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1.
Rev Neurosci ; 32(3): 351-361, 2021 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-33618441

RESUMO

The ongoing pandemic of Coronavirus disease 2019 (COVID-19) has infected more than 27 million confirmed cases and 8,90,000 deaths all around the world. Verity of viral infections can infect the nervous system; these viral infections can present a wide range of manifestation. The aim of the current study was to systematically review the COVID-19 associated central nervous system manifestations, mental and neurological symptoms. For that we conducted a comprehensive systematic literature review of four online databases, including Web of Science, PubMed, Scopus and Embase. All relevant articles that reported psychiatric/psychological symptoms or disorders in COVID-19 without considering time and language restrictions were assessed. All the study procedures were performed based on the PRISMA criteria. Due to the screening, 14 studies were included. The current study result indicated that, the pooled prevalence of CNS or mental associated disorders with 95% CI was 50.68% (6.68-93.88). The most prevalence symptoms were hyposmia/anosmia/olfactory dysfunction (number of study: 10) with 36.20% (14.99-60.51). Only one study reported numbness/paresthesia and dysphonia. Pooled prevalence of numbness/paresthesia and dysphonia was 5.83% (2.17-12.25) and 2.39% (10.75-14.22). The pooled prevalence of depression and anxiety was 3.52% (2.62-4.54) and 13.92% (9.44-19.08). Our findings demonstrate that COVID-19 has a certain relation with neurological symptoms. The hypsomia, anosmia or olfactory dysfunction was most frequent symptom. Other symptoms were headache or dizziness, dysgeusia or ageusia, dysphonia and fatigue. Depression, anxiety, and confusion were less frequent symptoms.


Assuntos
/epidemiologia , Ansiedade/epidemiologia , Depressão/epidemiologia , /fisiopatologia , Ansiedade/psicologia , Depressão/psicologia , Disgeusia/epidemiologia , Disgeusia/fisiopatologia , Disfonia/epidemiologia , Disfonia/fisiopatologia , Fadiga/epidemiologia , Fadiga/fisiopatologia , Cefaleia/epidemiologia , Cefaleia/fisiopatologia , Humanos , Hipestesia/epidemiologia , Hipestesia/fisiopatologia , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/fisiopatologia , Parestesia/epidemiologia , Parestesia/fisiopatologia , Prevalência
2.
BMJ Case Rep ; 14(2)2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33526525

RESUMO

We present a case of multifocal laryngotracheal amyloidosis (LTA) in a 43-year-old man with persistent and progressive dysphonia and dyspnoea, and a first inconclusive histology. Although laryngeal amyloidosis accounts for fewer than 1% of all benign laryngeal tumours, it is in fact the most common site of amyloid deposition in the head, neck and respiratory tract. The clinical scenario is non-specific and diagnosis depends on a high degree of suspicion and on histology. Imaging is useful in mapping lesions, which are often more extensive than they appear during laryngoscopy. Despite being a benign entity, the prognosis is variable with a high-rate and long-latency recurrences, requiring long-term follow-up.


Assuntos
Amiloidose de Cadeia Leve de Imunoglobulina/diagnóstico , Doenças da Laringe/diagnóstico por imagem , Doenças da Traqueia/diagnóstico por imagem , Adulto , Broncoscopia , Disfonia/fisiopatologia , Dispneia/fisiopatologia , Humanos , Amiloidose de Cadeia Leve de Imunoglobulina/patologia , Amiloidose de Cadeia Leve de Imunoglobulina/fisiopatologia , Doenças da Laringe/patologia , Doenças da Laringe/fisiopatologia , Laringoscopia , Masculino , Tomografia Computadorizada por Raios X , Doenças da Traqueia/patologia , Doenças da Traqueia/fisiopatologia
3.
FP Essent ; 501: 11-16, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33595263

RESUMO

Dysphonia is any alteration of voice quality or vocal effort that impairs communication and affects quality of life. In patients with dysphonia, voice qualities often are described as tremulous, hoarse, strained, or raspy, with altered pitch, breathiness, or vocal fatigue. Dysphonia is a sign of an underlying disease process. Up to one-third of individuals will experience dysphonia in their lifetime. The evaluation includes a history, physical examination, and, in some cases, laryngoscopy. The most common cause of dysphonia is acute laryngitis, with the majority of cases lasting fewer than 3 weeks. Longer duration of symptoms occurs with chronic laryngitis, laryngopharyngeal reflux, muscle tension dysphonia, benign vocal fold lesions, vocal fold paresis or paralysis, and spasmodic dysphonia. Laryngeal malignancy is uncommon; the major risk factors are smoking and concurrent alcohol use. Laryngoscopy should be performed in all patients with dysphonia that does not resolve or improve within 4 weeks or of any duration if a serious underlying etiology is suspected. Management is directed at the underlying etiology. Empiric treatment with antibiotics, corticosteroids, and antireflux drugs should be avoided in the absence of a clear indication. In patients with a definitive diagnosis, management includes vocal hygiene, voice therapy, pharmacotherapy, and surgery.


Assuntos
Disfonia , Paralisia das Pregas Vocais , Disfonia/diagnóstico , Disfonia/etiologia , Disfonia/terapia , Rouquidão , Humanos , Qualidade de Vida , Qualidade da Voz
4.
Artigo em Chinês | MEDLINE | ID: mdl-33541000

RESUMO

Objective:The aim of this study is to evaluate the efficacy of CO2 laser and CO2 laser combined with microsuture in the treatment of bilateral sessile polyps of vocal cords. Methods:Forty-eight patients with bilateral sessile polyps of vocal cords were randomly divided into CO2 laser group and CO2 laser combined with microsuture group. The surgical effect of each group and the difference between the two groups were evaluated by subjective score and objective voice analysis. Results:One month and three month after operation, Jitter, Shimmer, dysphonia severity index(DSI), the maximum phonation time(MPT), the parameters of G and voice handicap index(VHI-10) in the two groups were significantly different from pre-operation(P<0.05). There were also significant differences in Jitter, Shimmer, DSI and MPT between the two groups one month and three month after operation respectively(P<0.05). But no significant differences of the parameters of G and VHI-10 was noted between two groups(P>0.05). The incidence of postoperative vocal cord adhesion was 8.3% and 0 in two groups respectively, and there was no significant difference between the two groups(P>0.05). Conclusion:The CO2 laser combined with microsuturing technique can effectively improve the voice quality of patients with bilateral wide-based vocal cord polyps, and the effect is better than that of using CO2 laser alone.


Assuntos
Disfonia , Doenças da Laringe , Pólipos , Humanos , Doenças da Laringe/cirurgia , Fonação , Pólipos/cirurgia , Resultado do Tratamento , Prega Vocal/cirurgia , Qualidade da Voz
5.
Eur Arch Otorhinolaryngol ; 278(3): 839-841, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33392763

RESUMO

INTRODUCTION: Spasmodic dysphonia (SD), a form of focal dystonia, has been defined as a neurogenic, task-specific disorder characterized by abrupt spasms of intrinsic laryngeal muscles that result in phonatory breaks. There are three classic types of SD: adductor SD, abductor (ABSD) and mixed SD. Compared with the more common adductor form, treatment of ABSD with botulinum toxin injection is related to a shorter efficacy and improvement in only about 70% of patients [Blitzer et al. in Laryngoscope 108:1435-1441, 1998]. Moreover, due to the possible loss of efficacy over time or patient refusal for repeated injections, surgical solutions for permanent or at least long-term results must be considered. METHOD: The surgical technique we propose is based on transoral bilateral posterior cricoarytenoid muscle (PCA) coagulation by radiofrequency (Celon, pro surg 250-T30, Olympus, Germany, 10 W, in 3 spots, each side) under a microscope or rigid scope control. The procedure is performed in two sessions distant of 2-3 weeks to avoid the risk of bilateral vocal fold temporary paralysis in adduction. A 52-year-old female patient with no audible voicing, resistant to botulinum toxin and after failure of relaxation thyroplasty type III according to lssihki [Saito et al. in Case Rep Otolaryngol 2018:4280381, 2018] showed an improvement of the Voice Handicap Index (VHI-10) from 35/40 to 19/40. The patient was rated G2R3B2A1S2 according to GRABS scale. CONCLUSION: PCA coagulation for ABSD is a safe and reusable surgical option. It is less invasive than other techniques described before. To the best of our knowledge, this technique was never reported before in this type of SD.


Assuntos
Disfonia , Disfonia/tratamento farmacológico , Feminino , Alemanha , Humanos , Músculos Laríngeos , Pessoa de Meia-Idade , Fonação , Resultado do Tratamento , Distúrbios da Voz
6.
Bol. méd. postgrado ; 37(1): 68-72, Ene-Jun 2021. ilus
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1147883

RESUMO

Según datos de la OMS, la tuberculosis es una de las diez primeras causas de muerte en el mundo y es la primera causa de muerte por un agente infeccioso único. La incidencia de la tuberculosis ha disminuido por término medio un 1,5% anual desde el año 2000 sin embargo el impacto de la pandemia por el SARS-CoV-2 pudiera retardar el diagnóstico y tratamiento de nuevos casos de TB. Se presenta el caso de un paciente masculino de 26 años de edad quien consulta por presentar fiebre de predominio vespertino, pérdida de peso y disfonía de 6 meses de evolución. Los BK y cultivos de esputo seriados resultaron negativos. Es referido al Servicio de Otorrinolaringología y Cirugía Facial del Hospital Universitario Dr. Luis Gómez López donde se realiza una nasofibrolaringoscopía evidenciándose epiglotis con superficie de aspecto irregular que se extiende hasta aritenoides y zona interaritenoidea y bandas ventriculares edematizadas que no permiten visualizar repliegues vocales. Se realiza microcirugía laríngea para toma de biopsia reportando el estudio histopatológico proliferación de vasos neoformados, espacios intervasculares ocupados por macrófagos y linfocitos, presencia de múltiples lesiones nodulares formadas por macrófagos epiteloides rodeados por un halo de linfocitos y numerosas células gigantes de Langerhans. Se realiza el diagnóstico de tuberculosis laríngea y se inicia tratamiento antituberculoso(AU)


According to the WHO, tuberculosis represents one of the top ten causes of death worldwide and is the number one cause of death from a single infectious agent. The incidence of tuberculosis has decreased an average of 1.5% annually since the year 2000, however the impact of the SARS-CoV-2 pandemic could delay the diagnosis and treatment of new cases of TB. We report the case of a 26-year-old male who consulted for fever, weight loss and dysphonia with a duration of 6 months. BK and sputum cultures were negative for M. tuberculosis. The patient is referred to the Otorhinolaryngology and Facial Surgery Clinic of the Dr. Luis Gomez Lopez University Hospital where a nasofibrolaryngoscopy is performed showing an epiglottis with an irregular surface that extends to the arytenoids and interarytenoid zone and edematous ventricular bands that do not allow visualization of vocal folds. Laryngeal microsurgery is performed to obtain a biopsy sample. Histopathology reveals proliferation of newly formed vessels, intervascular spaces occupied by macrophages and lymphocytes, presence of multiple nodular lesions formed by epithelloid macrophages surrounded by a halo of lymphocytes and numerous giant Langerhans cells. Diagnosis of laryngeal tuberculosis is made and antituberculous treatment is initiated(AU)


Assuntos
Humanos , Masculino , Adulto , Sinais e Sintomas , Diagnóstico por Imagem , Tuberculose Laríngea/mortalidade , Tuberculose Laríngea/tratamento farmacológico , Disfonia , Febre
8.
BMJ Case Rep ; 13(12)2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33370978

RESUMO

A 57-year-old male chronic smoker with underlying diabetes mellitus presented with dysphonia associated with cough, dysphagia and reduced effort tolerance of 3 months' duration. Videoendoscope finding revealed bilateral polypoidal and erythematous true and false vocal fold with small glottic airway. The patient was initially treated as having tuberculous laryngitis and started on antituberculous drug. However, no improvement was observed. CT of the neck showed erosion of thyroid cartilage, which points to laryngeal carcinoma as a differential diagnosis. However, the erosion was more diffuse and appeared systemic in origin. The diagnosis of laryngeal perichondritis was made when the histopathological examination revealed features of inflammation, and the tracheal aspirate isolated Pseudomonas aeruginosa The patient made a good recovery following treatment with oral ciprofloxacin.


Assuntos
Doenças da Laringe/diagnóstico , Infecções por Pseudomonas/diagnóstico , Pseudomonas aeruginosa/isolamento & purificação , Antibacterianos/uso terapêutico , Ciprofloxacino/uso terapêutico , Tosse/microbiologia , Transtornos de Deglutição/microbiologia , Diagnóstico Diferencial , Disfonia/microbiologia , Humanos , Doenças da Laringe/complicações , Doenças da Laringe/tratamento farmacológico , Doenças da Laringe/microbiologia , Neoplasias Laríngeas/diagnóstico , Laringoscopia , Masculino , Pessoa de Meia-Idade , Infecções por Pseudomonas/complicações , Infecções por Pseudomonas/tratamento farmacológico , Infecções por Pseudomonas/microbiologia , Cartilagem Tireóidea/diagnóstico por imagem , Cartilagem Tireóidea/microbiologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Tuberculose Laríngea/diagnóstico , Prega Vocal/diagnóstico por imagem , Prega Vocal/microbiologia
9.
Artigo em Russo | MEDLINE | ID: mdl-33340296

RESUMO

OBJECTIVE: To increase the effectiveness of treatment of hypotonic functional dysphonia using physiotherapy in patients with neurovegetative disorders. MATERIAL AND METHODS: The study included 42 patients, aged from 25 to 64 years, with disturbed vocal function, which included anamnestic analysis, an objective study of ENT organs by conventional methods, a video stroboscopy of the larynx, a cytological study of smears from the laryngeal mucosa, and the determination of the functional state of the autonomic nervous system (ANS). RESULTS: The clinical-physiological study of VNS shows neurovegetative dysfunction (inadequate autonomic support of activity) in 10 patients. In these patients, the traditional conservative treatment was ineffective. Acupuncture used for treatment of neurovegetative disorders in these patients significantly improves the results of traditional treatment. CONCLUSION: The results indicate an increase in the effectiveness of physiotherapy treatment (reflexotherapy using magnetic-infrared laser radiation and acupuncture) of ANS condition. These measures can be carried out in conjunction with traditional methods of treatment or in the case of their low efficiency.


Assuntos
Disfonia , Laringe , Adulto , Sistema Nervoso Autônomo , Humanos , Pessoa de Meia-Idade , Modalidades de Fisioterapia , Estroboscopia
10.
Bol. méd. postgrado ; 36(2): 48-52, dic.2020. tab, graf
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1117900

RESUMO

Se realizó un estudio retrospectivo de revisión de 95 historias clínicas con el objetivo de determinar los factores predisponentes a la disfonía por hiperfunción laríngea en pacientes adultos que asistieron a la consulta de Otorrinolaringología del Hospital Universitario Dr. Luis Gómez López durante el lapso enero-diciembre 2016 a Junio 2017. Entre los resultados se encontró una predominancia del sexo masculino (82,4%) y una edad entre 37 a 44 años en 96,8% de los casos; 38% de los pacientes son profesionales expuestos a contaminación ambiental, 25% son profesionales de la voz; 79% no refiere tener hábito tabáquico; 38% refirió abusar de la voz, siendo las principales causas el hablar en exceso, cantar y gritar. El 67,4% de los pacientes están expuestos a vapores tóxicos, 86,3% al humo del tabaco y 82,1% al humo de la leña. El grado de disfonía más frecuente diagnosticado por nasofibrolaringoscopía fue grado II (60%). Es importante la detección temprana de los factores predisponentes asociados a la disfonía por hiperfunción laríngea de forma de implementar acciones que favorezcan las condiciones laborales y ambientales y mitiguen su influencia en la fisiología de la voz(AU)


A retrospective review of 95 medical charts was carried out with the objective of determining the predisposing factors for laryngeal hyperfunction dysphonia in adult patients attending the otorhinolaryngology consult of the Hospital Universitario Dr. Luis Gómez López, during the period January-December 2016 to June 2017. The results show a male predominance (82.4%) and an age between 37 to 44 years in 96.8% of cases; 38% of patients are professionals exposed to environmental pollution and 25% are voice professionals; 79% of patients don't smoke; 38% of cases abuse voice by speaking frequently, singing and shouting. 67.4% of patients have been exposed to vapors, 86.3% to tobacco smoke and 82.1% to firewood. Degree of dysphonia diagnosed by nasofibrolaryngoscopy was grade II (60%). Early detection of predisposing factors associated to laryngeal hyperfunction dysphonia is important in order to implement environmental actions to mitigate their influence in voice physiology(AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Qualidade de Vida , Distúrbios da Voz , Doenças da Laringe , Disfonia/diagnóstico , Disfonia/etiologia , Otolaringologia , Estresse Psicológico , Qualidade da Voz
11.
MMW Fortschr Med ; 162(21-22): 54-57, 2020 12.
Artigo em Alemão | MEDLINE | ID: mdl-33319291

Assuntos
Disfonia , Rouquidão , Humanos
12.
Medicine (Baltimore) ; 99(39): e22236, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991418

RESUMO

Articulation disorder is associated with impaired control of respiration and speech organ movement. There are many cases of dysarthria and dysphonia in stroke patients. Dysphonia adversely affects communication and social activities, and it can interfere with everyday life. The purpose of this study is to assess the association between phonation abilities and the vowel quadrilateral in stroke patients.The subjects were stroke patients with pronunciation and phonation disorders. The resonance frequency was measured for the 4 corner vowels to measure the vowel space area (VSA) and formant centralization ratio (FCR). Phonation ability was evaluated by the Dysphonia Severity Index (DSI) and maximal phonation time (MPT) through acoustic evaluation for each vowel. Pearsons correlation analysis was performed to confirm the association, and multiple linear regression analysis was performed between variables.The correlation coefficients of VSA and MPT/u/ were 0.420, VSA and MPT/i/ were 0.536, VSA and DSI/u/ were 0.392, VSA and DSI /i/ were 0.364, and FCR and DSI /i/ were -0.448. Multiple linear regression analysis showed that VSA was a factor significantly influencing MPT/u/ (ß = 0.420, P = .021, R = 0.147), MPT/i/ (ß = 0.536, P = .002, R = 0.262), DSI/u/ (ß = 0.564, P = .045, R = 0.256), and DSI/i/ (ß = 0.600, P = .03, R = 0.302).The vowel quadrilateral can be a useful tool for evaluating the phonation function of stroke patients.


Assuntos
Disfonia/terapia , Fonação , Reabilitação do Acidente Vascular Cerebral/métodos , Idoso , Disfonia/etiologia , Disfonia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Acidente Vascular Cerebral/complicações
13.
Clinics (Sao Paulo) ; 75: e1682, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32876106

RESUMO

OBJECTIVES: The objective of the study was to establish a cut-off point for high dysphonia risk in children using the Child Dysphonia Risk Screening Protocol (DRSP-C). METHODS: Through a preliminary study, voice recordings of 59 children (4-12 years of age) were collected during an auditory-perceptual analysis using the Consensus Auditory-Perceptual Evaluation of Voice protocol. Thirty of the patients had voice disorders (patient group), and 29 did not (control group). A risk score for dysphonia was then calculated, and data were compared between groups. The relationship between overall degrees of deviation and questionnaire scores was analysed. The questionnaire's validity was verified from the area under the Receiver Operating Characteristic (ROC) curve, and cut-off points were obtained based on diagnostic criteria for screening procedures. RESULTS: The DRSP-C score was found to be higher for the patient group, as was the partial score for vocal behaviour. No correlation was found between overall degrees of dysphonia and questionnaire scores. The area under the ROC curve was measured as 0.678, denoting limited diagnostic capacity. The cut-off point was set at 16.50. Thus, above this value, dysphonia risk is higher. CONCLUSION: A cut-off point for high dysphonia risk was calculated. The DRSP-C proved to be a promising tool for children's clinical vocal and health promotion and should be used in conjunction with General Dysphonia Risk Screening.


Assuntos
Disfonia , Criança , Pré-Escolar , Disfonia/diagnóstico , Humanos , Curva ROC , Índice de Gravidade de Doença , Inquéritos e Questionários , Qualidade da Voz
14.
Wiad Lek ; 73(4): 814-817, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32731723

RESUMO

Voice is a work tool for many professional groups. Currently, cases of dysphonia of multiple origin consist a growing issue. Voice disorders may result from disturbed voice production process, congenital defects, post-traumatic conditions, chronic diseases or hormonal disorders. Chronic diseases causing voice disorders include laryngopharyngeal reflux disease and esophageal reflux disease.The chronic character of reflux causes the formation of numerous morphological changes of the larynx, including: hyperemia of the mucosa limited to arytenoid and intraarytenoid area, edema of the vocal folds, edema of the larynx mucosa. These changes contribute to voice disorders. Among the pathological changes of voice organ etiologically associated with reflux, the following disease units may be distinguished: reflux laryngitis, subglottic edema, contact ulceration, larynx granuloma, larynx and pharynx cancer. Many of disorders in the upper respiratory tract are etiologically related to reflux, e.g. dysphonia, grunting, coughing and dyspnoea.


Assuntos
Disfonia , Edema , Refluxo Gastroesofágico , Humanos , Laringite , Laringe
15.
PLoS One ; 15(7): e0236009, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32658934

RESUMO

Mild Cognitive Impairment (MCI) is a syndrome characterized by cognitive decline greater than expected for an individual's age and education level. This study aims to determine whether voice quality and speech fluency distinguish patients with MCI from healthy individuals to improve diagnosis of patients with MCI. We analyzed recordings of the Cookie Theft picture description task produced by 26 patients with MCI and 29 healthy controls from Sweden and calculated measures of voice quality and speech fluency. The results show that patients with MCI differ significantly from HC with respect to acoustic aspects of voice quality, namely H1-A3, cepstral peak prominence, center of gravity, and shimmer; and speech fluency, namely articulation rate and averaged speaking time. The method proposed along with the obtainability of connected speech productions can enable quick and easy analysis of speech fluency and voice quality, providing accessible and objective diagnostic markers of patients with MCI.


Assuntos
Disfunção Cognitiva/epidemiologia , Disfonia/fisiopatologia , Fala/fisiologia , Qualidade da Voz/fisiologia , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Incidência , Masculino , Suécia/epidemiologia
16.
Artigo em Russo | MEDLINE | ID: mdl-32621469

RESUMO

OBJECTIVE: To conduct a cross-correlation analysis of the frequency of breathing and heart rhythm variability (HRV) in the diagnosis of autonomic disorders in patients with hypotonic type of functional dysphonia. MATERIAL AND METHODS: Twenty-eight women, aged between 21 and 63 years, with hypotonic type of functional dysphonia were examined. The examination of patients included an analysis of anamnesis, an objective ENT study by common methods, videostroboscopy of the larynx, and determination of the functional state of the autonomic nervous system (ANS). RESULTS: It was shown that in such patients, HRV contains alternating RR-intervals, which reduce the correlation coefficient between breathing fluctuations and sinus respiratory arrhythmia. In the majority of patients, ANS dysfunction is detected in the form of insufficient autonomic activity support, while the correlation coefficients (Rc) provide additional information about the autonomic tone. At high values of the correlation coefficient, the autonomic tone is optimal or reduced, at low values (below 0,5) it is optimal or elevated. At the same time, the correlation coefficient, which tends to zero at normal indicators of the total HRV power, indicates the state of ANS tension, which is associated with increased autonomic tone and can be one of the causes of sinus respiratory arrhythmia. CONCLUSION: The crosscorrelation analysis of HRV and breathing in patients with hypotonic type of functional dysphonia is one of the quantitative methods of the diagnosis of vegetative dystonia.


Assuntos
Doenças do Sistema Nervoso Autônomo , Disfonia , Adulto , Sistema Nervoso Autônomo , Feminino , Frequência Cardíaca , Humanos , Pessoa de Meia-Idade , Transtornos Psicofisiológicos , Adulto Jovem
17.
Ann Agric Environ Med ; 27(2): 314-316, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32588613

RESUMO

Degenerative lesions with hyperostosis on the anterior surface of cervical spine are common in clinical practice. In addition to pain being an effect of spinal dysfunction, they sometimes cause difficulties in swallowing or speaking as well as breathing disorders. A 52-year-old farmer with 4-year history of gradually intensifying dysphagia was admitted to hospital due to inability to intake a solid food, significant weight loss, and because of the appearance of a new symptom - dysphonia. Previous conservative treatment for swallow difficulties was ineffective. CT revealed a bone excrescence on the anterior surface of two cervical vertebrae which caused an oesophageal obstruction and compression of the vocal folds. Structural abnormalities of cervical spine should be considered in differential diagnosis of symptoms from the oesophagus and upper respiratory tract, especially when a first-line conservative treatment is not effective. In these cases, surgical removal of the osteophyte is an effective way of treatment.


Assuntos
Vértebras Cervicais/diagnóstico por imagem , Transtornos de Deglutição/diagnóstico , Disfonia/etiologia , Hiperostose/complicações , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/cirurgia , Diagnóstico Diferencial , Disfonia/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Resultado do Tratamento
18.
Am J Trop Med Hyg ; 103(2): 752-755, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32524951

RESUMO

An 88-year-old man with mutilating mucosal leishmaniasis (ML) involving septal perforation, with granulomas in the pharynx and larynx, was treated with oral miltefosine, 50 mg three times/day for 28 days. Miltefosine, an antineoplastic agent, is considered an alternative option for the treatment of ML, showing efficacies of 75-92% in Bolivia, Brazil, and Argentina. The patient denied having previous cutaneous (CL) leishmaniasis, and no CL lesions were recognized by physical examination. Parasites obtained from mucosal lesions were identified by cytochrome b gene sequencing as Leishmania guyanensis. Clinical cure was observed 2 months posttreatment, and no evidence of reactivation was observed in the 3-year follow-up. Adverse effects such as nausea, loss of appetite, and epigastric pain were experienced during treatment with miltefosine. There is a need for improved access to miltefosine in leishmaniasis-endemic areas of Latin America and a greater awareness of ML and its treatment among physicians working in endemic countries.


Assuntos
Antiprotozoários/uso terapêutico , Leishmaniose Mucocutânea/tratamento farmacológico , Doenças Nasais/tratamento farmacológico , Doenças Faríngeas/tratamento farmacológico , Fosforilcolina/análogos & derivados , Idoso de 80 Anos ou mais , Citocromos b/genética , Disfonia/etiologia , Humanos , Leishmania guyanensis/genética , Leishmania guyanensis/isolamento & purificação , Masculino , Perfuração do Septo Nasal/etiologia , Doenças Nasais/complicações , Doenças Nasais/patologia , Doenças Faríngeas/complicações , Doenças Faríngeas/patologia , Fosforilcolina/uso terapêutico , Índice de Gravidade de Doença
19.
Sci Rep ; 10(1): 10179, 2020 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-32576918

RESUMO

Adductor-type spasmodic dysphonia (ADSD) manifests in effortful speech temporarily relievable by botulinum neurotoxin type A (BoNT-A). Previously, abnormal structure, phonation-related and resting-state sensorimotor abnormalities as well as peripheral tactile thresholds in ADSD were described. This study aimed at assessing abnormal central tactile processing patterns, their spatial relation with dysfunctional resting-state connectivity, and their BoNT-A responsiveness. Functional MRI in 14/12 ADSD patients before/under BoNT-A effect and 15 controls was performed (i) during automatized tactile stimulus application to face/hand, and (ii) at rest. Between-group differential stimulation-induced activation and resting-state connectivity (regional homogeneity, connectivity strength within selected sensory(motor) networks), as well as within-patient BoNT-A effects on these differences were investigated. Contralateral-to-stimulation overactivity in ADSD before BoNT-A involved primary and secondary somatosensory representations, along with abnormalities in higher-order parietal, insular, temporal or premotor cortices. Dysphonic impairment in ADSD positively associated with left-hemispheric temporal activity. Connectivity was increased within right premotor (sensorimotor network), left primary auditory cortex (auditory network), and regionally reduced at the temporoparietal junction. Activation/connectivity before/after BoNT-A within-patients did not significantly differ. Abnormal ADSD central somatosensory processing supports its significance as common pathophysiologic focal dystonia trait. Abnormal temporal cortex tactile processing and resting-state connectivity might hint at abnormal cross-modal sensory interactions.


Assuntos
Disfonia/fisiopatologia , Distúrbios Distônicos/fisiopatologia , Células Receptoras Sensoriais/fisiologia , Toxinas Botulínicas Tipo A/uso terapêutico , Mapeamento Encefálico/métodos , Disfonia/tratamento farmacológico , Distúrbios Distônicos/tratamento farmacológico , Feminino , Mãos/fisiopatologia , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Córtex Motor/efeitos dos fármacos , Córtex Motor/fisiopatologia , Fonação/efeitos dos fármacos , Fonação/fisiologia , Células Receptoras Sensoriais/efeitos dos fármacos , Fala/efeitos dos fármacos , Fala/fisiologia
20.
Prague Med Rep ; 121(2): 114-117, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32553095

RESUMO

Spasmodic dysphonia is a primary task specific focal dystonia affecting the laryngeal muscles during speech. Most medical and surgical approaches to treatment of spasmodic dysphonia are aimed at the denervation of the laryngeal muscles to block symptom expression in the voice. The standard of care for the adductor form of spasmodic dysphonia is botulinum toxin chemodenervation. The common side effects of treatment with Botox are excessive breathiness and aspiration of fluids. We present the report of a delayed presentation of upper airway obstruction due to a complete vocal cords adduction requiring intubation ten days post Botox injection for the adductor form of spasmodic dysphonia. This presentation may be preceded by a change in voice, productive cough, shortness of breath, or odynophagia. We would recommend supportive treatment in an Intensive Care Unit and close liaison with the otolaryngology team for the management of this complication. Acute upper airway obstruction requiring tracheal intubation is a delayed complication of botulinum toxin administration in the adductor form of spasmodic dysphonia.


Assuntos
Toxinas Botulínicas Tipo A , Disfonia , Disfunção da Prega Vocal , Toxinas Botulínicas Tipo A/efeitos adversos , Disfonia/tratamento farmacológico , Humanos , Músculos Laríngeos , Fatores de Tempo , Resultado do Tratamento , Disfunção da Prega Vocal/induzido quimicamente
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