Audiovježbe Andrijašević, Andrea; Čulina, Mirta
Zbornik Veleučilišta u Rijeci,
2023, Letnik:
11, Številka:
1
Journal Article, Paper
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Gubitak sluha i tinitus svakodnevno u znatnoj mjeri otežavaju govornu komunikaciju pogođenim osobama. Teškoće slušanja uzrokovane njima mogu se ublažiti različitim terapijskim pristupima, međutim ...rehabilitacijski postupci usmjereni na poboljšanje slušanja kod odrasle populacije slabo su zastupljeni u zdravstvenom sektoru. U novije vrijeme, računalni programi za tretiranje različitih zdravstvenih teškoća sve više pokazuju potencijal, no često uz naknadu za korištenje. U ovom radu, spoznaje iz područja audiologije i audiorehabilitacije primijenjene su pri izradi besplatnog računalnog programa na hrvatskom jeziku namijenjenog odrasloj populaciji s teškoćama razumijevanja govora zbog stečenog oštećenja sluha ili izazvanih pojavom tonskog tinitusa. Izbor vježbi i način prezentacije zadataka u izrađenom programu vođeni su suvremenim terapijskim pristupima, a oslanjaju se i na primjere modernih računalnih programa za rehabilitaciju slušanja. Program sadrži dvanaest slušnih vježbi različitog stupnja zahtjevnosti za testiranje slušne razabirljivosti prilikom čijeg dizajniranja su se slijedili osnovni verbotonalni principi, stoga se pristupa prepoznavanju poznatih pojmova prije nepoznatih i optimalnim uvjetima slušanja prije neoptimalnih. Osim vježbi slušanja, program omogućava korisniku identifikaciju frekvencije tonskog tinitusa te terapiju Tailor-made notched music training (TMNMT) terapijom glazbom, koja za cilj ima smanjenje njegovog intenziteta. Izrađeni program može poslužiti kao dodatak standardnim udiorehabilitacijskim postupcima kod osoba sa stečenim oštećenjem sluha, a, osim terapijske funkcije, može pomoći i pripadnicima opće populacije u objektivnijoj samoprocjeni njihovog slušnog funkcioniranja.
Hearing loss and tinnitus represent a significant challenge for affected individuals in everyday spokencommunication. Hearing difficulties caused by them can be alleviated through different therapeuticapproaches, however hearing therapy approaches aimed at hearing improvement in the adultpopulation are not very common in the health sector. In recent years, desktop and mobile applicationsfor the treatment of a variety of health difficulties have shown potential, but unfortunately they arestill rarely available at no charge. In this paper, the knowledge in the area of audiology and hearingtherapy has been applied in designing a computer program for the Croatian speaking adult populationwith speech intelligibility difficulties caused by acquired hearing impairment and tonal tinnitus. Thetypes of exercises and their representation have been modelled based on the conventional hearingtherapy methods as well as on currently available web, mobile and desktop apps. The programcontains twelve listening exercises that differ in their degree of complexity, whose design was guidedby the fundamental principles of the verbotonal method. Accordingly, the exercises start with familiarterms before advancing to the unfamiliar ones and with optimal hearing conditions before movingon to the nonoptimal ones. In addition to these exercises, the program offers tonal tinnitus frequencyidentification and sound therapy for its loudness reduction based on the Tailor-made notched musictraining (TMNMT) principles. The program can serve as an addition to the conventional hearingtherapy for individuals in the later stages of adaptation to hearing aids or cochlear implants, as wellas help the non-diagnosed individuals to assess their hearing more objectively and, if necessary, seekprofessional help.
Logopedska procjena poremećaja glasa općenito uključuje perceptivnu procjenu, akustičku analizu, interpretaciju samoprocjene kvalitete glasa i komunikacijskih iskustava pacijenta. Primjenjuje se za ...postavljanje dijagnoze i planiranje sveobuhvatne, pacijentu usmjerene terapije. Spastična disfonija je fokalna laringealna distonija, koju karakteriziraju nevoljne mišićne kontrakcije u području grkljana. Nevoljni spazmi mišića grkljana uzrokuju prekide i zastoje u govoru.
U prošlim istraživanjima postavlja se pitanje osjetljivosti dosadašnjih preporučenih metoda procjene poremećaja glasa na specifičnosti spastične disfonije. U ovom radu je, stoga, izložen pregled istraživanja o logopedskoj procjeni glasa spastične disfonije, te se upućuje na ključne radove u kojima se postavljaju relevantna pitanja s obzirom na obilježja ovog poremećaja glasa. Izdvojeni su istraživački pristupi i ključna istraživačka pitanja u dosadašnjoj literaturi. Prikazan je primjer protokola primjenjiv u kliničkim uvjetima, te prijedlog ispitnih čestica za perceptivnu procjenu glasa spastične disfonije prilagođen na hrvatski jezik.
Severe dysphagia is a rare presenting symptom of primary hyperparathyroidism, whereas the most common hypercalcemia-related causes include gastrointestinal symptoms, such as anorexia, constipation, ...and pancreatitis. This case presentation aimed to describe swallowing difficulty as a leading symptom of hypercalcemia.
A 62-year-old man experienced vomiting, dysphagia bordering with aphagia, and 20-kg weight loss in a 2-month period. The parathyroid hormone and serum calcium levels were 102 pmol/L (reference range, 1.8-7.9 pmol/L) and 4.12 mmol/L (reference range, 2.14-2.53 mmol/L), respectively. Ultrasound-guided exploration of the neck revealed a large, rounded hypoechoic mass inferior to the left thyroid lobe, which contained parathyroid tissue on fine-needle aspiration cytology examination. Contrast-enhanced neck computed tomography revealed a mass measuring 3.6 × 2.6 × 2.5 cm behind the left thyroid lobe, alongside massive ventral spondylophytes of the cervical spine at the level of the postcricoid segment of the hypopharynx. Magnetic resonance imaging confirmed ventral tissue displacement due to spondylophyte size and location. Surgical exploration of the left side of the neck was performed, and the left lower parathyroid gland weighing 9.07 g was excised. Pathohistologic findings verified a parathyroid gland adenoma. The postoperative values showed parathyroid hormone and serum calcium levels at 4.54 pmol/L and 2.25 mmol/L, respectively.
The pathophysiology of dysphagia in hypercalcemia is not fully elucidated. In this case, the patient’s improvement after surgery implies a plausible connection between hypercalcemia and dysphagia, suggesting a causal relationship.
Although aphagia is not a typical presenting symptom of parathyroid adenoma, it should be noted in the differential diagnosis.
Background/ObjectiveSevere dysphagia is a rare presenting symptom of primary hyperparathyroidism, whereas the most common hypercalcemia-related causes include gastrointestinal symptoms, such as ...anorexia, constipation, and pancreatitis. This case presentation aimed to describe swallowing difficulty as a leading symptom of hypercalcemia.Case ReportA 62-year-old man experienced vomiting, dysphagia bordering with aphagia, and 20-kg weight loss in a 2-month period. The parathyroid hormone and serum calcium levels were 102 pmol/L (reference range, 1.8-7.9 pmol/L) and 4.12 mmol/L (reference range, 2.14-2.53 mmol/L), respectively. Ultrasound-guided exploration of the neck revealed a large, rounded hypoechoic mass inferior to the left thyroid lobe, which contained parathyroid tissue on fine-needle aspiration cytology examination. Contrast-enhanced neck computed tomography revealed a mass measuring 3.6 × 2.6 × 2.5 cm behind the left thyroid lobe, alongside massive ventral spondylophytes of the cervical spine at the level of the postcricoid segment of the hypopharynx. Magnetic resonance imaging confirmed ventral tissue displacement due to spondylophyte size and location. Surgical exploration of the left side of the neck was performed, and the left lower parathyroid gland weighing 9.07 g was excised. Pathohistologic findings verified a parathyroid gland adenoma. The postoperative values showed parathyroid hormone and serum calcium levels at 4.54 pmol/L and 2.25 mmol/L, respectively.DiscussionThe pathophysiology of dysphagia in hypercalcemia is not fully elucidated. In this case, the patient's improvement after surgery implies a plausible connection between hypercalcemia and dysphagia, suggesting a causal relationship.ConclusionAlthough aphagia is not a typical presenting symptom of parathyroid adenoma, it should be noted in the differential diagnosis.
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