Vocal function and vocal discomfort in sheltered and non-sheltered 7- to 10-year-old school children in Aracaju, Brazil.

OBJECTIVE: To compare vocal function, school performance, and vocal discomfort between sheltered and nonsheltered school children in Aracaju, Brazil. METHODS: A controlled cross-sectional study was carried out on 7- to 10-year-old children who attended school regularly. Two groups of children were studied: the study group (SG), with children who lived in a shelter, and the control group (CG) containing children who lived with their families. We interviewed 44 children for the SG and 15 (34%) revealed vocal discomfort (SG = 15). Concomitantly, we interviewed 400 regular school children from the same geographical area and 45 (11.25%) were selected for the control group (CG). They were paired by sex and age with the sheltered children using a 3:1 ratio. Both groups were interviewed about school performance and vocal discomfort and were evaluated using perceptual and acoustic measurements for the voice and larynx. RESULTS: Children from both groups had started public school late. There were more individuals with vocal discomfort in the SG and individuals in this group also had a slower speech rate and inadequate pneumophonic coordination compared with the CG. The Dysphonia Severity Index (DSI) revealed mild-moderate deviation for both groups. Upper harmonics and palatal tonsil hypertrophy were higher in the CG, whereas laryngeal constriction was more common in the SG. CONCLUSION: All the SG children revealed mild-moderate deviance on the DSI, a higher level of vocal discomfort, a slow speech rate, inadequate pneumophonic coordination, and laryngeal constriction. The results here presented suggest that social conditions are important for voice behavior in children.

Voice performance evaluation of street children from Aracaju, Brazil using perceptual-auditory and acoustic analyses.

OBJECTIVE: To compare the voice performance of children involved in street labor with regular children using perceptual-auditory and acoustic analyses. METHODS: A controlled cross-sectional study was carried out on 7- to 10-year-old children of both genders. Children from both groups lived with their families and attended school regularly; however, child labor was evident in one group and not the other. A total of 200 potentially eligible street children, assisted by the Child Labor Elimination Programme (PETI), and 400 regular children were interviewed. Those with any vocal discomfort (106, 53% and 90, 22.5%) had their voices assessed for resonance, pitch, loudness, speech rate, maximum phonation time, and other acoustic measurements. RESULTS: A total of 106 street children (study group [SG]) and 90 regular children (control group [CG]) were evaluated. The SG group demonstrated higher oral and nasal resonance, reduced loudness, a lower pitch, and a slower speech rate than the CG. The maximum phonation time, fundamental frequency, and upper harmonics were higher in the SG than the CG. Jitter and shimmer were higher in the CG than the SG. CONCLUSION: Using perceptual-auditory and acoustic analyses, we determined that there were differences in voice performance between the two groups, with street children having better quality perceptual and acoustic vocal parameters than regular children. We believe that this is due to the procedures and activities performed by the Child Labor Elimination Program (PETI), which helps children to cope with their living conditions.

Characteristics and professional use of voice in street children in Aracaju, Brazil.

The objective of the study was to evaluate voice characteristics of children engaged in street selling, which involves an essentially professional use of voice in this population. A controlled cross-sectional study was carried out. A randomly chosen sample of 200 school children with a history of street selling assisted by public social services and 400 school children without this experience was selected. Seven- to 10-year-old children of both sexes were studied. Both groups were interviewed and given vocal assessment (auditory-perceptual assessment and spectrographic acoustic measures) and otorhinolaryngological evaluation (physical and videonasolaryngoscopic examination). Children with abnormal results in both groups were compared using chi(2) (Chi-squared test). The significance level was established at 5% (P<0.05). Voice problems were detected more frequently in working children (106-53%) than in regular school children (90-22.5%). The control group achieved better school performance as more children in this group attend school regularly than street children, although age-for-grade deficit was similar. The control group had more access to medical visits (80-40%) and treatment with a doctor (34-17%). Language assessment has shown that the control group had more dysphonia (73-37%) and myofunctional orofacial disorders (20-10%). Street children had more normal voice but had more nasal disorders and greater glottal closure than the school control group. Voice disorders were present in both groups, but less frequently in street children. Although subject to inadequate living conditions, street children had better voice quality than the control group. An explanation could be that by adapting their voice professionally for selling goods in the streets, they developed adequate resilience to their difficult living conditions.

Pseudo-hemoptise por leishmaniose / Pseudohemoptysis caused by leihmaniasis

É apresentado caso de leihmaniose tegumentar americana (LTA) acometendo a mucosa da laringe que, dentre as manifestaçöes clínicas iniciais, aprsentou pseudo-hemoptise, levando ao diagnstico e tratamento errôneo de tuberculose pulmonar. A confirmaçäo etiológia foi estabelecida através de estudo hispopatológico. A localizaçä primaária na laringe é relativamente rara. É muito importante a experiência do broncoscopista em via aéreas superiores para fazer diagnóstico exato