mario Greters

The article aims at analyzing and connecting the ideas of justice and generations in a phenomenological perspective beyond the classical approaches (Rawls, Parfit, Jonas). It suggests a shift from the concept of generations to those of generating and generativity in a phenomenological sense. The debate involves different philosophical positions (including Dilthey, Schutz, Mannheim, Ortega, Heidegger and Ricoeur) about the main distinction ‘contemporaneity/not-contemporaneity’. At the end, the essay proposes a confrontation between phenomenology (Husserl) and philosophies of the otherness (Levinas, Derrida and Waldenfels), discussing three basic ideas: temporalization, historicity and generating of generations.

Patients with bilateral vestibulopathy (BVP) suffer from postural imbalance during daily life conditions which in turn leads to a high frequency of falls. Unfortunately, vestibular rehabilitation has only modest and somewhat inconsistent effects in this patient group. Approximately fifty percent of BVP-patients show an improved postural control after conventional vestibular rehabilitation training. New and more promising approaches are required. The individualized vibrotactile neurofeedback training (IVNT) in stance and gait conditions has already been described as highly effective in patients with various vestibular disorders. The purpose of the present multicenter study was to determine the efficacy of the IVNT in improving balance, reducing self-perceived disability, and improving gait in patients with confirmed BVP. In total, 22 patients performed the IVNT with the Vertiguard®-system for 10 daily sessions. The dizziness handicap inventory (DHI), the stance stability score of the...

OBJETIVO: verificar a inter-relação entre a recuperação postural e o bom ou baixo desempenho de indivíduos usuários de implante coclear (IC). MÉTODO: Foram avaliados 21 indivíduos divididos em três grupos: nove usuários de IC com bom desempenho, cinco de IC com baixo desempenho e sete controles. Todos os sujeitos foram submetidos a dois testes: Teste de Integração Sensorial (TIS) da Posturografia Dinâmica Computadorizada (PDC), com intervalo de 40 a 60 minutos entre eles, com a finalidade de observar o aprendizado de estratégias posturais no segundo teste. Os resultados obtidos foram submetidos à avaliação estatística. RESULTADOS: Os indivíduos com baixo desempenho apresentaram níveis significativamente mais baixos de aprendizado que os outros dois Grupos em C4, C5, C6 e IE. CONCLUSÂO: Os usuários de IC com bom desempenho mostraram melhor índice de recuperação postural quando comparados àqueles de IC com baixo desempenhoOBJECTIVE: To test the inter-relationship between postural reco...

Relato de 2 casos de sífilis adquirida em pacientes do sexo masculino, que apresentaram quadro de sintomas cocleovestibulares com hipoacúsia bilateral e tontura, além de alterações de outros nervos cranianos, como descrito no primeiro caso. Ambos os pacientes apresentaram desfecho favorável, com melhora dos sintomas após o tratamento. Ressaltamos a importância da suspeição diagnóstica para a doença, uma vez que pode ser curada e prevenida.

Balance problems in hemiparetic patients after stroke can be caused by different impairments in the physiological systems involved in postural control, including sensory afferents, movement strategies, biomechanical constraints, cognitive processing, and perception of verticality. Balance impairments and disabilities must be appropriately addressed. This article reviews the most common balance abnormalities in hemiparetic patients with stroke and the main tools used to diagnose them.

Introdução: A associação entre vertigem e dor cervical é queixa freqüente no ambulatório de otoneurologia, porém o diagnóstico da vertigem cervical de origem proprioceptiva e seu tratamento são ainda controversos. Forma de Estudo: Prospectivo descritivo. Objetivo: Avaliar as possíveis interferências do tratamento fisioterapêutico nas vertigens de origem cervical. Casuística e Método: Descrição de 10 casos diagnosticados como vertigem de origem cervical, com queixas de tonturas e cervicalgia, atendidos no Ambulatório de Otoneurologia do Departamento de Otorrinolaringologia do Hospital das Clínicas da FMUSP, submetidos a tratamento fisioterápico, avaliados através de questionário e com as queixas quantificadas em escala visual-analógica, antes e após o tratamento. Resultados: Dos 10 pacientes 7 (70%) relataram melhora ou desaparecimento das tonturas e 8 (80%) obtiveram o mesmo resultado em relação à cervicalgia. Conclusão: Os resultados apontam o tratamento fisioterápico como uma opçã...

1Department of Otolaryngology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil 2Department of Otolaryngology, Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil 3Department of Otorhinolaryngology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil 4Department of Otorhinolaryngology, Complexo Hospitalar Edmundo Vasconcelos, São Paulo, SP, Brazil 5Department of Otolaryngology, Universidade de São Paulo, São Paulo, SP, Brazil

Introdução: A vertigem postural ou posicional paroxística benigna (VPPB) é uma síndrome muito comum na prática clínica, pode ter etiologia diversa e seu tratamento baseia-se principalmente em manobras de reposição canalicular. Entretanto, algumas doenças do sistema nervoso central mimetizam a VPPB e precisam ser descartadas antes do diagnóstico da síndrome. Forma de Estudo: Relato de caso e revisão de literatura. Objetivo: Alertar os otorrinolaringologistas para maior investigação diante de sinais suspeitos de vertigem posicional não-benigna e discutir o manejo diante de uma revisão de literatura. Relato: Paciente de 43 anos, masculino, com queixa de tonturas rotatórias há três anos com evolução em crises principalmente ao deitar em decúbito lateral esquerdo e ao virar a cabeça para a esquerda. A prova de Dix-Hallpike mostrou-se positiva para a esquerda, sugerindo canalilitíase de canal semicircular posterior. A manobra de reposição de Epley resultou em desaparecimento das vertigens...

The article aims at analyzing and connecting the ideas of justice and generations in a phenomenological perspective beyond the classical approaches (Rawls, Parfit, Jonas). It suggests a shift from the concept of generations to those of generating and generativity in a phenomenological sense. The debate involves different philosophical positions (including Dilthey, Schutz, Mannheim, Ortega, Heidegger and Ricoeur) about the main distinction ‘contemporaneity/not-contemporaneity’. At the end, the essay proposes a confrontation between phenomenology (Husserl) and philosophies of the otherness (Levinas, Derrida and Waldenfels), discussing three basic ideas: temporalization, historicity and generating of generations.

Introduction The P3 cognitive evoked potential is recorded when a subject correctly identifies, evaluates and processes two different auditory stimuli. Objective to evaluate the latency and amplitude of the P3 evoked potential in 26 cochlear implant users with post-lingual deafness with good or poor speech recognition scores as compared with normal hearing subjects matched for age and educational level. Methods In this prospective cohort study, auditory cortical responses were recorded from 26 post-lingual deaf adult cochlear implant users (19 with good and 7 with poor speech recognition scores) and 26 control subjects. Results There was a significant difference in the P3 latency between cochlear implant users with poor speech recognition scores (G-) and their control group (CG) (p = 0.04), and between G- and cochlear implant users with good speech discrimination (G+) (p = 0.01). We found no significant difference in the P3 latency between the CG and G+. In this study, all G- patien...

 The P3 cognitive evoked potential is recorded when a subject correctly identifies, evaluates and processes two different auditory stimuli.  to evaluate the latency and amplitude of the P3 evoked potential in 26 cochlear implant users with post-lingual deafness with good or poor speech recognition scores as compared with normal hearing subjects matched for age and educational level.  In this prospective cohort study, auditory cortical responses were recorded from 26 post-lingual deaf adult cochlear implant users (19 with good and 7 with poor speech recognition scores) and 26 control subjects.  There was a significant difference in the P3 latency between cochlear implant users with poor speech recognition scores (G-) and their control group (CG) (  = 0.04), and between G- and cochlear implant users with good speech discrimination (G+) (  = 0.01). We found no significant difference in the P3 latency between the CG and G+. In this study, all G- patients had deafness due to meningitis, ...

This study aimed to evaluate if hearing performance is a predictor of postural control in cochlear implant (CI) users at least six months after surgery. Cross-sectional study including (CI) recipients with post-lingual deafness and controls who were divided into the following groups: nine CI users with good hearing performance (G+), five CI users with poor hearing performance (G-), and seven controls (CG). For each patient, computerized dynamic posturography (CDP) tests, a sensory organization test (SOT), and an adaptation test (ADT) were applied as dual task performance, with first test (FT) and re-test (RT) on the same day, including a 40-60min interval between them to evaluate the short-term learning ability on postural recovery strategies. The results of the groups were compared. Comparing the dual task performance on CDP and the weighted average between all test conditions, the G+ group showed better performance on RT in SOT4, SOT5, SOT6, and CS, which was not observed for G- and CG. The G- group had significantly lower levels of short-term learning ability than the other two groups in SOT5 (p=0.021), SOT6 (p=0.025), and CS (p=0.031). The CI users with good hearing performance had a higher index of postural recovery when compared to CI users with poor hearing performance.

Some patients with severe impairment of body balance do not obtain adequate improvement from vestibular rehabilitation (VR). To evaluate the effectiveness of Vertiguard™ biofeedback equipment as a sensory substitution (SS) of the vestibular system in patients who did not obtain sufficient improvement from VR. This was a randomized prospective clinical study. Thirteen patients without satisfactory response to conventional VR were randomized into a study group (SG), which received the vibrotactile stimulus from Vertiguard™ for ten days, and a control group (CG), which used equipment without the stimulus. For pre- and post-treatment assessment, the Sensory Organization Test (SOT) protocol of the Computerized Dynamic Posturography (CDP) and two scales of balance self-perception, Activities-specific Balance Confidence (ABC) and Dizziness Handicap Inventory (DHI), were used. After treatment, only the SG showed statistically significant improvement in C5 (p=0.007) and C6 (p=0.01). On the A...

Benign Paroxysmal Positional Vertigo (BPPV) is a frequent cause of dizziness and despite of the excellent results with its treatment, there is some controversy about management. To assess the efficacy of Epley Maneuver with and without post-maneuver restrictions. Prospective randomized. Fifty patients presenting BPPV of the posterior semicircular canal, treated with Epley Maneuver and divided into two groups: study group--23 patients--with post-maneuver restrictions, and control group--27 patients--without post-maneuver restrictions. No significant difference was found between the studied and the control group. Post-maneuver restrictions do not influence the efficacy of Epley Maneuver for BPPV management.