Sonoridades beckettianas: a criação vocal do intérprete

Pós-graduação em Artes - IA

Entre a expressão e a técnica: a terminologia do professor de canto - um estudo de caso em pedagogia vocal de canto erudito e popular no eixo Rio-São Paulo

Pós-graduação em Música - IA

Perceptual and acoustic parameters of vocal nodules in children

Vocal nodules constitute the major cause of dysphonia during childhood. Auditory-perceptual and acoustic vocal analyses have been used to differentiate vocal nodules from normal voice in children.Purpose: To study the value of auditory-perceptual and acoustic vocal analyses in assessments of children with nodules.Design: Diagnostic test study.Patients and interventions: A comparative study was carried out including 100 children with videolaryngoscopic diagnosis of vocal nodules (nodule group-NG); and 100 children without vocal symptoms and with normal videolaryngoscopic exams (control group-CG). The age range of both groups was between 4 and 11 years. All children underwent auditory-perceptual vocal analyses (GRBASI scale); maximum phonation time and s/z ratio were calculated, and acoustic vocal analysis (MDVP software) were carried out.Results: There was no difference in the values of maximum phonation time and s/z ratio between groups. Auditory-perceptual analysis indicated greater compromising of voice parameters for NG, compared to CG: G (79 versus 24), R (53 versus 3), B (67 versus 23) and S (35 versus 1). The values of acoustic parameters jitter, PPQ shimmer, APQ, NHR and SPI were higher for NG for CG. The parameter f0 did not differ between groups.Conclusion: Compromising of auditory-perceptual (G, R, B and S) and acoustic vocal parameters (jitter, PPQ shimmer, APQ, NHR and SPI) was greater for children with nodules than for those of the control group, which makes them important methods for assessing child dysphonia. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

Avaliação clínica, videolaringoscópica e vocal perceptivo-auditiva e acústica de professores disfônicos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Aquecimento e Desaquecimento Vocal em Estudantes de Pedagogia

Introduction: the voice is one of the main features of interaction between teacher and student. As teachers, future teachers are also risk population for the development of dysphonia and may be subject to protective intervention. Purpose: to evaluate the effect of a vocal warm-up and cool-down procedure at Pedagogy students. Method: A quasi-experimental study, pre-posttest without a control group, with fourteen Pedagogy students at a public university, participants of a short course. The analysis was performed by a self-assessment visual analogue scale of 10 cm, considering aspects related to the body and voice. The protocol was implemented in three steps: pre-test, post warm-up and post cool-down, and it was calculated the averages of the variables of discomfort and compared the measurements before and after performing each procedure. It was used the the Wilcoxon signed-rank statiscal test, adopting a significance level of 5%. Results: there was less discomfort with statistical significance after the vocal warm-up (p=0.002) and cool-down (p=0.001), with greater magnitude in both aspects related to voice. Conclusions: The vocal warm-up and cool-down have positive effects on the perception of students and should be taught to future teachers in order to prevent vocal disorders. The vocal cool-down, poorly researched, should not be passed over vocal health practices since its purpose showed obvious improvement in the investigated group.

Teatralidade em frequência e intensidade: análise da matriz vocal do espetáculo Passos, do grupo Obragem de Teatro e Cia

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Hyaluronic Acid Behavior in the Lamina Propria of the Larynx with Advancing Age

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Self-perception, complaints and vocal quality among undergraduate students enrolled in a Pedagogy course

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Dysarthria and quality of life in neurologically healthy elderly and patients with Parkinson's disease

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Psychogenic dysphonia: diversity of clinical and vocal manifestations in a case series

Introduction: Psychogenic dysphonia is a functional disorder with variable clinical manifestations.Objective: To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series.Methods: The study included 28 adult patients with psychogenic dysphonia, evaluated at a University hospital in the last ten years. Assessed variables included gender, age, occupation, vocal symptoms, vocal characteristics, and videolaryngostroboscopic findings.Results: 28 patients (26 women and 2 men) were assessed. Their occupations included: housekeeper (n = 17), teacher (n = 4), salesclerk (n = 4), nurse (n = 1), retired (n = 1), and psychologist (n = 1). Sudden symptom onset was reported by 16 patients and progressive symptom onset was reported by 12; intermittent evolution was reported by 15; symptom duration longer than three months was reported by 21 patients. Videolaryngostroboscopy showed only functional disorders; no patient had structural lesions or changes in vocal fold mobility. Conversion aphonia, skeletal muscle tension, and intermittent voicing were the most frequent vocal emission manifestation forms.Conclusions: In this case series of patients with psychogenic dysphonia, the most frequent form of clinical presentation was conversion aphonia, followed by musculoskeletal tension and intermittent voicing. The clinical and vocal aspects of 28 patients with psychogenic dysphonia, as well as the particularities of each case, are discussed. (C) 2014 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Aquecimento vocal para o canto erudito: teoria e prática

Vocal warm-ups are essential for the technical training of the singer, for good speech and performance, as well as essential for good vocal health and a long-lasting career. Objective: To analyze the theory and practice of the vocal warm-up in classical singing, from the perspective of different professionals in the voice field including: teachers, speech therapists and singers. Method: descriptive search, quantitative in nature, cross-sectional, with a questionnaire for voice teachers, singers and audiologists. The sample consisted of 165 subjects: 86 voice teachers, 64 speech pathologists, and 15 singers. Results: Teachers of Singing (97.7 %), singers (95.3 %) and students (93.3 %) use the vocal warm-up. Conclusion: From the results we can infer that most of the professionals surveyed point to the importance of the implementation of the vocal warm-up before a performance, and the strategy used by most voice instructors, speech therapists and singers is vocalization, i.e. aesthetic warm-up.

Voice disorders in teachers: clinical, videolaryngoscopical, and vocal aspects

Dysphonia is more prevalent in teachers than among the general population. The objective of this study was to analyze clinical, vocal, and videolaryngoscopical aspects in dysphonic teachers. Ninety dysphonic teachers were inquired about their voice, comorbidities, and work conditions. They underwent vocal auditory-perceptual evaluation (maximum phonation time and GRBASI scale), acoustic voice analysis, and videolaryngoscopy. The results were compared with a control group consisting of 90 dysphonic nonteachers, of similar gender and ages, and with professional activities excluding teaching and singing. In both groups, there were 85 women and five men (age range 31-50 years). In the controls, the majority of subjects worked in domestic activities, whereas the majority of teachers worked in primary (42.8%) and secondary school (37.7%). Teachers and controls reported, respectively: vocal abuse (76.7%; 37.8%), weekly hours of work between 21 and 40 years (72.2%; 80%), under 10 years of practice (36%; 23%), absenteeism (23%; 0%), sinonasal (66%; 20%) and gastroesophageal symptoms (44%; 22%), hoarseness (82%; 78%), throat clearing (70%; 62%), and phonatory effort (72%; 52%). In both groups, there were decreased values of maximum phonation time, impairment of the G parameter in the GRBASI scale (82%), decrease of F0 and increase of the rest of acoustic parameters. Nodules and laryngopharyngeal reflux were predominant in teachers; laryngopharyngeal reflux, polyps, and sulcus vocalis predominated in the controls. Vocal symptoms, comorbidities, and absenteeism were predominant among teachers. The vocal analyses were similar in both groups. Nodules and laryngopharyngeal reflux were predominant among teachers, whereas polyps, laryngopharyngeal reflux, and sulcus were predominant among controls.

Thioredoxin interacting protein genetic variation is associated with diabetes and hypertension in the Brazilian general population

Objective: To investigate the relationship between TXNIP polymorphisms, diabetes and hypertension phenotypes in the Brazilian general population. Methods: Five hundred seventy-six individuals randomly selected from the general urban population according to the MONICA-WHO project guidelines were phenotyped for cardiovascular risk factors. A second, independent, sample composed of 487 family-trios from a different site was also selected. Nine TXNIP polymorphisms were studied. The potential association between TXNIP variability and glucose-phenotypes in children was also explored. TXNIP expression was quantified by real-time PCR in 53 samples from human smooth muscle cells primary culture. Results: TXNIP rs7211 and rs7212 polymorphisms were significantly associated with glucose and blood pressure related phenotypes. In multivariate logistic regression models the studied markers remained associated with diabetes even after adjustment for covariates. TXNIP rs7211 T/rs7212 G haplotype (present in approximately 17% of individuals) was significantly associated to diabetes in both samples. In children, the TXNIP rs7211 T/rs7212 G haplotype was associated with fasting insulin concentrations. Finally, cells harboring TXNIP rs7212 G allele presented higher TXNIP expression levels compared with carriers of TXNIP rs7212 CC genotype (p = 0.02). Conclusion: Carriers of TXNIP genetic variants presented higher TXNIP expression, early signs of glucose homeostasis derangement and increased susceptibility to chronic metabolic conditions such as diabetes and hypertension. Our data suggest that genetic variation in the TXNIP gene may act as a "common ground" modulator of both traits: diabetes and hypertension. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

Endoscopic Laser Thyroarytenoid Myoneurectomy in Patients with Adductor Spasmodic Dysphonia: A Pilot Study on Long-Term Outcome on Voice Quality

Objectives. Adductor spasmodic dysphonia (ADSD) is a focal laryngeal dystonia, which compromises greatly the quality of life of the patients involved. It is a severe vocal disorder characterized by spasms of laryngeal muscles during speech, producing phonatory breaks, forced, strained and strangled voice. Its symptoms result from involuntary and intermittent contractions of thyroarytenoid muscle during speech, which causes vocal fold to strain, pressing each vocal fold against the other and increasing glottic resistance. Botulinum toxin injection remains the gold-standard treatment. However, as injections should be repeated periodically leading to voice quality instability, a more definitive procedure would be desirable. In this pilot study we report the long-term vocal quality results of endoscopic laser thyroarytenoid myoneurectomy. Study Design. Prospective study. Methods. Surgery was performed in 15 patients (11 females and four males), aged between 29 and 73 years, diagnosed with ADSD. Voice Handicap Index (VHI) was obtained before and after surgery (median 31 months postoperatively). Results. A significant improvement in VHI was observed after surgery, as compared with baseline values (P = 0.001). The median and interquartile range for preoperative VHI was 99 and 13, respectively and 24 and 42, for postoperative VHI. Subjective improvement of voice as assessed by the patients showed median improvement of 80%. Conclusions. Because long-term follow-up showed significant improvement of voice quality, this innovative surgical technique seems a satisfactory alternative treatment of ADSD patients who seek a definite improvement of their condition.

Videolaryngostroboscopy and voice evaluation in patients with rheumatoid arthritis

Arthritis may affect the larynx and produce symptoms such as hoarseness and vocal fatigue. Objective: This paper aimed to evaluate the laryngeal manifestations of rheumatoid arthritis. Methods: This is prospective study assessed 27 patients with rheumatoid arthritis with the aid of videolaryngostroboscopy, auditory-perceptual analysis of the speech using the GIRBAS scale, acoustic analysis and the Voice Handicap Index questionnaire. Results: Nineteen patients had laryngeal complaints, the main ones being intermittent dysphonia and sensation of a foreign body in the throat. The most frequent laryngoscopical finding was overlapping arytenoids. Three patients had low pitch, nine patients had mild dysphonia and roughness. Median acoustic measures were: F0, 198.39 Hz; Jitter, 0.815; Shimmer, 4.915; and NHR, 0.144. Regarding the Voice Handicap Index, the median score was zero in all domains. There was a statistically significant correlation between voice complaints and the domains of this index. Functional classes were significantly correlated to: overlapping arytenoids (p = 0.001), PPQ (p = 0.0257), Shimmer (p = 0.0295), APQ (p = 0.0195), and the VHI physical (p = 0.0227) and total domains (p = 0.0425). Conclusion: Laryngeal complaints were reported by 70.4% of the patients and laryngoscopical alterations were observed in 48% of the subjects. Voice acoustic evaluation and self-perception were altered.