碩士 / 馬偕醫學院 / 生物醫學研究所 / 107 / Hearing loss is the most common abnormality in the sensory system and usually caused by the death or damage of inner ear hair cells. The damage or loss of hair cells may be caused by genetic mutations, aging, noise exposure, ototoxic drugs or bacterial and viral infections. No matter the etiology of hearing loss, symptoms on the pa tients are including hearing the wrong words, difficulty in receiving high frequency sounds, often asking the other person to repeat again, hard to communicate in noisy environments, loud voices, tinnitus or brain noise. These symptoms significantly reduce the quality of life of the hearing loss patients. Genetic mutation is one of the main causes of hearing loss. The prevalence of congenital genetic sensorineural hearing loss in Taiwan is about 3 5/1000, and about 2/3 of them are genetic mutations. The m ost common three sensory gene mutations in Taiwanese sensory neurological hearing loss are GJB2 , SLC26A4 and mitochondrial 12SrRNA. This study mainly focuses on the hearing loss caused by the two most common GJB2 c.109G>A (p.V37I) and c.235delC genes in T aiwanese population, and we analyze the hearing loss severity by analyzing the hearing function of patients with congenital hearing loss. In addition, we also try to discuss the role of these two GJB2 mutations in the auditory system. In this study, we extracted the DNA from the deaf patients’oral mucosa and performing Q-PCR genotyping assays to confirm their genotype, there were 58 patients with the mutations mentioned above found from the genetic screening of 240 hearing loss patients. There were 34 patients (25 GJB2 c.109G>A; 9 GJB2 c.235delC) with a total of GJB2 mutations after excluding the elder patients (above 10 years-old) that may be caused by age related degeneration. We found that the hearing loss levels in patients with GJB2 c.235delC homozygous mutation (Left ear: 80.8 ± 8.40 dB HL ; Right ear: 91.7 ± 5.40 dB HL) are significantly higher than the levels in the patients with GJB2 c.109G>A homozygous mutation (Left ear: 56.0 ± 3.60 dB HL ; Right ear: 54.5 ± 4.0 dB HL); GJB2c.109G>A heterozygous mutation (Left ear: 93.3 ± 5.60 dB HL ; Right ear: 80.7 ± 7.10 dB HL) are similar to the levels in the patients with GJB2 c.235delC heterozygous mutation (Left ear: 76.7 ± 20.9 dB HL ; Right ear: 76.7 ± 24.0 dB HL); The hearing levels in the patients with GJB2 c.235delC homozygous mutation (Left ear: 80.8 ± 8.4 0 dB HL ; Right ear: 91.7 ± 5.4 0 dB HL) are similar to the levels in the patients with GJB2 c.235delC heterozygous mutation (Left ear: 76.7 ± 20.90 dB HL ; Right ear: 76.7 ± 24.0 dB HL). The hearing levels in the patients with GJB2 c.109G> A heterozygous mutation (Left ear: 93.3 ± 5.60 dB HL ; Right ear: 80.7 ± 7.10 dB HL) is significantly higher than the levels in the patients with GJB2 c.109G>A homozygous mutation (Left ear: 56.0 ± 3.60 dB HL ; Right ear : 54.5 ± 4.0 dB HL). Based on the above results, this study provides a deeper understanding of the degree of hearing loss caused by GJB2 c.235delC and c.109G>A mutations, and we found the relevance of homozygous and heterozygous mutations of GJB2 gene in the hearing of deaf patients. Although we provide the interesting observations regarding the GJB2 heterozygous/homozygous mutations and the hearing levels, the underlying mechanisms require more studies to elucidate in the future.

<p> Traumatic Brain Injury (TBI) is one of the most prevalent causes of injury in young adults,  and is a leading cause of hospitalization, disability, and even death. Although severe TBI can lead  to serious acute injury (such as brain hemorrhaging and skull fractures) and chronic disability, the vast majority (~80%) of TBIs are mild in nature, and do not present with such drastic symptoms.  As such, these mild TBIs may go undiagnosed or underreported. Without overt, acute symptoms,  mild TBIs may be particularly insidious as they are shown to correlate with increased risk of  chronic social and cognitive processing impairments, as well as the risk of developing  neurodegenerative diseases later in life. Additionally, many people who suffer TBIs, whether on  the sports field, field of battle, or even in everyday life, often are at increased risk of additional  TBIs, which likely increase the risk of life-long post injury complications. Given these risk factors,  there is a clear need to understand how mild TBIs affect the brain both acutely and chronically and  develop tactics to properly diagnose and treat mild injuries early.  In this dissertation, we argue for the potential use of Auditory Evoked Potentials (AEPs), a  clinically used noninvasive set of tests, as an effective route for improved diagnostics of mild TBIs.  To achieve this, we must first understand the relationship between underlying anatomical changes  and chronic deficits in mild injury. In blast induced TBIs, some of the most common sequalae,  both acutely and chronically, are auditory in nature. Temporary changes in hearing thresholds or  tinnitus are very common, but chronic impairments in more complex auditory processing tasks,  such as hearing speech-in-noise, are often reported as well. Although acute changes are likely due  to damage to the peripheral auditory system, there is mounting evidence suggesting damage to central auditory regions may play a clear role in chronic processing changes, however, this is still  poorly understood. Recent studies of concussions in sports medicine have found that impact  induced TBIs may produce long-term, but not acute, deficits in subtle auditory processing function  as well. Given its potential for ubiquitous damage following TBIs of multiple forms, understanding  the post-injury central auditory system can act as a window into the time-course and severity of  secondary biochemical changes and chronic processing issues seen following mild TBI.  Here we use a well-established rat blast TBI model to examine the acute and chronic time  course of auditory processing changes, as well as biochemical and anatomical changes. We show  a clear biphasic response of acute and chronic changes in auditory processing. Changes in  oxidative stress, inflammation, and inhibition/excitation show similar patterns within key regions  of the central auditory system (CAS), suggesting a link between AEP results and underlying  chronic damage. Our second objective was to design a more clinically relevant and consistent  animal model of free-range of motion impact induced TBI. Once developed, we examined similar  AEP and immunohistochemical tests to determine the degree of similarity of CAS changes in a  second form of TBI. Interesting, while AEP results suggest some long-term changes in auditory  processing, these were not identical to blast changes. Finally, we utilized a computational model  for axonal node damage to assess one method of potential damage resulting from the oxidative  stress changes post injury and provides a framework for future modeling techniques for improved  diagnosis and treatment. These results together suggest that AEPs have the potential to improve  diagnostics and monitoring tools in mild TBIs, regardless of injury type.  </p>

Submitted by ROBERTO PAULO CORREIA DE ARAÚJO (ppgorgsistem@ufba.br) on 2015-07-17T18:49:40Z No. of bitstreams: 1 CORDEIRO, Bianca Bastos.pdf: 1858286 bytes, checksum: 4d4f3a34b1e91cb091a8bc59a6a0483a (MD5) / Made available in DSpace on 2015-07-17T18:49:40Z (GMT). No. of bitstreams: 1 CORDEIRO, Bianca Bastos.pdf: 1858286 bytes, checksum: 4d4f3a34b1e91cb091a8bc59a6a0483a (MD5) / Introdução: Dentre as deficiências humanas, a auditiva pode ser considerada uma das mais devastadoras em relação ao convívio social, pois interfere diretamente no desenvolvimento da linguagem, fala, comunicação interpessoal e aprendizagem, podendo prejudicar o desempenho escolar e profissional da população afetada. No Brasil há uma escassez de estudos que apresentem o perfil dos pacientes atendidos em programas públicos de saúde auditiva, o que dificulta o planejamento adequado de medidas de prevenção e intervenção em saúde coletiva com a finalidade de atender as reais necessidades da população. Assim, estudos epidemiológicos, ao traçarem o perfil desses pacientes, são primordiais no auxílio a esse processo e melhor atendimento aos sujeitos que possuem perda auditiva. Objetivo: Caracterizar o perfil epidemiológico e clínico-audiológico dos pacientes do setor de Audiologia do Centro Docente Assistencial de Fonoaudiologia da Universidade Federal da Bahia (CEDAF). Metodologia: Inquérito epidemiológico ambulatorial, realizado com a população atendida no setor de Audiologia do referido centro, no ano de 2013, através da análise de 456 prontuários (ficha de anamnese e laudos de exames de audiometria e imitanciometria). Resultados: A população estudada foi composta por uma maioria de pacientes do sexo feminino, residentes em Salvador, com mediana de idade de 47,15 anos e renda mediana de 1000 reais. O nível de escolaridade mais frequente foi o ensino fundamental e as ocupações mais referidas foram estudante, aposentado e dona de casa. As queixas espontâneas mais apresentadas pelos pacientes foram zumbido, hipoacusia e perda auditiva. As queixas mais frequentes referidas em perguntas direcionadas foram perda auditiva, zumbido, tontura e dificuldade de compreensão de fala. Na maior parte dos indivíduos foi detectada a presença de perda auditiva, sendo que a do tipo sensorioneural foi a mais frequente. Houve maior prevalência de perda auditiva entre os pacientes expostos a produtos químicos, que tinham passado por uma internação com risco de óbito, haviam realizado tratamento quimioterápico, com outras co-morbidades, e em fumantes e ex-fumantes. Os indicadores de acurácia e a baixa concordância entre elas mostraram que tanto a queixa de perda auditiva referida na anamnese quanto a queixa espontânea de perda auditiva não são bons indicadores para a identificação da deficiência auditiva. Conclusão: A pesquisa traz informações sobre o perfil de paciente que é atendido num serviço público de diagnóstico audiológico de referência em Salvador, o que pode auxiliar no melhor atendimento a esses pacientes e também no diagnóstico das alterações auditivas, através da análise da efetividade do protocolo de anamnese utilizado no serviço. / Introduction: Among the human deficiencies, hearing can be considered one of the most devastating in relation to social life, because it interferes directly in the development of language, speech, interpersonal communication and learning, and that may harm the academic and professional performance of the affected population. In Brazil there is a lack of studies showing the profile of patients treated in public health programs of hearing, which hinders proper planning of prevention and intervention measures in public health in order to meet the real needs of the population. Thus, epidemiological studies, as they establish the profile of these patients, are rather important in helping this process in order to better the service to individuals who have hearing loss. Objective: Characterizing the epidemiological, clinical and audiological profile of patients from the audiology care sector in the Teaching Center of Speech Pathology from Federal University of Bahia (CEDAF). Method: Outpatient epidemiological survey carried out with the population served in the audiology sector of the center previously mentioned, in 2013, through 456 medical records analysis (anamnesis form and audiometry test reports and impedance). Results: The population studied in the analysis was composed of a majority of female patients who live in Salvador, with the average age of 47,15 years old and that makes an average income of 1,000 reais; local currency which is around $ 400 American dollars. The most common level of education was the primary and the most frequently mentioned occupations were student, retired and homemaker. The most spontaneous complaints presented by patients were tinnitus, partial or complete hearing loss. The most frequent complaints reported in the leading questions were hearing loss, tinnitus, dizziness and difficulty in speech understanding. In most individuals was detected hearing loss and the sensorineural was the most common among them. There was a higher prevalence of hearing loss among patients who were exposed to chemicals, which had gone through a hospital care with risk of death, the ones who had done chemotherapy, the ones with other comorbidities, and in smokers and former ones. Accuracy indicators and the low agreement between them showed that both the hearing loss complaints reported in the anamnesis and the spontaneous complaints of hearing loss are not good indicators for hearing loss identification. Conclusion: The study provides information on the patient’s profile that is attended in a reliable public audiological diagnosis center, in Salvador, which can help to better the care for these patients as well as the diagnosis of hearing disorders, by analyzing the effectiveness of the Protocol service used in the health centers.

INTRODUCTION: HIV-1/HTLV-1 coinfection occurs in about 10% to 16.3% of the Brazilian HIV-1infected population. Human retroviruses exhibit tropism for nervous tissue but little is known about the immune mechanisms of the spinal cord injury observed in HTLV- 1/HIV-1 co-infection. Cytokines and chemokines are important inflammatory mediators and should be involved on the occurrence of myelitis. To our knowledge, no studies on chemokines have been published in co-infected individuals. OBJECTIVE: To compare the neurological manifestations and immunological characteristics of HIV-1/HTLV-1 coinfected individuals with control subjects (blood donors), monoinfected by HTLV-1 and HIV-1. METHODS: This is a descriptive cross-sectional study of 16 coinfected patients (HIV- 1/HTLV-1), 20 blood donors, 56 infected by HTLV-1 and 49 by HIV-1. Volunteers in the study groups were submitted to neurological examination, dosage of cytokines and chemokines by Cytometric Bead Array technique (CBA) and HTLV-1 proviral load. Other tests included blood T CD4+ cell counts, viral load, serology for viral hepatitis B and C and syphilis. For statistical analysis the SPSS package and the GraphPad Prism were used. The serum levels of cytokines and chemokines were measured and the individuals were classified as high and low producers. We considered high-producer individuals those who presented serum cytokines and chemokines levels above the median value of the blood donors. RESULTS: The prevalence of HTLV-1 coinfection in HIV-1 infected subjects was of 2.6%. A higher frequency of tinnitus, urinary incontinence, difficulty in climbing stairs and the presence of the Romberg sign was described in coinfected individuals. The occurrence of myelopathy did not differ between the coinfected and the monoinfected HTLV-1 group (p=0.918). The mean T CD4+ cell count was higher in the coinfected group (p=0.014). There was no difference in the proviral load (HTLV-1) and viral load (HIV-1) between the study groups. Higher serum TNF- and decreased IL-4 and CCL5/RANTES were found in the coinfected group as compared to the HTLV-1 group and lower levels of IFN- and IL-4 as compared to the HIV-1 group. High-producers analysis revealed that the IL-6 levels were similar among the three study groups. CONCLUSION: The coinfected individuals presented a higher frequency of tinnitus, difficulty in climbing stairs, urinary incontinence and the Romberg sign. Higher serum TNF- and decreased IL-4 and CCL5/RANTES were found in the coinfected group as compared to the HTLV-1 group and lower levels of IFN- and IL-4 as compared to the HIV-1 group. / INTRODUÇÃO: A coinfecção HIV-1/HTLV-1 no Brasil ocorre em cerca de 10% a 16,3% da população infectada pelo HIV-1. Tais retrovírus apresentam tropismo pelo tecido nervoso entretanto pouco se conhece sobre os mecanismos imunes da interação do HTLV-1 e do HIV- 1, bem como sobre a ocorrência de lesão medular. As citocinas e quimiocinas são importantes mediadores inflamatórios e podem se relacionar com a ocorrência de mielite. Não tem estudos sobre o comportamento das quimiocinas na coinfecção HIV-1/HTLV-1. OBJETIVO: Comparar as manifestações neurológicas e as características imunológicas dos indivíduos coinfectados pelos vírus HIV-1/HTLV-1 com as de indivíduos controles doadores de sangue, monoinfectados pelos vírus HTLV-1 e HIV-1. MÉTODOS: Trata-se de estudo descritivo transversal com 16 coinfectados (HIV-1/HTLV-1), 20 doadores de sangue, 56 infectados pelo HTLV-1 e 49 pelo HIV-1. Após exame neurológico, realizou-se a dosagem das citocinas e quimiocinas por meio da técnica de Cytometric Bead Array (CBA) e carga proviral. Realizouse ainda contagem de células T-CD4+, carga viral, sorologias para hepatites virais B e C e VDRL. Para a análise estatística usou-se os programas SPSS e GraphPad Prism. Em relação aos níveis séricos das quimiocinas e citocinas identificaram-se os indivíduos alto e baixo produtores. Consideramos alto produtor os indivíduos com níveis acima da mediana global tendo como controle o grupo doador de sangue. RESULTADOS: A prevalência de coinfecção pelo HTLV-1 nos indivíduos HIV-1 positivos foi de 2,6%. Observou-se maior frequência de zumbido, incontinência urinária, dificuldade para subir escadas e sinal de Romberg nos indivíduos coinfectados. A ocorrência de mielopatia não foi significativamente diferente nos grupos coinfectado e monoinfectado pelo HTLV-1 (p=0,918). A contagem de células T-CD4+ estava mais elevada no grupo coinfectado (p=0,014). Não houve diferença quanto à carga proviral e viral. Os coinfectados se diferenciam do grupo HTLV-1 pelo aumento dos níveis séricos de TNF-, diminuição de IL-4 e de CCL5/RANTES e dos infectados pelo HIV-1 pelos baixos níveis de IFN- e IL-4. Na análise de frequência de altos produtores, verificou-se redução dos níveis de IL-2 no coinfectado semelhante ao grupo HTLV-1 e elevação de TNF-, IL-6, CXCL8/IL-8, CXCL10/IP-10 e diminuição de CCL5/RANTES semelhante ao grupo HIV-1. CONCLUSÃO: Os indivíduos coinfectados apresentam maior frequência de queixas de zumbido, dificuldade para subir escadas, incontinência urinária e sinal de Romberg. Os coinfectados se diferenciam do grupo HTLV-1 pelo aumento dos níveis séricos de TNF-, diminuição de IL-4 e de CCL5/RANTES e dos infectados pelo HIV-1 pelos baixos níveis de IFN- e IL-4.

Objective: To determine and analyze the acoustic conditions of ambulances, their impact on hearing health and quality of workers' life and also suggest improvements to the acoustics noise control on the vehicle. Methods: This was descriptive cross sectional study in five steps. In the first step measurements were performed in ambulance for analysis of acoustic conditions including measurements of reverberation time, airborne noise insulation and equivalent continuous sound level produced by the engine and siren. In the second step measures sound pressure level were performed in the cabin of the ambulance emergency while traveling. In the third step analysis of the exposure of a worker to noise during the workday. In the fourth stage two questionnaires were applied to workers, one related to the history of life and occupation, presence of auditory and non-auditory symptoms, among other investigations of possible causes of hearing loss, and the other relating to workers' perception about the quality of life. In the last step based on analysis of data collected were proposed measures for noise control in the vehicle and preserve the workers health. Data was analyzed statistically. Results: An average reverberation time of 0.37 s was found for the ambulance cabin. The total airborne sound insulation in the rear panel was smaller. The noise level inside the ambulance due to ambulance motor operation ranged from 61.5 dB(A) (1000rpm) to 70.8 dB(A) (3000 rpm) and the noise level due to operation of the siren was equal to 74.9dB(A) with a parked ambulance. The average equivalent sound level for 12 trips exceeded 85 dB(A), above the rate allowed by NR 15, with the high noise is associated with traffic conditions and use of siren. The most frequently reported symptoms were hearing tinnitus and intolerance to loud sounds. Most non-auditory symptoms were checked irritability, headache, difficulty in communicating and sleeping. Statistically significant difference was observed when analyzing the relationship between self-perception of drivers and nursing staff on hearing acuity, tinnitus, irritability and difficulty of communication, were the most reported symptoms presented by category of drivers. The WHOQOL - Bref, which measures the quality of life of respondents according to domains: Physical, Psychological, Social Relationships and Environment, observed lower values in the environment field, which confirms the impact of environmental conditions experienced in work on quality of life of these professionals and still observed a statistically significant difference when comparing drivers and nurses in relation to the environmental domain. Conclusion: The acoustic conditions of the mobile support unit are not appropriate because a negative impact on hearing health and quality of life of employees, as may produce psychological reactions in the sick being transported. Therefore, there is a need to develop policies to improve sound insulation in ambulances and focused on general health preventive actions aiming at the preservation and adaptation of the quality of life of these professionals. / Objetivo: Determinar e analisar as condições acústicas da unidade de suporte móvel, suas repercussões na saúde auditiva e qualidade de vida dos trabalhadores e sugerir melhorias das condições acústicas para controle do ruído no veículo. Métodos: Trata-se de estudo transversal descritivo dividido em cinco etapas. Na primeira etapa foram realizadas medições na unidade de suporte móvel para análise das condições acústicas incluindo as medidas do tempo de reverberação, isolamento de ruído aéreo e nível sonoro contínuo equivalente produzido pelo motor e sirene. Na segunda etapa foram realizadas medições do nível de pressão sonora na cabine da ambulância durante as viagens de emergência. Na terceira etapa foi realizada análise da exposição de um trabalhador ao ruído durante a jornada de trabalho. Na quarta etapa foram aplicados dois questionários aos funcionários, sendo um referente à história de vida e ocupação, presença de sintomas auditivos e não auditivos, entre outras investigações de possíveis causas de perda de audição; e o outro referente à percepção dos trabalhadores sobre a qualidade de vida. Na última etapa baseado na análise dos dados coletados foram propostas medidas para controle do ruído no veículo e preservação da saúde dos trabalhadores. Os dados foram analisados estatisticamente. Resultados: Um tempo de reverberação médio de 0.37 s foi encontrado para a cabine da ambulância. O isolamento de ruído aéreo total do painel traseiro foi menor. O nível sonoro no interior da ambulância devido ao funcionamento do motor da ambulância variou de 61.5 dB(A) (1000rpm) a 70.8 dB(A) (3000 rpm) e o nível sonoro devido ao funcionamento da sirene foi igual a 74.9dB(A) com a ambulância estacionada. A média do nível sonoro contínuo equivalente durante 12 viagens foi superior a 85 dB(A), valor acima do permitido pelas Norma Regulamentadora 15, sendo que o ruído elevado estava associado às condições do trânsito e uso da sirene. Os sintomas auditivos mais relatados foram zumbido e intolerância a sons fortes. Os sintomas não auditivos mais verificados foram irritabilidade, dor de cabeça, dificuldade de comunicação e alteração no sono. Foi observada diferença estatisticamente significante ao analisar a relação entre autopercepção de motoristas e técnicos de enfermagem sobre acuidade auditiva, presença de zumbido, irritabilidade e dificuldade de comunicação, sintomas mais relatados pela categoria de motoristas. Nos escores do WHOQOL-Bref, que mensuram a qualidade de vida dos entrevistados segundo os domínios: Físico, Psicológico, Relações Sociais e Meio Ambiente, observou-se menores valores no domínio do meio ambiente, o que confirma o impacto das condições ambientais vivenciadas no trabalho na qualidade de vida desses profissionais, sendo ainda observada diferença estatisticamente significante ao compararmos motoristas e enfermeiros em relação ao domínio ambiental. Conclusão: As condições acústicas da unidade de suporte móvel não estão adequadas, pois interferem negativamente na saúde auditiva e qualidade de vida dos trabalhadores, assim como podem produzir reações psicológicas nos enfermos que estão sendo transportados. Portanto, verifica-se a necessidade do desenvolvimento de ações para melhorar o isolamento sonoro em ambulâncias e ações preventivas voltadas à saúde geral visando à preservação e adequação da qualidade de vida desses profissionais.

Trotz langjähriger klinischer Erfahrung, vielen Untersuchungen und Studien, ist die korrekte Diagnosestellung eines Morbus Menière immer noch schwierig. Diagnostische Mittel sind vor allem eine ausführliche Anamnese, die ECOG, Tonaudiogramm und der Ausschluss anderer Innenohrerkrankungen. Betroffene erleiden häufig Schwindelanfälle, Tinnitus, Ohrdruck und verlieren an Hörvermögen. Der progressive Verlauf dieser Erkrankung lässt sich meist nur verlangsamen. Häufig startet die Therapie funktionserhaltend-medikamentös mit Betahistin und Antiemetika, im weiteren Verlauf sind meist operative Eingriffe wie die Saccotomie nötig. Dabei wird der Saccus endolymphaticus aufgesucht, geschlitzt und mittels Silikondreieck offengehalten, um damit eine Entlastung des endolymphatischen Systems zu schaffen. Zeigt sich nur wenig Besserung kann destruierend fortgefahren werden. Hierbei sind vor allem die Gentamycin-Therapie und die Neurektomie oder Labyrinthektomie Mittel der Wahl. Diese Untersuchung hatte das Ziel eine weitere diagnostische Methode zu finden, um die MM-Diagnose zu sichern und eine Prognose in Bezug auf die Therapie mittels Saccotomie zu liefern. Im Fokus stand hierbei der vestibuläre Aquädukt, welcher bereits in vielen Arbeiten auffällig in Form und Lage bei MM-Patienten gewesen war. Vor allem der Bezug des Aquäduktes zu den Bogengängen und dessen Länge wurden in der vorliegenden Studie genauer betrachtet. Dies geschah durch Messungen anhand von CT-Bildern. Der Winkel zwischen den Bogengängen und dem VA und die Länge des VA wurde gemessen und ausgewertet. Dies wurde zur Bestätigung der Methode, sowohl an menschlichen Felsenbeinpräparaten mit qualitativ unterschiedlichen CT-Aufnahmen als auch an Patienten durchgeführt. Dabei konnte man keine signifikanten Unterschiede innerhalb der verschiedenen CT-Aufnahmen der Felsenbeinpräparate feststellen. Mit Bestätigung der Reliabilität dieser Methode wurden dann Patienten untersucht. Dabei wurden zwei Gruppen gebildet, Nicht-MM- und MM-Patienten. Die Nicht-MM bestanden aus Patienten mit einem Akustikusneurinom der Gegenseite oder einem Cochlea-Implantat, welche keinen MM aufwiesen. Die MM-Patienten wurden alle mit einer Saccotomie behandelt und hatten damit einen gesicherten MM. Die Auswertung der Messergebnisse stellte dar, dass bei MM-Betroffenen die Länge mit durchschnittlich 7,9 mm im Vergleich mit Nicht-Betroffenen-VA (9,5 mm), signifikant reduziert war. Auch die Ergebnisse der Winkelmessung zeigte bei allen Bogengängen signifikante Unterschiede. Um die Ergebnisse der Winkelmessung besser zu kategorisieren, wurde der VA-Score erstellt. Dieser vereinigt die Ergebnisse der drei Bogengänge zu einem Wert von 1 bis 8. Auch hier erwiesen sich die MM-Patienten als auffällig, da sich diese im VA-Score 2 mit 44% häuften. Im Gegensatz dazu waren die Ergebnisse der nicht Erkrankten breiter verteilt. Zur weiteren Auswertung zählten außerdem die anamnestischen Daten und der Verlauf der Saccotomie. Dadurch konnte der Erfolg der Behandlung bestimmt und diese mit den Untersuchungen des VA des jeweiligen Patienten korreliert werden. Dabei stellte sich heraus, dass vor allem bei VA mit hohen Winkeln und sehr kurzen VA die Erfolgsquote geringer war. Damit könnte also ein Zusammenhang zwischen Form und Lage des VA und Therapie bestehen. Um dies sicher zu bestätigen, braucht es noch mehr Patienten und eine klinisch zugelassene Software, die diese Messungen durchführen kann. Hierbei ist vor allem eine gute Bildgebung des Innenohrs wichtig, um den VA optimal messen zu können. Um die Messungen schnell und zuverlässig durchführen zu können, wäre eine Software, welche die Messungen automatisch durchführen kann, ein möglicher Ansatz. Die ausführliche Voruntersuchung wird jedoch weiterhin notwendig sein, um MM sicher zu diagnostizieren. / Despite many years of clinical experience, many examinations and studies, the correct diagnosis of Meniere's disease is still difficult. Diagnostic tools are mainly a detailed medical history, the ECOG, tonal audiogram and the exclusion of other inner ear diseases. Affected individuals frequently experience vertigo, tinnitus, ear pressure, and loss of hearing. The progressive course of this disease can usually only be slowed down. Frequently, therapy starts with function-preserving drugs such as betahistine and antiemetics; in the further course, surgical interventions such as saccotomy are usually necessary. In this procedure, the saccus endolymphaticus is located, slit and held open by means of a silicone triangle in order to relieve the endolymphatic system. If there is only little improvement, destructive procedures can be continued. Gentamycin therapy and neurectomy or labyrinthectomy are the main methods of choice. The aim of this study was to find another diagnostic method to confirm the diagnosis of MD and to provide a prognosis regarding the therapy by saccotomy. The focus was on the vestibular aqueduct, which had already been shown in many studies to be conspicuous in shape and position in MD patients. Especially the relation of the aqueduct to the semicircular canals and its length were investigated in the present study. This was done by measurements based on CT images. The angle between the semicircular canals and the VA and the length of the VA were measured and evaluated. This was done to confirm the method, both on human petrous bone specimens with qualitatively different CT images and on patients. No significant differences were found within the different CT images of the petrous bone preparations. With confirmation of the reliability of this method, patients were then studied. Two groups were formed, non-MD and MD patients. The non-MM consisted of patients with an acoustic neuroma of the opposite side or a cochlear implant who did not have MD. The MD patients were all treated with saccotomy and thus had confirmed MD. The evaluation of the measurement results showed that the length was significantly reduced in MD patients with an average of 7.9 mm compared to non-affected VA (9.5 mm). The results of angle measurement also showed significant differences in all semicircular canals. To better categorize the results of the angle measurement, the VA score was created. This combines the results of the three semicircular canals into a score of 1 to 8. Again, the MD patients proved to be conspicuous, as they clustered in VA score 2 with 44%. In contrast, the results of the non-sufferers were more widely distributed. Further evaluation also included the anamnestic data and the outcome of the saccotomy. This made it possible to determine the success of the treatment and to correlate this with the examinations of the VA of the respective patient. It was found that especially VA with high angles and very short VA had a lower success rate. Thus, there could be a correlation between the shape and position of the VA and therapy. To confirm this for sure, more patients and clinically approved software that can perform these measurements are needed. Here, good imaging of the inner ear is especially important to be able to measure the VA optimally. To be able to perform the measurements quickly and reliably, software that can perform the measurements automatically would be a possible approach. However, the detailed preliminary examination will still be necessary to diagnose MD with certainty.

INTRODUÇÃO: A audição é um dos sentidos mais importantes para o ser humano, e seu funcionamento está interligado à sua produtividade, o que não é diferente aos músicos, já que ela é de suma importância para a qualidade de seu trabalho e permanência na carreira. O desenvolvimento de um programa de prevenção de perdas auditivas tem por objetivo modificar o comportamento dos músicos em relação à sua audição, uma vez que, constantemente, estão expostos a níveis de pressão sonora elevados e ao surgimento de lesões irreversíveis. Contudo, se medidas preventivas não forem realizadas corretamente, as exposições dos músicos frente à intensidade sonora elevada podem trazer prejuízos à saúde e alguns destes, irreversíveis como, a Perda Auditiva Induzida por Níveis de Pressão Sonora Elevados (PAINPSE) ou Perda Auditiva Induzida por Música (PAIM). OBJETIVO GERAL: submeter os músicos ao programa de prevenção de perdas auditivas (PPPA) e verificar sua eficácia. MATERIAL E MÉTODOS: Participaram componentes de quatro bandas musicais, correspondendo a um total de 16 participantes. Esses membros foram submetidos ao Programa de Prevenção de Perdas Auditivas (PPPA) que engloba as seguintes etapas: (1) medição do nível de pressão sonora no ensaio e show; (2) entrevista específica, Audiometria Tonal Liminar e de Altas Frequências, Logoaudiometria, Imitanciometria e Emissões Otoacústicas por estímulo Transientes e Produto de Distorção; (3) orientação sobre a utilização do Equipamento de Proteção Individual (EPI); e (4) a realização de medidas educativas por meio de workshops. RESULTADOS: O Nível de Pressão Sonora (NPS) durante os ensaios e apresentações/shows, encontram-se elevados, sintomas não auditivos estão presentes em 68, 75% da população total da amostra, presença de zumbido após o show em 100% da amostra; maiores dificuldades de compreensão de fala no ruído nos músicos que tocam baixo (75%). Ao traçar o perfil audiológico do músico foram encontrados: maiores médias dos limiares audiológicos por frequência das bandas estudadas em 500Hz e 3KHz (B1), 3KHz e 4KHz (B2), 3KHz, 4KHz e 6KHz (B3) e em 3KHz (B4); as maiores médias dos limiares audiológicos por frequência dos instrumentos estudados foram em 3KHz, 4KHz e 6KHz (voz), 3KHz e 4KHz (guitarra), 3KHz, 4KHz e 6KHz (baixo) e 3KHz, 4KHz (bateria); presença de entalhe nas frequências de 2KHz, 4KHz, 6KHz e 8KHz na audiometria tonal liminar; já na audiometria de altas frequências em todas as frequências apareceram ao menos um caso, reflexos ausentes em 4KHz (ipsilateral e contralateral); ausência de resposta em 4KHz para todos os baixistas bilateralmente (100%) quando pesquisado EOE por estímulo transiente e na produto de distorção foram encontradas ausência de respostas em 50% da amostra na frequência de 6KHz, sendo assim pesquisada a curva de crescimento (dp growth rate) aparecendo resposta em 75dB em quase 100% dos casos em que houve necessidade de sua realização. Quanto aos achados obtidos da avaliação realizada pelos participantes (músicos) referente ao website, os resultados mostraram que o mesmo atende às necessidades propostas, ou seja, a promoção da saúde auditiva em músicos. CONCLUSÃO: Existe a necessidade de serem tomadas medidas preventivas e a inserção dos músicos em um Programa de Prevenção de Perdas Auditivas (PPPA) a fim de proporcioná-los maiores condições de qualidade de vida e em seu trabalho, já que necessitam da sua audição para desempenhar com eficácia suas atividades e se manter no mercado de trabalho atuando como músico. / INTRODUCTION: Hearing is one of the most important senses for the human being, and its operation is interconnected to its productivity, which is no different to the musicians, since it is of the utmost importance for the quality of their work The development of a hearing loss prevention program, aims to modify the musicians behavior in relation to their hearing, once, constantly, are exposed to high sound pressure levels and the emergence of permanent injury. However, if preventives measures are not performed correctly, the exposures of the musicians facing the high sound intensity can bring losses to health and some of these, irreversible such as, Hearing Loss Induced by High Sound Pressure Levels (HLIHSPL) or Music-induced hearing loss (MIHL) - Noise-Induced Hearing Loss (NIHL). GENERAL OBJECTIVE: submit the musicians to the Hearing Loss Prevention Program (HLPP) and verify its effectiveness. MATERIAL AND METHODS: participated components from four musical bands, corresponding to a total of 16 participants. These members were submitted to the Hearing Loss Prevention Program (PPPA) that include the following steps: (1) measurement of the sound pressure level at the rehearsal and concert; (2) specific interview, Pure Tone Audiometry and High Frequencies, Logoaudiometry, Imitanciometry and Distortion Product Evoked Otoacoustic Emissions (DPEOE); (3) guidance on the use of Personal Protective Equipment (PPE); and (4) the achievement of educational measures through workshops. RESULTS: The Sound Pressure Level (SPL) during the rehearsals and performances/shows are elevated, symptoms not auditory are presents in 68,75% of the total sample population, presence of tinnitus after the show in 100% of the sample; major difficulties of speech comprehension in the noise of the musicians who playing bass (75%). When plotting the audiological profile of the musician were found: highest averages of audiological thresholds by frequency from the studied bands in 500Hz and 3KHz (B1), 3KHz and 4KHz (B2), 3KHz, 4KHz and 6KHz (B3) and in 3KHz (B4); the major averages of audiological frequency thresholds of the studied instruments were in 3KHz, 4KHz and 6KHz (voice), 3KHz and 4KHz (electric guitar), 3KHz, 4KHz and 6KHz (bass) and 3KHz, 4KHz (drums); presence of notch in the frequencies of 2KHz, 4KHz, 6KHz and 8 kHz in the pure tone audiometry; but in the high audiometry frequencies, in all frequencies appeared at least one case, missing reflexes in 4KHz (ipsilateral and contralateral); missing reply in 4KHz for all bassists bilaterally (100%) when researched EOE by transient stimulus and in the distortion product were found missing responses in 50% of the frequency sample of 6KHz, so researched the growth curve (dp growth rate) showing response in 75dB at almost 100% of cases which there was need for its achievement. CONCLUSION: there is a need to take preventive measures and the insertion of the musicians in the Hearing Loss Prevention Program (HLPP) in order to provide them greater conditions of quality of life and in their work, since they need their hearing to play effectively their activities and stay in the labor market working as a musician.

Made available in DSpace on 2016-04-27T18:11:56Z (GMT). No. of bitstreams: 1 Andrea Paz de Oliveira.pdf: 698490 bytes, checksum: 39bf14cf88f6257e050c4ada44797c77 (MD5) Previous issue date: 2012-07-30 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / INTRODUCTION: The balance disorders, clinically characterized as dizziness, vertigo, imbalance and falls are among the most common complaints of the elderly population. Aging impairs the ability of the central nervous system to perform the signal processing vestibular, visual and proprioceptive responsible for maintaining body balance and diminishes the capacity for adaptive changes in reflexes. These degenerative processes are responsible for the occurrence of vertigo and/or dizziness and imbalance in the geriatric population. The program of vestibular rehabilitation (VR) is composed of exercises that aim to promote the return of function of the static and dynamic balance, restoring also the spatial orientation and is one of the most effective methods to recover body balance in the elderly because it is able to decrease dizziness, better balance and consequently improve the quality of life of the elderly. OBJECTIVE: To investigate the effects of vestibular rehabilitation in a group of elderly patients with dizziness. METHOD: This is a prospective, longitudinal, qualitative and quantitative. All subjects responded to the dizziness handicap inventory (DHI Brazilian version - Dizziness Handicap Inventory) and underwent the tests of static and dynamic balance as follows: Romberg, Romberg Barre, Utenberg, Fournier and linear walking test with eyes open and eyes closed before and after the RV. There were eight VR sessions in groups of three to four subjects and the protocol used was the Cawthorne and Cooksey. The exclusion criteria was used Mini Mental State Examination - MMSE, which assists in screening the cognitive status of the elderly. RESULTS: We evaluated 10 patients, four men (40%) and 6 women (60%). In this sample, 60% of patients had tinnitus. Their ages ranged between 62 and 83 years, with a mean of 68.9 years. In the walking tests, all subjects were able to perform more tests, eyes open (EO) and Closed Eyes condition (EC) after VR, and the average VR for EO was 3.3 pre and post VR was 4,4 and provided the average pre EC VR = 1.5 and 3.7 after RV. The result of DHI was lower after the RV in all subjects, with the average of the DHI before RV was 33.8 and after RV was 8.0. CONCLUSION: The elderly with dizziness showed impaired quality of life in relation to physical, emotional and functional, evaluated the application of Brazilian DHI. After all reported a decrease in RV dizziness and improve balance with improved quality of life, both in the physical, functional and emotional. In all tests of static and dynamic seniors have improved, managing to do more tests after the RV. It was also observed that the factors age, sex and vestibular were not determining factors for the end of treatment response / INTRODUÇÃO: As alterações do equilíbrio corporal, clinicamente caracterizadas como tontura, vertigem, desequilíbrio e queda, estão entre as queixas mais comuns da população idosa. O envelhecimento compromete a habilidade do sistema nervoso central em realizar o processamento dos sinais vestibulares, visuais e proprioceptivos responsáveis pela manutenção do equilíbrio corporal, bem como diminui a capacidade de modificações dos reflexos adaptativos. Esses processos degenerativos são responsáveis pela ocorrência de vertigem e/ou tontura e de desequilíbrio na população geriátrica. O programa de Reabilitação Vestibular (RV) é composto por exercícios que objetivam promover o retorno da função dos equilíbrios estático e dinâmico, restaurando também a orientação espacial e é um dos métodos mais efetivos na recuperação do equilíbrio corporal do idoso, pois é capaz de diminuir a tontura, melhorar o equilíbrio e, consequentemente, melhorar a qualidade de vida dos idosos. OBJETIVO: Investigar os efeitos da reabilitação vestibular em um grupo de idosos com queixa de tontura. MÉTODO: trata-se de estudo prospectivo, longitudinal, quantiqualitativo. Todos os sujeitos responderam ao inventário de handicap para tontura (DHI versão brasileira - Dizziness Handicap Inventory) e realizaram os testes de equilíbrio estático e dinâmico a saber: Romberg, Romberg Barré, Utenberg, Fournier e teste de marcha linear com olhos abertos e com olhos fechados, antes e depois da RV. Foram realizadas oito sessões de RV em grupo de três a quatro sujeitos e, o protocolo utilizado foi o de Cawthorne e Cooksey. Como critério de exclusão foi utilizado o Mini Exame do Estado Mental MEEM, que auxilia na triagem do estado cognitivo do idoso. RESULTADO: Foram avaliados 10 pacientes, sendo 4 homens (40%) e 6 mulheres (60%). Nessa amostra, 60% dos pacientes apresentaram a queixa de zumbido. As idades variaram entre 62 e 83 anos, apresentando média de 68,9 anos. Nos testes de Marcha, todos os sujeitos conseguiram realizar mais testes, tanto na condição Olhos Abertos (OA) quanto na condição Olhos Fechados (OF) após a RV, sendo que a média para OA pré RV foi de 3,3 e pós RV foi de 4,4 e na condição OF a média pré RV foi de 1,5 e pós RV 3,7. O resultado do DHI foi menor após a RV em todos os sujeitos, sendo que a média do DHI pré RV foi de 33,8 e pós RV foi de 8,0. CONCLUSÃO: Os idosos com queixa de tontura apresentaram prejuízo na qualidade de vida, em relação aos aspectos físicos, funcionais e emocionais, avaliados à aplicação do DHI brasileiro. Após a RV todos relataram diminuição da tontura e melhora do equilíbrio, com melhora na qualidade de vida, tanto nos aspectos físico, funcional e emocional. Em todas as provas de equilíbrio estático e dinâmico os idosos obtiveram melhora, conseguindo fazer mais provas após a RV. Observou-se ainda que os fatores idade, sexo e exame vestibular não fatores determinantes para a resposta final do tratamento

Made available in DSpace on 2016-04-27T18:12:29Z (GMT). No. of bitstreams: 1 Marilia Bentes Paes.pdf: 1085708 bytes, checksum: 2770c549b4070939435a33f1de135462 (MD5) Previous issue date: 2008-02-25 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Introduction: There has been a worldwide demographic transition, characterized by a significant population increase in the specific age group of those who are 60 years old or older. This fact has brought an increasing concern towards elderly citizens. In this manner it is very important to carry on researches with different age groups of this particular population segment, since grouping these people simply as elders may conceal the bio-psychosocial differences existing amongst them. The subjects of this study were exclusively women. This option was made because they are the greater part of the elderly population and more frequently seek help at health units. Aim: To compare the vocal characteristics, awareness of aging, vocal complaints and vocal health of women between 60 and 90 years of age. Method: The subjects of this study were 94 elderly women, distributed in three groups: G1 (ages 60- 69), G2 (ages 70-79) and G3 (ages 80-90). A form consisting of questions on occupational aspects, everyday habits, vocal health, vocal and auditory aspects and perceptions about the aging process was filled out. Maximum phonation times of vowel /a/ and phonemes /s/ and /z/ were measured. A voice recording which registered spontaneous conversation of the subjects was also performed. Three speech therapists specialized in the voice field perceptually evaluated the recorded voices. The collected data was analyzed descriptively, and then statistical analysis was performed to compare the different age groups. Results: There was a statistically significant association between age group and vocal demand, reported difficulties to sing, reported hearing difficulties, use of hearing aids, respiratoryspeech coordination, articulation of speech and vocal quality. Although there was no statistically significant correlation between the following issues, there was a percentage increase along the age groups in other parameters: number of illnesses per person; phlegm complaints; complaints of hearing but not understanding; tinnitus complaints; reports of hearing impairments; use of hearing aids; watching television in high volumes; occurrence of low voice resonance; and awareness of vocal changes. As for the subjec􀁗􀁖􀂶􀀃􀁒􀁓􀁌􀁑􀁌􀁒􀁑􀀃􀁄􀁅􀁒􀁘􀁗􀀃􀁗􀁋􀁈􀀃 aging process, there was a predominance of references to physiological aspects and of the daily activities in the answers provided by G1 (62.5%) and by G2 (52.9%), and of emotional aspects in the answers given by G3 (53.6%). The following issues were more prevalent in answers of certain age groups: health, prejudice, social isolation and the importance of practicing physical activities, mainly in G1; sadness and loneliness in G2; tiredness, lack of physical wellness, despondency and changes in social relationships, primarily in G3. Conclusion: The comparison of women of ages 60-69, 70-79 and 80-90 leads to the conclusion that there are significant differences between age groups related to vocal demands, reported difficulties in singing, respiratory-speech coordination, articulation of speech, vocal quality, reported hearing impairments, and use of hearing aids. The physiologic and daily life aspects mainly present in the answers of G1 and G2 as well as the emotional aspects predominant of the answers in G3 are factors that affect the way these women look at aging in general, and how they feel towards their own aging process. This study enables us to reaffirm the bio-psychosocial nature of the aging process, which is different not only from one person to another, but also in each age group / Introdução: a preocupação com o idoso cresceu muito, pois despontou, no cenário mundial, uma transição demográfica, com um aumento significativo do número de pessoas com 60 anos ou mais. Considera-se fundamental realizar pesquisas com atenção às diferentes faixas etárias nesse segmento da população, pois agrupá-los simplesmente como idosos, pode ocultar as diversidades biopsicossociais existentes entre eles. Optou-se por realizar esta pesquisa somente com mulheres, pois elas constituem a maior parte da população idosa e promovem maiores demandas às unidades de saúde. Objetivo: comparar as características vocais, a propriocepção do envelhecimento, a queixa e a saúde vocal de mulheres entre 60 e 90 anos. Método: foi realizado um estudo com 94 idosas, distribuídas em três grupos: G1 (60- 69 anos), G2 (70-79 anos) e G3 (80-90 anos). Aplicou-se um formulário com questões sobre aspectos ocupacionais, hábitos cotidianos, saúde vocal, aspectos auditivos, aspectos vocais e percepção sobre o envelhecimento. Foram medidos os tempos máximos de fonação na emissão da vogal /a/ e nos fonemas /s/ e /z/. Realizou-se uma gravação da voz, na qual foi registrada a fala espontânea das participantes. Três juízes fonoaudiólogos especialistas em voz realizaram a análise perceptivo-auditiva das vozes. Foi realizada análise descritiva dos dados coletados e, por meio de análise estatística, realizaram-se as comparações entre as faixas etárias. Resultados: observou-se associação estatisticamente significativa entre a faixa etária e a demanda vocal, o relato de dificuldade para cantar, o relato de dificuldade para ouvir, o uso de prótese auditiva, a coordenação pneumo-fonoarticulatória, a articulação e a qualidade vocal. Apesar de não ter havido correlação estatisticamente significativa, notou-se um aumento percentual, a cada faixa etária, em outros parâmetros: número de doenças por pessoa; queixa de pigarro; queixa de que ouve, mas não compreende; queixa de zumbido; relato de alteração auditiva; uso de prótese auditiva; uso da televisão em volume alto; ocorrência de ressonância baixa; e percepção de mudança na voz. Quanto à opinião sobre o envelhecimento, houve predomínio de aspectos fisiológicos e de atividades cotidianas nas respostas do G1 (62,5%) e G2 (52,9%), e de aspectos emocionais e/ou psíquicos no G3 (53,6%). Emergiram de forma mais prevalente em algumas faixas etárias os seguintes fatores: a saúde, o preconceito, o isolamento social e a importância da realização de atividades, principalmente no G1; tristeza e solidão, no G2; o cansaço, a falta de disposição física, o desânimo e as modificações nas relações sociais, primordialmente no G3. Conclusão: A comparação entre as idosas de 60 a 69 anos, 70 a 79 anos e de 80 a 90 anos permitiu concluir que existem diferenças significativas, entre as faixas etárias, em relação à demanda vocal, ao relato de dificuldade para cantar, à coordenação pneumo-fonoarticulatória, à articulação, à qualidade vocal, ao relato de dificuldade para ouvir e ao uso de prótese auditiva. Os aspectos fisiológicos e de atividades cotidianas, mais citados pelo G1 e G2, e os aspectos emocionais e psíquicos, mais freqüentes nos discursos do G3, surgiram como fatores que afetam o modo como as idosas vêem a velhice e se sentem em relação ao seu próprio envelhecimento. Por meio desta pesquisa, pôde-se reafirmar a natureza biopsicossocial do envelhecimento e que este é um processo com diferenciações de uma pessoa para outra e a cada faixa etária

Trata-se de estudo descritivo, exploratório, transversal, quantitativo, realizado com mulheres em tratamento quimioterápico para neoplasias de mama, em Aracaju-Sergipe-Brasil. O objetivo foi avaliar a qualidade de vida relacionada à saúde (QVRS) destas mulheres que apresentaram reações adversas pós quimioterapia. Foram utilizados instrumentos contendo dados sócio demográficos, clínicos e terapêuticos, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 e formulário de registro de toxicidades dos antineoplásicos. Na análise dos dados, foram utilizados análise descritiva, cálculos de percentual, teste de Shapiro-Wilk, coeficiente de correlação de Pearson ou de Spearman, teste de ANOVA ou Kruskal-Wallis. Os resultados mostraram dados de 206 mulheres, a partir da segunda sessão de quimioterapia, com média de idade de 53,1 anos, maioria procedente de Sergipe, com Carcinoma Ductal Infiltrante, estadiamento III. A maioria realizou cirurgia oncológica, não realizaram radioterapia devido à grande fila de espera, o protocolo de quimioterapia mais comum foi TAC (docetaxel, doxorrubicina e ciclofosfamida). Quanto às reações adversas, a maioria não apresentou alterações hematológicas e metabólicas no momento da coleta das informações, nas alterações funcionais, a fadiga foi presente em 80,8% dos casos, de forma moderada. Nas alterações gastrintestinais, diarreia, constipação, mucosite, náusea, vômito e dor abdominal foram citadas pela maioria. Nas alterações dermatológicas, a alopecia, hiperpigmentação na pele, alterações nas unhas, prurido na pele, descamação e eritema multiforme foram citadas pelas entrevistadas. Nas alterações cardiovasculares, hipotensão e HAS sobressaíram-se. Nas alterações neurológicas, neuropatia periférica, perda da audição e zumbido foram comuns. Os resultados da avaliação da QVRS foram analisadas à luz do referencial teórico de Ferrel et al. (1995) com os seguintes resultados: média do escore 76,01; escalas funcionais apresentaram escore baixo, com aspectos físico, emocional, cognitivo, funcional e social bastante afetados após o tratamento, o desempenho de papéis e função emocional foram os mais prejudicados; na escala de sintomas, os domínios mais prejudicados foram: dificuldades financeiras, fadiga e insônia. Na análise de correlação, o escore geral da QVRS apresentou correlação estatisticamente significante com a quantidade de reações adversas na medula óssea. Em todos os casos estatisticamente significantes o domínio emocional apresentou correlações positivas e o domínio dor, correlações negativas. A idade apresentou correlação estatisticamente significante e negativa com os domínios físico e dificuldades financeiras e positiva com perda de apetite. Pelo procedimento de comparações múltiplas, as diferenças ocorreram entre os estados civis casado e separado e também casado e solteiro, entre as religiões católica e evangélica, entre os ensinos fundamental e médio e entre médio e superior; para a extensão da doença os domínios dor e insônia apresentaram diferenças estatisticamente significantes entre as categorias de extensão. Para renda mensal, os domínios fisico, desempenho de papel, emocional, constipação e dificuldades financeiras apresentaram diferenças estatisticamente significantes entre as categorias de renda. Nos domínios fisico, desempenho de papel e emocional as diferenças ocorreram entre as faixas de 1 a 3 e mais de 6 salários. Concluiu-se que as reações adversas causadas pelo tratamento antineoplásico com quimioterapia afetaram de algum modo as pacientes, causando déficits em vários domínios, prejudicando assim sua QVRS / It is a descriptive, exploratory, cross-sectional, quantitative study with women undergoing chemotherapy for breast cancer, in Aracaju, Sergipe, Brazil. The objective was to evaluate the quality of life related to health (HRQoL) of these women who had post-chemotherapy adverse reactions. Instruments containing sociodemographic, clinical and therapeutic data, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 and toxicities registration form of antineoplastic were used. In the data analysis, descriptive analysis, percentage calculations, Shapiro-Wilk test, Pearson correlation coefficient or Spearman, ANOVA and Kruskal-Wallis test, were used. The results showed data of 206 women from the second session of chemotherapy, a mean age of 53.1 years, coming most of Sergipe, with Infiltrating Ductal Carcinoma, stage III. Most of them did cancer surgery, did not undergo radiotherapy because of the long time of waiting, the most common chemotherapy protocol was TAC (docetaxel, doxorubicin and cyclophosphamide). For side effects, most showed no hematologic and metabolic abnormalities at the time of data collection, in the functional changes, fatigue was present in 80.8% of cases, moderately. In gastrointestinal upset, diarrhea, constipation, mucositis, náusea, vomiting and abdominal pain were cited by the majority. The skin changes, alopecia, hyperpigmentation in skin, nail changes, skin rash, peeling and erythema multiforme have been mentioned by the interviewers. Cardiovascular changes, hypotension and hypertension stood up. In neurological disorders, peripheral neuropathy, hearing loss and tinnitus were common. The results of the evaluation of HRQoL were analyzed using the theoretical framework of Ferrel et al. (1995) resulting in: average score of 76.01; functional scales showed low scores, with physical, emotional, cognitive, functional and social aspects greatly affected after treatment, role playing and emotional function were the most affected; symptom scale, with most affected areas, financial difficulties, fatigue and insomnia. In the correlation analysis, the overall score of HRQoL showed a statistically significant correlation with the number of adverse reactions in the bone marrow. In all cases statistically significant emotional domain showed positive correlations and the pain domain, negative correlations. Age showed a statistically significant and negative correlation with physical areas and financial difficulties and positive with loss of appetite. Using multiple comparisons, the differences occurred between marital status and married separately and also married and unmarried, between the catholic and evangelical religions, between primary and secondary education and between secondary and higher education; to the extent of disease areas, pain and insomnia were statistically different between the extension categories. For monthly income, the physical domains, role performance, emotional, constipation and financial difficulties were statistically different between the categories of income. In the physical domain, role-playing and emotional differences occurred between tracks 1-3 and over 6 wages. It was concluded that the adverse reactions caused by anticancer chemotherapy affected in some way the patients, causing deficits in several areas, thus hampering their HRQoL