Validation of the Questionnaire "Knowledge, Attitudes and Practices" in populations of pregnant women exposed to pesticides. / Validação do Questionário "Conhecimento, Atitudes e Práticas" em populações de gestantes expostas a agrotóxicos.

PURPOSE: to validate the CAP questionnaire in populations of pregnant women exposed to pesticides in the State of Paraná. METHODS: 382 pregnant women participated in the study, divided into two groups: Exposed to Pesticides (n = 320) and Not Exposed (n = 62). The validation process involved the validity of content, criteria and construct. The research stages were developed between August / 2018 to December / 2019 in the western and central-western regions of Paraná. RESULTS: the instrument demonstrated an acceptable agreement on the content validity through the evaluation of judges; the criterion validity through the established criterion showed no association; in the analysis of construct validity using the technique of known groups, it demonstrated homogeneity in the variables age, nationality and family income. CONCLUSION: the developed analysis indicated that the psychometric properties of the validation of the Brazilian version of the scale are consistent and adequate, which allows the recommendation of the application of the instrument in a national context.

OBJETIVO: validar o questionário CAP em populações de gestantes expostas aos agrotóxicos no Estado do Paraná. MÉTODO: participaram do estudo 382 gestantes, divididas em dois grupos: Expostas a Agrotóxicos (n=320) e Não Expostas (n=62). O processo de validação envolveu a validade de conteúdo, critério e constructo. As etapas da pesquisa foram desenvolvidas entre agosto/2018 a dezembro/2019 na região oeste e centro-oeste do Paraná. RESULTADOS: o instrumento demonstrou concordância aceitável na Validade de conteúdo por meio da avaliação de juízes; a Validade de critério por meio do critério estabelecido não apresentou associação; na análise da Validade de construto pela técnica de grupos conhecidos, demonstrou homogeneidade nas variáveis idade, nacionalidade e renda familiar. CONCLUSÃO: a análise desenvolvida indicou que as propriedades psicométricas da validação da versão brasileira da escala são consistentes e adequadas, o que permite a recomendação da aplicação do instrumento em contexto nacional.

Validação do Questionário "Conhecimento, Atitudes e Práticas" em populações de gestantes expostas a agrotóxicos / Validation of the Questionnaire "Knowledge, Attitudes and Practices" in populations of pregnant women exposed to pesticides

RESUMO Objetivo validar o questionário CAP em populações de gestantes expostas aos agrotóxicos no Estado do Paraná. Método participaram do estudo 382 gestantes, divididas em dois grupos: Expostas a Agrotóxicos (n=320) e Não Expostas (n=62). O processo de validação envolveu a validade de conteúdo, critério e constructo. As etapas da pesquisa foram desenvolvidas entre agosto/2018 a dezembro/2019 na região oeste e centro-oeste do Paraná. Resultados o instrumento demonstrou concordância aceitável na Validade de conteúdo por meio da avaliação de juízes; a Validade de critério por meio do critério estabelecido não apresentou associação; na análise da Validade de construto pela técnica de grupos conhecidos, demonstrou homogeneidade nas variáveis idade, nacionalidade e renda familiar. Conclusão a análise desenvolvida indicou que as propriedades psicométricas da validação da versão brasileira da escala são consistentes e adequadas, o que permite a recomendação da aplicação do instrumento em contexto nacional.

ABSTRACT Purpose to validate the CAP questionnaire in populations of pregnant women exposed to pesticides in the State of Paraná. Methods 382 pregnant women participated in the study, divided into two groups: Exposed to Pesticides (n = 320) and Not Exposed (n = 62). The validation process involved the validity of content, criteria and construct. The research stages were developed between August / 2018 to December / 2019 in the western and central-western regions of Paraná. Results the instrument demonstrated an acceptable agreement on the content validity through the evaluation of judges; the criterion validity through the established criterion showed no association; in the analysis of construct validity using the technique of known groups, it demonstrated homogeneity in the variables age, nationality and family income. Conclusion the developed analysis indicated that the psychometric properties of the validation of the Brazilian version of the scale are consistent and adequate, which allows the recommendation of the application of the instrument in a national context.

Characterization of patients with tinnitus seen by the Hearing Health service / Caracterização dos pacientes com zumbido atendidos por serviço de Saúde Auditiva

ABSTRACT Purpose: to establish the profile of individuals with tinnitus treated at a Hearing Health service and to associate the symptom with gender, audiological profile, and presence of vertigo. Methods: a descriptive, retrospective study with an analysis of 6,000 medical records of individuals treated at a hearing health service was carried out. The data collected from the medical records were: sociodemographic data, characteristics of hearing impairment, characteristics of tinnitus and vertigo, speech therapy interview, and otorhinolaryngological, audiological, otoneurological assessments, characteristics of life style and risk factors. An descriptive analysis was performed using the Chi-square test of association, adopting a statistical significance level of 5% (p<0.05) for the inferential analysis. Results: there was a statistically significant association between the presence of tinnitus and gender, normal hearing, and vertigo, and a significant association was also found between tinnitus and unilateral and bilateral conductive hearing loss, and unilateral and bilateral sensorineural hearing loss. Conclusion: there was a significant association, in the population evaluated, for the presence of tinnitus and female gender, normal hearing, unilateral and bilateral conductive hearing loss, unilateral and bilateral sensorineural hearing loss, and the presence of vertigo.

RESUMO Objetivo: estabelecer o perfil dos indivíduos com zumbido, atendidos em um serviço de Saúde Auditiva e associar o sintoma com gênero, perfil audiológico e presença de vertigem. Métodos: estudo descritivo, retrospectivo. Foi realizada a análise de 6.000 prontuários de indivíduos atendidos em um serviço de saúde auditiva, os dados coletados do prontuário foram: dados sociodemográficos, características da deficiência auditiva, caraterísticas do zumbido e da vertigem, entrevista fonoaudiológica, avaliações otorrinolaringológicas, audiológicas, otoneurológicas, estilo de vida e dos fatores de risco. A análise descritiva, foi realizada por meio do teste de associação Qui-quadrado, sendo adotado o nível de significância estatística de 5% (p<0,05) para a análise inferencial. Resultados: houve associação estatisticamente significante entre presença de zumbido e gênero, audição normal e vertigem e foi constatada também associação significante entre zumbido e perda auditiva condutiva unilateral e bilateral, perda auditiva sensorioneural unilateral e bilateral. Conclusão: houve associação significante, na população avaliada, para presença de zumbido e gênero feminino, audição normal, perda auditiva condutiva unilateral e bilateral, perda auditiva sensorioneural unilateral e bilateral e presença de vertigem.

Audiological Evaluation of Patients With Somatosensory Tinnitus Attributed to Temporomandibular Disorders.

Purpose Tinnitus and temporomandibular disorders have already been associated in the literature, but despite many studies, it is still an intriguing discussion point. This study aimed to evaluate the prevalence of hearing loss among somatosensory tinnitus patients with temporomandibular disorders and to assess the influence of tinnitus on patients' quality of life. Method An otolaryngologist examined 585 patients in order to detect and evaluate the presence of tinnitus. Subjects were evaluated using the Portuguese version of the Research Diagnostic Criteria for Temporomandibular Disorders. An analysis of the somatic component of tinnitus was performed. Tinnitus was rated according to its onset (at least 6 months) and intensity with a visual analog scale. The sample was composed of 100 patients with somatosensory tinnitus divided into two groups: Group 1 (with temporomandibular disorder, n = 85) and Group 2 (without temporomandibular disorder, n = 15). The audiological evaluation was composed of pure-tone audiometry, high-frequency audiometry, tympanometry, and transient-evoked otoacoustic emissions. The impact of tinnitus on quality of life was assessed by the Tinnitus Handicap Inventory adapted and validated to Portuguese language. Results Pure-tone audiometry did not differ with statistical significance between groups (p = .29), neither did the high-frequency audiometry results (p = .74). Tinnitus Handicap Inventory scores also did not show any differences between Groups 1 and 2 (p = .67). Conclusions Subjects with somatosensory tinnitus, who also have temporomandibular disorders, do not seem to have hearing impairment. Also, they do not have a higher quality of life handicap when compared to those without tinnitus and temporomandibular disorder.

Efeitos dos agrotóxicos na saúde auditiva de trabalhadores rurais / Effects of pesticides on the hearing health of rural workers / Efectos de los pesticidas en la salud auditiva de los trabajadores rurales

Introdução: O agrotóxico é um assunto complexo e está pulverizado em diversas instituições e ações, tanto no âmbito do SUS como em outros órgãos de governo, necessitando urgente de constituição de um grupo para viabilizar a articulação das diferentes instâncias. Objetivo: verificar os efeitos da contaminação por agrotóxicos na saúde auditiva de trabalhadores rurais. Material e Métodos: Participaram 8 trabalhadores rurais com no mínimo dois anos de experiência. Os trabalhadores selecionados foram submetidos a dois questionários e avaliação audiológica, por meio dos seguintes procedimentos: entrevista específica, questionário de qualidade de vida no trabalho, audiometria tonal liminar e de alta frequência, logoaudiometria, imitanciometria. A coleta de dados foi realizada na Clinica de Fonoaudiologia da Faculdade de Odontologia de Bauru-Universidade de São Paulo. Resultados: Na avaliação audiológica os resultados encontrados mostraram normalidade, de acordo com padrões pré-estabelecidos, entretanto os participantes foram orientados a realizar acompanhamento devido à faixa limite de normalidade na audiometria convencional e altas frequências, assim como a presença de recrutamento em alguns indivíduos. Conclusão: Os resultados sugerem que as exposições constantes aos agrotóxicos podem causar alterações do sistema auditivo periférico, mesmo que não haja presença de ruído no local de trabalho. Este estudo, e muitos outros, propõem dados que demonstram a importância de programas de prevenção quanto à exposição ao agrotóxico na saúde do trabalhador, implementar o controle dos agentes, assim como a vigilância. Outros trabalhos com uma população mais robusta devem ser desenvolvidos de forma a expor as evidências de comprometimento periférico.

Introduction: The pesticide is a complex issue and is powdered in various institutions and actions, both within the SUS and in other government agencies, requiring the urgence to set up a group to facilitate the articulation of different instances. Objective: To assess the effects of pesticide contamination on hearing health of rural workers. Methods: Participants were eight rural workers with at least two years of experience. Selected employees underwent two questionnaires, and audiological evaluation, using the following procedures: interview specifies, quality of life questionnaire at work, pure tone audiometry and high frequency, speech audiometry, tympanometry. Data collection was performed at the at the Speech Patology and Audiology of the Bauru School of Dentistry-University of São Paulo Results: In the audiological evaluation the results showed normal, according to established standards, however the participants were asked to perform periodic monitoring due to normal range in conventional audiometry and high frequencies as well as the presence of recruitment in some individuals. Conclusion: The results suggest that constant exposure to pesticides are likely to cause changes of the peripheral auditory system even if there is not noise present in the workplace. This study and many others propose data demonstrating the importance of prevention programs of the exposition to these agrochemicals to the worker health, highlighting vigilance . Other studies with larger populations should be developed in order to expose more evidence.

Introduccion: El agrotóxico es un asunto complejo y está pulverizado en diversas instituciones y acciones, tanto en el ámbito del SUS como en otros órganos de gobierno, necesitando urgente de constitución de un grupo para viabilizar la articulación de las diferentes instancias. Objetivo: verificar los efectos de la contaminación por agrotóxicos en la salud auditiva de trabajadores rurales. Material y Métodos: Participaron 8 trabajadores rurales con al menos dos años de experiencia. Los trabajadores seleccionados fueron sometidos a dos cuestionarios y evaluación audiológica, por medio de los siguientes procedimientos: entrevista específica, cuestionario de calidad de vida en el trabajo, audiometría tonal liminar y de alta frecuencia, logoaudiometría, imitanciometría. La recolección de datos fue realizada en la Clínica de Fonoaudiología de la en la Clínica de Logopedia de la Facultad de Odontología de Bauru-Universidad de São Paulo Resultados: En la evaluación audiológica los resultados encontrados mostraron normalidad, de acuerdo con estándares preestablecidos, sin embargo los participantes fueron orientados a realizar seguimiento debido al rango límite de normalidad en la audiometría convencional y altas frecuencias, así como la presencia de reclutamiento en algunos individuos. Conclusión: Los resultados sugieren que las exposiciones constantes a los agrotóxicos pueden causar alteraciones del sistema auditivo periférico aunque no haya presencia de ruido en el lugar de trabajo. Este estudio y muchos otros proponen datos que demuestran la importancia de programas de prevención en cuanto a esos químicos. Otros trabajos con mayor población deben ser desarrollados para exponer mayores evidencias.

O uso excessivo de smartphones em crianças, adolescentes e jovens: sintomas osteomusculares auto referidos / Excessive use of smartphonesin children, adolescents and young people: self reported musculoskeletal symptoms

Objetivo ­ Verificar sintomas osteomusculares auto referidos em crianças, adolescente e jovens usuários de smartphones. O uso contínuo de smartphones pode provocar dores musculares e lesões precoces. Nesse sentido, a promoção da saúde é necessária para a conscientização da população. Métodos ­ Foi efetuado um estudo transversal em escolas particulares de ensino fundamental, médio e superior, das quais participaram da amostra 124 alunos na faixa etária de 10 a 25 anos. A coleta de dados foi realizada por meio de questionários autoaplicativos abrangendo análise dos sintomas osteomusculares. Resultados ­ Os resultados demonstraram que os sintomas mais prevalentes foram dor cervical com 52%, braços 23% e mãos 36%. Conclusão ­ Concluiu-se que o uso excessivo do smartphone pode representar um problema de Saúde Pública, pois continuarão sendo utilizados praticamente à vida toda, ficando um alerta para impulsionar e fomentar discussões que visem aumentar a saúde e qualidade de vida

Objective ­ To verify self-reported musculoskeletal symptoms in children, adolescents and young smartphone users.Continued use of smartphones can lead to muscle pain and early injury. In this sense, health promotion is necessary for the awareness of the population. Methods ­ A cross-sectional study was carried out in private elementary, middle and high schools, in which 124 students aged 10 to 25 years participated in the sample. Data collection was performed through self-administered questionnaires covering analysis of musculoskeletal symptoms. Results ­ Results showed that the most prevalent symptoms were cervical pain with 52%, arms 23% and hands 36%. Conclusion ­ It was concluded that the excessive use of the smartphone may represent a Public Health problem, as they will continue to be used practically for a lifetime, being an alert to boost and foster discussions aimed at increasing health and quality of life

Autoperception of food conditions of elderly dental prosthetic users. / Autopercepção das condições alimentares de idosos usuários de prótese dentária.

PURPOSE: To evaluate the self-perception of the food conditions of elderly users of dental prosthesis, in order to verify the interference that dental prosthesis has in their feeding. METHODS: The present study counted with 60 elderly, participants of the Centro de Convivência Nair Ventorin Gurgacz (Community Center), aged between 60 and 88 years old. All participants answered to a questionnaire elaborated by the researchers and the Geriatric Oral Health Assessment Index (GOHAI). RESULTS: The elderly who participated in this study, mostly women, used a bimaxillary removable prosthesis for over 30 years; although they classified their nutrition as "good" and did not present preference for specific food consistency, they frequently felt pain while chewing. The average score of the GOHAI was 29.73, considered "low", the index dimension with worst score was physical function, that includes eating, speaking and swallowing. No relation was observed between time of use of dental prosthesis, age and the GOHAI scores. CONCLUSION: The elderly rarely complaint about discomfort or embarrassment on feeding, however, they present an average lower than expected in the GOHAI index, which indicates that, although they do not report it, many deteriorations, that seem to be natural may be happening and may be the cause of worst quality of life.

OBJETIVO: Avaliar a autopercepção das condições alimentares de idosos usuários de prótese dentária, verificando sua interferência na alimentação. MÉTODO: Participaram 60 idosos com idade entre 60 e 88 anos, usuários de prótese dentária total ou parcial, que frequentam assiduamente o Centro de Convivência Nair Ventorin Gurgacz ­ FAG em Cascavel, Paraná. Todos os indivíduos responderam a um questionário de identificação e ao protocolo Índice de Determinação da Saúde Bucal Geriátrica (GOHAI). RESULTADOS: Os idosos do estudo, maioria mulheres e usuários de prótese removível bimaxilar com mais de 30 anos, classificam sua alimentação como "boa" e não possuem preferência por consistência alimentar, embora frequentemente sintam dor ao mastigar os alimentos. A média pontuada no protocolo GOHAI foi classificada como "ruim" e o maior prejuízo dos idosos ocorreu no domínio físico, que engloba questões relacionadas à mastigação, deglutição e fala. Não foram constatadas relações entre o tempo de utilização da prótese dentária com a idade e os escores do GOHAI. CONCLUSÃO: Embora os idosos raramente tenham queixa sobre o modo de se alimentar, referindo desconforto ou constrangimento, apresentam uma média abaixo do esperado no protocolo, indicando que, ainda que não relatem, muitas modificações podem estar acontecendo, gradativamente, e que soam como naturais, gerando prejuízos à qualidade de vida em alimentação do idoso.

Achados audiológicos em portadores de zumbido subjetivo associado a DTM / Audiological findings in patients with subjective tinnitus associated with TMD / Hallazgos audiológicos en portadores de zumbido subjetivo asociado a DTM

Introdução: Sintomas otológicos são frequentes em pacientes com disfunção temporomandibular, e dentre esses sintomas destaca-se a prevalência do zumbido. Na literatura destacam-se diversos estudos que comprovam essa associação, embora a avaliação audiológica e otorrinolaringológica estejam dentro dos padrões de normalidade. Apesar de muitos estudos envolvendo equipes multiprofissionais, pouco se conseguiu esclarecer a associação de sintomas auditivos e DTM. Objetivo: Investigar a saúde auditiva em portadores de zumbido associado à DTM na etapa pré-tratamentos odontológicos. Metodologia: Foram avaliados 53 pacientes das clínicas de Ortodontia e Audiologia da Faculdade de Odontologia de Bauru, Universidade de São Paulo. Para investigar a saúde auditiva, os participantes realizaram entrevista específica, audiometria tonal liminar convencional e altas frequências, logoaudiometria, imitanciometria e emissões otoacústicas. Resultados: O zumbido unilateral foi relatado pela maioria dos indivíduos, sendo com presença de plenitude auricular, e sem otalgia. A maioria dos sujeitos apresentou audição normal bilateralmente, seguido de perda moderada. Conclusão: Os resultados evidenciaram que a ocorrência de alterações auditivas em portadores de DTM é significativa, sendo assim, o acompanhamento audiológico deve ser indicado em portadores de DTM.

Introduction: Otologic symptoms are frequent in patients with temporomandibular dysfunction, among these symptoms the prevalence of tinnitus is outstanding. In the literature we highlight several studies that prove this association, although the audiological and otorhinolaryngological evaluation are within the norms of normality. Despite many studies involving multiprofessional teams, it was not possible to clarify the association of auditory symptoms and TMD. Objective: To investigate hearing health in patients with tinnitus associated with TMD in the dental pre-treatment stage. Methodology: Fifty-three patients from the Orthodontics and Audiology clinics of Faculdade de Odontologia de Bauru, Universidade de São Paulo were evaluated. To investigate auditory health, the participants performed a specific interview, conventional and high frequency tonal audiometry, logoaudiometry, immitanciometry and otoacoustic emissions. Results: Unilateral tinnitus was reported by most individuals, with atrial fullness and no otalgia. The majority of the subjects presented normal hearing bilaterally, followed by moderate loss. Conclusion: The results evidenced that the occurrence of auditory alterations in patients with TMD is significant, and audiological follow-up should be indicated in patients with TMD.

Introducción: Síntomas otológicos son frecuentes en pacientes con disfunción temporamandibular, entre estos síntomas se destaca la prevalencia del zumbido. En la literatura se destacan diversos estudios que comprueban esa asociación, aunque la evaluación audiológica y otorrinolaringológica estén dentro de los patrones de normalidad. A pesar de muchos estudios involucrados en equipos multiprofesionales, poco se pudo aclarar la asociación de síntomas auditivos y DTM. Objetivo: Investigar la salud auditiva en portadores de zumbido asociado a la DTM en la etapa pretratamiento odontológico. Metodología: Se evaluaron 53 pacientes de las clínicas de Ortodoncia y Audiología de la Faculdade de Odontologia de Bauru, Universidade de São Paulo. Para investigar la salud auditiva, los participantes realizaron una entrevista específica, audiometría tonal liminar convencional y altas frecuencias, logoaudiometría, imitanciometría y emisiones otoacústicas. Resultados: El zumbido unilateral fue reportado por la mayoría de los individuos, siendo con presencia de plenitud auricular, y sin otalgia. La mayoría de los sujetos presentaron una audición normal bilateralmente, seguido de una pérdida moderada. Conclusión: Los resultados evidenciaron que la ocurrencia de alteraciones auditivas en portadores de DTM es significativa, siendo así, el acompañamiento audiológico debe ser indicado en portadores de DTM.

Planilha de triagem acústica da sala de aula: tradução e adaptação cultural para o Português Brasileiro / Classroom acoustical screening survey worksheet: translation and cultural adaptation to Brazilian Portuguese

RESUMO Introdução No ambiente escolar, os professores sentem-se incomodados em ministrar aulas em salas ruidosas e percebem a dificuldade dos alunos em ouvir a informação, constatando, assim, que o ruído não é apenas um incômodo, mas também um fator agravante, que interfere no rendimento escolar. Portanto, são imprescindíveis condições acústicas adequadas para o ambiente educacional. Atualmente, não há padronização da metodologia que deve ser utilizada para mensurações das características acústicas das salas de aula. Objetivo Traduzir e adaptar para o Português Brasileiro o protocolo “Classroom Acoustical Screening Survey Worksheet”. Métodos A tradução e a adaptação do protocolo incluiram tradução para o Português, adaptação linguística e revisão da equivalência gramatical e idiomática, assim como a validação de conteúdo, por meio de duas etapas: avaliação individual e reunião entre os especialistas. Resultados O protocolo foi traduzido e adaptado para o Português, resultando no instrumento “Planilha de triagem acústica da sala de aula”. O protocolo apresentou validade de conteúdo e, após apreciação e consenso dos especialistas, mostrou que a adaptação cultural do conteúdo foi clara e objetiva, sendo possível aplicá-la à realidade das salas de aula brasileiras. Conclusão O protocolo “Classroom Acoustical Screening Survey Worksheet” foi trazido e adaptado para o Português Brasileiro, sendo nomeado “Planilha de triagem acústica da sala de aula”. Estudos futuros deverão investigar sua aplicabilidade e efetividade na observação das características acústicas das salas de aula no cenário nacional.

ABSTRACT Introduction In the school environment, teachers feel uncomfortable when teaching in noisy classrooms and realize the difficulty of students in hearing the information, what makes the noise, not just an annoyance, but also an aggravating factor that interferes with school performance. Therefore, appropriate acoustic conditions to the educational environment are indispensable. Currently, there is no standardization of the methodology that should be used to measure the acoustic characteristics of classrooms. Purpose Translating and adapting into Brazilian Portuguese the “Classroom Acoustical Screening Survey Worksheet” protocol. Methods The translation and adaptation of the protocol have included the translation into Portuguese, linguistic adaptation, and grammar and idiomatic equivalences revision, as well as the content validation by means of two steps: individual evaluation and meeting of specialists. Results The protocol was translated and adapted into Portuguese. The protocol presented content validity, and after the appreciation and consensus of the experts, it was showed that the cultural adaptation of content was evident and objective, making possible to apply it in Brazilian classrooms. Conclusion “Classroom Acoustical Screening Survey Worksheet” protocol was translated and adapted into Brazilian Portuguese, and named “Planilha de triagem acústica da sala de aula.” Further studies should investigate its applicability and effectiveness in observing the acoustic characteristics of the classroom in the national scenario.

Brainstem auditory evoked potentials in children with lead exposure / Potencial evocado auditivo de tronco encefálico em crianças com exposição ao chumbo

Introduction: Earlier studies have demonstrated an auditory effect of lead exposure in children, but information on the effects of low chronic exposures needs to be further elucidated. Objective: To investigate the effect of low chronic exposures of the auditory system in children with a history of low blood lead levels, using an auditory electrophysiological test. Methods: Contemporary cross-sectional cohort. Study participants underwent tympanometry, pure tone and speech audiometry, transient evoked otoacoustic emissions, and brainstem auditory evoked potentials, with blood lead monitoring over a period of 35.5 months. The study included 130 children, with ages ranging from 18 months to 14 years, 5 months (mean age 6 years, 8 months ± 3 years, 2 months). Results: The mean time-integrated cumulative blood lead index was 12 µg/dL (SD ± 5.7, range:2.433). All participants had hearing thresholds equal to or below 20 dBHL and normal amplitudes of transient evoked otoacoustic emissions. No association was found between the absolute latencies of waves I, III, and V, the interpeak latencies I-III, III-V, and I-V, and the cumulative lead values. Conclusion: No evidence of toxic effects from chronic low lead exposures was observed on the auditory function of children living in a lead contaminated area. .

Introdução: Estudos anteriores têm demonstrado efeitos da exposição ao chumbo no sistema auditivo em crianças, porém a exposição deste metal em níveis baixos ainda precisa ser investigada. Objetivo: Investigar os efeitos da exposição crônica ao chumbo no sistema auditivo de crianças com histórico de baixo nível sanguíneo de chumbo por meio de um teste eletrofisiológico. Método: Estudo de coorte transversal contemporânea. Foram realizados imitanciometria, audiometria tonal liminar e vocal, emissões otoacústicas evocadas transientes e potenciais evocados auditivos de tronco encefálico, com o monitoramento sanguíneo de chumbo durante um período de 35,5 meses. Participaram 130 crianças na faixa etária de 18 meses a 14 anos e 5 meses (6a8 m ± 3a2 m). Resultados: A média estimada do índice de pumblemia foi 12 mg/dL (DP ± 5,7). Todos os participantes apresentaram limiares auditivos iguais ou inferiores a 20 dBNA e amplitude normal das emissões otoacústicas evocadas transientes. Não foi encontrada associação entre as latências absolutas das ondas I, III e V e interpicos I-III, III-V e I-V e os valores cumulativos de chumbo. Conclusão: Não foi observada evidência de efeitos tóxicos em baixas exposições crônicas ao chumbo sobre a função auditiva de crianças que vivem em uma área contaminada por este metal. .

Brainstem auditory evoked potentials in children with lead exposure.

INTRODUCTION: Earlier studies have demonstrated an auditory effect of lead exposure in children, but information on the effects of low chronic exposures needs to be further elucidated. OBJECTIVE: To investigate the effect of low chronic exposures of the auditory system in children with a history of low blood lead levels, using an auditory electrophysiological test. METHODS: Contemporary cross-sectional cohort. Study participants underwent tympanometry, pure tone and speech audiometry, transient evoked otoacoustic emissions, and brainstem auditory evoked potentials, with blood lead monitoring over a period of 35.5 months. The study included 130 children, with ages ranging from 18 months to 14 years, 5 months (mean age 6 years, 8 months ± 3 years, 2 months). RESULTS: The mean time-integrated cumulative blood lead index was 12 µg/dL (SD ± 5.7, range: 2.433). All participants had hearing thresholds equal to or below 20 dBHL and normal amplitudes of transient evoked otoacoustic emissions. No association was found between the absolute latencies of waves I, III, and V, the interpeak latencies I-III, III-V, and I-V, and the cumulative lead values. CONCLUSION: No evidence of toxic effects from chronic low lead exposures was observed on the auditory function of children living in a lead contaminated area.

Linguagem receptiva e expressiva de crianças institucionalizadas / Receptive and expressive language of institutionalized children

OBJETIVO: verificar o nível de desenvolvimento da linguagem de crianças que estão em abrigos e compará-lo ao de crianças que sempre permaneceram com a família biológica. MÉTODOS: foram participantes deste estudo 30 crianças com idade entre 14 e 47 meses. Para avaliação da linguagem foi utilizado o teste Avaliação do Desenvolvimento da Linguagem e, para a triagem da audição, foi realizada a audiometria com reforço visual utilizando o audiômetro pediátrico PA5. A verificação da audição foi feita como forma de averiguação de possíveis fatores de risco para o desenvolvimento da linguagem. RESULTADOS: a análise estatística permitiu constatar que, comparando as crianças do abrigo com as que sempre estiveram com a família biológica, não houve diferença estatisticamente significante quanto a Linguagem Receptiva, Expressiva ou Global. No entanto, pode ser verificado maior índice de distúrbios de linguagem nas crianças que estavam em abrigos. CONCLUSÃO: observou-se que as crianças abrigadas não apresentaram diferença estatisticamente significante quando comparadas às crianças que sempre permaneceram com suas famílias biológicas. .

PURPOSE: to check the language development of children who are in shelters and compare them to children who have always stayed with their biological families. METHODS: participants were 30 children aged 14 to 47 months. For language assessment was used the Language Development Evaluation test and the hearing assessment was held on visual reinforcement audiometry with PA5 Pediatric audiometer. The verification of the hearing was made as way to investigate possible risk factors for development of the language. RESULTS: statistical analysis revealed that, comparing children in the shelter with those who have always been with biological families, there was no statistically significant difference by Receptive, Expressive or Global Language. However, it may be verified that there was a higher rate of disturbances language in children who were in shelters. CONCLUSION: It can be concluded that, the children living in shelters have not presented any statistically significant difference in regards to language performance, when compared to the children who have always remained with their biological families. .

Avaliação audiológica em crianças com baixo nível de exposição cumulativa ao chumbo / Audiological evaluation in children with cumulative low-level of lead exposure

Objetivo verificar a ocorrência de perda auditiva sensorioneural em crianças com baixo nível de exposição cumulativa ao chumbo. Métodos 156 crianças intoxicadas por chumbo, 94 do sexo masculino e 62 do sexo feminino, na faixa etária entre 18 meses a 14 anos e 5 meses, foram submetidas a análise longitudinal do nível de Plumbemia em sangue, bem como audiometria tonal liminar e emissões otoacústicas evocadas por estímulo transiente. Resultados a população pesquisada apresentou um valor médio de Plumbemia estimada de 12,2±5,7mg/dL (faixa entre 2,4-33mg/dL); todas as crianças apresentaram resposta normal na audiometria tonal liminar em 20 dBNA nas frequências testadas, 0,5; 1; 2 e 4 kHz, para ambas as orelhas; as emissões otoacústicas evocadas por estímulo transiente estiveram presentes para todas as frequências bilateralmente, nas 79 crianças pesquisadas. Conclusão não foi constatada perda auditiva sensorioneural em crianças com histórico de baixo nível de exposição cumulativa por chumbo, assim como não foi encontrada lesão de células ciliadas externas na cóclea, mesmo que subclínicas. .

Purpose to verify the occurrence of sensorineural hearing loss in children with low level of cumulative lead exposure. Methods 156 lead-poisoned children, 94 males and 62 females, ranging in age from 18 months old to 14 years and 5 months old were subjected to analysis of longitudinal lead level in blood as well as pure tone audiometry and transient evoked otoacoustic emissions. Results the population studied had a mean estimated blood lead level of 12,2±5,7mg/dL (range between 2,4 and 33mg/dL); all children had a normal response in pure tone audiometry at 20 dBHL in the frequencies tested, 0.5, 1, 2 and 4 kHz, in both ears; the transient evoked otoacoustic emissions were presented for all frequencies bilaterally in 79 children surveyed. Conclusion there has been no hearing loss in children with a history of low cumulative lead exposure, as there was no injury of cochlear outer hair cells, even if subclinical. .

Results obtained with a low cost software-based audiometer for hearing screening

The implementation of hearing screening programs can be facilitated by reducing operating costs, including the cost of equipment. The Telessaúde (TS) audiometer is a low-cost, software-based, and easy-to-use piece of equipment for conducting audiometric screening. AIM: To evaluate the TS audiometer for conducting audiometric screening. METHODS: A prospective randomized study was performed. Sixty subjects, divided into those who did not have (group A, n = 30) and those who had otologic complaints (group B, n = 30), underwent audiometric screening with conventional and TS audiometers in a randomized order. Pure tones at 25 dB HL were presented at frequencies of 500, 1000, 2000, and 4000 Hz. A "fail" result was considered when the individual failed to respond to at least one of the stimuli. Pure-tone audiometry was also performed on all participants. The concordance of the results of screening with both audiometers was evaluated. The sensitivity, specificity, and positive and negative predictive values of screening with the TS audiometer were calculated. RESULTS: For group A, 100% of the ears tested passed the screening. For group B, "pass" results were obtained in 34.2% (TS) and 38.3% (conventional) of the ears tested. The agreement between procedures (TS vs. conventional) ranged from 93% to 98%. For group B, screening with the TS audiometer showed 95.5% sensitivity, 90.4% sensitivity, and positive and negative predictive values equal to 94.9% and 91.5%, respectively. CONCLUSIONS: The results of the TS audiometer were similar to those obtained with the conventional audiometer, indicating that the TS audiometer can be used for audiometric screening...

The influence of speech stimuli contrast in cortical auditory evoked potentials.

UNLABELLED: Studies about cortical auditory evoked potentials using the speech stimuli in normal hearing individuals are important for understanding how the complexity of the stimulus influences the characteristics of the cortical potential generated. OBJECTIVE: To characterize the cortical auditory evoked potential and the P3 auditory cognitive potential with the vocalic and consonantal contrast stimuli in normally hearing individuals. METHOD: 31 individuals with no risk for hearing, neurologic and language alterations, in the age range between 7 and 30 years, participated in this study. The cortical auditory evoked potentials and the P3 auditory cognitive one were recorded in the Fz and Cz active channels using consonantal (/ba/-/da/) and vocalic (/i/-/a/) speech contrasts. DESIGN: A crosssectional prospective cohort study. RESULTS: We found a statistically significant difference between the speech contrast used and the latencies of the N2 (p = 0.00) and P3 (p = 0.00) components, as well as between the active channel considered (Fz/Cz) and the P3 latency and amplitude values. These correlations did not occur for the exogenous components N1 and P2. CONCLUSION: The speech stimulus contrast, vocalic or consonantal, must be taken into account in the analysis of the cortical auditory evoked potential, N2 component, and auditory cognitive P3 potential.

Auditory complaints and audiologic assessment in children with surgically repaired cleft lip and palate

INTRODUCTION: At the initial consultation, the speech-language pathologist and audiologist may consider possible diagnostic hypotheses based on the child's history and the parents' complaint. AIM:To investigate the association of hearing complaints with the findings obtained in the conventional audiologic assessment in children with cleft lip and palate. Retrospective study. METHODS: We analyzed medical charts of 1000 patients with cleft lip and palate who underwent surgical repair between 1988 and 1995 at a mean age of 6 years 8 months. We excluded charts with records of inconsistent audiological responses and charts with missing data for any of the audiologic evaluations considered. Thus, the sample consisted of 393 records. RESULTS: Two hundred thirty-nine patients presented hearing loss in one or both ears, but only 3.8% reported hearing complaints. The most frequent were otorrhea followed by otalgia. There was no statistical significance between the complaint and gender (p = 0.26) nor between the complaint and hearing loss (p = 0.83). CONCLUSION: This study showed no association between the hearing complaint and the conventional audiologic assessment.

Influência dos contrastes de fala nos potenciais evocados auditivos corticais / The influence of speech stimuli contrast in cortical auditory evoked potentials

Estudos voltados aos potenciais evocados auditivos com estímulos de fala em indivíduos ouvintes são importantes para compreender como a complexidade do estímulo influencia nas características do potencial cognitivo auditivo gerado. OBJETIVO: Caracterizar o potencial evocado auditivo cortical e o potencial cognitivo auditivo P3 com estímulos de contrastes vocálico e consonantal em indivíduos com audição normal. MÉTODO: Participaram deste estudo 31 indivíduos sem alterações auditivas, neurológicas e de linguagem na faixa etária de 7 a 30 anos. Os potenciais evocados auditivos corticais e cognitivo auditivo P3 foram registrados nos canais ativos Fz e Cz utilizando-se os contrastes de fala consonantal (/ba/-/da/) e vocálico (/i/-/a/). Desenho: Estudo de coorte, transversal e prospectivo. RESULTADOS: Houve diferença entre o contraste de fala utilizado e as latências dos componentes N2 (p = 0,00) e P3 (p = 0,00), assim como entre o canal ativo considerado (Fz/Cz) e os valores de latência e amplitude de P3. Estas diferenças não ocorreram para os componentes exógenos N1 e P2. CONCLUSÃO: O contraste do estímulo de fala, vocálico ou consonantal, deve ser considerado na análise do potencial evocado cortical, componente N2, e do potencial cognitivo auditivo P3.

Studies about cortical auditory evoked potentials using the speech stimuli in normal hearing individuals are important for understanding how the complexity of the stimulus influences the characteristics of the cortical potential generated. OBJECTIVE: To characterize the cortical auditory evoked potential and the P3 auditory cognitive potential with the vocalic and consonantal contrast stimuli in normally hearing individuals. METHOD: 31 individuals with no risk for hearing, neurologic and language alterations, in the age range between 7 and 30 years, participated in this study. The cortical auditory evoked potentials and the P3 auditory cognitive one were recorded in the Fz and Cz active channels using consonantal (/ba/-/da/) and vocalic (/i/-/a/) speech contrasts. Design: A crosssectional prospective cohort study. RESULTS: We found a statistically significant difference between the speech contrast used and the latencies of the N2 (p = 0.00) and P3 (p = 0.00) components, as well as between the active channel considered (Fz/Cz) and the P3 latency and amplitude values. These correlations did not occur for the exogenous components N1 and P2. CONCLUSION: The speech stimulus contrast, vocalic or consonantal, must be taken into account in the analysis of the cortical auditory evoked potential, N2 component, and auditory cognitive P3 potential.

Correlation analysis of the long latency auditory evoked potential N2 and cognitive P3 with the level of lead poisoning in children

Introduction: The effects of lead on children's health have been widely studied. Aim: To analyze the correlation between the long latency auditory evoked potential N2 and cognitive P3 with the level of lead poisoning in Brazilian children. Methods: This retrospective study evaluated 20 children ranging in age from 7 to 14 years at the time of audiological and electrophysiological evaluations. We performed periodic surveys of the lead concentration in the blood and basic audiological evaluations. Furthermore, we studied the auditory evoked potential long latency N2 and cognitive P3 by analyzing the absolute latency of the N2 and P3 potentials and the P3 amplitude recorded at Cz. At the time of audiological and electrophysiological evaluations, the average concentration of lead in the blood was less than 10 ug/dL. Results: In conventional audiologic evaluations, all children had hearing thresholds below 20 dBHL for the frequencies tested and normal tympanometry findings; the auditory evoked potential long latency N2 and cognitive P3 were present in 95% of children. No significant correlations were found between the blood lead concentration and latency (p = 0.821) or amplitude (p = 0.411) of the P3 potential. However, the latency of the N2 potential increased with the concentration of lead in the blood, with a significant correlation (p = 0.030). Conclusion: Among Brazilian children with low lead exposure, a significant correlation was found between blood lead levels and the average latency of the auditory evoked potential long latency N2; however, a significant correlation was not observed for the amplitude and latency of the cognitive potential P3...

Correlation analysis of the long latency auditory evoked potential N2 and cognitive P3 with the level of lead poisoning in children.

INTRODUCTION: The effects of lead on children's health have been widely studied. AIM: To analyze the correlation between the long latency auditory evoked potential N2 and cognitive P3 with the level of lead poisoning in Brazilian children. METHODS: This retrospective study evaluated 20 children ranging in age from 7 to 14 years at the time of audiological and electrophysiological evaluations. We performed periodic surveys of the lead concentration in the blood and basic audiological evaluations. Furthermore, we studied the auditory evoked potential long latency N2 and cognitive P3 by analyzing the absolute latency of the N2 and P3 potentials and the P3 amplitude recorded at Cz. At the time of audiological and electrophysiological evaluations, the average concentration of lead in the blood was less than 10 ug/dL. RESULTS: In conventional audiologic evaluations, all children had hearing thresholds below 20 dBHL for the frequencies tested and normal tympanometry findings; the auditory evoked potential long latency N2 and cognitive P3 were present in 95% of children. No significant correlations were found between the blood lead concentration and latency (p = 0.821) or amplitude (p = 0.411) of the P3 potential. However, the latency of the N2 potential increased with the concentration of lead in the blood, with a significant correlation (p = 0.030). CONCLUSION: Among Brazilian children with low lead exposure, a significant correlation was found between blood lead levels and the average latency of the auditory evoked potential long latency N2; however, a significant correlation was not observed for the amplitude and latency of the cognitive potential P3.

Auditory complaints and audiologic assessment in children with surgically repaired cleft lip and palate.

INTRODUCTION: At the initial consultation, the speech-language pathologist and audiologist may consider possible diagnostic hypotheses based on the child's history and the parents' complaint. AIM: To investigate the association of hearing complaints with the findings obtained in the conventional audiologic assessment in children with cleft lip and palate. Retrospective study. METHODS: We analyzed medical charts of 1000 patients with cleft lip and palate who underwent surgical repair between 1988 and 1995 at a mean age of 6 years 8 months. We excluded charts with records of inconsistent audiological responses and charts with missing data for any of the audiologic evaluations considered. Thus, the sample consisted of 393 records. RESULTS: Two hundred thirty-nine patients presented hearing loss in one or both ears, but only 3.8% reported hearing complaints. The most frequent were otorrhea followed by otalgia. There was no statistical significance between the complaint and gender (p = 0.26) nor between the complaint and hearing loss (p = 0.83). CONCLUSION: This study showed no association between the hearing complaint and the conventional audiologic assessment.