No abstract

Os autores descrevem o papel do sistema dopaminérgico na fobia social. Evidências que indicam disfunção dopaminérgica são descritas, e o papel da dopamina como um regulador da atividade social é discutido.

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evaluated changes in quality of life and the cost-utility differential of implanting one versus two cochlear implants. RESULTS: Results indicate a 0.48 mean gain in health utility after bilateral cochlear implantation and a discounted cost per QALY of $24,859 in this cohort of patients. By comparing patient scores for unilateral and bilateral use, improvements in the domains of hearing, speech, emotion and cognition were noted, resulting in a mean gain in health utility of 0.11. Using this comparison, the discounted cost-utility differential between unilateral and bilateral cochlear implant placement was $2,154. CONCLUSION: This study found an improvement in quality of life and a favorable cost-utility associated with bilateral cochlear implantation in patients with profound hearing loss. The results also indicate that these patients showed additional improvements in quality of life after they received their second implant. Bilateral cochlear implantation was also cost-effective when compared to unilateral cochlear implant placement and can be offered as a beneficial, life-improving therapy in patients with severe hearing loss. SIGNIFICANCE: This is the first study showing improvements in quality of life and a favorable cost-utility after bilateral cochlear implantation in patients with profound hearing loss.