RESUMO Objetivo: Identificar e caracterizar a população de casos pediátricos encaminhados para o nosso centro de oxigenoterapia hiperbárica. Métodos: Estudo retrospetivo e observacional, que incluiu doentes pediátricos tratados com oxigenoterapia hiperbárica, de 2006 a 2021, no centro de referência de medicina hiperbárica do norte de Portugal. As variáveis de interesse foram extraídas dos processos clínicos eletrônicos. Resultados: O nosso estudo incluiu 134 casos. Os motivos de encaminhamento mais frequentes foram intoxicação por monóxido de carbono (n=59) e surdez súbita neurossensorial (n=41). Em 75 casos (56%) o tratamento foi iniciado em contexto de urgência. Os sintomas de apresentação à admissão variaram entre os diferentes casos, sendo os mais frequentes cefaleias e náuseas/vômitos. No que diz respeito à intoxicação por monóxido de carbono, as fontes mais comuns foram o aquecedor, lareira/braseiro e caldeira. Com relação aos efeitos adversos, foram identificados um caso de intoxicação por oxigênio e quatro casos de barotrauma do ouvido médio. Conclusões: A causa mais frequente de encaminhamento foi a intoxicação por monóxido de carbono. Todos os pacientes evoluíram favoravelmente e foram registrados poucos efeitos adversos, o que enfatiza a segurança desta terapia. Uma vez que a maioria dos pediatras pode não estar informada sobre os potenciais benefícios da oxigenoterapia hiperbárica, é de extrema importância promovê-los para que esta técnica seja cada vez mais implementada. Objetivo Métodos observacional 200 2021 Portugal eletrônicos Resultados 13 n=59 n59 n 59 (n=59 n=41. n41 n=41 . 41 (n=41) 7 56% 56 (56% urgência náuseasvômitos náuseas vômitos náuseas/vômitos aquecedor lareirabraseiro lareira braseiro caldeira adversos médio Conclusões terapia promovêlos promovê los implementada 20 202 1 n=5 n5 5 (n=5 n4 n=4 4 (n=41 (56 2 n= (n= (n=4 (5 (n (

ABSTRACT Objective: To identify and characterize the population of Pediatric patients referred to our hyperbaric oxygen therapy center. Methods: Retrospective and observational study, including pediatric patients treated with hyperbaric oxygen therapy, from 2006 to 2021, at the hyperbaric medicine reference center in the north of Portugal. Variables of interest were extracted from electronic medical records. Results: Our study included 134 patients. The most frequent reasons for referral were carbon monoxide poisoning (n=59) and sudden sensorineural hearing loss (n=41). In 75 cases (56%), treatment was initiated in an urgent context. Symptom presentation at Emergency Department varied among patients, the most frequent being headache and nausea/vomiting. Concerning carbon monoxide poisoning, the most common sources were water heater, fireplace/brazier, and boiler. Regarding adverse effects, it was identified one case of intoxication by oxygen and four cases of middle ear barotrauma. Conclusions: The most frequent cause for referral was carbon monoxide poisoning. All patients evolved favorably, with few side effects being reported, emphasizing the safety of this therapy. While most pediatricians may not be aware of the potential benefits arising with hyperbaric oxygen therapy, it is of upmost importance to promote them, so that this technique is increasingly implemented. Objective Methods 200 2021 Portugal records Results 13 n=59 n59 n 59 (n=59 n=41. n41 n=41 . 41 (n=41) 7 56%, 56 56% , (56%) context nauseavomiting nausea vomiting nausea/vomiting heater fireplacebrazier fireplace brazier fireplace/brazier boiler barotrauma Conclusions favorably reported them implemented 20 202 1 n=5 n5 5 (n=5 n4 n=4 4 (n=41 (56% 2 n= (n= (n=4 (56 (n (5 (

ABSTRACT We present the case of a 37-year-old woman who underwent bilateral penetrating keratoplasty for congenital hereditary endothelial dystrophy at the age of 10 years. Over the subsequent 27 years, the patient’s vision slowly deteriorated. Our examination revealed decompensation of the right corneal graft. We addressed this with regraft surgery. We then learned that the patient had been suffering from progressive hearing loss since adolescence. Tonal audiometry revealed hearing per ceptive deafness of 25 dB, which was more prominent in the left ear. Because the patterns of progressive sensorineural hearing loss and congenital hereditary endothelial dystrophy have both been linked to the same gene, slc4a11, we tested our patient for mutations in this gene. The test was positive for a heterozygous slc4a11 gene fifth exon mutation on chromosome 20p13-p12, which causes a frameshift. A combined clinical and genetic evaluation confirmed a diagnosis of Harboyan syndrome. After the genetic diagnosis of the disease, she was evaluated for the need for a hearing aid due to her hearing loss. The patient was also informed about genetic counseling. 37yearold yearold 37 year old 1 years 2 patients s deteriorated graft surgery adolescence dB ear slca slc slc4a1 20p13p12, 20p13p12 pp 20p13 p12, p12 p 20p13-p12 frameshift syndrome disease counseling 3 slc4a 20p13p1 20p1 p1 20p13-p1 20p13p 20p 20p13-p

ABSTRACT Introduction/framework/objectives: Training in Occupational Health and Security, even though employers must provide 40 hours per year to each worker, is not valued or fulfilled, in most cases, even using the most classic techniques. In recent years, Virtual Reality has evolved a lot and has developed content that can be used in this context. This review attempted to gather data on the most recent publications on the topic, even though the bibliography is reasonably scarce. Methodology: This is a Bibliographic Review, initiated through a search carried out in April 2023 in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP”. Content: Some authors distinguish Virtual from Augmented Reality, the latter consist in adding details in the moment; it is already used in Civil Construction, Health, as well as Emergency/Help/Firefighters. In the first, it will be possible to enter a non-real context, with the illusion of seeing, hearing and/or feeling in different ways, in three dimensions. Both can be used in a work context, although in terms of Occupational Health and Safety this is still little explored. Some researchers consider that the classic (and, in a certain way, passive) methodology of carrying out education and promotion in the context of Occupational Health and Safety is increasingly less appropriate. Virtual Reality technology can make the experience more appealing, didactic and interactive, even in complex and dangerous sectors, such as construction and various industrial sectors, and without participants taking real risks. Attention, memory and concentration are enhanced; as well as motivation, satisfaction and confidence, and generally more quickly. In practice, employees start to perform tasks faster, with fewer errors and with less learning time. Discussion and Conclusions: There seems to be no doubt that most individuals consider it more interesting to learn through techniques included in Virtual and/or Augmented Reality, versus classical methodologies, so it is assumed that this will be the evolution that will occur, especially when this technology becomes more accessible and economical; at least as long as there are jobs for a reasonable part of the population, if the most catastrophic predictions associated with Artificial Intelligence do not became real. It would be interesting to quantify how many companies in the country already use Virtual Reality, as well as with what specific objectives and results, publishing such summaries in specialized magazine.

RESUMO Introdução/enquadramento/objetivos: A formação no setor da Saúde e Segurança Ocupacionais, ainda que os empregadores tenham de proporcionar 40 horas anuais a cada trabalhador, não é valorizada, nem cumprida, na maioria dos casos, mesmo utilizando as técnicas mais clássicas. Nos últimos anos a Realidade Virtual tem evoluído bastante e tem desenvolvido conteúdos que poderão ser utilizados neste contexto. Tentou-se com esta revisão reunir dados do que mais recente se publicou sobre o tema, ainda que a bibliografia seja razoavelmente escassa. Metodologia: Trata-se de uma Revisão Bibliográfica, iniciada através de uma pesquisa realizada em abril de 2023 nas bases de dados “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina e RCAAP”. Conteúdo: Alguns autores distinguem Realidade Virtual de Aumentada, na medida em que esta última parte do que realmente está ao alcance visual e acrescenta informação adicional, no momento; já é utilizada a nível de Construção Civil, Saúde, bem como Emergência/Socorro/atividades no setor dos Bombeiros. Na primeira será possível entrar num contexto não real, com a ilusão de estar a ver, ouvir e/ou sentir de formas diversas, a três dimensões. Ambas podem ser utilizadas em contexto laboral, ainda que a nível de Saúde e Segurança Ocupacionais tal ainda esteja pouco explorado. Alguns investigadores consideram que a metodologia clássica (e, de certa forma, passiva) de realizar educação e promoção, em contexto de Saúde e Segurança Ocupacionais está cada vez menos adequada. A Realidade Virtual consegue tornar a experiência mais apelativa, didática e interativa, mesmo em setores complexos e perigosos, como a construção civil e indústria, e sem que os participantes corram riscos reais. Potencia-se a atenção, memória e concentração; bem como motivação, satisfação e confiança, e geralmente de forma mais célere. Na prática os funcionários passam a executar as tarefas de forma mais rápida, com menos erros e com menos tempo de aprendizagem. Discussão e Conclusões: Não parecem existir dúvidas que a generalidade dos indivíduos considera mais interessante realizar aprendizagem através de técnicas inseridas na Realidade Virtual e/ou Aumentada, versus as metodologias clássicas, pelo que se supõe que será essa a evolução a ocorrer, sobretudo quando esta tecnologia se tornar mais acessível e económica; pelo menos enquanto existirem postos de trabalho para parte razoável da população, caso as previsões mais catastróficas associadas à Inteligência Artificial não se concretizem. Seria interessante quantificar quantas empresas no país já utilizam a Realidade Virtual, com que objetivos e resultados específicos, publicando tais sínteses em revista especializada.

ABSTRACT This article presents ethnographic notes and critical reflections I made as a participant observer at the public hearing for Case n. 0011-18-CN, concerning equal marriage, held on March 29, 2019. Guided by the questions "Why is the recognition of equal marriage a subject of dispute?" and "How does the recognition of equal marriage become a moral field of dispute?", it examines the legal, symbolic and procedural mechanisms that emerged during the debate and approval of one of the protective measures the Constitutional Court had to consider recognizing this civil right in Ecuador. This note provides theoretical-methodological insights and some empirical findings derived from my ethnographic work as part of a broader research project on citizenship regimes.

RESUMEN Este artículo recoge mis anotaciones y mis reflexiones etnográficas, como observadora participante, en la audiencia pública del caso n.° 0011-18-CN -matrimonio igualitario- del 29 de marzo del 2019. Orientada por las preguntas ¿por qué el reconocimiento del matrimonio igualitario es un campo de disputa? y ¿cómo el reconocimiento del matrimonio igualitario se convierte en un campo de disputa del orden moral?, se examinan los mecanismos legales -simbólicos y procedimentales- que se produjeron a través del debate y anuencia en torno a una de las acciones de protección que la Corte Constitucional ecuatoriana tuvo que procesar para reconocer este derecho civil. Esta nota presenta algunos aprendizajes teórico-metodológicos y hallazgos empíricos desprendidos del ejercicio etnográfico dentro de un programa de investigación más amplio.

Abstract Introduction In clinical practice, patients with the same degree and configuration of hearing loss, or even with normal audiometric thresholds, present substantially different performances in terms of speech perception. This probably happens because other factors, in addition to auditory sensitivity, interfere with speech perception. Thus, studies are needed to investigate the performance of listeners in unfavorable listening conditions to identify the processes that interfere in the speech perception of these subjects. Objective To verify the influence of age, temporal processing, and working memory on speech recognition in noise. Methods Thirty-eight adult and elderly individuals with normal hearing thresholds participated in the study. Participants were divided into two groups: The adult group (G1), composed of 10 individuals aged 21 to 33 years, and the elderly group (G2), with 28 participants aged 60 to 81 years. They underwent audiological assessment with the Portuguese Sentence List Test, Gaps-in-Noise test, Digit Span Memory test, Running Span Task, Corsi Block-Tapping test, and Visual Pattern test. Results The Running Span Task score proved to be a statistically significant predictor of the listening-in-noise variable. This result showed that the difference in performance between groups G1 and G2 in relation to listening in noise is due not only to aging, but also to changes in working memory. Conclusion The study showed that working memory is a predictor of listening performance in noise in individuals with normal hearing, and that this task can provide important information for investigation in individuals who have difficulty hearing in unfavorable environments. practice loss factors sensitivity Thus subjects age processing Thirtyeight Thirty eight G1, G , (G1) 1 2 3 years G2, (G2) 6 8 Test GapsinNoise Gaps Noise test BlockTapping Block Tapping listeninginnoise variable aging environments (G1 (G2 (G

Abstract Introduction One of the paths in the investigation of congenital sensorineural hearing loss (CSNHL) is to try to characterize its etiology through the inner ear evaluation using high resolution computer tomography (CT) scans. With minor malformation, it is not always possible for a simple visual inspection to recognize if the structure in the inner ear is normal or not. Objective To verify if measurements of the inner ear are predictive of sensorineural hearing loss (SNHL) and suggest cutoff points of size limits. Methods Retrospective cross-sectional study of inner ear CT scan measurements of 214 patients, 50 with congenital SNHL (CSNHL) and 164 acquired SNHL (ASNHL) (control group). Results In the CSNHL group, central bony island (CBI) were 0.48 mm smaller (p < 0.001), cochlear nerve aperture was (CNA) 0.10 mm smaller (p < 0.001), and cochlea height was (CH) 0.15 mm smaller (p < 0.001). Vestibular aqueduct (VA) and cochlea width (CW) were similar between groups (0.70 vs 0.72, p = 0.19, and 7.20 vs 7.15 p = 0.23). The predictive cutoff points for CSNHL were CBI = 3.6 mm, CAN = 1.4 mm, CH = 3.4 mm, CW = 7.0 mm, and VA = 0.9 mm. Conclusion Congenital sensorineural hearing loss determined a decrease in CBI, opening of the cochlear nerve (OCN), and CW. Thus, these measures, at the cutoff points indicated, should make us aware of the diagnosis of congenital hearing loss. (CSNHL (CT scans malformation (SNHL limits crosssectional cross sectional 21 patients 5 16 ASNHL (ASNHL control group. group . group) (CBI 048 0 48 0.4 0.001, 0001 0.001 , 001 0.001) CNA (CNA 010 10 0.1 (CH 015 15 0.001. (VA (CW 0.70 070 70 (0.7 072 72 0.72 019 19 0.19 720 7 20 7.2 715 7.1 0.23. 023 0.23 23 0.23) 36 3 6 3. 14 1 4 1. 34 7. 09 9 0. OCN, OCN (OCN) Thus measures indicated 2 04 000 0.00 00 01 0.7 07 (0. 71 02 0.2 (OCN 0.0 (0 (

Abstract Introduction Williams syndrome (WS) is a genetic disorder caused by a microdeletion in chromosome 7, affecting ~ 28 genes. Studies have demonstrated conductive losses seemingly related to the absence of the elastin gene and mild to profound sensorineural losses due to cochlear fragility. Objective To characterize and compare the peripheral auditory system and auditory brainstem response (ABR) of adults with WS and neurotypical adults matched by age and gender. Methods We conducted a cross-sectional observational study with 30 individuals of both sexes, aged 18 to 37 years – 15 of them with WS (study group) and 15 with neither the syndrome nor hearing complaints (control group), matched for sex and age. The subjects underwent pure-tone and speech audiometry, acoustic immittance, transient-evoked otoacoustic emissions (TEOAEs), and ABR. Results Early-onset sensorineural hearing loss was found in 53.3% of the study sample, mostly mild, occurring above 3 kHz. The TEOAEs were absent in 53.3% of assessed subjects; for those in whom they were present, the signal-to-noise responses were significantly lower than in the control group. In the ABR, increased absolute latencies were observed in waves I and III. Conclusion Individuals with WS have early and progressive cochlear impairments, mainly affecting the basal region of the cochlea. They may have low brainstem changes which seem to begin in adulthood. (WS 7 2 genes fragility ABR (ABR gender crosssectional cross sectional sexes 1 group group, , puretone pure tone audiometry immittance transientevoked transient evoked TEOAEs, (TEOAEs) Earlyonset Early onset 533 53 53.3 sample kHz present signaltonoise signal noise III impairments cochlea adulthood (TEOAEs 5 53.

Abstract Introduction Myringoplasty is a common otologic procedure to restore the integrity of the tympanic membrane in cases of traumatic or pathologic perforations. Many grafting materials have been used with different techniques. Objective In the present work, we evaluate the surgical and audiological outcomes of periosteal graft overlying the mastoid cortex through a retroauricular incision in a pediatric cohort. Methods A retrospective study was carried out involving all children aged ≤ 16 years who underwent periosteal graft myringoplasty for the treatment of chronic suppurative otitis media with dry central perforation in our hospital from April 2019 to April 2021. All patients were followed up for one year to assess the anatomical success and functional outcomes by comparing the preoperative and postoperative (after six months) results of pure tone audiometry (PTA). Results The sample was composed of 36 patients; 20 of them were female (55.6%) and 16 were male (44.4%) subjects, with ages ranging from 7 to 16 (mean: 12.7) years. Four patients underwent surgery in both ears (with an interval of 6 to 9 months). Out of 40 surgeries performed, 38 ears have shown anatomical success (95%). A highly significant improvement in hearing was obtained (the mean difference between the pre- and postoperative results of the PTA was of 14.6 ± 3.45 dB (p < 0.001). Conclusion We advocate the use of periosteal graft in the pediatric population as a good alternative for other types of grafts, with comparable and even better functional and anatomical outcomes. perforations techniques work cohort 1 201 2021 after months PTA. . (PTA) 3 2 55.6% 556 55 (55.6% 44.4% 444 44 4 (44.4% subjects (mean 12.7 127 12 months. performed 95%. 95 95% (95%) pre 146 14 14. 345 45 3.4 p 0.001. 0001 0.001 0 001 0.001) grafts 202 (PTA 55.6 5 (55.6 44.4 (44.4 12. (95% 34 3. 000 0.00 00 55. (55. 44. (44. (95 0.0 (55 (44 (9 0. (5 (4 (

Abstract Introduction CyberKnife (CK) radiosurgery is a treatment strategy for vestibular schwannoma (VS). Objectives To evaluate hearing preservation (HP) after CK for VS. Data Synthesis The study was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, and it was registered at the International Prospective Register of Systematic Reviews (PROSPERO, under number CRD42021250300). The inclusion criteria were based on the population, intervention, comparison, outcome, timing and study design (PICOTS) strategy: population – patients with VS; intervention – CK; Comparison – none; Outcome – serviceable HP defined by Gardner and Robertson as grades I or II, or by the American Academy of Otolaryngology and Head and Neck Surgery as classes A or B; timing – mean follow-up longer than 1 year; and study design – retrospective or prospective studies. The exclusion criteria were: studies not published in English; studies published before January 2000 and after October 2021; and studies only including patients with neurofibromatosis type 2 or submitted to a previous treatment. The PubMed/MEDLINE, EMBASE, Web of Science, Cochrane Library, LILACS, and IBECS databases were used and last searched on October 27th, 2021. Statistical heterogeneity was assessed using I2 statistics. The appraisal checklist was used to assess the risk of bias in the included studies. A total of 222 studies were analyzed, and 13 were included in the synthesis, which represents 493 participants with serviceable hearing before intervention. The mean HP rate after CK using a random effects model was of 68% (95% confidence interval [95%CI]: 59–76%) at a mean follow-up of 42.96 months. Conclusion The longer follow-up period was associated with a lower HP rate after CK radiosurgery for VS in the qualitative synthesis. (CK . (VS) (HP MetaAnalyses Meta Analyses PRISMA (PRISMA statement PROSPERO, PROSPERO (PROSPERO CRD42021250300. CRD42021250300 CRD CRD42021250300) comparison outcome PICOTS (PICOTS none II B followup follow up year English 200 2021 PubMedMEDLINE PubMed MEDLINE PubMed/MEDLINE EMBASE Science Library LILACS 27th th statistics 22 analyzed synthesis 49 68 95% 95 (95 95%CI 95CI CI [95%CI] 59–76% 5976 59 76 4296 42 96 42.9 months (VS CRD4202125030 20 202 4 6 9 (9 [95%CI 59–76 597 5 7 429 42. CRD420212503 ( 59–7 CRD42021250 59– CRD4202125 CRD420212 CRD42021 CRD4202 CRD420 CRD42 CRD4

Abstract Introduction When cases of idiopathic sudden sensorineural hearing loss (SSNHL) are treated successfully, most clinicians assume the normality and symmetry of the auditory processing. This assumption is based on the recovery of the detection ability on the part of the patients, but the auditory processing involves much more than detection alone. Since certain studies have suggested a possible involvement of the central auditory system during the acute phase of sudden hearing loss, the present study hypothesized that auditory processing would be asymmetric in people who have experienced sudden hearing loss. Objective To assess the physiologic and electrophysiological conditions of the cochlea and central auditory system, as well as behavioral discrimination, of three primary aspects of sound (intensity, frequency, and time) in subjects with normal ears and ears treated successfully for SSNHL. Methods The study included 19 SSNHL patients whose normal and treated ears were assessed for otoacoustic emissions, speech auditory brainstem response, intensity and pitch discrimination, and temporal resolution in a within-subject design. Results The otoacoustic emissions were poorer in the treated ears compared to the normal ears. Ear- and sex-dependent differences were observed regarding otoacoustic emissions and pitch discrimination. Conclusion The asymmetrical processing observed in the present study was not consistent with the hearing threshold values, which might suggest that the central auditory system would be affected regardless of the status of the peripheral hearing. Further experiments with larger samples, different recovery scenarios after treatment, and other assessments are required. (SSNHL alone discrimination intensity, (intensity frequency time 1 response withinsubject within subject design Ear sexdependent sex dependent values samples treatment required

Abstract Introduction The limited access to temporal fine structure (TFS) cues is a reason for reduced speech-in-noise recognition in cochlear implant (CI) users. The CI signal processing schemes like electroacoustic stimulation (EAS) and fine structure processing (FSP) encode TFS in the low frequency whereas theoretical strategies such as frequency amplitude modulation encoder (FAME) encode TFS in all the bands. Objective The present study compared the effect of simulated CI signal processing schemes that either encode no TFS, TFS information in all bands, or TFS only in low-frequency bands on concurrent vowel identification (CVI) and Zebra speech perception (ZSP). Methods Temporal fine structure information was systematically manipulated using a 30-band sine-wave (SV) vocoder. The TFS was either absent (SV) or presented in all the bands as frequency modulations simulating the FAME algorithm or only in bands below 525 Hz to simulate EAS. Concurrent vowel identification and ZSP were measured under each condition in 15 adults with normal hearing. Results The CVI scores did not differ between the 3 schemes (F (2, 28) = 0.62, p = 0.55, η2p = 0.04). The effect of encoding TFS was observed for ZSP (F (2, 28) = 5.73, p = 0.008, η2p = 0.29). Perception of Zebra speech was significantly better with EAS and FAME than with SV. There was no significant difference in ZSP scores obtained with EAS and FAME (p = 1.00) Conclusion For ZSP, the TFS cues from FAME and EAS resulted in equivalent improvements in performance compared to the SV scheme. The presence or absence of TFS did not affect the CVI scores. (TFS speechinnoise noise (CI users (EAS FSP (FSP (FAME lowfrequency (CVI ZSP. . (ZSP) 30band band 30 sinewave sine wave (SV vocoder 52 1 hearing F 2, 2 (2 28 062 0 62 0.62 055 55 0.55 ηp η 0.04. 004 0.04 04 0.04) 573 5 73 5.73 0008 008 0.008 0.29. 029 0.29 29 0.29) 1.00 100 00 scheme (ZSP ( 06 6 0.6 05 0.5 0.0 57 7 5.7 000 0.00 02 0.2 1.0 10 0. 5. 1.

Abstract Introduction The World Health Organization (WHO) estimates that ~ 32 million children worldwide are affected by hearing loss (HL). Cochlear implant is the first-line treatment for severe to profound sensorineural HL. It is considered one of the most successful prostheses developed to date. Objective To evaluate the oral language development of pediatric patients with prelingual deafness implanted in a reference hospital for the treatment of HL in southern Brazil. Methods We conducted a retrospective cohort study with a review of medical records of patients undergoing cochlear implant surgery between January 2009 and December 2018. Language development was assessed by reviewing consultations with speech therapy professionals from the cochlear implant group. Results A total of 152 children were included in the study. The mean age at cochlear implant surgery was of 41 months (standard deviation [SD]: ± 15). The patients were divided into six groups considering the type of language most used in their daily lives. We found that 36% of children use oral language as their primary form of communication. In a subanalysis, we observed that patients with developed or developing oral language had undergone cochlear implant surgery earlier than patients using Brazilian Sign Language (Língua Brasileira de Sinais, LIBRAS, in Portuguese) or those without developed language. Conclusion The cochlear implant is a state-of-the-art technology that enables the re-establishment of the sense of hearing and the development of oral language. However, language development is a complex process known to present a critical period to properly occur. We still see many patients receiving late diagnosis and treatment, which implies a delay and, often, the impossibility of developing oral communication. Level of Evidence Level 3 (cohort study). WHO (WHO . (HL) firstline first line date Brazil 200 2018 group 15 4 standard SD [SD] 15. 15) lives 36 communication subanalysis Língua Sinais LIBRAS Portuguese stateoftheart state art reestablishment re establishment However occur often study) (HL 20 201 1 [SD 2

ABSTRACT We present the case of a young female health worker, resident in a high Andean region of Peru, with recent exposure to farm animals and arthropods, who developed acute febrile undifferentiated syndrome, severe thrombocytopenia and pulmonary and abdominal extravasation. Subsequently, the patient developed meningitis and early onset bilateral neurosensorial hypoacusis and showed reactive serology to acute infection by Rickettsia sp. Epidemiological and clinical considerations in the differential diagnosis for early management are discussed.

RESUMEN Se presenta el caso de una mujer joven, trabajadora de salud, residente en una región altoandina del Perú, con exposición reciente a animales de granja y artrópodos, que presenta síndrome febril agudo indiferenciado, trombocitopenia severa y extravasación pulmonar y abdominal. Posteriormente desarrolla meningitis e hipoacusia neurosensorial bilateral de instalación temprana y muestra serología reactiva a infección aguda por Rickettsias sp. Se discuten las consideraciones epidemiológicas y clínicas en el diagnóstico diferencial para un manejo oportuno.

Abstract This article seeks to discuss how human senses are capable of providing understanding and identification of realities, often neglected due to the exacerbated use of technologies to the detriment of human contact and face-to-face viewing. This is not an opposition to the use of technologies as auxiliary mechanisms in the research process, especially in data organization and analysis processes, since technology is necessary, inevitable and has become an important ally in the construction of scientific knowledge. However, the objective of this article is to discuss the dialogicity of qualitative research with the human senses - hearing, smell, taste, vision and touch and answer the research question: Can the senses be understood as fundamental categories in methodologies applied to qualitative research in a way that empirical? The methodological design was developed from a qualitative perspective of a bibliographic nature, with examples of cases in which the meanings are already explored by organizations, in addition to resuming studies initiated by Tuzzo et al. (2023) who discussed the dialogicity of qualitative research in relation to quantitative research, seeking to reflect on epistemological questions such as: How important is qualitative analysis in the context of research, especially empirical, and how can and should it assume a dialogic character with quantitative research actions? And what is qualitative about quantitative research? As a result, it was noticed that in qualitative research there is quantifiable information, without altering the research, so that quantitative research is also carried out in the light of qualitative processes. With regard to human senses and qualitative research, the results also point to dialogicity allowing new perspectives for investigation. We conclude that the senses are capable of interfering in research results, with a view to altering the perspective and perception of the researched and the researcher himself.

Resumo Esse artigo busca discutir como os sentidos humanos são capazes de proporcionar a compreensão e a identificação de realidades, muitas vezes negligenciadas em função do uso exacerbado das tecnologias em detrimento do contato humano e do olhar presencial. Não se trata de oposição ao uso das tecnologias como mecanismos auxiliares no processo de pesquisa, sobretudo, nos processos de organização e análises de dados, posto que a tecnologia é necessária, inevitável e tem se tornado aliada importante na construção do conhecimento científico. Contudo, o objetivo deste artigo é discutir a dialogicidade da pesquisa qualitativa com os sentidos humanos - audição, olfato, paladar, visão e tato e responder à questão de investigação: Podem os sentidos serem compreendidos como categorias fundamentais em metodologias aplicadas às pesquisas qualitativas de modo empírico? O desenho metodológico foi elaborado a partir da perspectiva qualitativa de caráter bibliográfico, com exemplos de casos em que os sentidos já são explorados pelas organizações, além de retomar estudos iniciados por Tuzzo et al. (2023) que discutiram a dialogicidade da pesquisa qualitativa em relação à pesquisa quantitativa, buscando refletir sobre questões epistemológicas como: Qual a importância da análise qualitativa no âmbito das pesquisas, sobretudo empíricas, e de que forma podem e devem assumir um caráter dialógico com as ações de pesquisa quantitativa? E ainda o que há de qualitativo na pesquisa quantitativa? Como resultados, percebeu-se que nas pesquisas qualitativas há informações quantificáveis, sem alteração da pesquisa, de modo que, também a pesquisa quantitativa se realiza à luz de processos qualitativos. No que diz respeito aos sentidos humanos e à pesquisa qualitativa, também os resultados apontam para uma dialogicidade permitindo novos prismas para a investigação. Concluímos que os sentidos são capazes de interferir nos resultados das pesquisas, tendo em vista alterar o olhar e a percepção do pesquisado e do próprio pesquisador.