Saúde-game: um jogo sério para informar sobre o coronavírus e combater a falsa informação / Health-game: a serious game to inform about coronavirus and combat false information

O mercado de games digitais no Brasil tem um crescimento de destaque nos últimos anos. Nessa área têm se destacado os jogos educativos, que demonstram resultados positivos para a prática de gamificação no processo de aprendizado. Este artigo apresenta um jogo sério em formato de quiz que visa informar sobre a COVID-19, ressaltando a importância do compartilhamento de informações verídicas sobre o vírus. Faz-se uso de uma metodologia para regionalização de informações com ênfase nas situações cotidianas pretendendo, assim, combater falsas informações de forma prática, escalável e lúdica. Os resultados, obtidos a partir da validação com 30 estudantes que testaram o game, serviram de material de apoio para melhorias no jogo e apontam que, mesmo utilizando técnicas relativamente simples e já usuais no cenário de jogos sérios, é possível inovar nesse campo e fornecer à sociedade uma ferramenta conectada ao momento e às dificuldades por ele enfrentadas.

The market for digital games in Brazil has been growing prominently in recent years. In this area, educational games have been highlighted, which demonstrate positive results for the practice of gamification in the learning process. This article presents a serious quiz game that aims to inform you about the COVID-19, highlighting the importance of sharing truthful information about the virus. Making use of a methodology for regionalization of information with emphasis on everyday situations, thus intending to combat false information in a practical, scalable and playful way. The results, obtained from the validation with 30 students who tested the game, served as supporting material for improvements in the game and point out that, even using relatively simple and already usual techniques in the serious game scenario, it is possible to innovate in this field and provide society with a tool connected to the moment and difficulties it faces.

Multicriteria approach to prioritize forest restoration areas for biodiversity conservation in the eastern Amazon.

Due to the global magnitude of forest degradation and deforestation and the high cost of ecological restoration, several approaches have been used to prioritize conservation or restoration areas based on different objectives and criteria. The present work aims to develop a multicriteria approach to defining forest restoration priority areas in the Itacaiúnas River basin, eastern Amazon, that maximizes the criteria equitably. The selected criteria were: improve forest connectivity, provide climatic refuges for biodiversity, mitigate the impacts of deforestation on streamflow, and improve the probability of natural regeneration. A strong difference between selected areas was observed when the criteria of forest connectivity and mitigate the impact on streamflow were considered separately, but greater equity among the criteria was achieved using the multicriteria approach. The most priority areas were concentrated near protected areas. The method used provides a flexible framework, and different criteria or subarea selections can be applied for different purposes to facilitate adaptive management. Analyzing forest restoration prioritization on rural properties can provide guidance for conserving and restoring biodiversity at the landscape scale while complying with legal requirements.

Sentidos da violência. A trajetória do Fórum Social de Manguinhos (2007-2016) / Meanings of Violence. The trajectory of the Social Movement Forum of Manguinhos (2007-2016)

Esta dissertação busca descrever diferentes configurações de atores sociais em seus rearranjos após intervenções do poder público no Complexo de Manguinhos. Pretendemos com isso identificar os sentidos atribuídos à violência que mobilizam a ação coletiva em um cenário de arbitrariedades de atuação do Estado e progressiva militarização do território da favela. Dois grandes eventos promoveram reorganizações dos atores sociais nas favelas do Complexo de Manguinhos: a inclusão no Programa de Aceleração do Crescimento (PAC) e a instalação de uma Unidade de Polícia Pacificadora (UPP). Podemos identificar três momentos de reconfiguração de atores coletivos deste território no período estudado. Na primeira configuração (2007-2009), o Fórum Social de Manguinhos (FSM) foi constituído a partir da mobilização dos moradores para o acompanhamento das intervenções do PAC e posteriormente tornou-se espaço de denuncia da arbitrariedade estatal, após a retirada do Estado das mesas de negociação. A segunda configuração (2009-2012), quando, após ameaças a alguns de seus membros e a desmobilização dos moradores, o FSM se afasta do acompanhamento direto do PAC e busca criar novas estratégias de atuação em Manguinhos. Nesse período com a assessoria da Escola Nacional de Saúde Pública (ENSP/FIOCRUZ), nas reuniões do FSM foram discutidas a criação de outros coletivos como o Conselho Comunitário de Manguinhos (CMM) e o Conselho Gestor Intersetorial (CGI) do TEIAS-Escola Manguinhos. A terceira configuração (2013-2016) foi marcada pela implantação da UPP no território. O FSM retomou sua atuação de denúncias das arbitrariedades cometidas pelo Estado, nesse momento através da violência policial. Acolheu também em suas reuniões mulheres que tiveram seus filhos mortos por agentes da UPP, dando apoio a constituição do coletivo Mães de Manguinhos. O FSM pautou sua atuação a partir de diferentes sentidos atribuídos à violência, conforme as inflexões de sua trajetória: da demanda pelas condições estruturais de urbanização que contribuíam para um cenário de violências, passando pela violência estatal que desconsidera a voz dos moradores para intervir no território, chegando à denúncia da violência policial e do racismo estrutural que torna os moradores da favela vítimas seletivas. Para empreender essa tarefa travei diálogo com as Ciências Sociais, especialmente com os estudos sobre violência urbana e associativismo social. Realizei a análise de documentos elaborados pelo Fórum Social de Manguinhos no período e entrevistas em profundidade com uma ex-integrante e dois atuais integrantes do Fórum Social de Manguinhos. (AU)

This study seeks to describe distinct configurations of social actors and their rearrangements after State interventions in Manguinhos Favela Complex. We intend to identify the meanings assigned to violence that urges collective action in the context of State abuse and the militarization of favela territory. Two major events promoted the rearrangement of social actors of Manguinhos Favela Complex: the selection of Manguinhos to receive the government´s Growth Acceleration Plan (Programa de Aceleração do Crescimento ­ PAC) and the inauguration of a military unit of proximity law-enforcement, named Pacifying Police Unit (Unidade de Polícia Pacificadora ­ UPP). We can identify three moments of reconfiguration of social collectives on Manguinhos. In the first configuration (2007-2009), the Social Movement Forum of Manguinhos (Fórum Social de Manguinhos ­ FSM) was assembled by Manguinhos dwellers trying to interfere in the Growth Acceleration Plan interventions. Later, after the State withdrawal from negotiations, the FSM becomes a place to denounce State abuse. In the second configuration (2009-2012), after some members of FSM were threatened and the demobilization of Manguinhos dwellers, FSM departed from follow-up PAC interventions, and seeks new strategies to act in Manguinhos. In this period, with the assistance of the National School of Public Health (Escola Nacional de Saúde Pública ­ ENSP), FSM meetings were used to discuss the creation of other collectives in Manguinhos. The third configuration (2013-2016) was marked by the UPP inauguration. FSM resumed the denouncement of State abuse, now through police violence. FSM also welcomed mothers of juveniles murdered by cops in its meetings, giving support for the assembling of a new collective, Mothers of Manguinhos. FSM guided it actions by different meanings assigned to violence according to the inflections in its trajectory, from structural conditions of urbanization that contributed to a scenario of violence to State abuse by police violence and structural racism. To do this research, I dialogued with studies in urban violence and social associativism, analyzed FSM public documents, and interviewed members and former members of FSM. (AU)

Preliminary Correlation of the Immunoexpression of Cathepsin B and E-Cadherin Proteins in Vocal Fold Leukoplakia.

OBJECTIVES: Early identification of vocal fold leukoplakia (VFL), which has a risk of progressing to malignant transformation, remains a controversial topic. The identification of biological markers for diagnosing these lesions would lead to a more effective treatment. We aimed to analyze the immunoexpression of cathepsin B and E-cadherin in VFL and correlate it with clinical and epidemiological data and disease prognosis. METHODS: Thirty-two patients with VFL treated with microsurgery were retrospectively evaluated. The patients were distributed according to the histological results into Group A (low grade) and Group B (high grade). The expression of markers was quantitatively determined as per their staining intensity and tissue distribution using ImageLab. The index of expression (IE) of each marker was correlated with tobacco and alcohol consumption, signs of laryngopharyngeal reflux, and local recurrence of the lesion. RESULTS: The correlation between the IE of markers and variables within the two groups (A and B) demonstrated that patients in Group B with local recurrence had a higher IE of cathepsin B. When all patients (A + B) were included, the same analysis demonstrated that the IE of cathepsin B was higher among smokers and patients who did not show signs of reflux and that the IE of E-cadherin was higher only in patients with recurrence. CONCLUSION: Patients with moderate to severe dysplasia and carcinoma in situ who smoked as well as had a high IE of cathepsin B were more prone to local recurrence. Regardless of the type of histological lesion, patients with signs of laryngopharyngeal reflux had a lower IE of cathepsin B. The IE of E-cadherin was higher among patients with VFL who relapsed after initial treatment.

The role of protected and deforested areas in the hydrological processes of Itacaiúnas River Basin, eastern Amazonia.

To protect indigenous land and avoid the spread of deforestation in the Amazon, state and federal Brazilian agencies recognized several protected areas since the 1990s. However, the importance of these protected areas in the water cycle and the hydrologic connection with surrounding landscapes is little analyzed. In this study, we evaluated the role of preserved and deforested areas in the water balance in the Itacaiúnas River Basin using the MGB hydrological model. We estimated the impacts of land cover changes on evapotranspiration and discharge for four scenarios: Preserved (1984 land cover), Recent (2013 land cover, with 50% deforestation), Hypothetical deforestation of protected areas (70% deforestation) and complete deforestation of protected areas (79% deforestation). We showed that deforestation of the remaining preserved area could be responsible for a decrease of 23% (3.5 km³/year) in water transfer to the atmosphere by evapotranspiration. Furthermore, we showed that each 15% of deforestation occurring between the Preserved and Recent scenarios increased the average discharges by 5.4% (40 m³/s). Additionally, past land cover changes in the headwaters of the Itacaiúnas River Basin caused statistically significant changes in discharges inside the protected areas. This insight is considered important due to the association between increases in discharges and water quality issues. The results suggest that headwater areas of secondary drainages that run into the forested domains should be prioritized for reforestation programs. Likewise, the reforestation of nonprotected areas could be responsible for restoring ecosystem services, including hydrological functions, biodiversity and water quality.

Vocal Symptoms and Associated Risk Factors between Male and Female University Teachers.

Introduction Many recent studies on teachers warn of the adverse effects that voice problems have on work performance. However, only a few of these studies included university teachers. Objective To compare the vocal symptoms and risk factors between male and female university teachers in a private institution within the city of São Paulo. Methods In a cross-sectional survey, a voice self-evaluation form prepared by the Ministry of Labor in Brazil was administered to 846 university teachers at a private institution in the city of São Paulo. Results The percentage of hoarseness, vocal tract discomfort, neck pain and foreign body sensation was significantly higher in female than in male subjects. A significantly higher percentage of males participated in other professional activities in addition to teaching, reported working in a calm environment compared with working in a moderately or severely tense and stressful environment, and rated themselves as calm, slightly stressed and anxious or moderately stressed and anxious rather than very stressed and anxious. A significantly higher percentage of females spent most of their time teaching compared with performing other professional activities, and rated themselves as chatty or impulsive. Conclusion Among university teachers, a significantly higher percentage of females than males reported hoarseness, vocal tract discomfort, neck pain and foreign body sensation. Some risk factors related to work organization, workplace environment, voice care and quality of life variables were related to this higher prevalence in females.

Vocal Symptoms and Associated Risk Factors between Male and Female University Teachers

Abstract Introduction Many recent studies on teachers warn of the adverse effects that voice problems have on work performance. However, only a few of these studies included university teachers. Objective To compare the vocal symptoms and risk factors betweenmale and female university teachers in a private institution within the city of São Paulo. Methods In a cross-sectional survey, a voice self-evaluation form prepared by the Ministry of Labor in Brazil was administered to 846 university teachers at a private institution in the city of São Paulo. Results The percentage of hoarseness, vocal tract discomfort, neck pain and foreign body sensation was significantly higher in female than in male subjects. A significantly higher percentage of males participated in other professional activities in addition to teaching, reported working in a calm environment compared with working in a moderately or severely tense and stressful environment, and rated themselves as calm, slightly stressed and anxious ormoderately stressed and anxious rather than very stressed and anxious. A significantly higher percentage of females spent most of their time teaching compared with performing other professional activities, and rated themselves as chatty or impulsive. Conclusion Among university teachers, a significantly higher percentage of females than males reported hoarseness, vocal tract discomfort, neck pain and foreign body sensation. Some risk factors related to work organization, workplace environment, voice care and quality of life variables were related to this higher prevalence in females.

Educational Software Applied in Teaching Electrocardiogram: A Systematic Review.

BACKGROUND: The electrocardiogram (ECG) is the most used diagnostic tool in medicine; in this sense, it is essential that medical undergraduates learn how to interpret it correctly while they are still on training. Naturally, they go through classic learning (e.g., lectures and speeches). However, they are not often efficiently trained in analyzing ECG results. In this regard, methodologies such as other educational support tools in medical practice, such as educational software, should be considered a valuable approach for medical training purposes. METHODS: We performed a literature review in six electronic databases, considering studies published before April 2017. The resulting set comprises 2,467 studies. From this collection, 12 studies have been selected, initially, whereby we carried out a snowballing process to identify other relevant studies through the reference lists of these studies, resulting in five relevant studies, making up a total of 17 articles that passed all stages and criteria. RESULTS: The results show that 52.9% of software types were tutorial and 58.8% were designed to be run locally on a computer. The subjects were discussed together with a greater focus on the teaching of electrophysiology and/or cardiac physiology, identifying patterns of ECG and/or arrhythmias. CONCLUSIONS: We found positive results with the introduction of educational software for ECG teaching. However, there is a clear need for using higher quality research methodologies and the inclusion of appropriate controls, in order to obtain more precise conclusions about how beneficial the inclusion of such tools can be for the practices of ECG interpretation.

Vocal Tract Discomfort and Risk Factors in University Teachers.

OBJECTIVES: To characterize the presence of and risk factors for throat pain or irritation among male and female university teachers in private institutions within the city of São Paulo. STUDY DESIGN: This is a cross-sectional survey. METHODS: Voice self-evaluation forms prepared by the Brazilian Ministry of Labor were administered to 846 university teachers in a private institution in the city of São Paulo, Brazil. RESULTS: The prevalence of throat pain or irritation was 50.8% and was higher in the women (62.7%) than in the men (43.5%). The prevalence of throat pain or irritation was higher among professionals ≤60 years old and among those who spent most of their time teaching compared with those who spent most of their time performing other professional activities. Other factors, such as noise and sound competition, air pollution, stress and anxiety, personal habits, and lifestyle/quality of life, were related to the presence of throat pain or irritation. CONCLUSIONS: University teachers demonstrated a high prevalence of throat pain or irritation. Factors such as age ≤60 years, female gender, time-consuming professional activities, noise and sound competition in the work environment, stress and anxiety, air pollution, access to water, personal habits, and lifestyle/quality of life were related to the presence of throat pain or irritation.

The Effectiveness of the Comprehensive Voice Rehabilitation Program Compared With the Vocal Function Exercises Method in Behavioral Dysphonia: A Randomized Clinical Trial.

OBJECTIVE: To evaluate the effectiveness of the Comprehensive Voice Rehabilitation Program (CVRP) compared with Vocal Function Exercises (VFEs) to treat functional dysphonia. STUDY DESIGN: This is a randomized blinded clinical trial. METHODS: Eighty voice professionals presented with voice complaints for more than 6 months with a functional dysphonia diagnosis. Subjects were randomized into two voice treatment groups: CVRP and VFE. The rehabilitation program consisted of six voice treatment sessions and three assessment sessions performed before, immediately after, and 1 month after treatment. The outcome measures were self-assessment protocols (Voice-Related Quality of Life [V-RQOL] and Voice Handicap Index [VHI]), perceptual evaluation of vocal quality, and a visual examination of the larynx, both blinded. RESULTS: The randomization process produced comparable groups in terms of age, gender, signs, and symptoms. Both groups had positive outcome measures. The CVRP effect size was 1.09 for the V-RQOL, 1.17 for the VHI, 0.79 for vocal perceptual evaluation, and 1.01 for larynx visual examination. The VFE effect size was 0.86 for the V-RQOL, 0.62 for the VHI, 0.48 for the vocal perceptual evaluation, and 0.51 for larynx visual examination. Only 10% of the patients were lost over the study. CONCLUSIONS: Both treatment programs were effective. The probability of a patient improving because of the CVRP treatment was similar to that of the VFE treatment.

Hoarseness and Risk Factors in University Teachers.

PURPOSE: To characterize the presence of hoarseness and the risk factors in male and female university teachers in private institutions in the city of São Paulo, Brazil. STUDY DESIGN: Cross-sectional survey. METHODS: Voice self-evaluation forms prepared by the Brazilian Ministry of Labor were administered to 846 university teachers in a private institution in the city of São Paulo, Brazil. RESULTS: Prevalence of hoarseness in the sample is 39.6%. Percentage of hoarseness is higher in females (51.8%) than in males (32.6%). Comparing hoarseness and time of teaching, it was observed that the percentage of hoarseness is lower in a time shorter or equal to 1 year, and it is higher in a time between 10 and 20 years. Percentage of hoarseness is lower in the maximum workload of one to three class hours per day compared with the other workloads. Percentage of hoarseness is lower when the maximum number of students per classroom is less than 30 than when it is between 101 and 150 students. Other factors like in terms of noise and sound competition, air pollution, and in terms of causing stress and anxiety, besides habits and style/quality of life are related to the presence of hoarseness. CONCLUSION: University teachers show high percentage of hoarseness. Factors, such as time of teaching, females, work organization, workplace, in terms of noise and sound competition, air pollution, and in terms of causing stress and anxiety, besides habits and style/quality of life, are related to the presence of hoarseness in this group.

Presentation of the Comprehensive Vocal Rehabilitation Program for the treatment of behavioral dysphonia / Apresentacao do Programa Integral de Reabilitacao Vocal para o tratamento das disfonias comportamentais

Voice rehabilitation is the main treatment option in cases of behavioral dysphonia, and it has the purpose of enhancing the quality of vocal production and voice-related life aspects. Several efforts have been made to offer a clinical practice that is based on evidence, including the development of specific therapeutic protocols as an option for clinical and scientific improvement. It is necessary to define the focus/objective of the dysphonia treatment, type of approach, and duration in order to establish the intervention criteria. This paper describes the organization of a program of behavioral dysphonia treatment, based on an approach that has been used for over twenty years, named Comprehensive Vocal Rehabilitation Program, and also to present its concepts, theory, and practical fundamentals. The program has an eclectic approach and associates body work, glottal source, resonance, and breathing coordination in addition to knowledge about vocal hygiene and communicative behavior. The initial proposal suggests a minimum time of intervention of six therapeutic sessions that can be adapted according to the patient' s learning curve and development. The goal is to offer a rational and structured therapeutic approach that can be reproduced in other scenarios. .

A reabilitação vocal é a primeira opção de tratamento nos quadros de disfonia comportamental e tem como objetivo a melhoria da produção vocal e da qualidade de vida nos aspectos relacionados à voz. Muitos esforços estão sendo feitos para que a prática clínica fonoaudiológica seja baseada em evidências, o que inclui o desenvolvimento de protocolos terapêuticos específicos como opção para o aprimoramento clínico e científico. É necessário definir o foco/objetivo, tipo de abordagens e tempo de tratamento para estabelecer critérios de intervenção nas disfonias. Este artigo registra a organização de um programa de tratamento da disfonia comportamental, que consiste em abordagens utilizadas há mais de duas décadas na clínica vocal, denominado Programa Integral de Reabilitação Vocal, e apresenta os seus conceitos, teoria e fundamentos práticos. O programa tem abordagem eclética e associa trabalhos de corpo, fonte glótica, ressonância e coordenação pneumofônica, aliados aos conhecimentos de higiene vocal e atitude comunicativa. A proposta inicial sugere intervenção mínima com seis sessões de terapia, que podem ser adaptadas ao tempo de aprendizado e desenvolvimento do paciente. A intenção é oferecer uma prática terapêutica racional e estruturada, que possa ser reproduzida em outros cenários. .

Presentation of the Comprehensive Vocal Rehabilitation Program for the treatment of behavioral dysphonia.

Voice rehabilitation is the main treatment option in cases of behavioral dysphonia, and it has the purpose of enhancing the quality of vocal production and voice-related life aspects. Several efforts have been made to offer a clinical practice that is based on evidence, including the development of specific therapeutic protocols as an option for clinical and scientific improvement. It is necessary to define the focus/objective of the dysphonia treatment, type of approach, and duration in order to establish the intervention criteria. This paper describes the organization of a program of behavioral dysphonia treatment, based on an approach that has been used for over twenty years, named Comprehensive Vocal Rehabilitation Program, and also to present its concepts, theory, and practical fundamentals. The program has an eclectic approach and associates body work, glottal source, resonance, and breathing coordination in addition to knowledge about vocal hygiene and communicative behavior. The initial proposal suggests a minimum time of intervention of six therapeutic sessions that can be adapted according to the patient's learning curve and development. The goal is to offer a rational and structured therapeutic approach that can be reproduced in other scenarios.

Eletromiografia laríngea em pacientes com disfonia e fechamento glótico incompleto / Laryngeal electromyography in dysphonic patients with incomplete glottic closure

O diagnóstico de comprometimento do nervo laríngeo superior e de ramos do laríngeo recorrente demanda eletromiografia, pois as alterações à laringoscopia são inespecíficas. OBJETIVO: Avaliar eletrofisiologicamente a função dos nervos laríngeo superior e inferior por meio da atividade elétrica dos músculos por eles inervados, em pacientes com disfonia com coaptação incompleta das pregas vocais à fonação. MÉTODO: Estudo prospectivo; 39 indivíduos com disfonia e fechamento glótico incompleto foram submetidos à eletromiografia dos músculos tireoaritenóideo, cricotireóideo e cricoaritenóideo lateral bilateralmente. Foram avaliadas atividade de inserção, no repouso (fibrilação, onda positiva e fasciculação) e durante contração voluntária dos músculos (recrutamento, amplitude e duração do potencial e latência entre início da atividade elétrica e a sonorização). RESULTADOS: Não observamos alteração na atividade de inserção e no repouso. Nenhum paciente apresentou recrutamento alterado. A média da amplitude dos potenciais elétricos esteve compatível com a normalidade nos músculos testados, assim como a duração do potencial e o tempo de latência entre o início da atividade elétrica e a sonorização. CONCLUSÃO: Não observamos sinais de desnervação nos músculos tireoaritenóideo, cricotireóideo e cricoaritenóideo lateral bilateralmente nos pacientes estudados.

The lack of specificity in laryngoscopical examination requires that the diagnosis of superior laryngeal and recurrent laryngeal nerve involvement be carried out with the aid of electromyography. OBJECTIVE: This study aims to assess the electrophysiological function of the superior and inferior laryngeal nerves by measuring the electrical activity of the muscles they innervate in dysphonic patients with incomplete closure of the vocal folds during phonation. METHOD: Thirty-nine patients with incomplete glottic closure were enrolled in a prospective study and had their cricothyroid, thyroarytenoid, and lateral cricoarytenoid muscles examined bilaterally through electromyography. Insertion activity, electrical activity at rest (fibrillation, positive wave and fasciculation) and during muscle voluntary contraction (recruitment, amplitude, potential length and latency between electrical activity and phonation) were measured. RESULTS: No altered test results were observed for parameters insertion activity and electrical activity at rest. None of the patients had recruitment dysfunction. The mean electrical potential amplitude values were within normal range for the tested muscles, as were potential durations and latency times between the onset of electrical activity and phonation. CONCLUSION: No signs of denervation were seen in the thyroarytenoid, cricothyroid, and lateral cricoarytenoid muscles of the studied patients.

Influence of aging on hyaluronic acid concentration in the vocal folds of female rats.

UNLABELLED: The vibration of the vocal fold lamina propria is an important factor involved in vocal production and aging may change the amount of hyaluronic acid in the vocal fold leading to dysphonia. AIMS: This study compares the concentration of hyaluronic acid in vocal folds of aged and young female rats. STUDY DESIGN: experimental. MATERIALS AND METHODS: We used the vocal cords of 13 female rats divided into two groups: five aged rats and eight young ones. The tissue concentration of hyaluronic acid was determined using the fluorimetric method with the hyaluronic acid binding-protein coated on plates of enzyme-linked immunosorbent assay (ELISA), conjugated with biotin. Europium-labeled streptavidin was added and, after europium release with the use of enhancement solution, the final fluorescence was measured in a fluorometer. RESULTS: We found the following concentrations of hyaluronic acid in vocal fold according to the group: 581.7 ng/mg in old female rats and 1275.6 ng/mg in young female rats. Statistical analysis showed differences between groups. CONCLUSIONS: The vocal folds of old female rats have a lower concentration of hyaluronic acid when compared to such concentration on the vocal folds of young female rats.

Influência do envelhecimento na concentração de ácido hialurônico nas pregas vocais de ratas fêmeas / Influence of aging on hyaluronic acid concentration in the vocal folds of female rats

A vibração das pregas vocais é um importante fator envolvido na produção vocal e o envelhecimento pode alterar a quantidade de ácido hialurônico da prega vocal levando a disfonia. OBJETIVO: Este estudo compara a concentração de ácido hialurônico nas pregas vocais de ratas fêmeas idosas e jovens. Desenho do estudo: estudo experimental. MATERIAL E MÉTODO: Foram utilizadas pregas vocais de 13 ratas fêmeas divididas em dois grupos: cinco ratas idosas e oito ratas jovens. A concentração tecidual do ácido hialurônico foi determinada por meio de método fluorimétrico utilizando a proteína de ligação ao ácido hialurônico imobilizada em placas de enzyme-linked immunosorbent assay (ELISA) e também conjugada à biotina. Estreptavidina marcada com európio foi adicionada e, depois de európio ter sido liberado com o uso de solução de enhancement; a fluorescência final foi medida em um fluorímetro. RESULTADOS: Foram encontradas as seguintes concentrações de ácido hialurônico nas pregas vocais de acordo com os grupos: 581,7 ng/mg em ratas idosas e 1275,6 ng/mg em ratas jovens. A análise estatística mostrou diferença entre os grupos. CONCLUSÃO: A prega vocal de ratas idosas tem uma menor concentração de ácido hialurônico do que a concentração da prega vocal de ratas jovens.

The vibration of the vocal fold lamina propria is an important factor involved in vocal production and aging may change the amount of hyaluronic acid in the vocal fold leading to dysphonia. AIMS: This study compares the concentration of hyaluronic acid in vocal folds of aged and young female rats. Study design: experimental. MATERIALS AND METHODS: We used the vocal cords of 13 female rats divided into two groups: five aged rats and eight young ones. The tissue concentration of hyaluronic acid was determined using the fluorimetric method with the hyaluronic acid binding-protein coated on plates of enzyme-linked immunosorbent assay (ELISA), conjugated with biotin. Europium-labeled streptavidin was added and, after europium release with the use of enhancement solution, the final fluorescence was measured in a fluorometer. RESULTS: We found the following concentrations of hyaluronic acid in vocal fold according to the group: 581.7 ng/mg in old female rats and 1275.6 ng/mg in young female rats. Statistical analysis showed differences between groups. CONCLUSIONS: The vocal folds of old female rats have a lower concentration of hyaluronic acid when compared to such concentration on the vocal folds of young female rats.

Laryngeal sequelae of recurrent respiratory papillomatosis surgery in children.

OBJECTIVE: To evaluate laryngeal sequelae from surgical treatment of recurrent respiratory papillomatosis in children, as well as associated risk factors. METHODS: Case-control study. Medical record data analysis of 50 children with recurrent respiratory papillomatosis, divided into two groups: with and without laryngeal sequelae. The group of patients with laryngeal sequelae was compared to those without sequelae in regard to the onset of disease, age at first surgery, number and frequency of surgeries, disease stage, and type of surgery (CO2 laser, cold forceps). RESULTS: 23 patients (46%) sustained laryngeal sequelae. The most frequent sequela was anterior commissure synechia (17 patients [34%]), followed by glottic stenosis (six patients [12%]). There was no statistically significant difference between groups with and without laryngeal sequelae regarding the disease onset (p = 0.93), age at first surgery (p = 0.68), number of surgeries (p = 0.22), annual frequency of surgery (p = 0.93), presence of papilloma in anterior (p = 0.430) or posterior commissure (p = 0.39), and type of surgery (p = 0.27). The Derkay anatomical score (a staging system that assesses the extent of the disease in the aerodigestive tract) was significantly higher in the laryngeal sequelae group (p = 0.04). CONCLUSION: Laryngeal sequelae are a frequent complication of recurrent respiratory papillomatosis surgical treatment in children, particularly anterior commissure synechiae and glottic stenosis. Advanced stages are associated with increased risk of laryngeal sequelae after surgery.