Association of Skeletal and Dental Maturity Indicators with the Onset of Menarche and Its Applicability for Growth Modification of Jaw Bases in Females Aged between 7 and 14 Years

Orthodontic diagnosis and treatment planning for skeletal problems in growing children must involve growth prediction. Apart from the knowledge of chronological, dental and skeletal age of a growing patient, it is also mandatory to predict growth and its outcome during the treatment. In females, onset of menarche is a sign of pubertal growth and a biological skeletal maturity indicator. Studies have shown that there is an association amongst skeletal and dental maturity indicators. This study was therefore designed to estimate association between skeletal- and dental-maturity indicators and onset of menarche in females and evaluate its applicability for growth modification in females.METHODS140 female patients were divided into 7 groups and each patient was asked about their menarcheal status. Radiographs such as orthopantomography, lateral cephalogram and middle phalanx of third finger were taken from each patient to assess the CVMI status, stages of dental calcification and MP3 stages.RESULTSThe correlation between onset of menarche, CVMI status, stages of dental calcification and MP3 stages is of high statistical significance (p-0.0001).CONCLUSIONSThere are strong correlations between all the parameters studied which signifies that assessment of skeletal maturation with any of the above methods studied, gives exact growth maturation age of the patient.

Utilização de estéreos pessoais por alunos do ensino médio: mensuração da intensidade utilizada e hábitos de uso / Use of digital audio players by high school students: measurement of use intensity and usage habits

RESUMO Objetivo Esta pesquisa teve como objetivo mensurar em um ambiente ruidoso o nível de pressão sonora dos estéreos pessoais de jovens do ensino médio, levantar suas queixas auditivas e extra-auditivas e seus hábitos de uso. Considerando-se ainda a preocupação com a saúde auditiva e as fontes utilizadas pelos jovens para obtenção de informações sobre o assunto. Método Trata-se de um estudo observacional, descritivo, quantitativo, de delineamento transversal, do qual participaram jovens do ensino médio. Inicialmente foi realizado o exame de emissões otoacústicas evocadas por estímulos transientes, seguido da resolução de um questionário e a mensuração do nível de pressão sonora dos reprodutores de música utilizados em situação ruidosa simulada. Resultados A partir da mensuração dos estéreos pessoais, foram encontradas as intensidades mínima, de 69 dB(A), e máxima, de 93 dB(A). Os resultados mostraram hábitos nocivos à saúde auditiva sendo realizados pelos jovens, tais como tempo de uso (horas, dias e anos) e intensidade utilizada nos estéreos pessoais, assim como sintomas que podem indicar suscetibilidade a perdas auditivas. Observou-se que os jovens, em sua maioria, afirmam preocupar-se com sua audição, no entanto não há mudança de atitude diante dessas situações. Conclusão O hábito do uso do estéreo pessoal é iniciado muito cedo dentro da população escolar e, em muitos casos, esse costume é praticado com o equipamento em intensidades elevadas, o que pode acarretar diversos prejuízos a esses alunos.

ABSTRACT Purpose The main goal of this study was to measure the sound pressure level of digital audio players of high school students and investigate their auditory and non-auditory complaints, and their hearing habits. Another goal was to consider the concern with hearing health and the knowledge sources used by young people to gather information about the subject. Methods This is an observational, descriptive, quantitative, and cross-sectional study, which had the participation of high school students. The first step was an examination of transient-evoked optoacoustic emissions, followed by the application of a questionnaire and the measurement of the volume of audio players. Results The results showed harmful habits of young people regarding hearing health, such as an excessive time of use (hours, days and years) and high volume levels of digital audio players (DAPs), as well as symptoms that may point to hearing loss. It was found that most young people seem to be concerned about their hearing; however, there is no change of attitude to such situations. Conclusion The students develop the habit of using DAPs at very early ages and, in many cases, this habit is practiced with the equipment operating at high intensities, which can cause several hearing losses in these students.

Analysis of Output Levels of an MP3 Player: Effects of Earphone Type, Music Genre, and Listening Duration

BACKGROUND AND OBJECTIVES: To prevent noise induced hearing losses caused by listening to music with personal listening devices for young adults, this study was aimed to measure output levels of an MP3 and to identify preferred listening levels (PLLs) depending on earphone types, music genres, and listening durations. SUBJECTS AND METHODS: Twenty-two normal hearing young adults (mean=18.82, standard deviation=0.57) participated. Each participant was asked to select his or her most PLLs when listened to Korean ballade or dance music with an earbud or an over-the-ear earphone for 30 or 60 minutes. One side of earphone was connected to the participant’s better ear and the other side was connected to a sound level meter via a 2 or 6 cc-couplers. Depending on earphone types, music genres, and listening durations, loudness A-weighted equivalent (LAeq) and loudness maximum time-weighted with A-frequency sound levels in dBA were measured. RESULTS: Neither main nor interaction effects of the PLLs among the three factors were significant. Overall output levels of earbuds were about 10-12 dBA greater than those of over-the-ear earphones. The PLLs were 1.73 dBA greater for earbuds than over-the-ear earphones. The average PLL for ballad was higher than for dance music. The PLLs at LAeq for both music genres were the greatest at 0.5 kHz followed by 1, 0.25, 2, 4, 0.125, 8 kHz in the order. CONCLUSIONS: The PLLs were not different significantly when listening to Korean ballad or dance music as functions of earphone types, music genres, and listening durations. However, over-the-ear earphones seemed to be more suitable to prevent noise induce hearing loss when listening to music, showing lower PLLs, possibly due to isolation from the background noise by covering ears.

Queixas e hábitos auditivos de usuários de equipamento portátil de som / Complaints and hearing habits of portable stereo set users / Quejas y los hábitos de los usuarios de la audición de sonido portátiles

A exposição a ruídos em atividades de lazer, especialmente com o uso de fones de ouvido, pode afetar a saúde, o trabalho e as relações sociais de usuários desses dispositivos, sobretudo no que diz respeito à intensidade e ao tempo de exposição ao som. Objetivo: Caracterizar as queixas e hábitos auditivos de um grupo de usuários de equipamento portátil de som. Método: Foi aplicado um questionário semiestruturado sobre hábitos auditivos em um grupo de alunos e profissionais de uma universidade privada durante um evento social na própria instituição. Oitenta sujeitos responderam perguntas sobre hábitos e queixas auditivas e tiveram o nível de pressão sonora do equipamento de som (MP3, celular, IPod) estimado por meio de um medidor de nível de pressão sonora. Resultados: As principais queixas referidas após o uso do equipamento foram zumbido, dificuldade para entender e necessidade de aumentar o volume da televisão ou rádio após ouvir música. As queixas auditivas foram mais frequentes entre aqueles usuários que ouviam música em mais elevada intensidade. Conclusão: A maioria dos entrevistados relatou queixas auditivas após o uso do equipamento portátil de som (EPS), sendo mais frequentes entre aqueles que ouviam música em mais elevada intensidade.

Exposure to noise in leisure activities, especially with the use of headphones, can affect the health, labor and social relations of users of these devices, especially with regard to the intensity and the sound exposure time. Objective: To characterize the complaints and hearing habits of a group of adults in their use of portable stereo set. Methods: A semi-structured questionnaire about hearing habits was applied to a group of students during a social event at the University. Eighty subjects answered questions about habits and hearing complaints and had the sound pressure level of sound equipment (MP3, mobile phone, iPod) estimated by means of a sound pressure level meter. Results: The main complaints reported after the use of the equipment were buzzing, trouble understanding and need to increase the volume of television or radio after listening to music. Hearing problems were more frequent among those users who listened to music at a higher intensity. Conclusion: The majority of respondents reported hearing problems after portable stereo set use, which were more frequent among those who listened to music at a higher intensity.

La exposición al ruido en actividades de ocio, especialmente con el uso de auriculares, puede afectar a la salud, el trabajo y las relaciones sociales de los usuarios de estos dispositivos, especialmente en relación con la intensidad y el tiempo de exposición al ruido. Objetivo: Caracterizar las quejas y hábitos de escucha de un grupo de adultos debido al uso portátil equipo de sonido. Se aplicó un cuestionario semi-estructurado sobre hábitos de escucha en un grupo de estudiantes durante un evento social en la Universidad. Método: Ochenta sujetos respondieron preguntas sobre los hábitos y recibir las quejas y tenía el nivel de presión sonora de equipos de sonido (MP3, teléfonos móviles, iPod) estimado utilizando un medidor de nivel de presión sonora. Resultados: Las principales quejas reportadas después de la utilización de los equipos zumbaban, problemas para comprender y necesitan aumentar la intensidad de la televisión o la radio después de escuchar música. las afecciones auditivas fueron más frecuentes entre aquellos usuarios que escucharon música a una mayor intensidad. Conclusión: La mayoría de los encuestados declaró haber oído las quejas después de EPS de uso, que fueron más frecuentes entre los que escuchaban música a una mayor intensidad.

High-frequency profile in adolescents and its relationship with the use of personal stereo devices / Perfil de alta frequência em adolescentes e sua relação com o uso de MP3 players

Abstract Objective: To analyze and correlate the audiometric findings of high frequencies (9–16 kHz) in adolescents with their hearing habits and attitudes, in order to prevent noise-induced hearing loss. Method: This was a descriptive cross-sectional study, which included 125 adolescents in a sample of normal-hearing students, at a state school. The subjects performed high-frequency audiometry testing and answered a self-administered questionnaire addressing information on sound habits concerning the use of personal stereo devices. The sample was divided according to the exposure characteristics (time, duration, intensity, etc.) and the results were compared with the observed thresholds, through the difference in proportions test, chi-squared, Student's t-test, and ANOVA, all at a significance level of 0.05. Results: Average high-frequency thresholds were registered below 15 dB HL and no significant correlation was found between high frequency audiometric findings and the degree of exposure. Conclusion: The prevalence of harmful sound habits due to the use of personal stereo devices is high in the adolescent population, but there was no correlation between exposure to high sound pressure levels through personal stereos and the high-frequency thresholds in this population.

Resumo Objetivo: Analisar e correlacionar os achados audiométricos de altas frequências (9-16 kHz) em adolescentes com seus hábitos e atitudes de audição para prevenir perda auditiva induzida por ruído. Método: Este é um estudo transversal descritivo que incluiu 125 adolescentes em uma amostra de alunos ouvintes em uma escola estadual. Os indivíduos foram submetidos a testes de audiometria de altas frequências e responderam a um questionário autoadministrado que abordava informações sobre hábitos sonoros com relação ao uso de MP3 players. A amostra foi dividida de acordo com as características de exposição (tempo, duração, intensidade etc.) e os resultados foram comparados com os limites observados, por meio dos testes de diferença de proporções, qui-quadrado, t de Student e análise de variância (Anova), todos em um nível de significância de 0,05. Resultados: Foi registrada média de limiares de altas frequências abaixo de 15 dB HL e não foi encontrada correção significativa entre os achados audiométricos de altas frequências e o grau de exposição. Conclusão: A prevalência de hábitos sonoros prejudiciais devido ao uso de MP3 players é alta na população adolescente, porém não houve correlação entre a exposição a altos níveis de pressão sonora por meio de MP3 players e os limiares de altas frequências nessa população.

Analysis of Factors Affecting Output Levels and Frequencies of MP3 Players

Exposure to high levels of music that could lead to music induced hearing loss (MIHL) has been of recent interest especially for young adults, considering their excessive use of personal listening devices such as MP3 player. More attention should be drawn to MIHL for noting that early noise exposure leads to earlier onset of presbycusis. In search of appropriate and safe listening habits for young adults, this investigation was aimed to evaluate output levels and frequencies generated by the Samsung galaxy note MP3 player depending on two earphone types; ear-bud and over-the-ear earphones and three music genres; rock, hip-hop, ballade. A sound level meter was used to measure output level and frequency spectrum between 12.5 and 16000 Hz at all 1/3-octave bands. The following results can be summarized. 1) The earphone styles did not produce significant difference in output levels, but the music genres did. However, the results of music genres varied. 2) Neither earphone styles nor music genres produced significant difference in frequency response spectrum, except music genres at the volume settings we usually listen to. Additionally, volume levels should be lower than 50% for usual listening situation. Through this investigation, it was noted that the frequency range was substantial between 50 and 1000 Hz regardless of the styles of earphones and music genres, implying that we should be cautious of this frequency range when we listen to music. Researchers should give more attention to the effects of the mixture of output level and frequency spectrum, considering that the auditory system has frequency specificity from the periphery to the central to provide refined methods for protecting our ears from MIHL.

Digital radiograph of the middle phalanx of the third finger (MP3) region as a tool for skeletal maturity assessment.

Objective: To evaluate the reliability of the digital radiograph of the middle phalanx of the third finger (MP3) in skeletal maturity assessment Study Design: Fifty children (24 girls and 26 boys) belonging to the circumpubertal age-group were selected for the study. Two radiographs - lateral cephalogram and digital radiograph of the MP3 region - were taken in each child. Age assessment was based on the changes in shape of the cervical vertebrae and the epiphysis of the middle phalanx of the third finger of the left hand. The radiographs were assessed by three examiners. The inter- and intraexaminer variability were determined by the Wilcoxon rank sign test and the Kruskal-Wallis test and were found to be nonsignificant. Examiner 3 showed the best intraexaminer agreement and was selected to evaluate the radiographs for the entire study. Results: The correlation determined between the MP3 stages and cervical vertebrae maturity index (CVMI) stages, the peak-wise distribution of the MP3 stages, and the correlation between the MP3 stages and the chronological age were found to be highly significant. Conclusions: Digital radiograph of the MP3 region is definitely a simple, reliable, cost-effective, and time-saving technique for the assessment of skeletal maturity.

Estimación de riesgos y hábitos de uso de reproductores de música personal en una muestra de población chilena / Personal music player usage habits and risks in a Chilean population sample

Introducción: El uso irresponsable de reproductores de música personal ha sido determinado como una conducta de riesgo en salud, en relación al trauma acústico crónico que inducirían. La proporción de usuarios en niveles de riesgo, así como los factores que se relacionan con una escucha riesgosa no han sido evaluados en nuestro país. Objetivo: Describir características de uso de reproductores de música personal en una muestra chilena de población, estimando niveles de riesgo de trauma acústico e identificando factores de riesgo asociado. Material y método: Se aplicó un cuestionario a pacientes de consulta otorrinolaringológica, estudiantes universitarios y a contactos de redes sociales mediante versión on-line, indagando sobre conductas de uso de reproductores musicales. En base a datos de estudios anteriores se estimó el nivel de presión sonora y la dosis de ruido a la que cada usuario estaría expuesto según sus preferencias de uso. Resultados: De 508 encuestados el 12 por ciento superó la máxima exposición a ruido permitida por la legislación chilena. Los factores que más se correlacionaron con alcanzar niveles de riesgo fueron la intensidad del volumen escogida por el usuario (r =0,76), seguido por el tiempo de uso semanal (r =0,51) y, más débilmente, por el tipo de audífono utilizado (r =0,31). Destaca que ninguno de los encuestados que usan audífonos supraauriculares está en riesgo de desarrollar trauma acústico crónico. Discusión: Se estima que el trauma acústico recreacional sobrepasaría en los próximos años al trauma acústico ocupacional como problema de salud pública. Una proporción importante de usuarios estaría en niveles de riesgo. Los factores encontrados como determinantes de riesgo indican que las estrategias de intervención deben enfocarse hacia la escucha responsable por parte del usuario (escuchar al menor volumen confortable posible) más que en la implementación o selección de determinadas tecnologías.

Introduction: The irresponsible use of personal music players has been identified as an emerging health risk behavior related to the noise induced hearing loss they would produce. Listening habits and risk factors involved have not been assessed in our country. Aim: To assess personal music player usage habits in a Chilean sample, estimating noise-induced hearing loss and to identify risk factors. Material and method: A questionnaire was applied to patients attending ENT consult, university students and social networks contacts through on-line version. Listening habits were explored. Based on data from previous studies, we estimated the sound pressure level and the noise-dose to which each user would be exposed according to their specific listening preferences. Results: Of 508 respondents, 12 percent exceeded the maximum noise exposure allowable by Chilean law. The factors that stronger correlated with risk levels were the intensity chosen by the user by (r =0.76), followed by cumulative weekly listening time (r =0.51) and in a weaker relation, by type of headset used (r =0.31) nevertheless none of supra-auricular hearing devices reached risk levels. Discussion: It's estimated that in the next decade, music and recreational exposure will become the leading noise induced hearing loss source. One of each eight users exceeds maximum recommended levels. Risk factors analysis indicated that intervention strategies must focus on responsible listening by the user, lowering chosen-intensity, rather than selecting a specific type of player or earphone.

Reproductores de música personal: una conducta de riesgo emergente / Personal music players: an emerging health risk behavior

Introducción: El uso irresponsable de reproductores de música personal ha sido considerado como una conducta de riesgo en salud emergente. Objetivos: Determinar el perfil sonorométrico de distintos tipos de reproductores, con distintos tipos de fonos y a distintos niveles de control de volumen, estimando niveles de trauma acústico mediante normas para trauma acústico ocupacional. Material y método: Estudio descriptivo. Con sonómetro en cámara silente y utilizando muestra estandarizada de música se evaluaron 3 tipos de reproductor y 2 tipos de fonos a 25 por ciento, 50 por ciento, 75 por ciento y 100 por ciento del nivel máximo de salida. Resultados: El nivel de salida alcanzó un máximo de 119 dB SPL(A). Existen diferencias entre tipos de reproductor. Fonos supraauriculares reducen de manera constante alrededor de 12 dB el nivel de salida, independientemente del aparato o nivel de volumen utilizado. Bajo 50 por ciento del volumen máximo ningún tipo de reproductor alcanza una dosis de ruido (equivalente a 85dB en 8 horas) en menos de 24 horas. A 75 por ciento de volumen se alcanza una dosis de ruido hasta en 1,9 horas, pero a 100 por ciento se alcanza hasta en 4,5 minutos. Discusiones: Los reproductores de música personal pueden emitir altas presiones sonoras consideradas riesgosas según normas para trauma acústico ocupacional. Aparentemente el uso de audífonos supraauriculares pudiese ser beneficioso, aunque finalmente el daño acústico potencial depende del nivel de intensidad escogido por el usuario, y el tiempo de uso. Esperamos que este trabajo contribuya a tomar conciencia sobre esta nueva conducta de riesgo en salud auditiva.

Introduction: An irresponsible use of personal music players has been considered as an emerging health risk behavior. Aim: To determine output profiles of different personal music players, considering different phone types and different volume/output control levels, thus estimating exposure limits by noise-induced hearing loss guidelines. Material and methods: Descriptive study. We evaluated sound pressure outputs within an audiometric silent chamber using a standardized music sample in 3 types of players and 2 types of phones at 25 percent, 50 percent, 75 percent and 100 percent of maximum output. Results: The peak output pressure was 119 dB SPL (A). There were significant differences between players. Supra-ear phones steadily reduced about 12 dB of output pressure, regardless of the device or volume level selected. Under 50 percent of maximum output no player reached one noise-dose (equivalent to 85 dB at 8 hours, maximum noise exposure permitted in many guidelines) within 24 hrs. At 75 percent of maximum output one noise-dose was reached up to 1.9 hours. At 100 percent of output it was achieved as short as in 4.5 minutes. Discussions: Personal music players can emit high sound pressures considered risky by noise-induced hearing loss standards. Apparently the use of supra-ear headphones could be beneficial, but ultimately the potential acoustic damage depends on the intensity/output level chosen by the user and the usage time. We hope this work will help raise awareness about this emerging health risk behavior.