Programa de saúde vocal para educadores: ações e resultados

TEMA: a voz do professor tem sido foco de estudos nas últimas duas décadas devido à alta ocorrência de alterações vocais nesta classe profissional, assim, reforçou-se a necessidade dos professores participarem de ações para garantir saúde vocal. Poucos são os estudos na literatura que descrevem programas e seus resultados. PROCEDIMENTOS: Descrever um Programa de Saúde Vocal desenvolvido no período 2002 a 2005, para educadores de ensino público (infantil e fundamental) do interior do Estado de São Paulo, composto por grupos básicos de voz oferecendo conhecimento teórico prático de cuidados vocais, com triagem da qualidade da voz dos participantes; grupos avançados buscando reorganização dos processos de fonação e do uso vocal em sala de aula. RESULTADOS: em média 56% dos educadores inscritos frequentaram as ações; 62,9% das vozes apresentavam distúrbios na triagem vocal com maioria em grau discreto; no início dos grupos avançados 100% dos educadores participantes referiram mais de 3 sintomas associados ao uso vocal, e após, somente 45% deles ainda de 4 a 13 sintomas; os dados de autopercepção vocal revelaram baixos escores de impacto da voz nas atividades profissionais. CONCLUSÃO: a descrição revelou a necessidade de ajustes constantes do programa para alcançar seus objetivos. A baixa participação às ações pode estar relacionada à presença de impacto discreto da voz nas atividades profissionais, fato a ser mais bem investigado no futuro, e o benefício constatado objetivamente da participação dos educadores nos grupos avançados de voz foi a diminuição na quantidade de sintomas vocais.

Morphometric and histochemical study of the human vocal muscle

The present study was conducted on vocal muscles removed at autopsy Rom adult individuals (10 men and 8 women, aes ranging from 48 to 78 years) with no laryngeal disease. Histologic analysis was performed with hematoxylin and eosin staining, and histochemical analysis was performed by nicotinamide-adenine-dinucleotide tetrazolium reductase, succinate dehydrogenase, and acid and alkaline myofibrillar adenosine triphosphatase reactions. The histochemical reactions showed that the muscle consists of slow-twitch oxidative (SO), fast-twitch glycolytic (FG), and fast-twitch glycolytic oxidative (FOG) fibers distributed in mosaic form. The frequencies of SO, FOG, and FG fibers were 40.50%, 54.75%, and 4.75%, respectively. The higher frequency of SO and FOG oxidative fibers characterizes the muscle as having aerobic metabolism, resistance to fatigue, and fast contraction. The mean minimum diameters were 31.37 mu m for SO fibers and 36.46 mu m for FOG and FG fibers.

Morphological and quantitative aspects of nodule formation in hemolymph of the blowfly Chrysomya megacephala (Fabricius, 1794)

Insects manifest effective immune responses that include both cellular and humoral components. Morphological and quantitative aspects of cellular and Immoral cooperation during nodule formation in Chrysomya megacephala hemolymph against Saccharomyces cerevisae yeast cells were demonstrated for the first time. The analyses were performed in non-injected larvae (NIL), saline-injected larvae (SIL) and yeast-injected larvae (YIL). The hemolymph of injected groups was collected 0.5, 1, 2, 4, 12, 24, 36, or 48-h post-injection. Morphological aspects of YIL nodulation were investigated using transmission electron microscopy (TEM). Quantitative analyses consisted of total (THC) and differential hemocyte counts (DHC) in all the groups and total yeast count (TYC) in YIL, which were performed in an improved Neubauer chamber. Nodule formation was initiated at approximately 2-h post-injection. Twelve hours after the injection, TEM revealed the presence of an amorphous membrane, at the same time that circulating hemocyte number decreased significantly contrasting the increase of yeast number. Our results showed the ability of C megacephala hemolymph to perform humoral encapsulation when hemocyte population is insufficient to eliminate the microorganisms, warranting consideration in future investigations on the relative roles played by cellular and humoral elements of innate immunity of this calliphorid. (c) 2007 Elsevier B.V. All rights reserved.

Paralisia de corda vocal e cisto de tiroide

The authors present a rare case of vocal cord paralysis following thyroid cyst. The clinical diagnostic and evolution aspects are presented. The importance of precise evaluation of the thyroid gland in all cases of vocal cord paralysis is emphasized.

Laryngeal electromyography: Contribution to vocal fold immobility diagnosis

Laryngeal Electromyography (LEMG) is a diagnostic test commonly used in patients with vocal fold movement disorder The aim of this study is to describe LEMG in patients with vocalfold immobility. A total of 55 dysphonic patients with vocal fold immobility diagnosed by laryngeal endoscopy were grouped according to probable clinical cause: 1) unknown; 2) traumatic; or 3) tumoral compression. They were submitted to LEMG by percutaneous insertion of concentric needle electrode. LEMG was conclusive in all patients and showed a majority with peripheral nerve injury. LEMG diagnosed peripheral nerve damage in 25 group 1, 12 group 2, and 11 group 3 patients. LEMG was normal in 4 patients, suggesting cricoarytenoid joint fixation. Central nervous system disorders was suggested in 2 and myopathic pattern in 1. As the major cause of vocal fold immobility is peripheral nerve damage, LEMG is an important test to confirm diagnosis.

Low-grade endometrial stromal sarcoma presenting as vaginal nodule

Endometrial stromal sarcoma is a rare neoplasm of the uterus. Extrauterine locations of this neoplasm, excluding metastases or local extension, are even more unusual and are usually associated with the presence of endometriosis. The authors report a case of endometrial stromal sarcoma presenting as a vaginal wall nodule, without any sign of primary uterine tumor after extensive evaluation or presence of endometriosis. The morphology, immunohistochemical profile, differential diagnoses, and pathogenesis are discussed, as well as a review of the literature on this issue. © 2004 Elsevier Inc. All rights reserved.

Fine needle aspiration biopsy of gastrointestinal stromal tumor presenting as an umbilical mass (Sister Mary Joseph's nodule)

The Sister Mary Joseph (SMJ) nodule is a clinical sign of metastatic cancer involving the umbilicus. The vast majority of these instances represent adenocarcinomas arising from ovarian or colorectal primaries. We present a patient who presented with ascites and the SMJ lesion that turned out to be a metastatic gastrointestinal stromal tumor after fine needle aspiration biopsy was performed. The lesion was subsequently histologically confirmed. Gastrointestinal stroma tumor involving the umbilicus is exceedingly uncommon and only rarely presents in this fashion. The cytomorphological features, differential diagnosis, and comparison with the tissue specimen are made. © 2006 Elsevier Inc. All rights reserved.

Vocal folds vibrations with a three-dimensional deformable model

In this work a computational method is presented to simulate the movements of vocal folds in three dimensions. The proposed model consists of a mesh free structure where each vertex is connected its neighbor through a group spring-damper. Forced oscillations were studied by time varying surface forces. The preliminary results using this model are similar with the literature and with the experimental stroboscopic observations of larynx. © 2006 IEEE.

Nodule growth and nitrogen fixation of Calopogonium mucunoides L. show low sensitivity to nitrate

It is well established that nitrate is a potent inhibitor of nodulation and nitrogen fixation in legumes. The objective of this study was to demonstrate the relative insensitivity of these processes to nitrate with Calopogonium mucunoides, a tropical South American perennial legume, native to the cerrado (savannah) region. It was found that nodule number was reduced by about half in the presence of high levels of nitrate (15 mM) but nodule growth (total nodule mass per plant) and nitrogen fixation (acetylene reduction activity and xylem sap ureide levels) were not affected. Other sources of N (ammonium and urea) were also without effect at these concentrations. At even higher concentrations (30 mM), nitrate did promote significant inhibition (ca. 50%) of acetylene reduction activity, but no significant reduction in xylem sap ureides was found. The extraordinary insensitivity of nodulation and N2 fixation of C. mucunoides to nitrate suggests that this species should be useful in studies aimed at elucidating the mechanisms of nitrate inhibition of these processes. © 2010 Springer Science+Business Media B.V.

Necrotizing sialometaplasia as a cause of a non-ulcerated nodule in the hard palate: A case report

Introduction. Necrotizing sialometaplasia is a benign, self-limiting and rare inflammatory disease which, on clinical and histological examination, mimics malignant neoplasms. Case report. We report the case of a healthy 25-year-old Caucasian woman with a three-week history of a painless lump on her hard palate. Oral examination revealed a nodule consisting of two lobules on the right side that measured 2.5 cm. Her mucosa was normal in color and a fluctuant area was detected in the posterior region upon palpation. Our patient was submitted to incisional biopsy and histopathological examination. The histological diagnosis was necrotizing sialometaplasia. The lesion had healed spontaneously after 30 days, with observed signs of involution of the nodule. Conclusion: Histopathological examination is necessary for the diagnosis of necrotizing sialometaplasia because the clinical features of this condition can mimic other diseases, particularly malignant neoplasms. © 2011 Oliveira Alves et al; licensee BioMed Central Ltd.

Granular cell tumor presenting as a tongue nodule: Two case reports

Introduction. Granular cell tumor is an uncommon neoplasm that can occur in any part of the body, including the orofacial region. The tumor is usually benign, but there are reports of cases in which the tumor shows a locally aggressive behavior, malignancy, and distant metastases. The most widely accepted hypothesis is that granular cell tumor arises from the altered metabolism of Schwann cells. The tumor is typically asymptomatic and appears as a nodule that does not exceed 3 cm. Case presentation. In case 1, a 26-year-old Caucasian man was seen at the Oral Medicine out-patient clinic of the São José dos Campos Dental School, Universidade Estadual Paulista, with a 'small blister on the tongue', which he had noted approximately three years ago. The nodule was located on the dorsum of the tongue, measured about 1.5 cm in diameter, and was not tender to palpation. Treatment consisted of an excisional biopsy performed on the basis of the diagnostic hypothesis of granular cell tumor, which was confirmed by microscopic analysis. In case 2, a 31-year-old Caucasian woman attended the out-patient clinic of the São José dos Campos Dental School, Universidade Estadual Paulista, with a five-year history of a 'painful lump on the tongue'. Intra-oral examination revealed the presence of a nodular lesion measuring approximately 0.8 cm in diameter, which was located deep in the submucosa of the right lateral margin of the tongue. Treatment consisted of an excisional biopsy performed on the basis of the differential diagnosis of neurofibroma and granular cell tumor. Microscopic analysis defined the final diagnosis of granular cell tumor. Conclusions: Granular cell tumor is an uncommon tumor that must be carefully diagnosed and treated correctly. © 2012 Sena Costa et al; licensee BioMed Central Ltd.

Clinical diagnosis and histological analysis of vocal nodules and polyps

Recent studies emphasize the importance of the clinical-histology correlation in laryngeal pathologies. Objective: To compare the ENT diagnosis with the pathology diagnosis one of 132 surgical specimens, from 119 patients with vocal nodules and polyps. Method: Retrospective study. We investigated the paraffin blocks corresponding to the lesions of the operated patients. We made new histology cross-sections, totaling 396 new slides, divided into three groups: hematoxylin and eosin, Gomori trichrome and PAS. We analyzed the following histological parameters: epithelium, lamina propria, basement membrane, vascular changes. We compared the laryngological and pathological diagnoses, and we did the statistical analysis, checking the predominant histological aspects in each lesion. Results: There was an agreement between the clinical and pathological diagnoses in 123 (93.18%) of 132 lesions analyzed (42.42% nodules and 50.76% polyps). In the histological parameters we found: epithelial changes such as nodules hyperplasia (82.14%) and polyp atrophy (31.34%). Lamina propria: edema in polyps (71.43%), fibrosis in the nodules (57.14%). Basement membrane: thickened nodules (100%), thin/no change in polyps (100%). There was a predominance of vascular changes in the polyps. Conclusion: We found a high correlation between the ENT diagnosis and the pathology report. Histopathologically, the nodules presented with predominantly epithelial changes, lamina propria and basement membrane fibrosis, while the polyps by changes strictly on the lamina propria and vascular aspects.

Vocal Economy in Vocally Trained and Untrained Female Subjects

Objectives: Vocally trained actresses are expected to have more vocal economy than nonactresses. Therefore, we hypothesize that there will be differences in the electroglottogram-based voice economy parameter quasi-output cost ratio (QOCR) between actresses and nonactresses. This difference should remain across different levels of intensity. Methods: A total of 30 actresses and 30 nonactresses were recruited for this study. Participants from both groups were required to sustain the vowels /a/, /i/, and /u/, in habitual, moderate, and high intensity levels. Acoustic variables such as sound pressure level (SPL), fundamental frequency (F0), and glottal contact quotient (CQ) were obtained. The QOCR was then calculated. Results: There were no significant differences among the groups for QOCR. Positive correlations were observed for QOCR versus SPL and QOCR versus F0 in all intensity levels. Negative correlation was found between QOCR and CQ in all intensity levels. Considering the differences among intensity levels, from habitual to moderate and from moderate to loud, only the CQ did not differ significantly. The QOCR, SPL, and F0 presented significant differences throughout the different intensity levels. Conclusion: The QOCR did not reflect the level of vocal training when comparing trained and nontrained female subjects in the present study. Both groups demonstrated more vocal economy in moderate and high intensity levels owing to more voice output without an increase in glottal adduction. © 2013 The Voice Foundation.

Opção ou desconhecimento?: panorama da prática interpretativa ligada ao repertório vocal existente no Brasil de 1730 a 1850, sob o ponto de vista do registro fonográfico brasileiro realizado entre 1957 e 2005

Pós-graduação em Música - IA