Voice Handicap Index: Cut-Off Points for Screening European Portuguese With Voice Disorders.

OBJECTIVES: To determine cut-off values of the Voice Handicap Index (VHI) and the shortened version (VHI-10) for European Portuguese (EP) with voice disorders. In addition, to analyze the discriminatory power of individual items of the VHI-10 and the ability to detect differences in various Ear Nose and Throat (ENT) diagnoses. STUDY DESIGN: Cross-sectional cohort study. METHODS: All participants completed the EP VHI and a 4-point self-assessment of voice disorder severity. The case group (subjects with voice disorders) underwent assessment through strobovideolaryngoscopy examinations by ENT surgeons and perceptual analyses by speech-language pathologists (SLPs). In contrast, the control group was evaluated solely by SLPs. Data were analyzed using a receiver-operating characteristic curve to determine the accuracy and cut-off values of the VHI and VHI-10. RESULTS: The study involved a sample of 350 adults (171 cases and 179 controls), predominantly women aged 18-88 years. The area under curve (AUC) for VHI and VHI-10 was 0.997 [95% confidence interval (CI): 0.992-1] and 0.998 [95% CI: 0.995-0.999], respectively. Optimal cut-off values were identified as 13.5 for VHI (0.994 sensitivity and 0.989 specificity) and 5.5 for VHI-10 (0.977 sensitivity and 0.955 specificity). Each individual item within the VHI-10 significantly contributed to the overall assessment, exhibiting varying discriminatory power ranging from excellent (AUC = 0.937) to poor (AUC = 0.637). Significant differences were found in the case group between neurogenic disorders and healthy larynx (P = 0.014), structural and physiologic minor laryngeal abnormalities (P = 0.006), and inflammatory disorders (P = 0.043). CONCLUSIONS: The VHI and the VHI-10 exhibited accurate screening properties for predicting EP speakers with voice disorders.

Paratrygon aiereba irradiated anti-mucus serum reduce edematogenic activity induced in experimental model.

Accidents by freshwater stingrays are common in northern Brazil, there is no specific therapy for high morbidity and local tissue destruction. The irradiation of venoms and toxins by ionizing radiation has been used to produce appropriate immunogens for the production of antisera. We planned to study the efficacy of stinging mucus irradiation in the production of antisera, with serum neutralization assays of edematogenic activity and quantification of cytokines performed in animal models of immunization with native and irradiated mucus of Paratrygon aiereba, a large freshwater stingray. Antiserum potency and its cross-reactivity with mucus from other freshwater stingrays were detected by ELISA. Immunization models demonstrated the ability to stimulate a strong humoral response with elevated levels of serum IgG detectable by ELISA, and both native and irradiated mucus were immunogenic and capable of recognizing mucus proteins from other freshwater neotropical stingrays. Mucus P. aiereba causes cellular and humoral adaptive immune responses in cells of immunized mice producing antibodies and cytokines such as TNF-α, IL-6 and IL-17. Rabbit antisera immunized with mucus from P. aiereba irradiated at 2 kGy showed a significant reduction of mucus-induced edematogenic activity in mice. Our data suggest that the use of antisera against freshwater stingray mucus show the possibility of specific therapy for these accidents.

Self-evaluation of communication experiences after laryngectomy (SECEL): translation and psychometric properties in European Portuguese.

Introduction: The patients' perception of how communication dysfunction may cause a disadvantage is important information for the clinical decision-making process.Objectives: This study aimed to translate the self-evaluation of communication experiences after laryngectomy (SECEL) to the European Portuguese (EP) and to assess its feasibility, acceptability, reliability, and validity.Material and methods: A cross-sectional study was carried out, and a cluster sample of seven ENT outpatient clinics was drawn. The EP-SECEL was filled in by 129 people with laryngectomy, aged 29-81 years and 25 of those completed it in the second time. Patients have also filled in the European Organization for Research Treatment of Cancer Quality of Life Questionnaire (EORCT), the core quality of life questionnaire (QLQ-C30) and the 35-item Head and Neck module (H&N35).Results: The EP-SECEL has the same conceptual meaning, semantics, idiomatic, format and score equivalence as the original one. Psychometric analyses revealed that it is feasible (missing <1%, to fill out took about 15 minutes for most patients), acceptable (floor and ceiling effects inferior to 15%), reliable (excellent internal consistency, Cronbach's alpha = 0.90, and moderate test-retest, Spearman's rhô = 0.64), well-constructed (66% of the total variance is explained by exploratory factor analysis), significantly convergent (correlates with the EORTC QLQ-C30 and H&N35) and validly discriminates people with total and partial laryngectomy as well as people with different primary means-of-communication.Conclusions: This study supports that the EP-SECEL has sufficient psychometric qualities to be considered an adequate tool to be recommended for assessing health-related quality of life among laryngectomy patients.