Distúrbio de voz e qualidade de vida em professores: um estudo caso-controle / Voice disorder and quality of life in teachers: a case-control / Trastorno de la voz y calidad de vida en docentes: un estudio de casos y controles

Introdução: percepção do indivíduo sobre sua voz e impactos no cotidiano tem sido objeto de estudos que buscam a relação entre qualidade de vida e bem-estar. Objetivo: analisar a relação entre qualidade de vida e presença de distúrbio de voz em docentes da rede municipal de São Paulo. Método: estudo do tipo caso-controle, pareado por escola, com 272 professoras da rede municipal de ensino de São Paulo (167 casos e 105 controles), responderam questionários Condição de Produção Vocal-Professor e World Health Organization Quality of Life/bref, avaliados fonoaudiológica e otorrinolaringológicamente. Foi realizado teste de associação de Qui-quadrado para análise entre a presença de distúrbio de voz e os domínios do WHOQOL/bref. e modelos de regressão logística para calcular a Razão de Chances bruta e ajustada para avaliar riscos em relação às variáveis independentes de interesse. Resultados: os grupos mostraram-se semelhantes quanto a dados sociodemográficos, situação funcional, ambiente e organização de trabalho, e diferentes na autorreferencia a sintomas vocais, confirmando a natureza de estudo caso-controle. Na análise descritiva de cada um dos domínios do WHOQOL/bref, o referente ao meio ambiente apresentou pior média, seguido pelo físico, psicológico e relações sociais. O domínio físico apresentou significância estatística se comparado aos outros domínios, seguido pelo psicológico e do meio ambiente. Não houve diferença significativa sobre as relações sociais. Conclusão: houve associação entre presença de distúrbio de voz e comprometimento do domínio físico da qualidade de vida, havendo um aumento de chances de quase três vezes de quem tem distúrbio vocal apresentar baixos escores no referido domínio.

Introduction: the individual's perception of their voice and impacts on their daily lives has been the object of studies that seek the relationship between quality of life and well-being. Objective: to analyze the relationship between quality of life and the presence of voice disorder in teachers from the municipal network of São Paulo. Method: case-control study, paired by school, with 272 teachers from the municipal education network of São Paulo (167 cases and 105 controls) using questionnaires Vocal Production Condition-Teacher, World Health Organization Quality of Life/bref, speech therapy and otorhinolaryngological assessment, test of Chi-square association, logistic regression models to calculate the crude and adjusted Odds Ratio to assess risks in relation to the independent variables of interest. Results: the groups were similar in terms of sociodemographic data, functional situation, work environment and organization, and different in terms of self-reference to vocal symptoms, confirming the nature of a case-control study. In the descriptive analysis of each of the WHOQOL/bref domains, the one referring to the environment had the worst average, followed by the physical, psychological and social relationships. The physical domain was statistically significant when compared to the other domains, followed by the psychological and environmental domains. There was no significant difference on social relationships. Conclusion: there was an association between the presence of voice disorder and impairment of the physical domain of quality of life, with an increase of almost three times the chances of those who have voice disorder to have low scores in that domain.

Introducción: la percepción que tiene el individuo de su voz y los impactos en su vida diaria ha sido objeto de estudios que buscan la relación entre calidad de vida y bienestar. Objetivo: analizar la relación entre la calidad de vida y la presencia de trastorno de la voz en docentes de la red municipal de São Paulo. Método: estudio de casos y controles, pareado por colegio, con 272 docentes de la red de educación municipal de São Paulo (167 casos y 105 controles), respondieron los cuestionarios Condición de Producción Vocal-Docente y Calidad de Vida de la Organización Mundial de la Salud / bref y evaluaron logopedia y otorrinolaringología. El análisis estadístico incluyó la prueba de asociación de chi-cuadrado y modelos de regresión logística. Resultados: en los grupos, similitudes en cuanto a datos sociodemográficos, situación funcional, ambiente, organización del trabajo y diferencias en la autorreferencia a los síntomas vocales, confirmando la naturaleza de un estudio de casos y controles. En el análisis descriptivo de los dominios WHOQOL / bref, el medio ambiente tuvo el peor promedio, seguido de las relaciones físicas, psicológicas y sociales. Para el dominio físico, significación estadística en comparación con los otros dominios, seguido de psicológico y ambiental. En las relaciones sociales, no hubo diferencia significativa. Conclusión: hubo asociación entre la presencia de trastorno de la voz y el deterioro del dominio físico de la calidad de vida, con un aumento de casi tres veces las posibilidades de que quienes tienen trastorno de la voz tengan puntuaciones bajas.

The relationship between pulmonary and swallowing functions in patients with neuromuscular diseases followed up by a tertiary referral center: a cross-sectional study.

INTRODUCTION: Respiratory muscle weakness is common in patients with neuromuscular diseases (NMD). This puts them at risk for dysphagia and other pulmonary complications. OBJECTIVES: To investigate the relationship between pulmonary function and swallowing in NMD. MATERIALS AND METHODS: In this cross-sectional study, medical records of patients undergoing treatment at the Tertiary Referral Center for Neuromuscular Diseases of Hospital de Apoio de Brasília, Brazil, were reviewed. Respiratory function was assessed through spirometry (FVC and FEV1 measured) and swallowing assessed by the Dysphagia Risk Evaluation Protocol and the Functional Oral Intake Scale. RESULTS: Two hundred and twenty-two patients were included. Dysphagia was present in 46.8% of patients and impairment of pulmonary function in 64.0%. The mean FVC observed was 66.9% and FEV1 was 66.0%, indicating restrictive lung disease. A correlation between the decline of pulmonary and swallowing functions was observed in patients with NMDs (FVC vs. DREP, R = 0.46; FVC vs. FOIS, R = 0.42; FEV1 vs. DREP, R = 0.42; FEV1 vs. FOIS, R = 0.40, p<.01). FVC and FEV1 values tend to be lower in patients with dysphagia in the context of NMD. CONCLUSIONS: A positive correlation between pulmonary function and swallowing outcomes was observed in patients with NMD. Despite respiratory and swallowing impairment being widely present in the population with NMD, they require different treatments according to the disease's pathophysiology. Future studies should be conducted to explore the disease-specific relationship between pulmonary function and swallowing in patients with NMD.

Anal cancer screening in a high-risk behavior group: A local picture / Rastreamento de câncer anal em um grupo de comportamento de alto risco: uma imagem local

ABSTRACT Study objectives To perform anal lesion and anal cancer screening in men living with HIV/AIDS. Methods This is a descriptive, observational, cross-sectional study. Data were obtained from the Specialized Assistance Service (SAE) in Divinópolis, Minas Gerais. A sociodemographic, epidemiological, and sexual behavior questionnaire was applied; material was collected for cytology, high-resolution anoscopy (AAR) was performed, and an acceptability questionnaire applied. Main results Of the 50 men living with HIV/AIDS invited to participate in this study, 6% were excluded because they were illiterate, 40% refused to participate, and 54% participated in the survey. Among these, all answered the self-administered questionnaire. However, ten (37.0%) underwent proctological examination and anal cytology. Of these, two did not respond to the acceptability questionnaire. No anal lesions were identified during AAR and no biopsy was required. A 10% change in anal cytology was found. Conclusions Through the study it was possible to construct a flow of referrals from the SAE to the UFSJ Coloproctology outpatient clinic. Moreover, the existence of internal stigmas on the part of the participants regarding the proctological examination and the lack of information about anal cancer screening are challenges to be overcome.

RESUMO Objetivos do estudo Realizar o rastreamento de lesões anais e câncer anal em homens vivendo com HIV/AIDS. Métodos Trata-se de estudo descritivo observacional transversal, cujos dados foram obtidos no Serviço de Assistência Especializada (SAE) em Divinópolis, Minas Gerais. Foi aplicado questionário sociodemográfico, epidemiológico e de comportamento sexual; realizada coleta de material para citologia, Anuscopia de Alta Resolução (AAR) e aplicado questionário de aceitabilidade do exame. Principais resultados Dos 50 homens vivendo com HIV/AIDS convidados a participar do presente estudo, 6% foram excluídos por serem analfabetos, 40% se recusaram a participar e 54% participaram da pesquisa. Entre estes, todos responderam o questionário autoaplicado. Entretanto, 10 (37.0%) realizaram o exame proctológico e a citologia anal. Desses, dois não responderam ao questionário de aceitabilidade. Não foram identificadas lesões anais durante a AAR, não sendo necessária a realização de biópsia. Foi encontrado 10% de alteração à citologia anal. Conclusões Por meio do estudo foi possível construir um fluxo de encaminhamentos do SAE para o ambulatório de Coloproctologia da UFSJ. Ademais, a existência de estigmas internos por parte dos participantes no que concerne à realização do exame proctológico e a falta de informação a respeito do rastreamento do câncer anal são desafios a serem vencidos.

Oral squamous papilloma: a view under clinical, fluorescence and histopathological aspects.

Oral squamous papilloma is a benign tumor whose pathogenesis has been associated with human papillomavirus infection. Thus, it is noteworthy that human papillomavirus infection is one of the risk factors associated with the development of cervical, anogenital, pharynx, larynx and oral cavity carcinomas. Oral squamous papilloma can affect any region of the oral cavity, and transmission of human papillomavirus can occur by direct contact, sexual intercourse or from mother to child during delivery. The diagnosis is clinical and histopathological, with surgical removal representing the treatment of choice. Recently, widefield optical fluorescence has been used as a complementary examination to the conventional clinical examination in the screening of oral pathological lesions and for the delimitation of surgical margins. We report a case of oral squamous papilloma with its clinical, histopathological features and, in addition, from the perspective of wide field optical fluorescence.

Oral squamous papilloma: a view under clinical, fluorescence and histopathological aspects / Papiloma escamoso oral: uma visão sob aspectos clínicos, de fluorescência e histopatológicos

ABSTRACT Oral squamous papilloma is a benign tumor whose pathogenesis has been associated with human papillomavirus infection. Thus, it is noteworthy that human papillomavirus infection is one of the risk factors associated with the development of cervical, anogenital, pharynx, larynx and oral cavity carcinomas. Oral squamous papilloma can affect any region of the oral cavity, and transmission of human papillomavirus can occur by direct contact, sexual intercourse or from mother to child during delivery. The diagnosis is clinical and histopathological, with surgical removal representing the treatment of choice. Recently, widefield optical fluorescence has been used as a complementary examination to the conventional clinical examination in the screening of oral pathological lesions and for the delimitation of surgical margins. We report a case of oral squamous papilloma with its clinical, histopathological features and, in addition, from the perspective of wide field optical fluorescence.

RESUMO O papiloma escamoso oral é um tumor benigno, cuja patogênese tem sido associada à infecção pelo papilomavírus humano. A infecção pelo papilomavírus humano é um dos fatores de risco associado ao desenvolvimento dos carcinomas cervicais, anogenitais, faríngeos, laríngeos e da cavidade oral. O papiloma escamoso oral pode acometer qualquer região da cavidade oral, e a transmissão do papilomavírus humano ocorre por contato direto, relação sexual ou de mãe para filho durante o parto. O diagnóstico é clínico e histopatológico, e a remoção cirúrgica representa o tratamento de escolha. Recentemente, a fluorescência óptica de campo amplo tem sido empregada como exame complementar ao exame clínico convencional, no rastreio de lesões patológicas orais e para delimitação de margens cirúrgicas. Relatamos um caso de papiloma escamoso oral com suas características clínicas e histopatológicas, sob a perspectiva da fluorescência óptica de campo amplo.

Juvenile-onset recurrent respiratory papillomatosis with pulmonary involvement and carcinomatous transformation

Papilloma associated with recurrent respiratory papillomatosis (RRP), caused by human papilloma virus (HPV) infection types 6 and 11, is the most common benign neoplasm of the larynx. The clinical features of RRP vary widely from mild to aggressive forms. RRP in children is known as juvenile-onset recurrent respiratory papillomatosis (JORRP). Its outcome may be poor or even fatal due to the high rate of recurrence and eventual spread to the entire respiratory tract. Pulmonary invasion is reported to occur in 3.3% of patients with RRP, and malignant transformation in 0.5% of patients. We report the case of a 39-year-old female patient with a diagnosis of JORRP from the age of 3 years, with extensive bilateral pulmonary involvement and malignant transformation. Analysis of the papilloma and carcinomatous tissues revealed the presence of HPV type 11, which is associated with rapid and aggressive progression. We discussed the case on the basis of a literature review on pulmonary invasion, malignant transformation, and HPV 11 aggressiveness.

Juvenile-onset recurrent respiratory papillomatosis with pulmonary involvement and carcinomatous transformation.

Papilloma associated with recurrent respiratory papillomatosis (RRP), caused by human papilloma virus (HPV) infection types 6 and 11, is the most common benign neoplasm of the larynx. The clinical features of RRP vary widely from mild to aggressive forms. RRP in children is known as juvenile-onset recurrent respiratory papillomatosis (JORRP). Its outcome may be poor or even fatal due to the high rate of recurrence and eventual spread to the entire respiratory tract. Pulmonary invasion is reported to occur in 3.3% of patients with RRP, and malignant transformation in 0.5% of patients. We report the case of a 39-year-old female patient with a diagnosis of JORRP from the age of 3 years, with extensive bilateral pulmonary involvement and malignant transformation. Analysis of the papilloma and carcinomatous tissues revealed the presence of HPV type 11, which is associated with rapid and aggressive progression. We discussed the case on the basis of a literature review on pulmonary invasion, malignant transformation, and HPV 11 aggressiveness.

The Perception of Aversiveness of Surgical Procedure Pictures Is Modulated by Personal/Occupational Relevance.

It is well established that emotions are organized around two motivational systems: the defensive and the appetitive. Individual differences are relevant factors in emotional reactions, making them more flexible and less stereotyped. There is evidence that health professionals have lower emotional reactivity when viewing scenes of situations involving pain. The objective of this study was to investigate whether the rating of pictures of surgical procedure depends on their personal/occupational relevance. Fifty-two female Nursing (health discipline) and forty-eight Social Work (social science discipline) students participated in the experiment, which consisted of the presentation of 105 images of different categories (e.g., neutral, food), including 25 images of surgical procedure. Volunteers judged each picture according to its valence (pleasantness) and arousal using the Self-Assessment Manikin scale (dimensional approach). Additionally, the participants chose the word that best described what they felt while viewing each image (discrete emotion perspective). The average valence score for surgical procedure pictures for the Nursing group (M = 4.57; SD = 1.02) was higher than the score for the Social Work group (M = 3.31; SD = 1.05), indicating that Nursing students classified those images as less unpleasant than the Social Work students did. Additionally, the majority of Nursing students (65.4%) chose "neutral" as the word that best described what they felt while viewing the pictures. In the Social Work group, disgust (54.2%) was the emotion that was most frequently chosen. The evaluation of emotional stimuli differed according to the groups' personal/occupational relevance: Nursing students judged pictures of surgical procedure as less unpleasant than the Social Work students did, possibly reflecting an emotional regulation skill or some type of habituation that is critically relevant to their future professional work.

Análise da produção científica nacional sobre distonia focal laríngea / Analysis of national scientific production on laryngeal focal dystonia

Objetivo: Analisar parte da produção científica fonoaudiológica e médica brasileira acerca da distonia focal laríngea, entre os anos de 1980 a 2010. Método: Caracterizar todas as publicações encontradas sobre distonia focal laríngea em periódicos nacionais especializados em Fonoaudiologia e Medicina, no período entre 1980 a 2010, quanto à distribuição de sua frequência, considerando-se o período das publicações, a temática abordada, o procedimento metodológico, a vertente epistemológica e a área da Fonoaudiologia e Medicina a que pertence a publicação. Resultados: 37 artigos foram encontrados, 14(37,8%) em periódicos fonoaudiológicos e 23(62,2%) em periódicos médicos. Embora sem significância estatística, observou-se, em números absolutos, um crescimento da produção, especialmente na primeira década do século XXI. Das 07 temáticas encontradas as mais frequentes foram: caracterização da distonia e efeito do uso de toxina botulínica com 13 (35,1%) artigos respectivamente em cada uma. Quanto à vertente epistemológica 36 (97,3%) artigos eram positivistas. Quanto às áreas de atuação de todos os trabalhos do campo fonoaudiológico, 14(37,8%), eram sobre Voz; nas áreas médicas, 14(60,8%) eram sobre Neurologia; 8(34,7%) sobre Otorrinolaringologia e 1(4,4%) sobre Endocrinologia. Quanto ao procedimento metodológico 13(35,1%) eram Experimentais; 11(29,7%) eram Estudo de Caso Clínico; 9(24,3%) Estudo Bibliográfi co e 4(10,8%) Levantamento. Conclusão: A análise da produção científica fonoaudiológica e médica brasileira acerca da distonia focal laríngea, entre os anos de 1980 a 2010, mostrou que os estudos experimentais sobre efeito do uso de toxina botulínica no funcionamento das pregas vocais foram os mais freqüentes e que o positivismo foi a vertente epistemológica preponderante.(AU)

Purpose: to analyze part of Brazilian Speech-Language and Hearing Sciences and Medical Sciences production on focal laryngeal dystonia, between the years of 1980 and 2010. Method: characterize all papers found in Brasilian specialized journals about focal laryngeal distonia considering: publication period; distribution per period; themes; methodological procedure; epistemological filiations; the areas of Medical and Speech-Language and Hearing Sciences to which the production belongs. Results: 37 articles were found: 14(37.8%) in Speech-Language and Hearing Sciences papers and 23(62.2%) in medical papers. The publications were mainly concentrated in this fi rst decade of the XXI century. Seven themes were found, the most frequent ones: characterization of dystonia and effect of botulinum toxin use with 13(35.1%) articles each. Regarding the epistemological filiations 36(97.3%) papers were positivist. Regarding the areas all the Speech-Language and Hearing Sciences works, 14(37.8%), were about Voice; in the Medical areas 14 (60.8%) were about Neurology; 8(34.7%) about Otorinolaryngology and 1(4.4%) about Endocrinology. Regarding the methodological procedure 13(35.1%) were Experimental Studies; 11(29.7%) Clinical Case Studies; 9(24.3%) Literature Studies and 4(10.8%) Data Collection Studies. Conclusion: The analysis of Brazilian Speech-Language and Hearing Sciences and Medical Sciences production on focal laryngeal dystonia between the years of 1980 and 2010 showed that experimental studies about the effect of botulinum toxin use on the vocal chords functioning were the most frequent and that positivism was the hegemonic epistemological filiation.(AU)

Objetivo: analizar parte de la producción científi ca fonoaudiológica y médica brasileña acerca de distonía focal laríngea, entre los años de 1980 a 2010. Método: Caracterizar todas las publicaciones encontradas sobre distonía focal laríngea en periódicos nacionales especializados en Fonoaudiología y Medicina, durante el período entre 1980 y 2010, cuanto a su distribución de frecuencia, llevándose en cuenta el período de las publicaciones, las temáticas involucradas, el procedimiento metodológico, la vertiente epistemológica y el área de la Fonoaudiología y Medicina a que pertenece la publicación. Resultados: 37 artículos fueron encontrados, 14(37,8%) en periódicos fonoaudiológicos y 23(62,2%) en periódicos médicos. Aunque sin significancia estadística, se observó, en números absolutos, un crecimiento de la producción especialmente en la primera década del siglo XXI. De las siete temáticas encontradas las mas frecuentes fueron: caracterización de la distonia y efecto del uso de toxina butolinica con 13 (35,1%) artículos respectivamente cada una. Cuanto a la vertiente epistemológica 36 (97,3%) artículoseran positivistas. Cuanto a las áreas de actuación, de todos los trabajos del campo fonoaudiológico 14(37,8%) eran sobre Voz; en las áreas médicas 14(60,8%) eran sobre Neurología; 8(34,7%) sobre Otorrinolaringología y 1(4,4%) sobre Endocrinologia. Cuanto al procedimiento metodológico 13(35,1%) eran Experimentales; 11(29,7%) eran Estudios de Caso Clínico; 9(24,3%) Estudio Bibliográfi co; y 4(10,8%) Encuestas. Conclusión: El análisis de la producción científi ca fonoaudiológica y médica brasileña acerca de distonía focal laríngea, entre los años de 1980 a 2010 mostró que los estudios experimentales sobre el efecto del uso de la toxina butolinica en el funcionamiento de las cuerdas vocales fueron los mas frecuentes y que el positivismo fue la vertiente epistemológica dominante.(AU)

Análise da produção científica nacional sobre distonia focal laríngea / Analysis of national scientific production on laryngeal focal dystonia

Objetivo: Analisar parte da produção científica fonoaudiológica e médica brasileira acerca da distonia focal laríngea, entre os anos de 1980 a 2010. Método: Caracterizar todas as publicações encontradas sobre distonia focal laríngea em periódicos nacionais especializados em Fonoaudiologia e Medicina, no período entre 1980 a 2010, quanto à distribuição de sua frequência, considerando-se o período das publicações, a temática abordada, o procedimento metodológico, a vertente epistemológica e a área da Fonoaudiologia e Medicina a que pertence a publicação. Resultados: 37 artigos foram encontrados, 14(37,8 em periódicos fonoaudiológicos e 23(62,2) em periódicos médicos. Embora sem significância estatística, observou-se, em números absolutos, um crescimento da produção, especialmente na primeira década do século XXI. Das 07 temáticas encontradas as mais frequentes foram: caracterização da distonia e efeito do uso de toxina botulínica com 13 (35,1) artigos respectivamente em cada uma. Quanto à vertente epistemológica 36 (97,3) artigos eram positivistas. Quanto às áreas de atuação de todos os trabalhos do campo fonoaudiológico, 14(37,8), eram sobre Voz; nas áreas médicas, 14(60,8) eram sobre Neurologia; 8(34,7) sobre Otorrinolaringologia e 1(4,4) sobre Endocrinologia. Quanto ao procedimento metodológico 13(35,1) eram Experimentais; 11(29,7) eram Estudo de Caso Clínico; 9(24,3) Estudo Bibliográfi co e 4(10,8) Levantamento. Conclusão: A análise da produção científica fonoaudiológica e médica brasileira acerca da distonia focal laríngea, entre os anos de 1980 a 2010, mostrou que os estudos experimentais sobre efeito do uso de toxina botulínica no funcionamento das pregas vocais foram os mais freqüentes e que o positivismo foi a vertente epistemológica preponderante.

Purpose: to analyze part of Brazilian Speech-Language and Hearing Sciences and Medical Sciences production on focal laryngeal dystonia, between the years of 1980 and 2010. Method: characterize all papers found in Brasilian specialized journals about focal laryngeal distonia considering: publication period; distribution per period; themes; methodological procedure; epistemological filiations; the areas of Medical and Speech-Language and Hearing Sciences to which the production belongs. Results: 37 articles were found: 14(37.8) in Speech-Language and Hearing Sciences papers and 23(62.2) in medical papers. The publications were mainly concentrated in this fi rst decade of the XXI century. Seven themes were found, the most frequent ones: characterization of dystonia and effect of botulinum toxin use with 13(35.1) articles each. Regarding the epistemological filiations 36(97.3) papers were positivist. Regarding the areas all the Speech-Language and Hearing Sciences works, 14(37.8), were about Voice; in the Medical areas 14 (60.8) were about Neurology; 8(34.7) about Otorinolaryngology and 1(4.4) about Endocrinology. Regarding the methodological procedure 13(35.1) were Experimental Studies; 11(29.7) Clinical Case Studies; 9(24.3) Literature Studies and 4(10.8) Data Collection Studies. Conclusion: The analysis of Brazilian Speech-Language and Hearing Sciences and Medical Sciences production on focal laryngeal dystonia between the years of 1980 and 2010 showed that experimental studies about the effect of botulinum toxin use on the vocal chords functioning were the most frequent and that positivism was the hegemonic epistemological filiation.

Objetivo: analizar parte de la producción científi ca fonoaudiológica y médica brasileña acerca de distonía focal laríngea, entre los años de 1980 a 2010. Método: Caracterizar todas las publicaciones encontradas sobre distonía focal laríngea en periódicos nacionales especializados en Fonoaudiología y Medicina, durante el período entre 1980 y 2010, cuanto a su distribución de frecuencia, llevándose en cuenta el período de las publicaciones, las temáticas involucradas, el procedimiento metodológico, la vertiente epistemológica y el área de la Fonoaudiología y Medicina a que pertenece la publicación. Resultados: 37 artículos fueron encontrados, 14(37,8) en periódicos fonoaudiológicos y 23(62,2) en periódicos médicos. Aunque sin significancia estadística, se observó, en números absolutos, un crecimiento de la producción especialmente en la primera década del siglo XXI. De las siete temáticas encontradas las mas frecuentes fueron: caracterización de la distonia y efecto del uso de toxina butolinica con 13 (35,1) artículos respectivamente cada una. Cuanto a la vertiente epistemológica 36 (97,3) artículoseran positivistas. Cuanto a las áreas de actuación, de todos los trabajos del campo fonoaudiológico 14(37,8) eran sobre Voz; en las áreas médicas 14(60,8) eran sobre Neurología; 8(34,7) sobre Otorrinolaringología y 1(4,4) sobre Endocrinologia. Cuanto al procedimiento metodológico 13(35,1) eran Experimentales; 11(29,7) eran Estudios de Caso Clínico; 9(24,3) Estudio Bibliográfi co; y 4(10,8) Encuestas. Conclusión: El análisis de la producción científi ca fonoaudiológica y médica brasileña acerca de distonía focal laríngea, entre los años de 1980 a 2010 mostró que los estudios experimentales sobre el efecto del uso de la toxina butolinica en el funcionamiento de las cuerdas vocales fueron los mas frecuentes y que el positivismo fue la vertiente epistemológica dominante.

Environmental impoverishment and aging alter object recognition, spatial learning, and dentate gyrus astrocytes.

Environmental and age-related effects on learning and memory were analysed and compared with changes observed in astrocyte laminar distribution in the dentate gyrus. Aged (20 months) and young (6 months) adult female albino Swiss mice were housed from weaning either in impoverished conditions or in enriched conditions, and tested for episodic-like and water maze spatial memories. After these behavioral tests, brain hippocampal sections were immunolabeled for glial fibrillary acid protein to identify astrocytes. The effects of environmental enrichment on episodic-like memory were not dependent on age, and may protect water maze spatial learning and memory from declines induced by aging or impoverished environment. In the dentate gyrus, the number of astrocytes increased with both aging and enriched environment in the molecular layer, increased only with aging in the polymorphic layer, and was unchanged in the granular layer. We suggest that long-term experience-induced glial plasticity by enriched environment may represent at least part of the circuitry groundwork for improvements in behavioral performance in the aged mice brain.

Postpartum depression in Recife - Brazil: prevalence and association with bio-socio-demographic factors / Depressão pós-parto em Recife - Brasil: prevalência e associação com fatores biossociodemográficos

OBJECTIVE:To use a semi-structured interview to detect depression in postpartum women according to the criteria proposed by the DSM in child health care clinics in the city of Recife, together with the proper association of this disorder to bio-socio-demographic data. METHODS: The study used a cross-section method and contained a convenience sample of 400 women that were between 2 and 26 weeks of postpartum in child health care clinics. A bio-socio-demographic questionnaire and the Portuguese version of the Structured Clinical Interview for DSM-IV Axis I Disorders were used. RESULTS: Twenty nine of the mothers (7.2 percent) were diagnosed as suffering from postpartum depression. Women with a past history of psychiatric disorders, a family history of psychiatric disorder and some sort of clinical complication presented a higher prevalence of depression. The same happened to those with a past history of spontaneous abortion, those who had a transpelvic birth and those over 8 weeks of puerperium. CONCLUSION: The rate of postpartum depression in this sample, 7.2 percent, was lower than that reported by other Brazilian studies. It probably occurred because the other researchers used screening scales to assess this estimate instead of a clinical interview.

OBJETIVO: Utilizar uma entrevista clínica semiestruturada para a detecção de depressão em mulheres puérperas, de acordo com os critérios do DSM em serviços de puericultura da cidade do Recife, juntamente com uma apropriada associação entre esse transtorno e dados biossociodemográficos. MÉTODOS: O estudo utilizou um corte transversal e teve uma amostra de conveniência de 400 mulheres que levavam seus bebês para ambulatórios de puericultura e que estavam entre 2 e 26 semanas de pós-parto. Um questionário biossociodemográfico e a versão em português do Structured Clinical Interview for DSM-IV Axis I Disorders foram utilizados. RESULTADOS: Vinte e nove das mães (7,2 por cento) foram diagnosticadas como tendo depressão pós-parto. Mulheres com história pregressa de transtornos mentais, história familiar de transtornos mentais e com alguma complicação médica geral apresentaram prevalência maior de depressão. O mesmo ocorreu com aquelas com história anterior de abortamento espontâneo, aquelas que haviam tido parto transpelviano e aquelas que estavam com mais de 8 semanas de puerpério. CONCLUSÃO: A taxa de depressão pós-parto na nossa amostra, 7,2 por cento, foi menor do que aquelas relatadas em outros estudos brasileiros. Isso provavelmente ocorreu porque os outros pesquisadores utilizaram instrumentos de triagem para depressão em vez de entrevistas clínicas.

Postpartum obsessive-compulsive disorder: prevalence and clinical characteristics.

OBJECTIVE: The principal aims of this study were to examine the prevalence rate, clinical characteristics, and related factors of postpartum obsessive-compulsive disorder (OCD). METHOD: The subjects were a nonclinical sample of 400 postpartum women. They were interviewed from the 2nd up to the 26th week after birth. The Mini International Neuropsychiatric Interview was used for diagnosis of OCD, the Yale-Brown Obsessive-Compulsive Symptom Checklist was used to determine the types of obsessions and compulsions, and the Structured Clinical Interview for DSM-IV Axis I Disorders was used to diagnose comorbid depressive episode. RESULTS: Thirty-six (9%) of the sample met the diagnostic criteria for OCD according to the Mini International Neuropsychiatric Interview, and 9 (2.3%) reported postpartum onset OCD. Obsessive-compulsive disorder was more frequent in mothers with personal history of previous psychiatric disorder, somatic disease, or obstetric complication in pregnancy/birth, and who were multiparous. The most common obsessions were aggressive, contamination and miscellaneous, and compulsion for washing/cleaning and checking, and 38.9% have a comorbid depressive episode. CONCLUSION: Women have increased risk of OCD or obsessive-compulsive symptoms in the postpartum period. For this reason, all women, particularly women with previous psychiatric history, somatic disease, or with complications in pregnancy or at the birth should be carefully screened for OCD in the postpartum period.

Mediastinal teratoma with malignant degeneration.

Here, we report the case of a patient with a slowly-progressing anterior mediastinal teratoma submitted to surgical resection. The anatomopathological examination of the sample revealed malignant degeneration to carcinoid tumor. Such evolution is very rare, and we have found only three related studies in the literature. We describe the clinicopathological features of the tumor and discuss the treatment administered. The evolution was satisfactory, and the patient was submitted to oncological treatment.

Teratoma de mediastino com degeneração maligna / Mediastinal teratoma with malignant degeneration

No presente artigo, relatamos o caso de um paciente portador de teratoma de mediastino anterior, de evolução lenta, o qual foi submetido à ressecção cirúrgica. O exame anatomopatológico da peça revelou degeneração maligna para tumor carcinóide. Tal evolução é extremamente rara, sendo encontrados na literatura apenas três artigos correlatos. Apresentamos uma descrição clínico-patológica do tumor e, por fim, discutimos a conduta terapêutica. Houve evolução satisfatória, e o paciente foi submetido a tratamento oncológico.

Here, we report the case of a patient with a slowly-progressing anterior mediastinal teratoma submitted to surgical resection. The anatomopathological examination of the sample revealed malignant degeneration to carcinoid tumor. Such evolution is very rare, and we have found only three related studies in the literature. We describe the clinicopathological features of the tumor and discuss the treatment administered. The evolution was satisfactory, and the patient was submitted to oncological treatment.