Evidências de validade de critério concorrente e preditiva do Instrumento de Rastreio da Comunicação de Crianças de 0 a 36 meses (IRC-36) / Evidence of concurrent and predictive criterion validity of the Child Communication Screening Instrument from 0 to 36 months (IRC-36)

RESUMO Objetivo Determinar evidências de validade de critério concorrente e preditiva do Instrumento de Rastreio da Comunicação de crianças de 0 a 36 meses (IRC-36). Método Participaram da pesquisa 78 pais/responsáveis de crianças que frequentam o serviço de puericultura das Unidades de Saúde da Família, além de 33 crianças com idades entre 0 e 36 meses, convidadas para segunda etapa do estudo. Na primeira etapa do estudo, 13 profissionais de saúde foram treinados para realizar a aplicação do IRC-36 nos pais/responsáveis das crianças. No segundo momento, os pais responderam a uma nova aplicação do IRC-36 e as crianças foram avaliadas com o Denver II. Resultados O IRC-36 apresentou correlação com o Denver II em mais da metade dos casos, confirmando a validade de critério concorrente do instrumento. Os resultados do IRC-36 da primeira etapa quando correlacionados com o Denver II, não apresentaram valores significativos. O valor de ponto de corte do instrumento foi 12, sendo este o valor de referência entre crianças em risco e sem risco para alteração da comunicação. O instrumento apresentou valor de acurácia dentro dos níveis preconizados e alta sensibilidade. A ocorrência de risco para alteração da comunicação apresentou-se maior na segunda aplicação do IRC-36. Conclusão O estudo apresentou evidências de validade de critério concorrente, indicando que o instrumento possui evidências de medidas de acurácia e de validade para o rastreio da comunicação de crianças de 0 a 36 meses sendo capaz de identificar risco para as alterações da comunicação.

ABSTRACT Purpose To determine evidence of concurrent and predictive criterion validity of the Communication Screening Instrument for children aged 0 to 36 months (IRC-36). Methods 78 parents/guardians of children who attend the childcare service of the Family Health Centers participated in the research, in addition to 33 children aged between 0 and 36 months, invited to the second stage of the study. In its first stage, 13 health professionals were trained to apply the IRC-36 to the children's parents/guardians. In the second moment, the parents responded to a new IRC-36 application, and the children were evaluated with Denver II. Results IRC-36 correlated with Denver II in more than half of the cases, confirming the instrument's concurrent criterion validity. IRC-36 results in the first stage did not significantly correlate with Denver II. The instrument's cutoff value was 12, which is the reference value between children at risk and not at risk of communication disorders. The instrument had high sensitivity and an accuracy value within the recommended levels. The occurrence of risk of communication changes was higher in the second IRC-36 application. Conclusion The study presented evidence of concurrent criterion validity, indicating that the instrument has evidence of accuracy and validity measures to screen communication in children aged 0 to 36 months, being able to identify the risk for communication disorders.

Hábitos de sono e autoavaliação miofuncional orofacial de crianças com risco para distúrbios respiratórios do sono / Sleep habits and orofacial myofunctional self-assessment of children at risk for sleep breathing disorders

RESUMO Objetivo Identificar e correlacionar as queixas de alterações miofuncionais orofaciais e de risco para distúrbios respiratórios do sono com hábitos de sono na infância. Método Participaram 71 pais ou responsáveis de crianças de 6 a 11 anos, matriculadas em uma escola pública. Foi aplicado um formulário com questões semiestruturadas/anamnese e os protocolos Nordic Orofacial Test-Screening - entrevista, Pediatric Obstructive Sleep Apnea Screening Tool Questionnaire, e Children's Sleep Habits Questionnaire - todos em suas versões em português/Brasil no formato online. Para a análise estatística, realizou-se o teste de correlação de Spearman, considerando o nível de significância de 5%. Resultados 29 crianças eram do sexo feminino (40,8%) e 42 do sexo masculino (59,2%), com média de idade de 8,52 anos. As queixas miofuncionais orofaciais encontradas foram relacionadas às funções de respiração (35,2%), mastigação e deglutição (32,4%) e hábitos deletérios (33,8%). Todas as crianças apresentaram um baixo risco para distúrbios respiratórios do sono e quanto aos hábitos de sono, 23 crianças (32,39%) apresentaram uma somatória menor, enquanto que 48 crianças (67,61%) ultrapassaram 41 pontos. Conclusão Houve correlação entre risco para distúrbios respiratórios do sono em crianças com as queixas de alterações miofuncionais orofaciais e com a baixa qualidade/maus hábitos de sono.

ABSTRACT Purpose To identify orofacial myofunctional complaints and sleep-disordered breathing and correlate them with sleep habits in childhood. Methods The study included 71 parents/guardians of public school children aged 6 to 11 years. They answered a form with semi-structured medical history questions and the Nordic Orofacial Test-Screening - interview, the Pediatric Obstructive Sleep Apnea Screening Tool Questionnaire, and the Children's Sleep Habits Questionnaire - all of them in their Portuguese/Brazilian versions in an online format. Statistical analyses used Spearman's correlation, setting the significance level at 5%. Results There were 29 female children (40.8%) and 42 male ones (59.2%), with a mean age of 8.52 years. The study found orofacial myofunctional complaints related to breathing functions (35.2%), chewing and swallowing (32.4%), and deleterious habits (33.8%). All children were at a low risk of sleep-disordered breathing. As for sleep habits, 23 children (32.39%) had a lower total score, whereas 48 children (67.61%) exceeded 41 points. Conclusion There was a correlation between the risk of sleep-disordered breathing in children with complaints of orofacial myofunctional disorders and poor sleep quality/habits.

Panorama da Saúde Auditiva infantil no Sistema Único de Saúde no estado de Sergipe / Children's Hearing Health Panorama in the Unified Health System in the state of Sergipe

RESUMO Objetivo Descrever o panorama da saúde auditiva infantil no Sistema Único de Saúde do estado de Sergipe. Método Estudo quantitativo e retrospectivo, composto por quatro etapas: 1) Busca no Cadastro Nacional de Estabelecimento de Saúde das instituições conveniadas ao Sistema Único de Saúde no estado de Sergipe que realizam serviços obstétricos e dos serviços que atuam na saúde auditiva; 2) Obtenção de dados de cobertura da Triagem Auditiva Neonatal (TAN), por meio do DATASUS (de 2012 a 2020); 3) Coleta de dados em prontuários das instituições com obstetrícia e/ou que realizam a TAN; e 4) Entrevista aos responsáveis das crianças em reabilitação auditiva. Os resultados foram sumarizados por meio de estatística descritiva (frequência absoluta e relativa, medidas de tendência central e de dispersão). Resultados Dos 29 estabelecimentos com obstetrícia, um realiza a TAN. Há dois Centros de Referência em Saúde Auditiva (CRSA) com habilitação para implante coclear e dois Centros Especializados em Reabilitação. De 2012 a 2020 a cobertura da TAN no estado foi inferior a 40% e quando realizada na maternidade, houve ausência de encaminhamentos para a realização do Potencial Evocado Auditivo de Tronco Encefálico (PEATE) e do diagnóstico audiológico. Observou-se cobertura considerável no CRSA com menor taxa de evasão para realizar PEATE e com taxa de diagnóstico de 4,8%. O tempo médio da TAN universal à reabilitação foi superior ao recomendado. Conclusão Existe necessidade de aumentar a cobertura da TAN, ajustar a rede de saúde auditiva para a articulação nos diferentes níveis de atenção e diminuir o tempo para identificação, diagnóstico e início da reabilitação.

ABSTRACT Purpose To describe the panorama of children's hearing health in the Unified Health System of the state of Sergipe. Methods A quantitative and retrospective study consisting of four steps: 1) Search the National Registry of Health Establishments of institutions affiliated to the Health Unic System in the state of Sergipe that perform obstetric services and hearing health services; 2) Collecting Neonatal Hearing Screening (NHS) coverage data through DATASUS (from 2012 to 2020); 3) Data collection from medical records of institutions with obstetrics and that perform NHS; and 4) Interview with the guardians of children undergoing auditory rehabilitation. The results were summarized using descriptive statistics (absolute and relative frequency, measures of central tendency, and dispersion). Results Only one out of the 29 establishments with obstetrics performs NHS. Two of the Hearing Health Reference Centers (HHRC) are qualified for cochlear implants and two Specialized Centers are qualified for Rehabilitation. From 2012 to 2020, NHS coverage in the state was less than 40%, and when performed in the maternity ward, there were no referrals for Brainstem Auditory Evoked Response (BERA) and audiological diagnosis. The HHRC showed considerable coverage and a lower evasion rate to perform BERA, with a diagnosis rate of 4.8%. The mean time from the NHS to rehabilitation was longer than recommended. Conclusion NHS coverage must be increased, adjusting the hearing health network to articulate the different levels of care, and reducing the time for identification, diagnosis, and start of rehabilitation.

Adaptação transcultural do Instrumento de Rastreio para a Disfonia (IRD-Br) para o Português Europeu (PE) / Cross-cultural adaptation of the Dysphonia Screening Tool (DST-Br) for European Portuguese (EP)

RESUMO Objetivo Realizar a adaptação transcultural do Instrumento de Rastreio para a Disfonia (IRD-Br) para o Português Europeu (PE). Métodos Foi realizada a adaptação transcultural do IRD-Br para o PE de acordo com as seguintes etapas: tradução, retrotradução, análise de um comitê de especialistas e pré-teste. Na etapa de pré-teste, participaram 30 indivíduos disfônicos com idades entre os 18 e 87 anos, sendo 24 do sexo feminino e 6 do sexo masculino. Resultados Foi necessária a inserção de um enunciado na versão em PE do instrumento. Houve divergência na retrotradução do título, sendo resolvida na análise do comitê de especialistas. Um item apresentou divergência na tradução e na retrotradução, sendo definida a versão final na análise do comitê de especialistas. Um item e a chave de resposta apresentaram consenso em todas as etapas. No pré-teste, todos os itens receberam 100% de respostas sim ou não, e nenhum recebeu resposta não aplicável. Conclusão A adaptação do IRD-Br para o PE foi bem sucedida. A versão para o português europeu do instrumento foi denominada de Instrumento de Rastreio para a Disfonia em português europeu - IRD-PT.

ABSTRACT Purpose To perform a cross-cultural adaptation of the Brazilian Dysphonia Screening Tool (DST-Br) for European Portuguese (EP). Methods The cross-cultural adaptation of the DST-Br for EP was carried out in four stages: translation, back-translation, expert committee review, and pre-testing. The pre-testing involved 30 dysphonic individuals (24 women and 6 men) aged between 18 and 87 years old. Results An additional statement was required in the EP version of the instrument. Disagreement in the back-translation of the title was resolved through an expert committee review. One item presented discrepancies in the translation and back-translation, with the final version determined through an expert committee review. One item and the answer key reached a consensus in all stages. During pre-testing, all items received 100% "yes" or "no" responses, and none were marked as "not applicable". Conclusion The cross-cultural adaptation of DST-Br for use in EP was successfully carried out. The European Portuguese version of the instrument was named the Instrumento de Rastreio para a Disfonia em português europeu (IRD-PT) / Dysphonia Screening Tool in European Portuguese.

Método de Desenvolvimento das Habilidades de Comunicação no Autismo - DHACA: validação da aparência e do conteúdo / Method for Developing Communication Skills in Autism - DHACA: appearance and content validation

RESUMO Objetivo Validar a aparência e o conteúdo do método de Desenvolvimento das Habilidades de Comunicação no Autismo (DHACA). Método Trata-se de estudo de validação de abordagem quali-quantitativa. Participaram do estudo dez juízes fonoaudiólogos com expertise na área da comunicação alternativa. Os juízes receberam o livro de comunicação, bem como a descrição dos princípios, habilidades e estratégias do método DHACA e um formulário com itens relativos à apreciação da aparência e conteúdo do método. A validade foi calculada usando o índice de validade de conteúdo. Resultados A análise das respostas possibilitou o cálculo do grau de concordância entre os juízes e a elaboração da nova versão do instrumento. O cálculo do Índice de Validade de Conteúdo revelou uma validade de conteúdo excelente. Os juízes deram sugestões referentes aos aspectos de conteúdo do livro de comunicação, nos textos de participação do parceiro de comunicação e modelagem, uso de dicas e habilidades comunicativas. Conclusão O grau de concordância observado entre os juízes possibilitou a obtenção da validação da aparência e do conteúdo do método DHACA, considerando-se os itens isoladamente e o instrumento como um todo, podendo ter seu uso recomendado na prática clínica fonoaudiológica.

ABSTRACT Purpose To validate the appearance and content of the DHACA method to develop communication skills in autism. Methods This qualitative and quantitative validation study included 10 speech-language-hearing judges with expertise in alternative communication. The judges received the communication book, the description of the principles, skills, and strategies in the DHACA method, and a form with items for them to appraise the appearance and content of the method. The validity was calculated with the content validity index. Results The response analysis made it possible to calculate the degree of agreement between judges and develop the new instrument version. The calculation of the content validity index revealed excellent content validity. The judges made suggestions regarding the content of the communication book, texts regarding the participation of communication partners and modeling, using cues, and communicative skills. Conclusion The degree of agreement between judges ensured the validation of the appearance and content of the DHACA method, considering the items alone and the whole instrument. Hence, its use can be recommended for speech-language-hearing clinical practice.

Encoding of speech sounds with frequency-following response in infants with Congenital Zika Syndrome: A case-controlled study

ABSTRACT Purpose: to investigate the frequency-following response (FFR) for sustained neural activity. Methods: 39 individuals, aged between 20 to 47 months old were divided into 2 groups: (i) 20 individuals without prenatal exposure to the congenital Zika syndrome (CZS) or hydrocephaly, normal development, no risk factors for hearing loss or syndromic hearing impairment and (ii) 19 individuals diagnosed with CZS and microcephaly - based on imaging studies linked to the clinical presentation of the condition. All participants exhibited normal click-ABR tests. FFR waveforms were documented using the /da/ syllable employing the Navigator Pro. The statistical analysis used was ANOVA (p-value <0.05). Results: no distinctions were observed concerning the variables of group, age, or gender with respect to FFR latency values, except for an interaction between gender and group for latency values associated with waves V and F. Children with CZS and microcephaly showed a difference for latency values in wave V for both males and females, when compared to the control group. Conclusion: children presented with CZS and microcephaly showed higher average latencies for waves V, A, C, D and F (male) compared to the control group, whereas, in waves E, F (female) and O they showed higher values in the control group.

Post-COVID-19 syndrome: An investigation of speech-language-hearing symptoms / Síndrome Pós-COVID-19: investigação de sintomas fonoaudiológicos

ABSTRACT Purpose: to investigate speech-language-hearing symptoms in adults after the acute phase of COVID-19 and the impact of these persistent symptoms on their physical and emotional aspects, functional capacity, and social relationships. Methods: 204 adults who tested positive for COVID-19 between January 2021 and July 2022 and who completed an online questionnaire, addressing different variables. Data were analyzed with descriptive statistics. Results: the most prevalent symptoms up to 30 days after infection were tiredness (46%), memory loss (40.2%), and ageusia (26.5%). The most found long-term symptoms were memory loss (34.3%), tiredness (21.1%), and difficulties in starting a sentence or conversation (10.1%). Anosmia and ageusia were also cited. These persistent symptoms had an impact on their emotional aspect (33.3%), followed by the physical (26%) and occupational (25%) ones. Conclusion: this study found persistent symptoms after the acute phase of COVID-19, which can lead to speech-language-hearing disorders, such as impaired oral language and eating. These persistent symptoms impacted the participants' emotional, physical, and occupational aspects.

RESUMO Objetivo: investigar a presença de sintomas fonoaudiológicos em adultos após o período da fase aguda da COVID-19, além do impacto da manutenção desses sintomas nos aspectos físicos, emocionais, capacidade funcional e relações sociais. Métodos: participaram 204 adultos que testaram positivo para COVID-19 no período de janeiro de 2021 a julho de 2022 e que preencheram um questionário on- line, abordando diferentes variáveis. Os dados foram analisados por meio de estatística descritiva. Resultados: os sintomas mais prevalentes até 30 dias após a infecção foram cansaço (46%), perda de memória (40,2%) e ageusia (26,5%). Os sintomas de longa duração mais observados foram perda de memória (34,3%), cansaço (21,1%) e dificuldades para iniciar um diálogo ou frase (10,1%). Anosmia e ageusia também foram citadas. Houve impacto da manutenção desses sintomas no aspecto emocional (33,3%), seguido dos aspectos físicos (26%) e ocupacionais (25%). Conclusão: neste estudo foram encontrados sintomas persistentes após o período da fase aguda da COVID-19 que podem levar a alterações fonoaudiológicas, como prejuízo na linguagem oral e nas questões alimentares. A manutenção desses sintomas impactou nos aspectos emocionais, físicos e ocupacionais dos participantes.

Analysis of age criteria for provision of the personal frequency-modulated system: An integrative review / Análise do critério de idade para fornecimento do sistema de frequência modulada: uma revisão integrativa

ABSTRACT Purpose: to critically analyze whether the legislation regarding the Personal Frequency-Modulated (FM) System device encompasses most of the students with hearing impairment to facilitate the development of skills required for communication, literacy, and learning. Methods: a legislative analysis of the norms regarding the use of the Personal Frequency-Modulated (FM) System device. Relevant legislations were searched on public databases such as the Planalto and the Ministry of Health portals. Brazilian laws, ordinances, and relevant guidelines were consulted as well. Literature Review: Ordinance n. 1,274 of June 25, 2013, the CONITEC Report on FM in 2020 and GM/MS Ordinance No. 2,465, of September 27, 2021, which regulate the Personal Modulated Frequency System device, were identified. Conclusion: the initial ordinance of 2013, which regulated the Personal Frequency-Modulated (FM) System, was revised and updated, because it did not include children under six years of age, who are in the peak phase of oral language learning.

RESUMO Objetivo: analisar criticamente se a legislação garantidora do dispositivo Sistema de Frequência Modulada Pessoal abrange a população adequada de escolares com deficiência auditiva no critério idade, de forma a favorecer o desenvolvimento das habilidades necessárias para a comunicação, a alfabetização e a aprendizagem dessas crianças. Métodos: trata-se de uma análise legislativa das normas referentes ao uso do dispositivo Sistema de Frequência Modulada Pessoal. Para a busca da legislação pertinente, foram utilizados bancos de dados públicos, tais como: o portal do Planalto e o portal do Ministério da Saúde. Foram consultadas as leis, portarias e diretrizes Brasileiras no que se refere ao uso do Dispositivo Sistema de Frequência Modulada Pessoal. Revisão da Literatura: foram identificadas na Revisão de Literatura a Portaria n. 1.274 de 25 de junho de 2013, o Relatório do CONITEC sobre o FM no ano de 2020 e a Portaria GM/MS Nº 2.465, de 27 de setembro de 2021 que regulamentam o dispositivo Sistema de Frequência Modulada Pessoal. Conclusão: é evidente que a portaria inicial de 2013, a qual regulamentava o fornecimento do Sistema FM, foi revista e atualizada, uma vez que não contemplava crianças menores de 6 anos, em fase de máxima aprendizagem da linguagem oral, pré-alfabetização e letramento, mesmo que estivessem inseridas em instituições escolares.

Proposals to promote health and prevent voice disorders in occupational voice users: A scoping review / Propostas de promoção da saúde e prevenção de distúrbios vocais para profissionais da voz: revisão de escopo

ABSTRACT Purpose: to characterize the actions of vocal health promotion and/or prevention of vocal disorders applied to voice professionals. Methods: a scoping review following the PRISMA-ScR guidelines in SciELO and PubMed databases was conducted. Articles that had as participants voice professionals without concomitant vocal treatment, that described proposals for health promotion or vocal disorders prevention, published between 2010 and 2023, were included. They were grouped into categories and data were presented descriptively. Literature Review: eighteen articles with artistic and non-artistic voice professionals, mostly teachers, were included. Most of the studies focused on healthy voices, aiming at primary prevention. Many articles presented guidance on vocal hygiene and health and used resources such as vocal enhancement, voice workshop, voice amplifiers and apps. All the articles positively mentioned their results, especially with regard to self-perception in relation to voice, vocal quality and quality of life, awareness of positive and harmful practices to the voice. Conclusion: the proposals contemplated different levels of prevention, but most focused on primary prevention, including vocally healthy participants; all articles indicated positive results in voice self-perception, voice quality and quality of life, and awareness of positive and harmful voice practices.

RESUMO Objetivo: caracterizar as ações de promoção de saúde vocal e/ou prevenção de distúrbios vocais aplicadas em profissionais da voz. Métodos: foi conduzida uma revisão de escopo seguindo as diretrizes do PRISMA-ScR nas bases de dados SciELO e PubMed. Foram incluídos artigos que tivessem como participantes profissionais da voz sem tratamento vocal concomitante, que descrevessem propostas de promoção da saúde ou prevenção de distúrbios vocais, publicados entre 2010 e 2023. Os artigos foram agrupados em categorias e os dados apresentados de forma descritiva. Revisão da Literatura: foram incluídos 18 artigos com profissionais da voz artística e não-artística, em sua maioria professores. A maior parte dos estudos tinha como foco vozes saudáveis, visando a prevenção primária. Muitos artigos apresentaram orientações sobre higiene e saúde vocal e utilizaram recursos como aprimoramento vocal, oficina de voz, amplificadores de voz e aplicativos. Todos os artigos mencionam resultados benéficos, principalmente no que se refere à autopercepção em relação a voz, qualidade vocal e de vida, conscientização de práticas positivas e prejudiciais à voz. Conclusão: as propostas contemplaram diferentes níveis de prevenção, mas a maioria tinha como foco a prevenção primária, incluindo participantes vocalmente saudáveis; todos os artigos indicaram resultados favoráveis na autopercepção em relação à voz, qualidade vocal e de vida e conscientização de práticas benéficas e prejudiciais à voz.

Como a hiperbilirrubinemia deve ser considerada na definição do protocolo da triagem auditiva para neonatos de risco? / How should hyperbilirubinemia be considered in the definition of the hearing screening protocol for neonates at risk?

RESUMO Objetivo Analisar a hiperbilirrubinemia como indicador para a realização do protocolo de risco na triagem auditiva neonatal (TAN) e no monitoramento auditivo em neonatos a termo e prematuros. Método Trata-se de um estudo observacional, transversal e retrospectivo. Foram incluídas 554 crianças nascidas em uma maternidade pública, subdivididas em dois grupos: (G1) com 373 recém-nascidos a termo; (G2) com 181 neonatos prematuros. Os dados foram coletados nos prontuários dos participantes, a fim de se obter informações referentes ao resultado da TAN realizada por meio do registro do Potencial Evocado Auditivo de Tronco Encefálico, às condições de nascimento, características clínicas, intervenções realizadas, resultados do primeiro exame de bilirrubina total (BT) e bilirrubina indireta (BI) e do pico de BT e BI. Realizou-se análise estatística descritiva e inferencial dos dados, com adoção do nível de significância de 5%. Resultados No teste da TAN, foram observadas taxas de encaminhamento para reteste inferiores no G1 em relação ao G2. Não houve diferença entre os grupos quanto à ocorrência do tipo de parto, sexo, presença de incompatibilidade sanguínea Rh e ABO, deficiência de enzima G6PD e realização de fototerapia. Em relação aos níveis de BT e BI no primeiro exame e no momento do pico, não houve diferenças entre os neonatos com resultado "passa" e "falha" na TAN-teste nos dois grupos. Conclusão Os níveis de bilirrubina no período neonatal abaixo dos valores recomendados para indicação de exsanguineotransfusão não estão diretamente relacionados ao resultado "falha" na TAN em neonatos a termo e prematuros.

ABSTRACT Purpose To analyze hyperbilirubinemia as an indicator for the definition of risk protocol in newborn hearing screening (NHS) and in auditory monitoring in full-term and preterm neonates. Methods This is an observational, cross-sectional and retrospective study. A total of 554 children born in a public maternity hospital were included and divided into two groups: (G1) with 373 full-terms neonates; (G2) with 181 preterm neonates. Data were collected from the participant's medical records to obtain information regarding the result of the NHS, performed by recording the automated auditory brainstem response (AABR), birth conditions, clinical characteristics, interventions performed, and results of the first test of total bilirubin (TB) and indirect bilirubin (IB) as well as the peak of TB and IB. A descriptive statistical analysis of the results was performed, and the level of significance adopted was 5%. Results On the NHS test, quotes of retest referral rates were smaller in G1 when compared to G2. There was no significant difference between the groups regarding type of delivery, gender, presence of Rh and ABO incompatibility, G6PD enzyme deficiency, and performance of phototherapy. TB and IB levels at the first exam and at peak time did not differ between neonates with "pass" and "fail" results on the NHS test in both groups. Conclusion Bilirubin levels in the neonatal period below the recommended values for indication of exchange transfusion are not directly related to the "fail" result on the NHS tests in term and preterm neonates.

Enfrentamento da subnotificação da perda auditiva induzida por ruído relacionada ao trabalho: a experiência de uma oficina educativa em planejamento e programação local em saúde do trabalhador / Addressing underreported occupational noise-induced hearing loss: the experience of an educational workshop on local occupational health planning and program

Resumo Introdução: a subnotificação da Perda Auditiva Induzida por Ruído (Pair) relacionada ao trabalho é um problema que contribui para a invisibilidade e falta de prioridade deste agravo nos programas de Saúde do Trabalhador (ST). Logo, ações de educação permanente voltadas ao planejamento estratégico-situacional podem contribuir para o enfrentamento desta realidade. Objetivo: apresentar e discutir a experiência de uma intervenção educativa com técnicos da ST de uma macrorregião de saúde do estado da Bahia, Brasil, sobre o uso do Planejamento e Programação Local em Saúde (PPLS) como ferramenta para ampliação da notificação da Pair relacionada ao trabalho Métodos: a intervenção consistiu em uma oficina estruturada em cinco etapas, as quais proporcionaram discussão sobre a Pair, conhecimento do PPLS, prática do PPLS, socialização dos resultados e avaliação do evento. Resultados: a prática do PPLS, a partir de um problema real, viabilizou o delineamento de ações concretas de enfrentamento da subnotificação da Pair a serem implementadas nos Centros de Referência em Saúde do Trabalhador (Cerest) e no estado como um todo. Conclusão: a experiência mostrou-se bem-sucedida ao fomentar a tomada de consciência e mobilização dos técnicos para enfrentamento da subnotificação da Pair, ao tempo que propiciou qualificação em PPLS dos participantes.

Abstract Introduction: underreported occupational noise-induced hearing loss (ONIHL) is an issue that increases the invisibility and lack of priority of this condition in occupational health (OH) programs. Hence, permanent education actions focused on strategic-situational planning may help address the situation. Objective: to present and discuss the experience of an educational intervention in OH technicians of a larger health region in the state of Bahia, Brazil, approaching the use of the Local Health Planning and Program (PPLS, in Portuguese) as a toll to increase reports of ONIHL. Methods: the intervention had a workshop structured into five stages, which approached ONIHL discussions, PPLS knowledge, PPLS practice, result socialization, and event evaluation. Results: real-problem PPLS practice made it possible to outline concrete actions to address underreported ONIHL, which can be implemented in Occupational Health Reference Centers (Cerest) and other settings statewide. Conclusion: the experience proved to be positive, raising technicians' awareness of underreported ONIHL and mobilizing them to address the underreporting of ONIHL, while also effectively training participants to use PPLS.

Tecnologia auditiva assistiva em usuários de implante coclear em ambientes reverberantes com múltiplas fontes de ruído / Assistive listening technology in cochlear implant users in reverberant environments with multiple noise sources

RESUMO Objetivo Avaliar a contribuição da tecnologia de escuta assistida em usuários de implante coclear (IC) em situações de reverberação e ruído. Métodos Estudo transversal prospectivo aprovado pelo Comitê de Ética Institucional (CAAE 8 3031418.4.0000.0068). Foram selecionados adolescentes e adultos usuários de IC com surdez pré ou pós-lingual. Para usuários bilaterais, cada orelha foi avaliada separadamente. O reconhecimento de fala foi avaliado por meio de listas gravadas de palavras dissílabas apresentadas a 65 dBA a 0° azimute com e sem o Mini Microfone2 (Cochlear™) conectado ao processador de fala Nucleus®6. A reverberação da sala foi medida como 550 ms. Para avaliar a contribuição do dispositivo de escuta assistida (DEA) em ambiente reverberante, o reconhecimento de fala foi avaliado no silêncio. Para avaliar a contribuição do DEA em reverberação e ruído, o reconhecimento de fala foi apresentado a 0° azimute com o ruído proveniente de 8 alto-falantes dispostos simetricamente a 2 metros de distância do centro com ruído de múltiplos falantes usando relação sinal-ruído de +10dB. Para evitar viés de aprendizado ou fadiga, a ordem dos testes foi randomizada. A comparação das médias foi analisada pelo teste t para amostras pareadas, adotando-se nível de significância de p<0,005. Resultados Dezessete pacientes com idade média de 40 anos foram convidados e concordaram em participar, sendo 2 participantes bilaterais, totalizando 19 orelhas. Houve contribuição positiva significante do Mini Mic2 na reverberação e ruído+reverberação (p<0,001). Conclusão DEA foi capaz de melhorar o reconhecimento de fala de usuários de IC tanto em situações de reverberação quanto ruidosas.

ABSTRACT Purpose This study aimed to evaluate the contribution of assistive listening technology with wireless connectivity in cochlear implant (CI) users in reverberating and noise situations. Methods Prospective cross-sectional study approved by the Institutional Ethics Committee (CAAE 8 3031418.4.0000.0068). Adolescents and adults CI users with pre- or post-lingual deafness were selected. For bilateral users, each ear was assessed separately. Speech recognition was assessed using recorded lists of disyllabic words presented at 65 dBA at 0° azimuth with and without the Wireless Mini Microphone 2 (Cochlear™) connected to the Nucleus®6 speech processor. Room reverberation was measured as 550 ms. To assess the contribution of the assistive listening device (ALD) in a reverberating environment, speech recognition was assessed in quiet. To assess the contribution of the ALD in reverberation and noise, speech recognition was presented at 0° azimuth along with the noise coming from 8 loudspeakers symmetrically arranged 2 meters away from the center with multi-talker babble noise using signal to noise ratio of +10dB. To avoid learning bias or fatigue, the order of the tests was randomized. Comparison of means was analyzed by t test for paired samples, adopting significance level of p <0.005. Results Seventeen patients with a mean age of 40 years were invited and agreed to participate, with 2 bilateral participants, totaling 19 ears assessed. There was a significant positive contribution from the Mini Mic2 in reverberation, and noise+reverberation (p <0.001). Conclusion ALD was able to improve speech recognition of CI users in both reverberation and noisy situations.

Medidas de proteção contra a COVID-19: impactos comunicativos, sociais e emocionais em usuários de aparelhos de amplificação sonora individual / Protective measures against COVID-19: communicative, social and emotional impacts on hearing aids users

RESUMO Objetivo investigar os impactos comunicativos, sociais e emocionais gerados pela adoção de medidas protetivas contra a COVID-19 e associá-los ao grau da perda auditiva e ao tempo de uso dos aparelhos de amplificação sonora individual. Métodos estudo transversal e quantitativo, com 72 indivíduos, divididos em adultos e idosos, com perda auditiva bilateral, de grau até moderadamente severo, protetizados antes da pandemia em um programa público de saúde auditiva e que mantiveram uso efetivo dos dispositivos. Os sujeitos foram convidados a participar do estudo enquanto aguardavam consulta. Os prontuários foram acessados, a fim de coletar informações sobre o perfil audiológico e adaptação/uso dos aparelhos de amplificação sonora individual. Em sala silenciosa, foi aplicado, oralmente, protocolo contendo questões objetivas e os dados foram tabulados e submetidos aos testes estatísticos Igualdade de Duas Proporções e Qui-Quadrado. Resultados nos dois grupos, um número significativo de usuários teve a comunicação impactada pelo uso de máscaras e pelo distanciamento físico, predominando, entre os adultos, a dificuldade com as tecnologias digitais (celulares/computadores), enquanto nas videochamadas, os prejuízos comunicativos foram mais experenciados pelos idosos. Os empecilhos comunicativos e sociais existiram, independentemente do perfil audiológico e do tempo de uso dos dispositivos. Quando questionados se deixaram de se comunicar e se as medidas afetaram a sua vida social, as respostas ficaram divididas entre "sim/às vezes" e "não". Quanto ao impacto emocional das medidas protetivas, constatou-se maior repercussão entre os adultos. Conclusão as medidas protetivas afetaram a comunicação dos usuários de aparelhos de amplificação sonora individual, porém, não desencorajaram as trocas comunicativas e as interações sociais de, aproximadamente, metade da amostra, sendo o impacto emocional mais evidente nos adultos. Tais dificuldades não estiveram relacionadas ao perfil audiológico e uso diário dos dispositivos.

ABSTRACT Purpose to investigate the communicative, social, and emotional impacts generated by adopting protective measures against COVID-19 and associate them with the degree of hearing loss and the time of use of hearing aids. Methods cross-sectional quantitative study, with 72 individuals, divided into adults and older adults, with bilateral hearing loss up to moderately severe degree, users of hearing aids fitted before the pandemic in a public hearing health program who had maintained effective use of the devices. The participants were invited to participate in the study while waiting for an appointment and signed the consent form. After that, medical records were accessed to collect information about audiological profiles and the fitting/use of hearing aids. Afterward, a protocol with objective questions was orally applied in a silent room. Data were tabulated and subjected to Equality of Two Proportions and Chi-Square statistical tests. Results in both groups, a significant number of users had communication impacted by the use of masks and by social distancing, with difficulty with digital technologies (cell phones/computers) predominating among adults, while older adults more commonly experienced communicative impairments during video calls. The communicative impediment existed regardless of the audiological profile and device use time. When asked if they stopped communicating and if the measures affected their social life, the sample was divided between "yes/sometimes" and "no". As for the emotional impact of protective measures, there was a greater impact among adults. Conclusion protective measures affected the communication of hearing aids users but did not discourage communicative exchanges and social interactions for approximately half of the sample, with the emotional impact being more evident in adults. Such difficulties were not related to the audiological profile and daily use of the devices.

Predictors of hearing outcomes in patients undergoing ossicular chain reconstruction in a developing country / Factores predictores de desenlaces auditivos en pacientes llevados a reconstrucción de la cadena osicular en un país en vía de desarrollo

Objective: To explore the social and clinical factors that predict audiometric outcomes in patients undergoing ossicular chain reconstruction. Methods: A retrospective analytical cohort study was conducted, including patients 18 years of age or older with a history of chronic otitis media (COM) and/or any of its complications, who underwent ossicular chain reconstruction with Partial Ossicular Replacement Prosthesis (PORP) or Total Ossicular Replacement Prosthesis (TORP), at Hospital San José and Hospital infantile Universitario de San José between 2012 and 2020. We excluded patients with ossicular chain malformations and those with incomplete information. Information about sociodemographic and clinical factors was collected. Additionally, the surgery findings information was analyzed using the Ossiculoplasty outcome parameter staging ( OOPS) index. Results: A total of 35 adult patients who underwent ossicular chain reconstruction were retrospectively studied. An improvement was evidenced in the Preoperative Pure-Tone Average (PTA) and postoperative PTA (p-value=0.036), as well as in the pre and postoperative air-bone gap (ABG) (p-value < 0.01). A moderate correlation coefficient was found between the OOPS index and the postoperative PTA (p= 0.429), and between the OOPS index and the postoperative (ABG) (p= 0.653). Conclusion: We found that a higher OOPS score is correlated with worse hearing outcomes postoperatively, and there was no association between the demographic or pathologic factors with a worse postoperative hearing outcome. Therefore, OOPS index can predict audiometric outcomes in patients undergoing ossicular chain reconstruction in a developing country, regardless of the demographic or pathologic factors.

Objetivo: Evaluar los factores sociales y clínicos que predicen los desenlaces audiométricos en pacientes llevados a reconstrucción de cadena osicular en un país envía de desarrollo. Métodos: Se realizo un estudio de cohorte analítico retrospectivo donde se incluyeron pacientes mayores de 18 años, con antecedente de otitis media crónica y/o alguna complicación/secuela de esta, que fueron llevados a reconstrucción de la cadena osicular con prótesis PORP - TORP de la Fundación Universitaria de Ciencias de la Salud entre el año 2012 y 2020, se excluyeron pacientes con malformaciones de la cadena osicular y aquellos con informacion incompleta de su historia clinica y quirurgica. Resultados: La población estudiada fue 35 pacientes, en los cuales se compararon variables demográficas, antecedentes de rinitis o tabaquismo activo, parámetros audiológicos pre y postoperatorios, y hallazgos intraquirurgicos. Se evidenció una diferencia estadísticamente significativa entre el promedio tonal auditivo (PTA) preoperatorio y el PTA postoperatorio (p-valor=0.036), así como en el gap aéreo- oseo pre y post operatorio ( p-valor < 0.01). Se reportó un coeficiente de correlación moderado entre el índice OOPS y el PTA post operatorio (p = 0.429), y entre el índice OOPS y el gap aéreo óseo post operatorio (p = 0.653), lo que indica que a mayor puntaje en el índice OOPS peores desenlaces auditivos. Conclusión: En este estudio un mayor puntaje en el índice OOPS se correlacionó con peores desenlaces auditivos. No se evidenció correlación entre los factores demográficos u otras comorbilidades descritas y un peor desenlace auditivo post operatorio. Aunque se obtuvo un GAO postoperatorio ≤20dB en el 48.5% de los pacientes, se observó una disminución en el GAO estadísticamente significativo.

Hipoacusia en el síndrome de Vogt-Koyanagi-Harada: reporte de caso y revisión de la literatura / Hearing loss in Vogt-Koyanagi-Harada syndrome: case report and literature review

El síndrome de Vogt-Koyanagi-Harada (VKH) es una rara enfermedad granulomatosa multisistémica caracterizada por aparición de panuveítis grave bilateral y desprendimiento seroso de retina; puede acompañarse de un amplio espectro de síntomas extraoculares como los auditivos, y la afección más frecuente es la hipoacusia neurosensorial. Su etiología se reconoce como respuesta autoinmune mediada por células T contra antígenos de melanocitos presentes en coroides, meninges, cóclea y piel. Asimismo, factores genéticos del huésped se han identificado como predisponentes para su aparición, y es la presencia del alelo HLA-DR4, en particular el subtipo HLA-DRB1 0405, el más estudiado hasta la fecha. El tratamiento se basa en administración de corticosteroides sistémicos en dosis altas, sin embargo, es escasa la evidencia que evalúa específicamente la eficacia de estos medicamentos sobre sus manifestaciones audiovestibulares. Este artículo expone un caso de síndrome de VKH con compromiso auditivo concomitante y realiza una breve revisión narrativa de la literatura.

Vogt-Koyanagi-Harada syndrome (VKHS) is a rare multisystemic granulomatous disease, characterized by severe bilateral panuveitis and serous retinal detachment; it can be associated with a wide spectrum of extraocular symptoms, such as auditory symptoms, and the most common condition is sensorineural hearing loss. Its etio-logy is recognized as a T-cell-mediated autoimmune response against melanocyte antigens present in the choroid, meninges, cochlea, and skin. Likewise, host genetic factors have been identified as predisposing for its development, specifically the pre-sence of the HLA-DR4 allele, the HLA-DRB1 0405 subtype is the most studied up to date. Treatment is based on the administration of high doses of systemic corticos-teroids, however, there is not much evidence that specifically evaluates the efficacy of these medications on their audiovestibular manifestations. This article presents a clinical case of VKH syndrome with concomitant hearing impairment and carries out a short narrative review of the literature.

Characteristics and influencing factors of hearing loss among noise-exposed workers in a large machinery maintenance enterprise / 环境与职业医学

Background The current increasing trend of new cases of occupational noise-induced deafness indicates that the hearing loss of occupational population has not been effectively controlled in China. It is of great significance to study the characteristics of hearing loss among noise-exposed workers and its related factors. Objective To investigate characteristics and influencing factors of hearing loss among occupational noise-exposed workers in a large machinery maintenance enterprise, and to provide a scientific basis to prevent and control noise-induced hearing loss. Methods A cross-sectional survey was conducted to investigate male Han occupational noise-exposed workers in a large mechanical maintenance enterprise. We acquired demographic characteristics, occupational exposure history, and individual life behavior characteristics of the workers through questionnaires, collected occupational exposure level data from annual occupational disease hazard factor surveillance reports, obtained pure tone hearing threshold test data through occupational health examinations, and estimated individual noise exposure levels using cumulative noise exposure (CNE). According to the results of pure tone air conduction hearing threshold test, the workers were divided into a hearing loss group and a normal hearing group. The chi-square test was employed to compare the occupational exposure characteristics and individual life behavior characteristics between the two groups. Additionally, the trend chi-square test was utilized to analyze the changing trends of age, length of service, CNE, and hearing loss rate within the two groups. The relationship between high-frequency hearing loss in both ears and its related influencing factors was assessed by a multiple logistic regression model. Results The M (P25, P75) of CNE for the 2531 occupational noise-exposed workers was 97.51 (95.39, 99.96) dB(A)·year. The incidence of hearing anomaly, binaural high-frequency hearing anomaly, random ear high-frequency hearing anomaly, binaural low-frequency hearing anomaly, and random ear low-frequency hearing anomaly were 22.48%, 16.59%, 22.13%, 2.77%, and 3.52%, respectively. High-frequency hearing threshold increase was the main reason for hearing anomaly (98.42%). In comparison to the CNE ≤ 97 dB(A)·year group, the 97 dB(A)·year<CNE≤ 100 dB(A)·year group and the CNE>100 dB(A)·year group experienced a 36.4% and 52.3% increase in the risk of bilateral high-frequency hearing loss, respectively. The smoking group exhibited a 43.5% elevated risk of bilateral high-frequency hearing loss when compared to the non-smoking group. Conversely, the group frequently wearing hearing protection equipment demonstrated a 23.6% lower risk of bilateral high-frequency hearing loss in comparison to the group occasionally wearing protective equipment. The data suggested that CNE＞97 dB(A)·year and smoking might be independent risk factors for bilateral high-frequency hearing loss, and frequently wearing hearing protection equipment might be an important protective factor. Conclusion Increased CNE and smoking can elevate the risk of high-frequency hearing loss, while personal hearing protection can effectively reduce the risk of hearing loss.

Hearing loss and its relationship with blood pressure among workers exposed to noise in a brewery / 公共卫生与预防医学

Objective To investigate the health status of workers exposed to noise in a brewery in Beijing and to analyze the relationship between hearing loss and blood pressure. Methods A total of 949 noise-exposed workers in a brewery who participated in occupational health examination were selected as the investigation subjects. A survey was conducted to investigate the pure tone hearing threshold and abnormal blood pressure of the workers with different characteristics, and to analyze the relationship between the two. Results Among the noise-exposed workers, the detection rates of hearing abnormality, hypertension, and increased systolic and diastolic blood pressure were 73.55%, 52.37%, 43.84% and 46.47%, respectively. The detection rates of hearing abnormality, indicators of hypertension, high frequency hearing threshold abnormality and increased binaural high frequency hearing threshold on average in males were higher than those in females (P 0.05), the detection rates of other hearing abnormality, indicators of hypertension, speech frequency hearing threshold abnormality, high frequency hearing threshold abnormality，increased binaural high frequency hearing threshold on average and the weighted value of the better ear's hearing threshold all increased or had an increasing trend with the increase of age or working years (P< 0.05). The detection rates of hypertension in the groups with high frequency hearing threshold abnormality and increased binaural high frequency hearing threshold on average were higher than those in the normal group (P＜0.05). Conclusion The noise-exposed workers in the brewery have hearing impairment, which is related to the occurrence of hypertension. It is recommended to strengthen the publicity and education on noise protection and take protective measures to reduce the occurrence of occupational noise injury.

The Electroacoustic Performance of Digital Noise Reduction Systems in Commercial Hearing Aids with Malay Speech-Plus-Noise Test Signals (Prestasi Elektroakustik Sistem Pengurangan Hingar Digital dalam Alat Bantu Pendengaran Komersial dengan Isyarat Ujian Pertuturan-Dalam-Bising Bahasa Melayu) / Jurnal Sains Kesihatan Malaysia

@#One of the most frequent complaints of individuals with hearing impairment is listening comfort in noisy environments. In order to improve listening comforts in background noise, digital noise reduction (DNR) systems are incorporated into hearing aids (HAs). Each hearing aid manufacturer has its proprietary algorithm for the DNR system. The amount of attenuation (dB) provided by the DNR system can be quantified using the hearing aid analyser. However, the standard test signals in the hearing aid analyser could not quantify the attenuation of DNR for speech mixed with noise signals. Therefore, this study aimed to (i) develop speech-plus-noise test signals that incorporate Malay sentences and (ii) quantify the efficacy of DNR systems in commercial hearing aids using the newly developed test signals. Six different brands of hearing aids with identical technology but from different manufacturers were subjected to electroacoustic testing utilising newly created Malay speech-in-noise test signals with and without DNR enabled. The total root-meansquare (RMS) gain reduction for each HA was calculated. The results show that the types of noise, the signal-to-noise ratio and the gender of the speaker have a significant effect (p<0.05) on the amount of gain reduction in the HA output as a result of the DNR system in each HA . In conclusion, the newly developed Malay speech-in-noise test signals can be used to verify the efficacy of DNR system in commercial hearing aids.

Development of Chinese herbal medicine for sensorineural hearing loss

According to the World Health Organization's world report on hearing, nearly 2.5 billion people worldwide will suffer from hearing loss by 2050, which may contribute to a severe impact on individual life quality and national economies. Sensorineural hearing loss (SNHL) occurs commonly as a result of noise exposure, aging, and ototoxic drugs, and is pathologically characterized by the impairment of mechanosensory hair cells of the inner ear, which is mainly triggered by reactive oxygen species accumulation, inflammation, and mitochondrial dysfunction. Though recent advances have been made in understanding the ability of cochlear repair and regeneration, there are still no effective therapeutic drugs for SNHL. Chinese herbal medicine which is widely distributed and easily accessible in China has demonstrated a unique curative effect against SNHL with higher safety and lower cost compared with Western medicine. Herein we present trends in research for Chinese herbal medicine for the treatment of SNHL, and elucidate their molecular mechanisms of action, to pave the way for further research and development of novel effective drugs in this field.

Clinical features of CAPOS syndrome caused by maternal ATP1A3 gene variation: a case report / 临床耳鼻咽喉头颈外科杂志

CAPOS syndrome is an autosomal dominant neurological disorder caused by mutations in the ATP1A3 gene. Initial symptoms, often fever-induced, include recurrent acute ataxic encephalopathy in childhood, featuring cerebellar ataxia, optic atrophy, areflflexia, sensorineural hearing loss, and in some cases, pes cavus. This report details a case of CAPOS syndrome resulting from a maternal ATP1A3 gene mutation. Both the child and her mother exhibited symptoms post-febrile induction,including severe sensorineural hearing loss in both ears, ataxia, areflexia, and decreased vision. Additionally, the patient's mother presented with pes cavus. Genetic testing revealed a c. 2452G>A（Glu818Lys） heterozygous mutation in theATP1A3 gene in the patient . This article aims to enhance clinicians' understanding of CAPOS syndrome, emphasizing the case's clinical characteristics, diagnostic process, treatment, and its correlation with genotypeic findings.