Profil audiométrique des surdités à Brazzaville / Audiometric pattern of deafness in Brazzaville

Introduction. La surdité est une perturbation auditive correspondant à la diminution ou la suppression de la capacité d'entendre le son. L'objectif de cette étude était de déterminer le profil audiométrique de la surdité à Brazzaville Méthodologie. Il s'agissait d'une étude transversale descriptive et rétrospective réalisée dans les services d'Oto-Rhino-Laryngologie et chirurgie cervico-facialedu CHU de Brazzaville et de l'hôpital de référence de Talangaï. L'étude s'est déroulée sur une période de 12 moisallant du 01 janvier2021 au 31 décembre 2021 et avait inclus les patients présentant une hypoacousie et /ou vertige périphérique et ayant réalisé une audiométrie tonale liminaire mettant en évidence une surdité. Résultats. Nous avons étudié360 dossiers depatients atteints de surdité. La moyenne d'âge était 24,6 ans avec une prédominance féminine (57%). Les étudiants et les élèves constituaient la classe professionnelle la plus retrouvée (47,2%). Le signe fonctionnel le plus représenté était l'hypoacousie bilatérale avec 88,6%. L'audiométrie tonale liminaire était dominée par la surdité de perception moyenne (41,6%).Conclusion. La surdité estun handicap auditif invalidantdont la prise en charge pourrait être améliorée par l'utilisation de l'audiométrie tonale.

Introduction.Deafness is an auditory disturbance corresponding to the decrease or suppression of the ability to hear sound. The objective of this study was to determine the audiometric profile of deafness in Brazzaville. Methodology. This was a descriptive and retrospective cross-sectional study conducted in the Oto-Rhino-Laryngology and Cervico-Facial Surgery departments of the University Hospital of Brazzaville and the Talangai reference hospital. The study took place over a period of 12 months from January 1, 2021, to December 31, 2021, and included patients with hearing loss and/or peripheral vertigo who underwent a pure-tone audiometry revealing deafness. Results.We studied 360 medical records of patients with deafness. The average age was 24.6 years with a female predominance (57%). Students and pupils constituted the most frequently encountered professional group (47.2%). Bilateral hearing loss was the most represented functional sign, accounting for 88.6%. Pure-tone audiometry was predominantly indicative of moderate sensorineural hearing loss (41.6%). Conclusion. Deafness is a disabling auditory handicap that could benefit from improved management through the use of pure-tone audiometry.

Creencias y prácticas para el cuidado de la salud de las personas sordas de Antioquia

Objetivo: Describir las creencias y prácticas para el cuidado de la salud de personas sordas de Antioquia, con el fin de identificar necesidades en educación para la salud de esta población. Metodología: estudio cualitativo, con técnicas etnográficas, enmarcado en una investigación acción participación Se condujeron 24 entrevistas semiestructuradas y 4 grupos focales con personas sordas, en encuentros mediados por un intérprete oficial de la lengua de señas colombiana, de los que se registró video y audio, para su posterior transcripción y análisis. Resultados: Emergieron denuncias relacionadas con la barrera lingüística que les impide conocer sobre el cuidado de la salud; también surgieron creencias y prácticas adquiridas en el hogar y con pares acerca la salud sexual y reproductiva, la salud mental y los estilos de vida. Los participantes manifestaron inquietudes y preocupaciones sobre el cuidado, la salud y la enfermedad, que no han sido abordadas con claridad y en su propia lengua. Conclusiones: Las personas sordas reclaman educación para el cuidado de la salud, de calidad y bajo un enfoque diferencial, que contribuya a su autonomía, autodeterminación y al goce efectivo del derecho a la salud.

Objective: To describe the beliefs and practices for health care of deaf people in Antioquia, in order to identify health education needs of this population. Methodology: qualitative study with ethnographic techniques framed in a participatory action research; 22 semi-structured interviews and 4 focus groups were conducted with deaf people, in meetings mediated by an official interpreter of the Colombian Sign Language, of which video and audio were recorded for later transcription and analysis. Results: Complaints related to the language barrier that prevents them from knowing about health care emerged; beliefs and practices acquired at home and with peers about sexual and reproductive health, mental health, and lifestyles. The participants expressed concerns about care, health and illness that have not been addressed clearly and in their own language. Conclusions: Deaf people demand quality health care education under a differential approach, which will contribute to their autonomy, self-determination and the effective enjoyment of the right to health.

Objetivo: Descrever as crenças e práticas de atenção à saúde de pessoas surdas em Antioquia, a fim de identificar as necessidades de educação em saúde dessa população. Metodologia: estudo qualitativo com técnicas etnográficas, enquadrado numa pesquisa-ação participante; Foram realizadas 22 entrevistas semiestruturadas e 4 grupos focais com pessoas surdas, em encontros mediados por um intérprete oficial da Língua de Sinais Colombiana, dos quais foram gravados vídeo e áudio para posterior transcrição e análise. Resultados: Emergiram queixas relacionadas à barreira da língua que os impede de saber sobre os cuidados de saúde; crenças e práticas adquiridas em casa e com colegas sobre saúde sexual e reprodutiva, saúde mental e estilos de vida. Os participantes expressaram preocupações e preocupações sobre cuidados, saúde e doença que não foram abordadas de forma clara e em sua própria linguagem. Conclusões: Os surdos demandam uma educação em saúde de qualidade sob um enfoque diferenciador, que contribua para sua autonomia, autodeterminação e gozo efetivo do direito à saúde.

Colesteatoma congénito: revisión de la literatura

El colesteatoma congénito es una entidad clínica única y desafiante, que se caracteriza por acumulación anormal de queratina en el oído medio, medial a la membrana timpánica. Se presenta, mayoritariamente, en el género masculino, con una incidencia estimada de 0.12 por 100.000 habitantes, representando el 4% a 24% de los colesteatomas en población pediátrica y un 2% a 5% del total de colesteatomas. Su origen aún es controversial, siendo la teoría más aceptada, la del arresto epitelial. Su diagnóstico es clínico, variando la sintomatología según severidad del compromiso, presentándose desde hallazgo incidental, hipoacusia de conducción, hasta presentar otalgia y perforación timpánica. Las imágenes se consideran un apoyo complementario preoperatorio. El tratamiento es quirúrgico, con diferentes técnicas disponibles, las cuales se deben definir de manera individual en el caso de cada paciente. Es fundamental su diagnóstico y manejo precoz, para lograr un tratamiento oportuno con menor tasa de complicaciones y compromiso a largo plazo. A continuación, se presenta una revisión de la literatura respecto de esta patología, para difusión en nuestro medio.

Congenital cholesteatoma (CC) is a unique and challenging clinical entity characterized by abnormal accumulation of keratin in the middle ear, medial to the tympanic membrane, being more frequent in the male gender, with an estimated incidence of 0.12 per 100,000 inhabitants. It represents 4% to 24% of cholesteatomas in the pediatric population and 2% to 5% of all cholesteatomas. Its cause is still controversial, the most accepted theory being epithelial arrest. The diagnosis is clinical, varying the symptoms according to the severity of the compromise, from incidental finding, through conduction hearing loss, to presenting otalgia and tympanic perforation. Images are considered additional preoperative support. Treatment is predominantly surgical, with different techniques available, which must be defined individually. Its early discovery and management are essential to achieve proper treatment with a lower rate of complications and long-term commitment. We present a review of the literature regarding CC to provide information relevant to our area of expertise.

Implantación coclear en pacientes de edad avanzada: Resultados auditivos

Introducción: El envejecimiento de la población, así como la ampliación en las indicaciones de implantación, hace que cada día haya más pacientes implantados mayores de 65 años, lo que supone un reto a nivel de ajuste y optimización auditiva. Se ha constatado que la implantación coclear en pacientes de edad avanzada generalmente conduce a una mejoría, tanto auditiva como en la neurocognición, la depresión, el aislamiento social, la actividad física y la calidad de vida. Objetivo: Los objetivos de este estudio son valorar las características de los pacientes implantados a partir de 65 años en un centro terciario, analizar los beneficios e identificar particularidades clínicas en este grupo de pacientes. Material y Método: Se llevó a cabo un estudio retrospectivo con un seguimiento de 5 años postcirugía de pacientes con implante MED-EL y se realizó una visita preoperatoria y un seguimiento con audiometría en campo libre y audiometría verbales postquirúrgica al año, 3 años y 5 años postquirúrgico. Resultados: Se incluyó a 16 pacientes implantados unilateralmente. La edad media inicio pérdida fue de 36,75 años. La edad media de cirugía fue de 71,44 años. Los resultados auditivos fueron satisfactorios, con una media de audiometría en campo libre de 44,33 dB al año, 43,33 dB a los 3 años y 41,66 dB a los 5 años. El resultado en las audiometrías verbales (test de bisílabos y test de frases) fue mejor en el grupo de pacientes con adaptación bimodal. Conclusión: En nuestra experiencia, la implantación coclear en ≥65 años sí que logra mejorar las capacidades auditivas medidas, tanto en audiometría de campo libre como en pruebas verbales. La adaptación bimodal mejora los resultados auditivos, a pesar de la dificultad de procesamiento de los dos estímulos diferentes.

Introduction: The aging of the population, as well as the expansion in the indications for implantation means that every day there are more implanted patients over 65 years of age, which represents a challenge in terms of hearing adjustment and optimization. Cochlear implantation in elderly patients has been found to generally lead to improvements in hearing and neurocognition, depression, social isolation, physical activity, and quality of life. Aim: The objectives of this study are to assess the characteristics of patients over 65 years of age implanted in a tertiary center, analyze the benefits and identify clinical particularities in this group of patients. Material and Method: A retrospective study was carried out with a 5-year post-surgery follow-up of patients with a MED-EL implant, and a preoperative visit and follow-up with free-field audiometry and post-surgical speech audiometry were performed at one year, 3 years and 5 years post-surgery. Results: Sixteen unilaterally implanted patients were included. The mean age at onset of loss was 36.75 years. The mean age at surgery was 71.44 years. Hearing results were satisfactory, with a mean free field audiometry of 44.33 dB at one year, 43.33 dB at 3 years, and 41.66 dB at 5 years. The result in the verbal audiometries (disyllable test and sentence test) was better in the group of patients with bimodal adaptation. Conclusión: In our experience, cochlear implantation in patients ≥ 65 years of age does manage to improve hearing capacities measured both in free-field audiometry and in verbal tests. Bimodal adaptation improves auditory results, despite the difficulty ofprocessing the two different stimuli.

¿Basta con el habla? Evaluación del desarrollo del lenguaje en niños sordos prelocutivos durante los primeros seis años de vida. Una revisión sistemática / Is speech enough? Language development evaluation in the first 6 years of prelingually deaf children. A systematic review

RESUMEN Objetivo Sintetizar la información científica relevante sobre la evaluación del desarrollo del lenguaje en niños sordos prelocutivos durante los primeros seis años de vida, con el fin de determinar si es suficientes para confirmar la presencia de algún desarrollo de lenguaje en esta población, o si se requiere un enfoque más integral. Estrategia de investigación Se realizó una revisión estructurada de la literatura científica en las siguientes bases de datos: PubMed, Lilacs, Ibecs, Trip DataBase, Cochrane library, Clinical Trial y Nice. Criterios de selección revisiones sistemáticas, evaluaciones de tecnologías sanitarias, ensayos clínicos aleatorizados, estudios observacionales de cohorte y casos - controles; incluyendo publicaciones sobre evaluación de cualquier aspecto del desarrollo de lenguaje, cualquier intervención y en cualquier idioma, se excluyeron si únicamente evalúan audición o habla, sordera central, súbita, transitoria, sordoceguera, con otras discapacidades o con trastornos del espectro autista. Análisis de datos se usó la metodología GRADE para analizar la calidad de la evidencia. Resultados es factible realizar evaluaciones del desarrollo de lenguaje a niños sordos prelocutivos. Se obtiene una calidad de la evidencia moderada que sugiere cierta confianza en los resultados de las evaluaciones, siempre y cuando vengan acompañadas de una apreciación integral de otros elementos lingüísticos. Conclusión los resultados de las evaluaciones de lenguaje deben sostenerse, en mayor medida, en datos sobre el lenguaje receptivo y expresivo, y que cuyas evidencias pueden enriquecerse al adjuntar evaluaciones de elementos lingüísticos formales tanto de la modalidad oral como gestual, y de los componentes pragmáticos de los procesos comunicacionales.

ABSTRACT Purpose To synthesize the relevant scientific information regarding the assessment of language development in prelingually deaf children during their first six years of life, in order to determine whether it is sufficient to confirm the presence of some language development in this population, or if a more integrated approach would be more appropriate. Research strategies A structured review of the relevant scientific literature was carried out in the following databases: PubMed, Lilacs, Ibecs, Trip DataBase, Cochrane library, Clinical Trial and Nice. Selection criteria Systematic reviews, health technology assessments, randomized clinical trials, observational cohorts and case-control studies; including publications of assessments concerning any aspect of language development or any intervention in any language. Evaluations related exclusively to hearing and speech, to central, sudden or transient deafness, to deaf-blindness, to further disabilities or to autism spectrum disorders, were excluded. Data analysis GRADE methodology was used to analyze evidence quality. Results It is possible to evaluate the language development of prelingually deaf children. A moderate quality of evidence was obtained, suggesting that the evaluations' results are fairly trustworthy, provided that the assessments are conducted within an integrated approach of other linguistic elements. Conclusion The results of the language evaluations must be supported mostly by receptive and expressive language data, and the found evidence can be improved by combining the assessments of the formal linguistic elements of both oral and gestural modalities with the pragmatic components of the communication process.

Brazilian Society of Otology task force - Vestibular Schwannoma - evaluation and treatment

Abstract Objective: To review the literature on the diagnosis and treatment of vestibular schwannoma. Methods: Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on vestibular schwannoma were eligible for inclusion. The American College of Physicians' guideline grading system and the American Thyroid Association's guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results: The topics were divided into 2 parts: (1) Diagnosis - audiologic, electrophysiologic tests, and imaging; (2) Treatment - wait and scan protocols, surgery, radiosurgery/radiotherapy, and systemic therapy. Conclusions: Decision making in VS treatment has become more challenging. MRI can diagnose increasingly smaller tumors, which has disastrous consequences for the patients and their families. It is important to develop an individualized approach for each case, which highly depends on the experience of each surgical team.

Instrumento de evaluación de la percepción de los contrastes mínimos en Lengua de Señas Chilena - evidencias de confiabilidad / Instrument to evaluate the perception of minimal contrasts in Chilean Sign Language - reliability evidence

RESUMEN Objetivo Obtener evidencias de confiabilidad de la prueba para evaluar la percepción de los contrastes mínimos en Lengua de Señas Chilena (LSCh). Método Participaron 10 niños y adolescentes Sordos con edades entre los 7 y 14 años, que fueron evaluados con la prueba de percepción de los contrastes mínimos en LSCh. En un primer momento se les aplicó la prueba, y entre 11 y 14 días después se les reaplicó nuevamente (confiabilidad test - retest). Para analizar los datos, fue realizada la correlación Rho de Spearman. Durante la primera aplicación se solicitó autorización a los padres de los niños y adolescentes para grabar las respuestas de los participantes para que otro evaluador pudiese repuntuar los protocolos, con el fin de obtener la confiabilidad interevaluador. Para el análisis de los datos se utilizó el cálculo estadístico first-order agreement coefficient (AC1) de Gwet. Resultados En la confiabilidad test - retest se obtuvo una correlación fuerte y significativa (Rho= 0,741; p=0,014). En la confiabilidad interevaluador, los valores de concordancia obtenidos varían entre 0,962 a 1 (p<0,001), indicando que la prueba presenta concordancia casi perfecta. Conclusión La prueba de percepción de pares de mínimos en LSCh presenta confiabilidad test - retest e interevaluador satisfactoria.

ABSTRACT Purpose Obtain evidence of the test reliability to evaluate the perception of minimum contrasts in Chilean Sign Language (LSCh). Methods Ten deaf children and adolescents aged between 7 and 14 years participated in this study. They were evaluated with the test of perception of minimal contrasts in LSCh. The test was reapplied 11 and 14 days after the first application (test-retest reliability). Spearman's Rho correlation was performed. During the first application, authorization was requested from the parents of the children and adolescents to record the responses of the participants so that another evaluator could re-score the protocols, in order to obtain inter-rater reliability. First-order agreement coefficient (AC1) Gwet's was used for data analysis. Results Test-retest obtained a strong and significant correlation (Rho= 0.741; p=0.014). The concordance values obtained inter-rater vary between 0.962 and 1 (p<0.001), indicating that the test presents almost perfect concordance. Conclusion The minimum pairs perception test in LSCh presents satisfactory test-retest and inter-rater reliability.

Contributions of musical approaches to the development of auditory, speech, and language skills of children and adolescents with cochlear implants: a scoping review / Contributos das abordagens musicais no desenvolvimento das habilidades auditivas, de fala e linguagem de crianças e adolescentes usuários de implante coclear: uma revisão de escopo

ABSTRACT Purpose: to map, through a scoping review, the contributions of musical approaches to developing auditory, speech, and language skills in children and adolescents using cochlear implants (CIs). Methods: a review conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews (PRISMA-ScR) and registered in PROSPERO, under the review registration number CRD42020205581. A bibliographic search was carried out in databases in 2020 and updated in August 2023. No date or language limits were applied. Literature Review: altogether, 1,351 studies were found through the search strategy. After the eligibility assessment based on the PCC strategy, 11 studies were selected and analyzed in full text. Conclusion: the studies have demonstrated that musical approaches contribute to developing auditory, speech, and language skills in children and adolescents using CIs.

RESUMO Objetivo: mapear, por meio de uma revisão de escopo, os contributos das abordagens musicais para o desenvolvimento das habilidades auditivas, de fala e linguagem de crianças e adolescentes usuários de implante coclear (IC). Métodos: esta revisão foi conduzida de acordo com o Preferred Reporting Items for Systematic Reviews and the Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) e registrada no PROSPERO com o número de registro da revisão: CRD42020205581. Foi realizada uma busca bibliográfica nas bases de dados em 2020 e atualizada em agosto de 2023. Não foram aplicados limites de data e idioma. Revisão da Literatura: foram encontrados 1.351 estudos por meio da estratégia de busca e após a avaliação de elegibilidade baseada pela estratégia PCC, 11 estudos foram selecionados e analisados na íntegra. Conclusão: os estudos demonstraram que as abordagens musicais contribuem para o desenvolvimento das habilidades auditivas, de fala e linguagem de crianças e adolescentes usuários de IC.

Entrevista com a professora maura corcini lopes: a produção do ser surdo na experiência da educação / Interview with professor maura corcini lopes: the production of the deaf subject in the experience of education

RESUMO Ao longo da presente entrevista, a Professora Maura Corcini Lopes, da Universidade do Vale do Rio dos Sinos, desenvolve um conjunto de análises relativas à educação de surdos, a partir de uma retomada dos artigos publicados na Revista Brasileira de Educação Especial sobre a educação de surdos, ao longo das três décadas de existência desse periódico. Ela convida o leitor a refletir sobre os tipos de saberes produzidos sobre a surdez e as formas como os sujeitos com surdez foram sendo narrados nesse período. Ao voltar a olhar para os últimos 30 anos de proposição de políticas educacionais no Brasil, a Professora Maura problematiza os efeitos dessas políticas na organização de práticas escolares destinados aos alunos surdos e na forma como a sociedade se relaciona com a diferença, pós-políticas de inclusão.

ABSTRACT Throughout this interview, Professor Maura Corcini Lopes, from the Universidade do Vale do Rio dos Sinos, develops a range of analyzes related to the education of the deaf people, starting from a resumption of the articles published in the Revista Brasileira de Educação Especial on the education of the deaf, throughout the three decades of the existence of this journal. She invites the reader to reflect on the types of knowledge produced about deafness and the ways in which the subjects with deafness were being narrated during this period. When looking back at the last 30 years of proposing education policies in Brazil, Professor Maura problematizes the effects of these policies in the organization of school practices aimed at deaf students and the way in which the society relates to difference, after inclusion policies.

Analysis of combined screening results for hearing and deafness in 842 newborns in Dalian / 中国医师进修杂志

Objective:To analyze the results of the joint screening of newborn hearing and deafness genes in Dalian to provide a reference for the prevention and control of hereditary deafness.Methods:Eight hundred and forty-two neonates born in Dalian Women and Children′s Medical Group from January 1, 2022 to May 30, 2022 were screened retrospectively, using AABR (automatic brainstem evoked potential). And 20 mutation sites of common genetic deafness 4 genes , including GJB2, GJB3, SLC26A4 (PDS) and mitochondrial genes associated with drug-induced deafness (MT-RNRI)(12SrRNA), were detected by high-throughput sequencing.Results:Among the 842 newborns, 840 passed hearing screening (99.8%); 36 cases (4.3%) passed the hearing screening but not the hearing loss gene screening; 804 cases passed through the both screening (95.5%); 2 cases (0.24%) failed in the both screening. 38 cases of deafness gene mutations were detected, with a total carrying rate of 4.51% (38/842). Among them, the carrying rates of heterozygous mutations in GJB2, GJB3, SLC26A4 (PDS), MT-RNRI (12SrRNA) were 1.90%, 0.24%, 1.30%, and 0.95%, respectively. The carrying rates of GJB2/GJB3 composite heterozygous mutations were 0.12%.Conclusions:The combined screening of neonatal hearing and deafness genes can reduce the missed rate of hearing screening. The carrier rate of neonatal deafness gene in Dalian is 4.51%, with the highest GJB 2 carrier rate, followed by SLC26A4 (PDS) carrier rate.

Risk assessment of occupational noise-induced hearing loss in worker in a metal tool manufacturing enterprise / 中国职业医学

Objective To evaluate the risk of occupational noise-induced hearing loss in workers in a metal tool manufacturing enterprise, and to carry out risk classification and risk management. Methods A total of 91 male noise-exposed workers from a metal tool manufacturing enterprise in Hebei Province were selected as the research subjects using the convenience sampling method. The work site survey on occupational health and the measurement on individual noise exposure level were carried out. The ISO 1999：2013 (E) Acoustics-Estimation of Noise-Induced Hearing Loss was used to predict the risk of high frequency hearing loss (HFHL) and occupational noise-induced deafness (ONID). The risk classification and risk management were conducted using the WS/T 754-2016 Guideline for Risk Management of Occupational Noise Hazard (hereinafter referred to as WS/T 754-2016). Results The individual noise exposure intensity of workers in the six work sites of the enterprise, including blade workers, sheet punching workers, roller forging workers (hoe), hole punching workers, roller forging workers(shovels), and carpenters, exceeded the national occupational exposure limit, with the maximum volume of 91.2-104.1 dB(A). Among these workers, the positions of blade workers, sheet punching workers, and roller forging workers (hoe) were identified as critical control points for noise hazards in the enterprise. The detection rates of HFHL and ONID were 24.2% and 8.8%, respectively. The risk prediction results showed that, based on the actual noise exposure time and age of the study subjects, the risk of HFHL and ONID ranged from 1.7%-48.8% and 0.0%-29.5%, respectively. The risks of HFHL caused solely by occupational noise exposure when working up to 50.0, 55.0, and 60.0 years of age were 11.4% to 64.7%, 16.4% to 65.1%, and 17.2% to 59.4%, respectively. The risks of ONID caused solely by occupational noise exposure were 0.0% to 45.5%, 4.2% to 51.7%, and 5.9% to 57.4%, respectively. Except for the blade workers, the predicted median of potential noise-induced permanent threshold shifts (NIPTS) in the other five positions were lower than the actual values of NIPTS, with the difference ranging from 3.0-28.3 dB, and 73.3% of them underestimated by 10.0 dB or more. Conclusion The outcome of noise exposure on the hearing of workers in this enterprise are severe. Risk management should be conducted according to the WS/T 755-2016.

Epidemiological characteristics and risk factors of occupational noise deafness in Nantong Area in 2017- 2021 / 公共卫生与预防医学

Objective To investigate the epidemiological characteristics of occupational noise induced deafness (ONID) in Nantong area and analyze the risk factors. Methods A total of 421 workers in hydropower industry who underwent physical examination in the outpatient clinic of Nantong Center for Disease Control and Prevention from January 2017 to December 2021 were selected as the research subjects.168 workers without ONID were divided into control group, and 253 workers diagnosed with ONID were divided into ONID group. The expression levels of serum cortisol, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the two groups were compared and analyzed. Results There were more males than females in both groups (P<0.05). With the increase of working age, the detection rate of ONID also increased significantly (P<0.05). The hearing thresholds of left and right ears in workers of different workplaces in the ONID group were higher than those in the control group (P<0.05), and the hearing thresholds of workers in water wheel room and water machine operation duty room were higher (P<0.05). The expression levels of cortisol, IL-6 and TNF-α in the serum of ONID patients were significantly higher than those in the control group. Multivariate analysis showed that workplace, serum cortisol, IL-6 and TNF-α were the main influencing factors for ONID. Conclusion Workplace, serum cortisol, IL-6 and TNF-α are all risk factors for ONID. Appropriate measures should be taken to strengthen the prevention and treatment of noise-induced hearing loss according to the influencing factors.

A Criança Surda como Sujeito do Olhar: Infância e Surdez nas Pesquisas em Educação / Deaf Child as a Subject of the Gaze: Childhood and Deafness in Education Research

RESUMO: O objetivo deste texto é debater como infância, criança, surdez e experiência visual têm se configurado como temas investigativos na Educação, detendo-se em uma análise sobre o olhar das crianças surdas e como sua experiência visual produz e é produzida pelo olhar. Realizou-se um levantamento bibliográfico no Banco de Theses e Dissertações da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes) e nos trabalhos aprovados nas reuniões nacionais da Associação Nacional de Pós-Graduação e Pesquisa em Educação (ANPEd) - GT Educação Especial, tendo como vetor decisivo pesquisas que tinham a infância e/ou a criança surda como temas centrais. Na análise das 23 pesquisas encontradas, verificaram-se três recorrências: a criança ou a infância surda como conceitos abrangentes, pouco abordados em suas singularidades; a experiência visual da criança surda assumida como secundária à aquisição, seja de outras linguagens (como, por exemplo, a escrita), seja da Língua Brasileira de Sinais (Libras), portanto, como experiência suplementar; o conceito de aprendizagem da criança surda vinculado à imagem como recurso didático. Com base nisso, percorreram-se pesquisas e trabalhos que rompem com essas recorrências e, assim, indicam caminhos para a construção de uma agenda de pesquisa sobre criança e infância surda.

ABSTRACT: The purpose of this text is to discuss how childhood, children, deafness and visual experience have been configured as research themes in Education, focusing on an analysis of the gaze of deaf children and how their visual experience produces and is produced by the gaze. A bibliographic review was carried out in the Theses and Dissertations Database of the Coordination for the Improvement of Higher Education Personnel (CAPES) and in the approved papers for the national meetings of the National Association of Research and Graduate Studies on Education (ANPEd) -Special Education Work Group), having as a decisive vector research that had childhood and/or deaf child as central themes. In the analysis of the 23 studies founded, three recurrences were verified: deaf child or childhood as general concepts, not assumed in their singularities; the visual experience of the deaf child assumed to be secondary to the acquisition, whether of other languages (such as writing), or the Brazilian Sign Language (LIBRAS), therefore, as a supplementary experience; the concept of learning for the deaf child linked to image as a didactic resource. Based on that, research and work that break with these recurrences have been investigated and thus indicate ways for the construction of a research agenda on children and deaf childhood.

Conhecimento e comportamentos de pessoas surdas em relação às infecções sexualmente transmissíveis / Conocimiento y conductas de personas sordas en relación a las infecciones de transmisión sexual / Knowledge and behaviors of deaf people in relation to sexually transmitted infections

Objetivo: identificar o conhecimento e os comportamentos de risco para infecções sexualmente transmissíveis em pessoas surdas. Método: estudo transversal realizado com 110 pessoas surdas residentes no noroeste do Paraná, selecionadas com a técnica da bola de neve. Os dados foram coletados mediante instrumento estruturado e submetidos à análise estatística descritiva e inferencial (uso de regressão logística múltipla). Resultados: a maioria possuía pouca informação sobre as formas de transmissão e prevenção das infecções sexualmente transmissíveis (menos de 40% de acertos em relação a hepatite, a gonorreia e a sífilis, sendo que 20,9% já teve sintoma de infecção sexualmente transmissível). Nove dos 26 que tiveram relação sexual casual não usaram preservativo. Pessoas bilíngues bimodal apresentaram mais chance de conhecer formas de transmissão e prevenção das infecções sexualmente transmissíveis e ter comportamentos sexuais seguros. Considerações finais: os surdos em estudo demonstraram pouco conhecimento sobre as formas de transmissão e prevenção de infecções sexualmente transmissíveis, o que constitui desafio para os profissionais de saúde.

Objetivo: identificar los conocimientos y las conductas de riesgo en relación con las infecciones de transmisión sexual en personas sordas. Método: estudio transversal realizado con 110 personas sordas que viven en el noroeste do Paraná, seleccionadas mediante la técnica de la bola de nieve. Los datos se recolectaron mediante un instrumento estructurado y se los sometió a análisis estadístico descriptivo e inferencial (uso de regresión logística múltiple). Resultados: la mayoría poseía escasa información sobre las formas de transmisión y prevención de las infecciones de transmisión sexual (menos de 40% de respuestas correctas con respecto a hepatitis, gonorrea y sífilis, donde el 20,9% ya presentó algún síntoma de una infección de transmisión sexual). Nueve de los 26 participantes que tuvieron relaciones sexuales casuales utilizaron preservativos. Las personas bilingües bimodales presentaron mayor probabilidad de conocer formas de transmisión y prevención de las infecciones de transmisión sexual y de realizar conductas sexuales seguras. Consideraciones finales: las personas sordas incluidas en el estudio demostraron tener escasos conocimientos sobre las formas de transmisión y prevención de infecciones de transmisión sexual, lo que representa un desafío para los profesionales de la salud.

Objective: To identify the knowledge and risk behaviors for sexually transmitted infections among deaf people. Method: A cross-sectional study conducted with 110 deaf individuals living in northeastern Paraná, selected by means of the snowball technique. The data were collected by means of a structured instrument and submitted to descriptive and inferential analysis (use of multiple logistic regression). Results: Most of the participants had limited information on the transmission and prevention means for sexually transmitted infections (less than 40% of correct answers in relation to hepatitis, gonorrhea and syphilis; and 20.9% have already had symptoms of some sexually transmitted infection). Nine of the 26 subjects that had casual sexual relationships did not use condoms. Bimodal bilingual people presented more chances of knowing transmission and prevention means for sexually transmitted infections and of indulging in safe sex behaviors. Final considerations: the deaf people under study showed limited knowledge about the transmission and prevention means for sexually transmitted infections, which represents a challenge for health professionals.

Evaluación neurológica durante el primer año en niños muy bajo peso al nacer con infección por citomegalovirus / Neurological evaluation during the first year in very low birth weight children with cytomegalovirus infection

Introducción: La infección congénita por citomegalovirus es causa de pérdida auditiva y alteraciones cognitivas. La infección perinatal por este virus es más frecuente en neonatos< 1500 g y produce menos secuelas neurológicas. Objetivo: Describir la evaluación neurológica en el primer año de vida en niños muy bajo peso al nacer con infección por citomegalovirus. Métodos: Estudio descriptivo y longitudinal en el que se incuyeron 14 neonatos< 1500 g, con diagnóstico de infección congénita o perinatal por citomegalovirus; a los cuales se les realizó evaluación del neurodesarrollo, ultrasonido craneal, potenciales evocados auditivos de tallo cerebral y potenciales visuales a las 40 semanas, a los seis meses y al año de edad gestacional corregida. En la primera evaluación se realizó además, electroencefalograma. Resultados: El 43 por ciento tuvo infección congénita y 57 por ciento infección perinatal. A las 40 semanas se evaluaron completamente 79 % de los casos, a los seis meses 64 por ciento y al año 36 por ciento. No se observaron anormalidades en el ultrasonido craneal, ni en el electroencefalograma. Al año de edad corregida, se detectaron alteraciones ligeras del neurodesarrolo en 33,3 por ciento del total de casos (2/6) y con igual porcentaje en los niños con infección congénita (1/3) y perinatal (1/3). En ningún paciente evaluado se detectó sordera neurosensorial, ni daño del nervio visual. Conclusiones: Las alteraciones del neurodesarrollo encontradas al año de edad corregida pueden estar relacionadas con la prematuridad o la infección por citomegalovirus. El seguimiento a mediano y largo plazo es necesario para detectar otras secuelas neurológicas de debut tardío(AU)

Introduction: Congenital cytomegalovirus infection is a cause of hearing loss and cognitive impairments. Perinatal infection by this virus is more frequent in neonates< 1500 g and produces fewer neurological sequelae. Objective: To describe neurological evaluation in the first year of life in very low birth weight children with cytomegalovirus infection. Methods: A descriptive and longitudinal study involving 14 neonates< 1500 g, with a diagnosis of congenital or perinatal cytomegalovirus infection; to which neurodevelopmental evaluation, cranial ultrasound, auditory brain stem evoked potentials and visual potentials were performed at 40 weeks, six months and one year of corrected gestational age. In the first evaluation, electroencephalogram was also performed. Results: 43 percent had congenital infection and 57 percent perinatal infection. At 40 weeks, 79 percent of cases were fully evaluated, at six months 64 percent and at one year 36 percent. No abnormalities were observed on the cranial ultrasound or electroencephalogram. At one year of corrected age, slight alterations in neurodevelopment were detected in 33.3 percent of all cases (2/6) and with the same percentage in children with congenital (1/3) and perinatal (1/3) infection. In no patient evaluated, sensorineural deafness or visual nerve damage was detected. Conclusions: The neurodevelopmental alterations found at one year of corrected age may be related to prematurity or cytomegalovirus infection. Medium- and long-term follow-up is necessary to detect other late-onset neurological sequelae(AU)

Disfunción crónica de órganos en pacientes con drepanocitosis. Parte II: manifestaciones renales, neurológicas y sensoriales / Chronic organ dysfunction in patients with sickle cell disease. Part II: renal, neurological and sensory manifestations

Introducción: El aumento de la expectativa de vida de pacientes con drepanocitosis, provoca que se sumen comorbilidades y disfunción crónica de órganos a las manifestaciones clínicas de la enfermedad. Objetivos: Analizar las alteraciones renales, neurológicas y sensoriales que aparecen en pacientes con drepanocitosis como manifestaciones de la disfunción orgánica crónica. Métodos: Se realizó una revisión de artículos publicados en los últimos 10 años con el uso de los buscadores PubMed, SciELO y Google Académico. Los términos de búsqueda fueron: drepanocitosis, disfunción orgánica, mortalidad, proteinuria, enfermedad renal crónica, infarto cerebral silente, trastornos neurocognitivos, retinopatía, sordera neurosensorial. Análisis y síntesis de la información: El efecto combinado de afectación glomerular, tubular e intersticial acarrea una disminución paulatina de la función renal. La progresión a la enfermedad renal crónica terminal es común y se asocia a incremento de la mortalidad. Las complicaciones del sistema nervioso central también pueden tener un impacto negativo en la supervivencia o provocar secuelas que influyen en la calidad de vida de los enfermos. Las afectaciones sensoriales tienen repercusiones biopsicosociales. Se describen aspectos relacionados con la prevalencia, diagnóstico y tratamiento de estas complicaciones. Conclusiones: Un seguimiento de los pacientes basado en estrategias para prevenir y diagnosticar de forma precoz las manifestaciones de disfunción crónica de órganos, puede disminuir las consecuencias desfavorables de estas complicaciones(AU)

Introduction: The increase in life expectancy of patients with sickle cell disease causes co-morbidities and chronic organ dysfunction to be added to the clinical manifestations of the disease. Objectives: To analyze the renal, neurological and sensory alterations that appear in patients with sickle cell disease as manifestations of chronic organic dysfunction. Methods: A review of the articles published in the last ten years was carried out using the search engines PubMed, SciELO and Google Scholar. The search terms were: sickle cell disease, organ dysfunction, mortality, proteinuria, chronic kidney disease, silent cerebral infarction, neurocognitive disorders, retinopathy, sensorineural deafness Analysis and synthesis of information: The combined effect of glomerular, tubular and interstitial involvement leads to a gradual decline in kidney function. Progression to end-stage chronic kidney disease is common and is associated with increased mortality. Central nervous system complications can also have a negative impact on survival or cause sequelae that influence the quality of life of patients. Sensory impairments have biopsychosocial repercussions. Aspects related to the prevalence, diagnosis and treatment of these complications are described. Conclusions: A follow-up of patients based on strategies to prevent and diagnose early the manifestations of chronic organ dysfunction can reduce the unfavorable consequences of these complications(AU)

Congenital hearing loss: a literature review of the genetic etiology in a Mexican population / Pérdida auditiva congénita: revisión de la etiología genética en la población mexicana

Abstract Hearing loss is the most frequent sensory disorder, with an incidence of 1:1500 live newborns. In more than 50% of patients, it is associated with a genetic cause, while in up to 30% of cases, it is related to syndromic entities. We performed a literature review of studies on congenital hearing loss of genetic origin in the Mexican population. We identified eight reports that showed that the pathogenic variants most frequently associated with hearing loss are related to the GJB2 gene, although in a low percentage (3%). Other mutations were identified in the GJB6, SLC26A4, or CHD23 genes. On this basis, a possible diagnostic strategy in Mexican patients with hearing loss is to consider an initial screening of these three genes. If these genes were negative for pathogenic variants, the following steps would be to consider second-generation sequencing analysis focused on panels of genes associated with hearing loss, isolated or syndromic, and if necessary, to perform exome or whole-genome analysis. Establishing an etiologic cause is critical in clinically evaluating patients with congenital hearing loss and their families. It can help determine rehabilitation strategies, such as hearing aids or cochlear implants and provide information on disease progression and genetic counseling in this population.

Resumen La pérdida auditiva es la alteración sensorial más frecuente, con una incidencia de 1:1500 recién nacidos vivos. En más del 50% de los pacientes se asocia con una causa genética, mientras que en más del 30% de los casos se asocia con entidades sindrómicas. Se llevó a cabo una revisión de la literatura de las investigaciones sobre la pérdida auditiva congénita de origen genético en la población mexicana. Se identificaron ocho reportes en los que se demostró que las variantes patogénicas más frecuentemente asociadas con pérdida auditiva se encuentran en el gen GJB2, aunque en un porcentaje bajo (3%). Se identificaron otras mutaciones en los genes GJB6, SLC26A4 o CHD23. Con base en esta información, una posible estrategia diagnóstica en pacientes mexicanos con pérdida auditiva es considerar un primer paso en el tamiz diagnóstico con los tres genes mencionados. Si estos genes fueran negativos para variantes patogénicas, el siguiente paso sería considerar el análisis por secuenciación de segunda generación enfocado en paneles de genes asociados con pérdida auditiva, tanto aislada como sindrómica, y en caso necesario, realizar el análisis del exoma o del genoma completo. Establecer una causa etiológica es un componente crítico en la evaluación clínica de los pacientes con pérdida auditiva congénita, ya que puede ayudar a determinar las estrategias de manejo y rehabilitación, como el uso de auxiliares auditivos o implantes cocleares, proporcionar información sobre la progresión de la enfermedad y dar asesoramiento genético en esta población.

Does size of the cochlear nerve affect postoperative auditory performance in pediatric cochlear implant patients with normal cochlear nerves? / O tamanho do nervo coclear afeta o desempenho auditivo pós-operatório em pacientes pediátricos com implante coclear e nervos cocleares normais?

Abstract Introduction Cochlear implantation is an effective treatment method for severe to profound hearing loss. Many factors that may influence cochlear implantation success have been explained in previous studies. Apart from those, minor differences in size of normal cochlear nerves may affect postoperative performance. Objective To investigate whether the minor differences in cochlear nerve size in normal cochlear nerves affect postoperative cochlear implant performance. Methods 30 pediatric prelingually deaf patients who were treated with cochlear implantation were included in this study. From the reconstructed parasagittal magnetic resonance images, the diameter and cross-sectional area of the cochlear nerve on the ipsilateral and contralateral side were measured. Auditory evaluations were performed 1, 3, 6 and 12 months following the first fitting. All the analysis was performed by using EARS®, evaluation of auditory responses to speech tool. Correlation between cochlear nerve diameter, cross-sectional area and postoperative auditory perception was analyzed to determine whether variation in cochlear nerve size contributes to postoperative auditory performance. Results The mean diameter of the cochlear nerve on the ipsilateral side was 718.4 μm (504.5 − 904.3 μm) and mean cross sectional area was 0.015 cm2 (0.012 − 0.018 cm2). On the contralateral side the mean cochlear nerve diameter was 714.4 μm (502.6 − 951.4 μm) and mean cross sectional area was 0.014 cm2 (0.011 − 0.019 cm2). The correlation between the diameter and cross-sectional area of the ipsilateral and contralateral cochlear nerve revealed no significance. Mean score at first month monosyllable-trochee-polysyllable test, MTP1, was 0.17 (0.08 − 0.33), at 6th month with 6 words test, 6th month MTP6 was 0.72 (0.39 − 1.0), at 6th month with 12 words, 6th month MTP 12 was 0.46 (0.17 − 0.75) and at 12th month with 12 words, 12th month MTP12 was 0.73 (0.25 − 1.0). There was no correlation between the monosyllable-trochee-polysyllable test, values at any time with the diameter of the ipsilateral cochlear nerve. However, the first month MTP, 6th month MTP6 and 12th month MTP12 correlated with the cross-sectional area of the ipsilateral cochlear nerve. Conclusion Measuring the cross sectional area of the normal- appearing cochlear nerve may give important prognostic knowledge on cochlear implant outcomes. In patients with a larger cross sectional area the auditory performance was better and faster. Although normal appearing, slight differences on cross sectional area of the cochlear nerve may affect performance. Measuring the size of the cochlear nerve on parasagittal magnetic resonance images may provide beneficial information on the postoperative rehabilitation process.

Resumo Introdução O implante coclear é um método de tratamento eficaz para a perda auditiva grave a profunda. Muitos fatores que podem influenciar o sucesso do implante coclear foram explicados em estudos anteriores. Além desses fatores, pequenas diferenças no tamanho dos nervos cocleares normais podem afetar o desempenho pós-operatório. Objetivo Investigar se pequenas diferenças no tamanho dos nervos cocleares normais afetam o desempenho pós-operatório do implante coclear. Método Foram incluídos neste estudo 30 pacientes pediátricos surdos pré-linguais, tratados com implante coclear. A partir de imagens de ressonância magnética parassagitais reconstruídas, foram medidos o diâmetro e a área de seção transversal do nervo coclear no lado ipsilateral e contralateral. As avaliações auditivas foram feitas 1, 3, 6 e 12 meses após a primeira adaptação. Todas as análises foram feitas com a ferramenta EARS® (do inglês evaluation of auditory responses to speech). A correlação entre o diâmetro do nervo coclear, a área transversal e a percepção auditiva pós-operatória foi analisada para determinar se a variação no tamanho do nervo coclear contribui para o desempenho auditivo pós-operatório. Resultados O diâmetro médio do nervo coclear no lado ipsilateral foi de 718,4 μm (504,5 a 904,3 μm) e a área da seção transversal média foi de 0,015 cm2 (0,012-0,018 cm2). No lado contralateral, o diâmetro médio do nervo coclear foi de 714,4 μm (502,6 a 951,4 μm) e a área da seção transversal média foi de 0,014 cm2 (0,011 a 0,019 cm2). A correlação entre o diâmetro e a área transversal do nervo coclear ipsilateral e contralateral não revelou qualquer significância. O escore médio do teste monosyllable-trochee-polysyllable no primeiro mês, denominado MTP1, foi de 0,17 (0,08-0,33), no sexto mês com teste de 6 palavras, MTP6, foi de 0,72 (0,39-1,0), no sexto mês com 12 palavras, MTP12, foi de 0,46 (0,17-0,75) e no 12° mês com 12 palavras, MTP12, foi de 0,73 (0,25-1,0). Não houve correlação entre os valores do teste monosyllable-trochee-polysyllable em qualquer momento com o diâmetro do nervo coclear ipsilateral. Entretanto, o teste monosyllable-trochee-polysyllable do primeiro mês, do 6° mês, e o do 12° mês correlacionaram-se com a área transversal do nervo coclear ipsilateral. Conclusão Medir a área da secção transversal do nervo coclear de aparência normal pode fornecer conhecimento prognóstico importante sobre os resultados do implante coclear. Em pacientes com área da secção transversal maior, o desempenho auditivo foi melhor e mais rápido. Embora o nervo coclear pareça normal, pequenas diferenças na área da secção transversal do nervo coclear podem afetar o desempenho, de forma que a medida do tamanho do nervo coclear nas imagens de ressonância magnética na projeção parassagital pode fornecer informações benéficas sobre o processo de reabilitação pós-operatória.