Limiar tonal de audibilidade de transplantados hepáticos em uso de diferentes protocolos de imunossupressão
Autor(a) principal: | |
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Data de Publicação: | 2005 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional Manancial UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/6543 |
Resumo: | Many are the problems already documented in scientific literature that can derive from immunosuppression, such as: infections, neurologic complications, systemic arterial hypertension, renal dysfunction, diabetes, bone disease, obesity, among others. Regarding hearing, there are reports in international scientific literature that associate change in the pure tone threshold of audibility to immunosuppressants. In the use of Csa, there is interaction with erythromicin and a case report of hearing loss associated with FK506. FK506 is a macrolide just like erythromycin, of which reports about sensorineural hearing loss have been described in literature for about three decades. Clinical observation of gross hearing alterations in patients subjected to orthotopic liver transplant has led to the interest in studying the auditory acuity of liver transplant patients (TxH), since in domestic literature there are no studies related with hearing in that population. The aim of this research was to verify the potential effects associated with hearing in liver transplant patients and compare the potential changes in the pure tone threshold stemming from the use of cyclosporin (Csa) and tacrolimus (FK506). The subjects were assessed by liminal pure tone audiometry for pure tone thresholds of audibility in 84 ears of 42 patients, before and after orthotopic liver transplant. The patients were divided in two groups, cyclosporin (Csa n=18) and tacrolimus (FK n=24). The statistic analysis was carried out through application of non-parametric tests and use of occupational audiology criteria. The results pointed out to a statistically significant change in pure-tone threshold, particularly in high frequencies, in orthotopic liver transplant. Csa and FK506 were assumed to have noxious effects on the inner ear of these patients. Other results showed a greater significant change in the pure-tone threshold, between the right and left ears, in high frequencies, in group FK. The analyses undertaken, from an occupational perspective, confirmed the statistic data that pointed out to a trend of change in the puretone threshold in group FK. It was concluded that: liver transplant patients showed a worse pure-tone threshold after orthotopic liver transplant; the ones using tacrolimus showed more accentuated losses than those using cyclosporin; the worsening in the pure-tone threshold of audibility is more accentuated in high frequencies; the ones using tacrolimus had a loss in the pure-tone threshold in both high and low frequencies. The effects of a worsened pure-tone threshold may be multifactorial, since these patients show more co-morbidities and, thus, are subjected to several drug treatments, being exposed to the adverse effects and side effects of the drugs used. It´s underscored, however, that in this study the patients served as witnesses to themselves before and after the orthotopic liver transplant. Further studies are suggested so that the variables can be sorted with the purpose of characterizing this population in order to institute a phonoaudiological counseling. |
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2007-03-132007-03-132005-01-28CORRÊA, Maria Elena Fortes Machado. PURE-TONE THRESHOLD OF AUDIBILITY OF LIVER TRANSPLANT PATIENTS USING DIFFERENT IMMUNOSUPPRESSION PROTOCOLS. 2005. 139 f. Dissertação (Mestrado em Fonoaudiologia) - Universidade Federal de Santa Maria, Santa Maria, 2005.http://repositorio.ufsm.br/handle/1/6543Many are the problems already documented in scientific literature that can derive from immunosuppression, such as: infections, neurologic complications, systemic arterial hypertension, renal dysfunction, diabetes, bone disease, obesity, among others. Regarding hearing, there are reports in international scientific literature that associate change in the pure tone threshold of audibility to immunosuppressants. In the use of Csa, there is interaction with erythromicin and a case report of hearing loss associated with FK506. FK506 is a macrolide just like erythromycin, of which reports about sensorineural hearing loss have been described in literature for about three decades. Clinical observation of gross hearing alterations in patients subjected to orthotopic liver transplant has led to the interest in studying the auditory acuity of liver transplant patients (TxH), since in domestic literature there are no studies related with hearing in that population. The aim of this research was to verify the potential effects associated with hearing in liver transplant patients and compare the potential changes in the pure tone threshold stemming from the use of cyclosporin (Csa) and tacrolimus (FK506). The subjects were assessed by liminal pure tone audiometry for pure tone thresholds of audibility in 84 ears of 42 patients, before and after orthotopic liver transplant. The patients were divided in two groups, cyclosporin (Csa n=18) and tacrolimus (FK n=24). The statistic analysis was carried out through application of non-parametric tests and use of occupational audiology criteria. The results pointed out to a statistically significant change in pure-tone threshold, particularly in high frequencies, in orthotopic liver transplant. Csa and FK506 were assumed to have noxious effects on the inner ear of these patients. Other results showed a greater significant change in the pure-tone threshold, between the right and left ears, in high frequencies, in group FK. The analyses undertaken, from an occupational perspective, confirmed the statistic data that pointed out to a trend of change in the puretone threshold in group FK. It was concluded that: liver transplant patients showed a worse pure-tone threshold after orthotopic liver transplant; the ones using tacrolimus showed more accentuated losses than those using cyclosporin; the worsening in the pure-tone threshold of audibility is more accentuated in high frequencies; the ones using tacrolimus had a loss in the pure-tone threshold in both high and low frequencies. The effects of a worsened pure-tone threshold may be multifactorial, since these patients show more co-morbidities and, thus, are subjected to several drug treatments, being exposed to the adverse effects and side effects of the drugs used. It´s underscored, however, that in this study the patients served as witnesses to themselves before and after the orthotopic liver transplant. Further studies are suggested so that the variables can be sorted with the purpose of characterizing this population in order to institute a phonoaudiological counseling.São muitos os problemas, já documentados na literatura científica, que podem decorrer da imunossupressão, tais como: infecções, complicações neurológicas, hipertensão arterial sistêmica, disfunção renal, diabete, doença óssea, obesidade, entre outros. Em relação à audição, há relatos na literatura científica internacional, que associam a alteração no limiar tonal de audibilidade aos imunossupressores. No uso da Csa há interação com a eritromicina e relato de um caso de perda auditiva associada com o FK506. O FK506 é um macrolídeo assim como a eritromicina cujos relatos a respeito de perda auditiva sensorioneural, são descritos na literatura há cerca de três décadas. A observação clínica de alterações grosseiras da audição, em pacientes submetidos ao transplante ortotópico de fígado (TOF), despertou o interesse por estudar a acuidade auditiva dos transplantados hepáticos (TxH), uma vez que, na literatura nacional, inexistem trabalhos relacionados à audição com esta população. O Objetivo desta pesquisa foi verificar os possíveis efeitos associados à audição em TxH e comparar possíveis alterações no limiar tonal de audibilidade (LTA) decorrentes do uso de ciclosporina (Csa) e do uso do tacrolimus (FK506). Os indivíduos foram avaliados por meio da audiometria tonal liminar para pesquisa dos limiares tonais de audibilidade (LTA) em 84 orelhas de 42 pacientes, antes e depois do TOF. Os pacientes foram divididos em dois grupos, ciclosporina (Csa n=18) e tacrolimus (FK n=24). A análise estatística foi realizada por meio da aplicação de Testes Não Paramétricos, e da utilização de critérios da audiologia ocupacional. Os resultados apontaram alteração no LTA estatisticamente significativa, em especial, nas freqüências altas, no TOF. Supõe-se que a Csa e o FK506 possam ter efeitos nocivos sobre a orelha interna desses pacientes. Outros resultados mostraram significativa alteração no LTA, entre a OD e OE, em freqüências altas, mais no Grupo FK. As análises realizadas, sob a ótica ocupacional, confirmaram os dados estatísticos, que apontaram uma tendência de alteração do LTA no Grupo FK. Concluiuse que: os pacientes transplantados hepáticos apresentam piora no LTA após o TOF; os que usam tacrolimus apresentam perdas mais acentuadas do que os da ciclosporina; a piora do LTA é mais acentuada nas freqüências altas; os que usam tacrolimus têm perda no LTA nas freqüências altas e baixas. Os efeitos de piora no LTA podem ser multifatoriais, pois esses pacientes apresentam muitas co-morbidades e, portanto, inúmeros tratamentos medicamentosos, expondo-se aos efeitos adversos ou reações colaterais das drogas utilizadas. Salienta-se, entretanto, que nesse estudo, os pacientes são testemunhos de si próprios, no pré e no pós TOF. Sugere-se mais pesquisas que possam separar as variáveis, no intuito de caracterizar essa população, para que se possa instituir aconselhamento fonoaudiológico.application/pdfporUniversidade Federal de Santa MariaPrograma de Pós-Graduação em Distúrbios da Comunicação HumanaUFSMBRFonoaudiologiaAudiometriaTransplantadosTransplante de fígadoImunossupressãoCNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIALimiar tonal de audibilidade de transplantados hepáticos em uso de diferentes protocolos de imunossupressãoPure-tone threshold of audibility of liver transplant patients using different immunosuppression protocolsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisCóser, Pedro LuizCosta, Maristela Juliohttp://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4765577E1http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4751961Y9Corrêa, Maria Elena Fortes Machado4007000000034003003003000f402368-6de4-4516-863d-cbedde3862219d511e90-613b-41fe-8c79-9a6fcf37cfcb309ec7cd-c584-4a1d-bdea-6dd7df743f02info:eu-repo/semantics/openAccessreponame:Repositório Institucional Manancial UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMORIGINALMARIAELENA.pdfapplication/pdf532122http://repositorio.ufsm.br/bitstream/1/6543/1/MARIAELENA.pdf3b4069fa7faf7e110266878521c9bf60MD51TEXTMARIAELENA.pdf.txtMARIAELENA.pdf.txtExtracted texttext/plain219089http://repositorio.ufsm.br/bitstream/1/6543/2/MARIAELENA.pdf.txt73f1abf17069b057f4a25722063a0bdfMD52THUMBNAILMARIAELENA.pdf.jpgMARIAELENA.pdf.jpgIM Thumbnailimage/jpeg5580http://repositorio.ufsm.br/bitstream/1/6543/3/MARIAELENA.pdf.jpg183b110a9e3e0e2af659750c486bc03fMD531/65432021-07-26 13:18:19.264oai:repositorio.ufsm.br:1/6543Repositório Institucionalhttp://repositorio.ufsm.br/PUBhttp://repositorio.ufsm.br/oai/requestouvidoria@ufsm.bropendoar:39132021-07-26T16:18:19Repositório Institucional Manancial UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.por.fl_str_mv |
Limiar tonal de audibilidade de transplantados hepáticos em uso de diferentes protocolos de imunossupressão |
dc.title.alternative.eng.fl_str_mv |
Pure-tone threshold of audibility of liver transplant patients using different immunosuppression protocols |
title |
Limiar tonal de audibilidade de transplantados hepáticos em uso de diferentes protocolos de imunossupressão |
spellingShingle |
Limiar tonal de audibilidade de transplantados hepáticos em uso de diferentes protocolos de imunossupressão Corrêa, Maria Elena Fortes Machado Audiometria Transplantados Transplante de fígado Imunossupressão CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA |
title_short |
Limiar tonal de audibilidade de transplantados hepáticos em uso de diferentes protocolos de imunossupressão |
title_full |
Limiar tonal de audibilidade de transplantados hepáticos em uso de diferentes protocolos de imunossupressão |
title_fullStr |
Limiar tonal de audibilidade de transplantados hepáticos em uso de diferentes protocolos de imunossupressão |
title_full_unstemmed |
Limiar tonal de audibilidade de transplantados hepáticos em uso de diferentes protocolos de imunossupressão |
title_sort |
Limiar tonal de audibilidade de transplantados hepáticos em uso de diferentes protocolos de imunossupressão |
author |
Corrêa, Maria Elena Fortes Machado |
author_facet |
Corrêa, Maria Elena Fortes Machado |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Cóser, Pedro Luiz |
dc.contributor.referee1.fl_str_mv |
Costa, Maristela Julio |
dc.contributor.referee1Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4765577E1 |
dc.contributor.authorLattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4751961Y9 |
dc.contributor.author.fl_str_mv |
Corrêa, Maria Elena Fortes Machado |
contributor_str_mv |
Cóser, Pedro Luiz Costa, Maristela Julio |
dc.subject.por.fl_str_mv |
Audiometria Transplantados Transplante de fígado Imunossupressão |
topic |
Audiometria Transplantados Transplante de fígado Imunossupressão CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA |
description |
Many are the problems already documented in scientific literature that can derive from immunosuppression, such as: infections, neurologic complications, systemic arterial hypertension, renal dysfunction, diabetes, bone disease, obesity, among others. Regarding hearing, there are reports in international scientific literature that associate change in the pure tone threshold of audibility to immunosuppressants. In the use of Csa, there is interaction with erythromicin and a case report of hearing loss associated with FK506. FK506 is a macrolide just like erythromycin, of which reports about sensorineural hearing loss have been described in literature for about three decades. Clinical observation of gross hearing alterations in patients subjected to orthotopic liver transplant has led to the interest in studying the auditory acuity of liver transplant patients (TxH), since in domestic literature there are no studies related with hearing in that population. The aim of this research was to verify the potential effects associated with hearing in liver transplant patients and compare the potential changes in the pure tone threshold stemming from the use of cyclosporin (Csa) and tacrolimus (FK506). The subjects were assessed by liminal pure tone audiometry for pure tone thresholds of audibility in 84 ears of 42 patients, before and after orthotopic liver transplant. The patients were divided in two groups, cyclosporin (Csa n=18) and tacrolimus (FK n=24). The statistic analysis was carried out through application of non-parametric tests and use of occupational audiology criteria. The results pointed out to a statistically significant change in pure-tone threshold, particularly in high frequencies, in orthotopic liver transplant. Csa and FK506 were assumed to have noxious effects on the inner ear of these patients. Other results showed a greater significant change in the pure-tone threshold, between the right and left ears, in high frequencies, in group FK. The analyses undertaken, from an occupational perspective, confirmed the statistic data that pointed out to a trend of change in the puretone threshold in group FK. It was concluded that: liver transplant patients showed a worse pure-tone threshold after orthotopic liver transplant; the ones using tacrolimus showed more accentuated losses than those using cyclosporin; the worsening in the pure-tone threshold of audibility is more accentuated in high frequencies; the ones using tacrolimus had a loss in the pure-tone threshold in both high and low frequencies. The effects of a worsened pure-tone threshold may be multifactorial, since these patients show more co-morbidities and, thus, are subjected to several drug treatments, being exposed to the adverse effects and side effects of the drugs used. It´s underscored, however, that in this study the patients served as witnesses to themselves before and after the orthotopic liver transplant. Further studies are suggested so that the variables can be sorted with the purpose of characterizing this population in order to institute a phonoaudiological counseling. |
publishDate |
2005 |
dc.date.issued.fl_str_mv |
2005-01-28 |
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2007-03-13 |
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2007-03-13 |
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CORRÊA, Maria Elena Fortes Machado. PURE-TONE THRESHOLD OF AUDIBILITY OF LIVER TRANSPLANT PATIENTS USING DIFFERENT IMMUNOSUPPRESSION PROTOCOLS. 2005. 139 f. Dissertação (Mestrado em Fonoaudiologia) - Universidade Federal de Santa Maria, Santa Maria, 2005. |
dc.identifier.uri.fl_str_mv |
http://repositorio.ufsm.br/handle/1/6543 |
identifier_str_mv |
CORRÊA, Maria Elena Fortes Machado. PURE-TONE THRESHOLD OF AUDIBILITY OF LIVER TRANSPLANT PATIENTS USING DIFFERENT IMMUNOSUPPRESSION PROTOCOLS. 2005. 139 f. Dissertação (Mestrado em Fonoaudiologia) - Universidade Federal de Santa Maria, Santa Maria, 2005. |
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