Hearing evaluation of portuguese school communities: school‑based audiology and hearing screening

Introduction: Hearing loss h sone raised impact in the development and academic progress of a child. In several developed countries, early detection is part of the national health plan through universal neonatal hearing screening (UNHS) and also with school hearing screening programs (SHSP), but only a few have published national data and revised protocols. Currently in Portugal, the UNHS is implemented in the main district hospitals but not the SHPS, as well we still do not make use of concrete data nor publication of studies on the national reality. Objectives: The incidence of the hearing loss and of otological problems was studied in school communities in the north of the country with 2550 participants between 3 and 17 years old. Methods: Statistical data collected within the schools with a standard auditory hearing screening protocol. All participants were evaluated with the same protocol, an audiological anamnesis, otoscopy and audiometric exam screening (500, 1000, 2000 and 4000 Hz) were fulfilled. Results: Different otological problems were identified and the audiometric screening exam counted auditory thresholds that outpointed uni and bilateral hearing loss in about 5.7% of the cases. Conclusions: The study has demonstrated that auditory school screening should take place as early as possible and be part of the primary health care to identify and direct children to appropriate rehabilitation, education and attendance. Thus, reducing high costs with late treatment.

A qualidade de vida no indivíduo com perda auditiva

Este estudo pretende medir a qualidade de vida dos indivíduos com perda auditiva (PA), definida pela perda média dos limiares aéreos tonais. Este estudo transversal quantitativo e descritivo foi conduzido entre Maio e Outubro de 2010 numa amostra de 328 indivíduos (47.0% do género masculino), com idade média ± desvio-padrão de 45.82 ± 12.93 anos, referenciados ao Gabinete de Audiologia do CHTS-UPA, EPE que foram avaliados e entrevistados. Recorreu-se à Versão Portuguesa 2 do Questionário de Estado de Saúde (SF-36v2) do CEIS-FE-UC, como instrumento para medir a qualidade de vida, complementado com um questionário de identificação e de dados sócio-demográficos e clínicos. RESULTADOS: Os indivíduos com perda auditiva que integraram a amostra do presente estudo revelaram piores percepções do Estado de Saúde do que as autopercepções dos elementos da amostra que constituiram os valores de referência, principalmente nas dimensões Saúde Geral da componente Física e nas dimensões Função Social e Saúde Mental da componente Mental da Saúde. CONCLUSÕES: a perda auditiva encontra-se negativamente associada a valores elevados de saúde, promovendo diferenças entre indivíduos com PA e indivíduos sem PA, nas dimensões do SF-36v2, Funcão Física e Social, Desempenho Físico e Emocional, Saúde Geral e Mental e Vitalidade. A avaliação da audição, a prevenção da perda auditiva e a reabilitação auditiva podem contribuir para uma melhoria do desempenho social e bemestar da população.

Avaliação auditiva de comunidades escolares portuguesas: Audiologia Escolar versus Rastreio Auditivo

Estudo da incidência da perda auditiva e de problemas otológicos em comunidades escolares do Norte do país de um totalde 2550 participantes, entre os 3 e os 17 anos de idade. Desenho do Estudo: Levantamento estatístico nas próprias instituições de ensino sendo realizado um protocolo de avaliação auditiva de rastreio. Material e Métodos: A todos os participantes foi realizado o mesmo protocolo de avaliação que consistiu numa anamnese audiológica, otoscopia e exame audiométrico de rastreio, sendo considerado como critério de inclusão a autorização prévia por parte do encarregado de educação. Resultados: Foram identificados diversos problemas otológicos e a audiometria tonal de rastreio contabilizou limiares auditivos indicativos de hipoacusia, uni e bilateralmente, em cerca de 5,7% dos casos. Conclusões: O rastreio auditivo deve ser realizado o mais precocemente possível e fazer parte integral dos cuidados de saúde primários, de modo a orientar a criança para uma educação e acompanhamento apropriados.

Analysis of the combined exposure to noise and ototoxic substances—pilot study

Abstract: Ototoxic substances have been associated to damage of the auditory system, and its effects are potentiated by noise exposure. The present study aims at analyzing auditory changes from combined exposure to noise and organic solvents, through a pilot study in the furniture industry sector. Audiological tests were performed on 44 workers, their levels of exposure to toluene, xylene and ethylbenzene were determined and the levels of noise exposure were evaluated. The results showed that workers are generally exposed to high noise levels and cabin priming filler and varnish sector workers have high levels of exposure to toluene. However, no hearing loss was registered among the workers. Workers exposed simultaneously to noise and ototoxic substances do not have a higher degree of hearing loss than those workers exposed only to noise. Thus, the results of this study did not show that the combined exposure to noise and the organic solvent is associated with hearing disorders.

Efeitos auditivos em doentes com tumores de cabeça e pescoço e tumores cerebrais sujeitos a Radioterapia e terapia combinada

Introdução: A capacidade auditiva dos doentes com neoplasias de cabeça e pescoço e tumores cerebrais pode ser comprometida com os tratamentos antineoplásicos realizados. A Quimioterapia com cisplatina pode provocar perda auditiva de condução ou neurossensorial, podendo agravar-se quando combinada com Radioterapia (RT). O objectivo deste trabalho foi a análise da relação entre a Terapia Combinada (Cisplatina+RT) e a Radioterapia isolada, e os seus efeitos adversos sobre a audição tendo em consideração a inclusão das estruturas do ouvido no campo de tratamento de RT. Métodos: Foram seguidos 10 doentes submetidos a Terapia Combinada (grupo TC) e 11 a Radioterapia isolada (grupo RT). A avaliação audiológica realizou-se antes do inicio (M1), no fim (M2) e um mês após (M3) o termo dos tratamentos e incluiu anamnese audiológica, otoscopia e audiometria tonal. Resultados: No grupo TC, 94,4% dos doentes apresentaram uma relação directamente proporcional entre a dose de radiação na cóclea e a perda auditiva. Esta relação só se verificou em 31% dos doentes do grupo RT, tendo-se verificado diferenças significativas entre grupos (p <0,001). Conclusões: Verificou-se maior incidência da perda auditiva no grupo TC relativamente ao grupo RT. Sugere-se um melhor planeamento do tratamento de RT, reduz - indo a dose à cóclea com o objectivo de minimizar a perda auditiva neurossensorial irreversível, sobretudo quando são utilizadas as duas modalidades de tratamento.

Análise da problemática da exposição dos músicos ao ruído: perceção ao ruído e determinação dos níveis de pressão sonora na prática musical em contexto escolar

A atenção face dada à problemática da perda auditiva induzida pelo ruído nos profissionais da música tem sido enfatizada estudos nos últimos anos. No entanto, no que respeita aos alunos de música, são ainda poucos os estudos que analisam esta problemática de modo a permitir compreender se estes poderão estar expostos a elevados níveis de ruído no decorrer da sua formação e desenvolver problemas auditivos. O presente estudo pretende caraterizar os níveis de pressão sonora a que alunos de música estão expostos no decorrer das aulas e analisar a perceção do risco dos mesmos e potenciais efeitos sobre o sistema auditivo. Foram analisadas duas Orquestras de Jazz e uma Orquestra Sinfónica de uma Escola Superior de Música (ESM) e de um Conservatório de Música (CM). No total foram selecionados 24 alunos de acordo com o seu instrumento, e medidos os níveis de pressão sonora em diversas aulas, ao longo de duas semanas com recurso a 8 dosímetros. Foi aplicado um questionário para a análise da perceção dos alunos ao ruído e realizados exames audiométricos para a avaliação auditiva dos alunos. Em geral, os resultados demostraram que os alunos estão expostos a níveis elevados de ruído no decurso das aulas de instrumento e ensaios. Foram obtidos elevados níveis de Lp,A,eqT na bateria, vibrafone, saxofone, trombone, clarinete e trompa. Nas três escolas, verificou-se valores mais baixos de exposição no contrabaixo, nomeadamente nas Aulas Individuais. Os valores de Lp,Cpico ultrapassaram o valor de ação inferior de 135 dB(C) na percussão e saxofone. Nas aulas teóricas os valores obtidos ultrapassaram recomendação de 35 dB(A). No que respeita à perceção dos alunos verificou-se que em geral consideram que a exposição a elevados níveis de pressão sonora não tem efeitos significativos na saúde. Apesar de se ter verificado que todos os alunos avaliados apresentam uma audição normal, tinnitus, hiperacusia, distorção e diplacusia foram identificados por um número significativo de alunos. Os resultados obtidos neste estudo refletem a necessidade de implementação de medidas de prevenção e controlo dos níveis de exposição dos alunos de música com vista a um aumento da sua consciencialização do risco.

Evaluation of the noise exposure of symphonic orchestra musicians

For musicians, the impact of noise exposure is not yet fully characterized. Some inconsistencies can be found in the methodology used to evaluate noise exposure. This study aims to analyze the noise exposure of musicians in a symphonic orchestra to understand their risk for hearing loss, applying the methodology proposed by ISO 9612:2009. Noise levels were monitored among musicians during the rehearsal of eight different repertoires. Test subjects were selected according to their instrument and position in the orchestra. Participants wore noise dosimeters throughout the rehearsals. A sound meter was used to analyze the exposure of the conductor. The results showed that musicians are exposed to high noise levels that can damage hearing. Brass, woodwind and percussion and timpani musicians were exposed to noise levels in excess of the upper exposure action level of 85 dB (A), while the other instrumental groups had a lower exposure action level of 80 dB (A). Percussion musicians were exposed to high peak noise levels of 135 dB (C). Sound levels varied by instrument, repertoire and position. Octave frequency analyses showed differences among musicians. This study suggests that musicians are at risk for hearing loss. There is a need for more effective guidelines applicable to all countries, which should define standardized procedures for determining musician noise exposure and should allow exposure level normalization to the year, including different repertoires.

Low-loss austempered ductile iron gears: experimental evaluation comparing materials and lubricants

An experimental study to evaluate the power dissipation of gears was performed. Three low-loss gear models were manufactured using standard 20° pressure angle tools. Austempered ductile iron (ADI) and 20MnCr5 carburized steel gears were tested in an FZG gear test machine using mineral, ester and polyalphaolephine (PAO)-based oils. The results compare power dissipation, the influence of different tooth flank geometries, materials and lubricants. This work concludes that conventional power-transmission gears can be replaced by these improved and more efficient low–loss models, which can be produced using common tools and that steel gears can be successfully replaced by austempered ductile iron gears.

Low torque loss gears: austempered ductile iron versus carburized steel

Low-loss power transmission gears operate at lower temperature than conventional ones because their teeth geometry is optimized to reduce friction. The main objective of this work is to compare the operating stabilization temperature and efficiency of low-loss austempered ductile iron (ADI) and carburized steel gears. Three different low-loss tooth geometries were adopted (types 311, 411 and 611, all produced using standard 20° pressure angle tools) and corresponding steel and ADI gears were tested in a FZG machine. The results obtained showed that low-loss geometries had a significant influence on power loss, gears 611 generating lower power loss than gears 311. At low speeds (500 and 1000 rpm) and high torque ADI gears generated lower power loss than steel gears. However, at high speed and high torque (high input power and high stabilization temperature) steel gears had better efficiency.

Influence of grease formulation on thrust bearings power loss

The minimization of the power loss and the use of the biodegradable greases have attracting considerable attention. To compare the energetic performance of biodegradable lubricant greases, power loss tests were performed on a modified four-ball machine. A correlation between the grease formulation and rheology was established with its energetic performance

Graphene-based biomimetic materials targeting urine metabolite as potential cancer biomarker: Application over different conductive materials for potentiometric transduction

This work presents a novel surface Smart Polymer Antibody Material (SPAM) for Carnitine (CRT, a potential biomarker of ovarian cancer), tested for the first time as ionophore in potentiometric electrodes of unconventional configuration. The SPAM material consisted of a 3D polymeric network created by surface imprinting on graphene layers. The polymer was obtained by radical polymerization of (vinylbenzyl) trimethylammonium chloride and 4-styrenesulfonic acid (signaling the binding sites), and vinyl pivalate and ethylene glycol dimethacrylate (surroundings). Non-imprinted material (NIM) was prepared as control, by excluding the template from the procedure. These materials were then used to produce several plasticized PVC membranes, testing the relevance of including the SPAM as ionophore, and the need for a charged lipophilic additive. The membranes were casted over solid conductive supports of graphite or ITO/FTO. The effect of pH upon the potentiometric response was evaluated for different pHs (2-9) with different buffer compositions. Overall, the best performance was achieved for membranes with SPAM ionophore, having a cationic lipophilic additive and tested in HEPES (4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid) buffer, pH 5.1. Better slopes were achieved when the membrane was casted on conductive glass (-57.4 mV/decade), while the best detection limits were obtained for graphite-based conductive supports (3.6 × 10−5mol/L). Good selectivity was observed against BSA, ascorbic acid, glucose, creatinine and urea, tested for concentrations up to their normal physiologic levels in urine. The application of the devices to the analysis of spiked samples showed recoveries ranging from 91% (± 6.8%) to 118% (± 11.2%). Overall, the combination of the SPAM sensory material with a suitable selective membrane composition and electrode design has lead to a promising tool for point-of-care applications.

New modified electrochemical conductive paper support for BSA detection

Chemical sensors and biosensors are widely used to detect various kinds of protein target biomolecules. Molecularly Imprinted Polymers (MIPs) have raised great interest in this area, because these act as antibody-like recognition materials, with high affinity to the template molecule. Compared to natural antibodies, these are also of lower cost and higher stability. There are different types of supports used to carry MIP materials, mostly of these made of gold, favourably assembled on a Screen Printed Electrode (SPE) strategy. For this work a new kind of support for the sensing layer was developed: conductive paper. This support was made by modifying first cellulose paper with paraffin wax (to make it waterproof), and casting a carbon-ink on it afterwards, to turn it conductive. The SPAM approach previously reported in1 was employed herein to assemble to MIP sensing material on the conductive paper. The selected charged monomers were (vinylbenzyl) trimethlammonium chloride (positive charge) or vinylbenzoic acid (negative charge), used to generate binding positions with single-type charge (positive or negative). The non-specific binding area of the MIP layer was assembled by chronoamperometry-assisted polymerization (at 1 V, for 60, 120 or 180 seconds) of vinylbenzoate, cross-linked with ethylene glycol vinyl ether. The BSA biomolecules lying within the polymeric matrix were removed by Proteinase K action. All preparation stages of the MIP assembly were followed by FTIR, Raman spectroscopy and, electrochemical analysis. In general, the best results were obtained for longer polymerization times and positively charged binding sites (which was consistent with a negatively-charged protein under physiological pH, as BSA). Linear responses against BSA concentration ranged from 0.005 to 100 mg/mL, in PBS buffer standard solutions. The sensor was further calibrated in standard solutions that were prepared in synthetic or real urine, and the analytical response became more sensitive and stable. Compared to the literature, the detection capability of the developed device is better than most of the reported electrodes. Overall, the simplicity, low cost and good analytical performance of the BSA SPE device, prepared with positively charged binding positions, seems a suitable approach for practical application in clinical context. Further studies with real samples are required, as well as gathering with electronic-supporting devices to allow on-site readings.