CARLA GENTILE MATAS
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina
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- Brainstem auditory pathway of children with acute lymphoid leukemia on chemotherapy with methotrexate(2020) LEITE, Renata Aparecida; VOSGRAU, Jessica Sales; CORTEZ NETO, Leticia; SANTOS, Nayara Pereira; MATAS, Sandro Luiz de Andrade; ODONE FILHO, Vicente; MATAS, Carla GentileObjective: Investigate the auditory pathway in the brainstem of children with acute lymphoblastic leukemia submitted to chemotherapy (by intravenous or intrathecal infusion). Methods: Fourteen children aged between 2 and 12 years with diagnosis of acute lymphoid leukemia were evaluated. The following procedures were used: meatoscopy, acoustic immitance measurements, tonal audiometry, vocal audiometry, transient otoacoustic emissions, and auditory brainstem response. Results: From the 14 children with normal auditory thresholds, 35.71% showed an alteration in auditory brainstem response, with a predominance of hearing impairment in the lower brainstem. It was found that 80% of the children with alteration had used intrathecal methotrexate less than 30 days and that 40% had the highest cumulative intravenous methotrexate doses. Conclusion: Children with acute lymphoblastic leukemia submitted to chemotherapy, present auditory pathway impairment in the brainstem, with a predominance of a low brainstem.
- Study of the neural plasticity in adults and older adults new hearing aid users(2020) SOUZA, Gabriela Valiengo de; MATAS, Carla Gentile; SILVA, Liliane Aparecida Fagundes; LOBO, Ivone Ferreira Neves; SAMELLI, Alessandra GiannellaABSTRACT Purpose: to monitor, with long-latency auditory evoked potentials, the plasticity of the central auditory pathways in adults and older adults, new users of hearing aids. Methods: a total of 15 adults and older adults, aged 55 to 85 years, participated in the research. They had a symmetric bilateral mild to moderate sensorineural hearing loss, without previous experience with any type of hearing aid. The long-latency auditory evoked potentials were conducted with and without amplification, at 60 and 75 dBnHL, with speech stimulus in a sound field, in two assessment moments: up to one week after fitting the hearing aid and after six months of its use. The Student’s t-test was used for statistical analysis, considering significant the p-value < 0.05. Results: responses with lower latency values were observed for the right ear in the second assessment. Comparing the first with the second assessment, both with and without the hearing aid, an increase in the amplitude of P2-N2 was observed, as well as an increase in the latency of the P2 component at the intensity of 75 dBnHL. No statistically significant differences were observed at the intensity of 60 dBnHL. Conclusion:the use of the hearing aid promoted the plasticity of the central auditory pathways, increasing the number of neurons responsive to the sound stimuli.
- Systematic review of interventions to prevent occupational noise-induced hearing loss - a follow-up(2020) SAMELLI, Alessandra Giannella; MATAS, Carla Gentile; GOMES, Raquel Fornaziero; MORATA, Thais CatalaniPurpose: To conduct a systematic review of the effectiveness of interventions to prevent occupational hearing loss, following up on the findings of the most recent version of Cochrane systematic review on the same topic. Research strategy: Searches were carried out in PubMed, Web of Science and Scopus databases. Selection criteria: The following interventions were considered: engineering/administrative controls; hearing protection devices (HPD); and audiological monitoring. Data analysis: For bias risk analysis, each study was assessed according to randomization, allocation, blinding, outcomes, other sources of bias. Results: 475 references were obtained. Of these, 17 studies met the inclusion criteria: one randomized, one interrupted time series, and 15 before and after studies. Most studies were conducted in industries; three in military and/or shooting training environments; one in an orchestra, and one in construction. Most studies showed a high risk of bias. Six studies found a reduction in short-term exposure to noise through engineering/administrative controls; one found a positive impact due to changes in legislation; five studies have found positive effects of HPD in reducing exposure to noise and of educational trainings in the use of HPD; lastly, two studies found a reduction in noise levels and an increase in the using of HPD due to the implementation of hearing conservation programs. Conclusion: All the studies concluded that the interventions used resulted in positive effects on hearing and/or on exposure to noise. Regarding long-term effects, most studies were limited to assessing immediate or short-term effects, reinforcing that studies including long-term follow-up be developed.
- Monitoramento eletrofisiológico do sistema auditivo central em crianças nascidas pequenas para a idade gestacional(2020) ANGRISANI, Rosanna Giaffredo; MATAS, Carla Gentile; DINIZ, Edna Maria Albuquerque; GUINSBURG, Ruth; AZEVEDO, Marisa Frasson deABSTRACT Purpose To follow up the central auditory system of children born small for gestational age, through electrophysiological evaluation of hearing, in order to verify the occurrence of possible neural dysfunctions in this system. Methods A longitudinal study was carried out with 23 children divided into four groups: Term-born group, subdivided into small for gestational age (four children) and four children born with appropriate weight for gestational age, whose age at the end of the research was three years old. Preterm group subdivided into small for gestational age (seven children), and appropriate for gestational age (eight children), whose corrected age, at the end of the research was three years old. All children were subjected to assessment of auditory brainstem auditory evoked potentials at birth, at six months and at three years of age, and Long-Latency Auditory Evoked Potential at three years. Results children born at term and small for gestational age had a higher occurrence of hearing alterations in relation to the other groups, with increased latency of waves III and V and interpeaks I-III and I-V. All children presented normal evaluation in the Long-Latency Auditory Evoked Potential. Conclusion Children born term and small for gestational age present dysfunctions in neural conduction in the brainstem and should be considered at risk for alterations in the development of the auditory skills that are necessary to guarantee quality of acoustic information processing.
- COVID-19 pandemic: Challenges and advances in the Physical Therapy, Speech-Language-Hearing Science, and Occupational Therapy undergraduate programs in Brazil(2020) SAMELLI, Alessandra G.; MATAS, Carla G.; NAKAGAWA, Naomi K.; SILVA, Talita N. Rossi da; MARTINS, Milton A.; JOAO, Silvia Maria Amado
- Audiological and electrophysiological assessment of professional orchestral musicians(2020) SAMELLI, Alessandra Giannella; RABELO, Camila Maia; SILVA, Liliane Aparecida Fagundes; GONZAGA, Denise; SANTIAGO, Joyce Miranda; MAGLIARO, Fernanda Cristina Leite; MATAS, Carla GentileABSTRACT Purpose: to verify whether the frequent musical exposure can impair peripheral and central auditory pathway responses in professional orchestral musicians. Methods: 45 male individuals from 19 to 40 years old participated in the study. They were divided into two groups: one comprising 30 orchestral musicians who played strings or wind instruments, and another with 15 nonmusicians. The two groups were submitted to both conventional and high-frequency pure-tone audiometry, transient-evoked otoacoustic emissions, and frequency-following response. The results were subjected to descriptive and inferential statistical analysis, using the one-way ANOVA unmatched samples parametric test, with a 5% significance level. Results: no significant differences were observed between the hearing thresholds in both conventional and high-frequency audiometry and frequency-following response. However, there were statistically significant differences between transient-evoked otoacoustic emission responses, with lower responses to musicians in comparison to the nonmusician group. Conclusion: the results suggest that frequent musical exposure experienced by orchestral musicians can impair the cochlear hair cells’ function. Therefore, audiological monitoring is important to detect subclinical impairments.
- Effects of chemotherapy on the auditory system of children with cancer: a systematic literature review(2020) LOPES, Nila Berbardes; SILVA, Liliane Aparecida Fagundes; SAMELLI, Alessandra Giannella; MATAS, Carla GentileABSTRACT Purpose: to identify and analyze the effects of chemotherapy on the auditory system of children and/or adolescents with cancer treated with cisplatin and carboplatin, assessed through standardized audiological procedures. Methods: studies in Brazilian Portuguese and in English were searched for, as available in the databases Science Direct, PubMed, LILACS, BIREME, Embase, SciELO, Web of Science and Cochrane. The descriptors were: Hearing Loss, Audiology, Child Cancer, Chemotherapy, and Child. Articles with levels 1 and 2 of scientific evidence, published in the last 20 years (1997 to 2017), were considered, of which the audiological results were analyzed, as well as the prevalence of hearing loss in children with cancer undergoing chemotherapy. Results: 3,625 articles were found, of which only 23 were selected for analysis in the present review. Studies have shown a high incidence of sensorineural hearing loss and decrease or even loss of otoacoustic emissions in children and adolescents with cancer, even after the first dose of chemotherapy drugs, with high frequencies being the most affected. Conclusion: there is evidence that both carboplatin and especially cisplatin from the first doses may impair the hearing of children and adolescents, mainly affecting the cochlear function, thus, the importance of long-term audiological monitoring.
- Tablet-based tele-audiometry: Automated hearing screening for schoolchildren(2020) SAMELLI, Alessandra G.; RABELO, Camila M.; SANCHES, Seisse G. Gandolfi; MARTINHO, Ana C.; MATAS, Carla G.Introduction To assess the performance of a tablet-based tele-audiometry method for automated hearing screening of schoolchildren through a comparison of the results of various hearing screening approaches. Methods A total of 244 children were evaluated. Tablet-based screening results were compared with gold-standard pure-tone audiometry. Acoustic immittance measurements were also conducted. To pass the tablet-based screening, the children were required to respond to at least two out of three sounds for all the frequencies in each ear. Several hearing screening methods were analysed: exclusively tablet-based (with and without 500 Hz checked) and combined tests (series and parallel). The sensitivity, specificity, positive and negative predictive values and accuracy were calculated. Results A total of 9.43% of children presented with mild to moderate conductive hearing loss (unilateral or bilateral). Diagnostic values varied among the different hearing screening approaches that were evaluated: sensitivities ranged from 60 to 95%, specificities ranged from 44 to 91%, positive predictive values ranged from 15 to 44%, negative predictive values ranged from 95 to 99%, accuracy values ranged from 49 to 88%, and area under curve values ranged from 0.690 to 0.883. Regarding diagnostic values, the highest results were found for the tablet-based screening method and for the series approach. Discussion Compared with the results obtained by conventional audiometry and considering the diagnostic values of the different hearing screening approaches, the highest diagnostic values were generally obtained using the automated hearing screening method (including 500 Hz). Thus, this application, which was developed for the tablet computer, was shown to be a valuable hearing screening tool for use with schoolchildren. Therefore, we suggest that this hearing screening protocol has the potential to improve asynchronous tele-audiology service delivery.
- Brainstem auditory evoked potentials in children with autism spectrum disorder(2020) KAMITA, Mariana Keiko; SILVA, Liliane Aparecida Fagundes; MAGLIARO, Fernanda Cristina Leite; KAWAI, Rebeca Yuko Couto; FERNANDES, Fernanda Dreux Miranda; MATAS, Carla GentileObjectives: This study aimed to analyze the neural encoding of verbal and nonverbal stimuli in individuals with autism spectrum disorder using brainstem auditory evoked potentials. Methodology: Thirty individuals between 7 and 12 years of age and of both genders participated in this study. Fifteen were diagnosed with autism spectrum disorder, and 15 had typical development. All subjects had normal hearing and no other impairments. An electrophysiological hearing assessment was performed using brainstem auditory evoked potentials with click and speech stimuli. Results: In the brainstem auditory evoked potentials with click stimuli, the mean wave I latency was longer for the right ear in both groups, and interpeak intervals III-V were greater for the individuals with autism spectrum disorder. For brainstem auditory evoked potentials with speech stimuli, wave V latency was shorter in individuals with autism spectrum disorder. Conclusion: These data suggest that individuals with autism spectrum disorder may have a dysfunction of the central auditory nervous system for nonverbal stimuli and faster neural encoding of the initial part of the verbal stimulus, suggesting hypersensitivity to complex sounds such as speech. (C) 2019 Sociedade Brasiteira de Pediatria.
- Oxidative Stress as a Risk Factor for Hearing Changes in HIV-positive Normal Listeners(2020) MATAS, Carla G.; PADILHA, Fernanda Yasmin O. M. M.; ANGRISANI, Rosanna M. G.; SAMELLI, Alessandra G.OBJECTIVES: Human immunodeficiency virus-positive (HIV+) individuals can experience a decrease in antioxidants. Such deficiency can make inner ear cells and synapses more vulnerable to oxidative stress, resulting in auditory alterations, even in the presence of normal thresholds. This study aims to compare the audiological findings of HIV+ patients (with and without exposure to anti-retroviral treatment) to those of healthy individuals. METHODS: This was a cross-sectional observational study, comprising 42 normal-hearing adults divided into the Control Group (CG), without HIV; Group I (GI), HIV+, without exposure to the highly active anti-retroviral therapy (HAART); Group II (GII), HIV+, with exposure to HAART. All participants underwent conventional audiometry (0.25-8 kHz), high-frequency audiometry (9-20 kHz), transient evoked otoacoustic emissions (TEOAEs), efferent auditory pathway's inhibitory effect assessment, brainstem auditory evoked potentials (BAEP5), and cognitive potential (P300). RESULTS: In the comparison of the hearing thresholds between the groups, there was a statistically significant difference for most of the frequencies assessed (GII presented hearing thresholds significantly poor when compared with other groups). The presence of TEOAE and the inhibitory effect was also verified in a significantly higher number of individuals in the CG than in the other groups. As for the BAEP, there was a statistically significant difference for the interpeak intervals I-V (GII showed higher values when compared with CG). For P300, there were no statistically significant differences. CONCLUSION: Normal-hearing HIV+ individuals (with and without exposure to HAART) presented with poor performance in the audiological procedures, suggesting the presence of auditory alterations even in the presence of normal-hearing thresholds.