in its prevalence in the last decade and may have a negative impact on the quality of life of the patient. However, it is still little explored in the context of primary health care. Objective: To demonstrate the scarcity of literature addressing tinnitus in primary health care. Method: A literature review was carried out using PubMed, Bireme, SciELO, Web of Science, Medline and Cochrane Library databases. Articles published in English, Portuguese and Spanish and approaching tinnitus in the specific context of primary care were considered. Results: 33 articles were found, of which 10 met the inclusion criteria. The selected papers highlight the impact of tinnitus on the individual's life, the importance of its approach in primary care, the need for the training of professionals involved in the care line and the relevance of having a multiprofessional team. Conclusion: Tinnitus is a relevant factor to be considered, but it is necessary to strengthen related actions in primary health care and to expand studies in this specific area.

Introducción: El acúfeno hay tenido un aumento significativo de su prevalencia en la última década y puede tener un impacto negativo en la calidad de vida de su portador. Todavía, es poco explorado en el contexto de la atención primaria. Objetivo: Demostrar la falta de literatura que aborda el acúfeno en el contexto de la atención primaria. Método: Una revisión de la literatura fue hecha utilizando las bases de datos PubMed, Bireme, SciELO, Web of Science, Medline y la Cochrane Library. Fueran considerados, los artículos publicados en inglés, portugués y español y que abordan el acúfeno en el contexto específico de la atención primaria. Resultados: Se encontraron 33 artículos, de los cuales 10 cumplieron los criterios de inclusión. Las obras seleccionadas muestran el impacto del tinnitus en la vida del individuo, la importancia de su enfoque en la atención primaria, la necesidad de formación de los profesionales que intervienen en la línea de cuidado y la importancia de contar con un equipo multiprofesional. Conclusión: El acúfeno es un factor relevante para el cuidado, siendo necesario reforzar las acciones relacionadas en la atención primaria y ampliar los estudios en esta área específica.