Objective Analysis Of Voice Quality In Patients With Thyroid Pathology.

OBJECTIVE: The goal of this study is to analyze the voice in patients with thyroid pathology through two objective indexes with great diagnostic accuracy. Overall vocal quality was evaluated with the Acoustic Voice Quality Index (AVQI v.03.01) and the breathy voice with the Acoustic Breathiness Index (ABI). DESIGN: Observational case-control study. SETTING: Hospital Universitario Nuestra Señora de Candelaria. PARTICIPANTS: Fifty-eight subjects, 29 controls and 29 thyroidectomy candidates. MAIN OUTCOME MEASURES: All participants with thyroid pathology completed the Spanish version of Voice Handicap Index-10. Also, patient complaints relating to possible laryngeal dysfunction were assessed through closed questions. A sustained vowel and three phonetically balanced sentences were recorded for each subject (118 samples). AVQI v.03.01 and ABI were assessed using the Praat program. Two raters perceptually evaluated each voice sample by using the Grade parameter of GRABS scale. RESULTS: Acoustic analysis shows that 55.17% of subjects present values above the pathological threshold of the AVQI, and 58.62% above that of the ABI. Results of the Student's test comparisons of the AVQI and ABI values between the control group and the thyroid group show significantly higher values of AVQI (t[56]  = -3.85, p < .001) and ABI (t[54.39]  = -4.82, p < .001) in thyroidectomy candidates. CONCLUSION: A mild decrease in vocal quality is part of the symptomatology presented by thyroidectomy candidates.

Immunochemical and Physical Quantitation of Grass and Olive Pollen Allergens: Correlation With Asthma Admissions in Cáceres, Spain.

BACKGROUND AND OBJECTIVES: The association between pollen counts and allergen levels in the air is controversial. Objectives: The aims of the study were to quantify total and major allergen levels of Phleum pratense and Olea europaea and to analyze their correlation with grass and olive pollen counts and the number of asthma attacks attended at Complejo Hospitalario Universitario, Cáceres, Spain. MATERIAL AND METHODS: A volumetric air sampler and a Burkard spore trap were used for pollen and aeroallergen collection during April- June 2011. Filters were extracted, and major allergens were quantified using enzyme-linked immunosorbent assay. RESULTS: May was the main grass pollination period, with a maximum peak of 1362 grains/m3 (May 13). The main pollination period for olive was April 30-May 20, with a maximum peak of 851 grains/m3 (May 11). A moderate correlation was observed between asthma exacerbations and grass pollen counts or Phleum total allergen levels; this became stronger when a 3-day offset was introduced. A significant association was observed between asthma exacerbations and total olive allergen or olive pollen grain levels when a 1-day offset was introduced. The maximum correlation (moderate-high) was observed 4 days and 6 days away from the maximum olive pollen peak and the maximum Ole e 1 peak level, respectively. CONCLUSIONS: This study reveals a significant correlation between grass and olive pollination and an increase in the number of visits to the emergency room for asthma attacks. The aerobiological pattern of allergen levels in the air is similar to that of pollen counts during the grass and olive pollination periods.

Atypical/Nor98 scrapie in the Basque Country: a case report of eight outbreaks.

BACKGROUND: Since 2002, an active surveillance program for transmissible spongiform encephalopathy in small ruminants in European Union countries allowed identification of a considerable number of atypical cases with similarities to the previously identified atypical scrapie cases termed Nor98. CASE PRESENTATION: Here we report molecular and neuropathological features of eight atypical/Nor98 scrapie cases detected between 2002 and 2009. Significant features of the affected sheep included: their relatively high ages (mean age 7.9 years, range between 4.3 and 12.8), their breed (all Latxa) and their PRNP genotypes (AFRQ/ALRQ, ALRR/ALRQ, AFRQ/AFRQ, AFRQ/AHQ, ALRQ/ALRH, ALRQ/ALRQ). All the sheep were confirmed as atypical scrapie by immunohistochemistry and immunoblotting. Two cases presented more PrP immunolabelling in cerebral cortex than in cerebellum. CONCLUSIONS: This work indicates that atypical scrapie constitutes the most common small ruminant transmissible spongiform encephalopathy form in Latxa sheep in the Spanish Basque Country. Moreover, a new genotype (ALRQ/ALRH) was found associated to atypical scrapie.

Factors that determine the loss of control when reducing therapy by steps in the treatment of moderate-severe asthma in standard clinical practice: A multicentre Spanish study. / Factores que condicionan la pérdida de control al reducir escalones terapéuticos en el tratamiento del asma moderada-grave en la práctica clínica habitual: estudio español multicéntrico.

BACKGROUND: Although the clinical practice guidelines recommend continuous adjustment of asthma treatment and reducing the maintenance drugs when achieving control (step-down), there are few studies of standard clinical practice aimed at collecting information on the factors that determine step-down failure. OBJECTIVE: To determine the factors that determine step-down failure in standard clinical practice of patients with moderate-severe asthma controlled by a combination of inhaled glucocorticoids and long-acting beta agonists. METHODS: A multicentre retrospective study included 374 patients with moderate-severe asthma controlled with inhaled glucocorticoids and long-acting beta agonists for whom the physician indicated a step-down in 2016. RESULTS: The step-down failed in 41.7% of the patients. The following factors were related to failure: greater patient age (P=.006), presence of at least 2 comorbidities (P=.016), greater severity level (severe persistent vs. moderate persistent) (P<.001), greater age at diagnosis (>40 years) (P=.045), the higher the therapeutic step before (P=.003) and after the change (P<.001), the shorter the time of improvement/control prior to the change (P=.019), lower FEV1 (P=.001) and a poorer Asthma Control Test score or Asthma Control Questionnaire score before the step-down (P<.001). The logistic regression analysis showed a higher probability of step-down failure in the more elderly patients (OR, 0.983; 95% CI 0.969-0.997) and those with severe asthma compared to those with moderate asthma (OR, 0.537; 95% CI 0.292-0.985), as well as an increased probability of success if the patients had the disease controlled for more than 6 months (OR, 2.253; 95% CI 1.235-4.112). CONCLUSION: In standard clinical practice conditions, step-down fails in a high percentage of patients, and the suggestion is to indicate step-down when the patient has had more than 6 months of disease control.

[Skin to skin contact after cesarean delivery.Theme update and actuation proposal]. / Contacto piel con piel tras un parto por cesárea. Puesta al día y propuesta de actuación.

Skin to skin contact (SSC) between mother and child immediately after birth is now considered to be an indicator of good clinical practice as it offers multiple benefits for both: it reduces stress levels of the mother, it facilitates affective bonding, breastfeeding and the newborns adaptation to extra-uterine life. However, in the vast majority of hospitals, mother and child are separated until complete recovery following a caesarean section, which can be several hours. In this article the advantages of SSC after a caesarean section, were analyzed, as well as the main difficulties in order to carry it out, which include maternal or neonatal instability and the reticence of the professionals themselves. An actuation procedure model is detailed, for its implementation in a safe manner and that at the same time, contribute to humanize the birth.

El contacto piel con piel (CPP) entre la madre y el recién nacido tras el nacimiento es considerado como uno de los indicadores de Buenas Prácticas Clínicas, ya que ofrece múltiples beneficios para ambos: reduce el nivel de estrés en la madre, facilita el desarrollo del vínculo afectivo, el éxito de la lactancia materna y la adaptación del recién nacido a la vida extrauterina. Sin embargo, en la mayoría de los hospitales se separa a madre e hijo el tiempo que dura la recuperación tras la cesárea, lo que puede extenderse varias horas. En este artículo se analizaron las ventajas del CPP tras las cesáreas y las principales dificultades para llevarlo a cabo, que incluyen inestabilidad materna o neonatal y reticencias de los propios profesionales. Se detalla un modelo de procedimiento de actuación para su puesta en marcha, de forma segura y que a la vez contribuya a humanizar el nacimiento.

Validation of the Acoustic Voice Quality Index Version 03.01 and the Acoustic Breathiness Index in the Spanish language.

OBJECTIVE: The aim of this study was to validate the Acoustic Voice Quality Index 03.01 (AVQIv3) and the Acoustic Breathiness Index (ABI) in the Spanish language. METHOD: Concatenated voice samples of continuous speech (cs) and sustained vowel (sv) from 136 subjects with dysphonia and 47 vocally healthy subjects were perceptually judged for overall voice quality and breathiness severity. First, to reach a higher level of ecological validity, the proportions of cs and sv were equalized regarding the time length of 3 seconds sv part and voiced cs part, respectively. Second, concurrent validity and diagnostic accuracy were verified. RESULTS: A moderate reliability of overall voice quality and breathiness severity from 5 experts was used. It was found that 33 syllables as standardization of the cs part, which represents 3 seconds of voiced cs, allows the equalization of both speech tasks. A strong correlation was revealed between AVQIv3 and overall voice quality and ABI and perceived breathiness severity. Additionally, the best diagnostic outcome was identified at a threshold of 2.28 and 3.40 for AVQIv3 and ABI, respectively. CONCLUSIONS: The AVQIv3 and ABI showed in the Spanish language valid and robust results to quantify abnormal voice qualities regarding overall voice quality and breathiness severity.

Fatty Acid Composition and Eicosanoid Levels (LTE4 and PGE2) of Human Milk from Normal Weight and Overweight Mothers.

Background: Maternal obesity is known to affect human milk composition. Long-chain polyunsaturated fatty acids (LCPUFA) are vital nutrients to the nervous system development and precursors of eicosanoids related to obesity (prostaglandin E2-PGE2-and leukotriene E4-LTE4). The aim of the present research was to study the lipid profiles, with particular emphasis to LCPUFAs, and the concentrations of eicosanoids PGE2 and LTE4, involved in adipose tissue development, in human milk from overweight mothers compared with normal weight mothers. Materials and Methods: Study including 46 overweight and 86 normal weight breastfeeding volunteers was carried out. Fatty acids and eicosanoids (PGE2 and LTE4) were analyzed in mature human milk. Fatty acids quantification was determined by gas chromatography and mass spectrometry. PGE2 and LTE4 were measured by immununoassay. Results: Human milk of overweight mothers had lower contents of n-3 LCPUFA, including eicosapentaenoic acid (20:5n-3, EPA) and docosahexaenoic acid (22:6n-3, DHA) and higher levels of total n-6 LCPUFA, compared with normal weight mothers (0.45 ± 0.23 versus 0.58 ± 0.38, p = 0.016; 0.05 ± 0.04 versus 0.08 ± 0.08, p = 0.005; 0.26 ± 0.15 versus 0.34 ± 0.22, p = 0.015; 0.84 ± 0.25 versus 0.74 ± 0.20, p = 0.029; respectively). Multiple regression analyses showed that maternal overweight was associated with human milk fatty acid profile. The levels of PGE2 and LTE4 in human milk did not show significant differences between groups. Conclusions: Our findings support the hypothesis that mother weight status influences human milk n-3 LCPUFA lipid composition, but not its relationship with PGE2 and LTE4 levels.

Cepstral analysis of normal and pathological voice in Spanish adults. Smoothed cepstral peak prominence in sustained vowels versus connected speech. / Análisis cepstral de la voz normal y patológica en adultos españoles. Medida de la prominencia del pico cepstral suavizado en vocales sostenidas versus habla conectada.

INTRODUCTION AND OBJECTIVES: In recent years, the use of cepstral measures for acoustic evaluation of voice has increased. One of the most investigated parameters is smoothed cepstral peak prominence (CPPs). The objectives of this paper are to establish the usefulness of this acoustic measure in the objective evaluation of alterations of the voice in Spanish and to determine what type of voice sample (sustained vowels or connected speech) is the most sensitive in evaluating the severity of dysphonia. METHOD: Forty subjects participated in this study 40, 20 controls and 20 with dysphonia. Two voice samples were recorded for each subject (one sustained vowel/a/and four phonetically balanced sentences) and the CPPs was calculated using the Praat programme. Three raters perceptually evaluated the voice sample with the Grade parameter of GRABS scale. RESULTS: Significantly lower values were found in the dysphonic voices, both for/a/(t[38]= 4.85, P<.000) and for phrases (t[38] = 5,75, P<.000). In relation to the type of voice sample most suitable for evaluating the severity of voice alterations, a strong correlation was found with the acoustic-perceptual scale of CPPs calculated from connected speech (rs = -0.73) and moderate correlation with that calculated from the sustained vowel (rs = -0,56). CONCLUSION: The results of this preliminary study suggest that CPPs is a good measure to detect dysphonia and to objectively assess the severity of alterations in the voice.

Association between combinations of genetic polymorphisms and epidemiopathogenic forms of bovine paratuberculosis.

Control of major mycobacterial diseases affecting livestock is a challenging issue that requires different approaches. The use of genetic markers for improving resistance to Mycobacterium avium subsp. paratuberculosis infection in cattle has been explored as a promising population strategy We performed paratuberculosis epidemiopathogenic phenotypic and genotypic characterization involving 24 SNPs in six candidate genes (NOD2, CD209, SLC11A1, SP110, TLR2 and TLR4) on 502 slaughtered Friesian cows. In the current study, we investigate whether recently proposed paratuberculosis (PTB) epidemiopathogenic (EP) forms (apparently free-AF, latent-LAT and patent-PAT) could be associated with some combination of these 24 SNPs. Best EP form grouping was obtained using a combination of 5 SNPs in four genes (CD209: rs210748127; SLC11A1: rs110090506; SP110: rs136859213 and rs110480812; and TLR2: rs41830058). These groups were defined according to the level of infection progression risk to patent epidemiopathogenic forms and showed the following distributions: LOWIN (low) with 39 (8%) cases (94.9% AF/5.1% LAT/0% PAT); LATIN (low) with 17 (3%) cases (5.9% AF/94.1% LAT/0% PAT); AVERIN (average) with 413 (82%) cases (52.1% AF/38.5% LAT/9.4% PAT) and PATIN (patent) with 33 (7%) cases (36.4% AF/24.2% LAT/39.4% PAT). Age of slaughter was significantly higher for LATIN (88.3 months) compared to AVERIN (65.3 months; p = 0.0007) and PATIN (59.1 months; p = 0.0004), and for LOWIN (73.9 months) compared to PATIN (p = 0.0233), and nearly significant compared to AVERIN (p = 0.0572) These results suggest that some selected genetic polymorphisms have a potential use as markers of PTB EP forms and thus add a new tool for the control of this widespread infection.

Immunochemical and physical quantitation of grass and olive pollen allergens: correlation with asthma admissions in Cáceres, Spain

BACKGROUND: The association between pollen counts and allergen levels in the air is controversial. OBJECTIVES: The aims of the study were to quantify total and major allergen levels of Phleum pratense and Olea europaea and to analyze their correlation with grass and olive pollen counts and the number of asthma attacks attended at Complejo Hospitalario Universitario, Cáceres, Spain. MATERIAL AND METHODS: A volumetric air sampler and a Burkard spore trap were used for pollen and aeroallergen collection during April- June 2011. Filters were extracted, and major allergens were quantified using enzyme-linked immunosorbent assay. RESULTS: May was the main grass pollination period, with a maximum peak of 1362 grains/m3 (May 13). The main pollination period for olive was April 30-May 20, with a maximum peak of 851 grains/m3 (May 11). A moderate correlation was observed between asthma exacerbations and grass pollen counts or Phleum total allergen levels; this became stronger when a 3-day offset was introduced. A significant association was observed between asthma exacerbations and total olive allergen or olive pollen grain levels when a 1-day offset was introduced. The maximum correlation (moderate-high) was observed 4 days and 6 days away from the maximum olive pollen peak and the maximum Ole e 1 peak level, respectively. CONCLUSIONS: This study reveals a significant correlation between grass and olive pollination and an increase in the number of visits to the emergency room for asthma attacks. The aerobiological pattern of allergen levels in the air is similar to that of pollen counts during the grass and olive pollination periods

ANTECEDENTES: La relación entre los niveles de pólenes en el aire y los niveles de alérgenos es controvertida. OBJETIVOS: El objetivo de este estudio fue cuantificar los niveles de alérgenos principales y totales de Phleum pratense y Olea europaea, y analizar su relación con los niveles de pólenes y el número de crisis asmáticas atendidas en el Complejo Hospitalario de Cáceres, España. MATERIAL Y MÉTODOS: Se captaron pólenes y aeroalérgenos durante Abril-Junio de 2011, utilizando un colector de aire volumétrico y una trampa Burkard. Se extrajeron los alérgenos de los filtros y se cuantificaron mediante ELISA. RESULTADOS: Mayo fue el periodo de mayor polinización, (13 de Mayo, pico máximo de 1.362 granos de polen de gramíneas/m3). El mayor periodo de polinización del olivo fue del 30 de Abril al 20 de Mayo, (11 de Mayo, pico máximo: 851 granos de polen de olivo/m3). Se observó una correlación moderada entre los niveles de polen o alérgenos totales y exacerbaciones de asma, que aumentó al introducir un desfase de 3 días (Phleum), y de 1 día (olivo). La máxima correlación se observó a los 4 y 6 días del pico máximo de polen y de Ole e 1, respectivamente. CONCLUSIONES: Este estudio muestra una correlación significativa entre la polinización de gramíneas y olivo y el aumento del número de visitas a urgencias debidas a crisis asmáticas. Los patrones aerobiológicos de los niveles de alérgenos en el aire son comparables a los recuentos de pólenes durante los periodos de polinización de gramíneas y olivo

Molecular identification of a new pestivirus associated with increased mortality in the Pyrenean Chamois (Rupicapra pyrenaica pyrenaica) in Spain.

Pestivirus infection was identified in 16 of 17 chamois during an outbreak of a previously unreported disease in Pyrenean chamois (Rupicapra pyrenaica pyrenaica) in northeastern Spain in 2001-02. By analysis of the 5' noncoding regions of the virus, we assigned it to the border disease virus cluster with pairwise similarity values ranging from 82.1% to 88.1%. It will be important to investigate the association of this pestivirus with disease in Pyrenean chamois.

Contacto piel con piel tras un parto por cesárea. Puesta al día y propuesta de actuación / Skin to skin contact after cesarean delivery. Theme update and actuation proposal

El contacto piel con piel (CPP) entre la madre y el recién nacido tras el nacimiento es considerado como uno de los indicadores de Buenas Prácticas Clínicas, ya que ofrece múltiples beneficios para ambos: reduce el nivel de estrés en la madre, facilita el desarrollo del vínculo afectivo, el éxito de la lactancia materna y la adaptación del recién nacido a la vida extrauterina. Sin embargo, en la mayoría de los hospitales se separa a madre e hijo el tiempo que dura la recuperación tras la cesárea, lo que puede extenderse varias horas. En este artículo se analizaron las ventajas del CPP tras las cesáreas y las principales dificultades para llevarlo a cabo, que incluyen in estabilidad materna o neonatal y reticencias de los propios profesionales. Se detalla un modelo de procedimiento de actuación para supuesta en marcha, de forma segura y que a la vez contribuya a humanizar el nacimiento

Skin to skin contact (SSC) between mother and child immediately after birth is now considered to be an indicator of good clinical practice as it offers multiple benefits for both: it reduces stress levels of the mother, it facilitates affective bonding, breastfeeding and the newborns adaptation to extra-uterine life. However, in the vast majority of hospitals, mother and child are separated until complete recovery following a caesarean section, which can be several hours. In this article the advantages of SSC after a caesarean section, were analyzed, as well as the main difficulties in order to carry it out, which include maternal or neonatal instability and the reticence of the professionals themselves. An actuation procedure model is detailed, for its implementation in a safe manner and that at the same time, contribute to humanize the birth

Evaluación del periodo de llenado y evacuación intestinal de Brachionus calyciflorus alimentado con Chlorella sp / Evaluation of the period of filling and intestinal evacuation of Brachionus calyciflorus fed on Chlorella sp / Avaliação do período de enchimento e evacuação intestinal de Brachionus calyciflorus (Rotifera: Brachionidae) alimentado com Chlorella sp

Resumen Con el fin de determinar la viabilidad del rotífero de agua dulce Brachionus calyciflorus utilizado como alimento vivo en la fase de larvicultura de especies ícticas, se evaluó el periodo cronológico de llenado y evacuación intestinal, mediante la alimentación con diferentes concentraciones de microalga Chlorella sp. en estado condensado. Los tratamientos fueron, T1: 1,2×106 células/mL, T2: 5,2×106 células/mL, T3: 10,4×106 células/mL y T4: 15,4×106 células/mL, en una densidad de 40 rotíferos/mL para cada tratamiento. Se realizó análisis de imagen, se aplicó una prueba de varianza ANOVA y test múltiple de Tukey a los resultados donde se establecieron diferencias significativas entre los tratamientos (P≤0.05); las variables analizadas fueron: volumen del cuerpo, volumen del intestino, volumen intestinal expresado en porcentaje y tiempo de tránsito intestinal. Para el análisis morfométrico el rango de volumen del cuerpo fue de 0,7×106µm3a 2,6 ×106µm3. El tiempo mínimo de llenado y evacuación fue de 60 minutos. Los porcentajes intestinales en su máxima repleción para cada tratamiento fueron T1: 5,55%, T2:8,62% T3:10,53% y T4: 8,08%, en consecuencia, el tiempo idóneo para suministrar el rotífero B. calyciflorus como alimento vivo en larvicultura, es de 105 - 225 minutos, después de iniciado la ingesta de la microalga.

Abstract In order to determine the viability of the freshwater rotiferBrachionus calyciflorusused as alive food in the phase of larviculture of ictic species,there was evaluated the chronological period of filling and intestinal evacuation, by means of the supply with different concentrations of microalgae Chlorella sp. in condensed condition. The treatments were, T1: 1.2 × 106 cells / mL, T2: 5.2 × 106 cells / mL, T3: 10.4 × 106 cells / mL and T4: 15.4 × 106 cells / mL, all of them with a density of 40 for each treatment. Analysis of image was realized, and it was applied a test of variance ANOVA and Tukey›s multiple test to the results where significant differences between the treatments were established (P≤0.05); the variables analyzed were: volume of body, bowel volume, intestinal volume expressed in percentage and intestinal transit time. For morphometric analysis, the volume rank of the body was of 0,7×106 µm3 to 2,6 ×106 µm3. The minimum filling and evacuation time were 60 minutes. The intestinal percentages in their maximum repletion for each treatment were T1: 5.55%, T2: 8.62% T3: 10.53% and T4: 8.08%, consequently, the suitable time to supply the rotiferB. Calyciflorusas alive food in larviculture it is of 105 - 225 minutes, after initiated the ingestion of the microalgae.

Resumo A fim de determinar a viabilidade do rotífero de água doce Brachionus calyciflorus utilizado como alimento vivo na fase de larvicultura, foi avaliado o período cronológico de enchimento e evacuação intestinal através da alimentação com diferentes concentrações de microalga Chlorella sp. em estado condensado. Os tratamentos foram, T1: 1,2×106 células/mL, T2: 5,2×106 células/mL, T3: 10,4×106 células/mL e T4: 15,4×106 células/mL, numa densidade de 40 rotíferos/mL para cada tratamento. Foi realizado um analise de imagem e aplicado um teste de variância ANOVA e o teste múltiplo de Tukey aos resultados dos tratamentos onde foram estabelecidas diferenças significativas (P≤0.05); as variáveis analisadas foram: volume corporal, volume intestinal, volume intestinal expresso em porcentagem e tempo de trânsito intestinal. Para a análise morfométrica, a faixa de volume corporal foi de 0,7×106 µm3 a 2,6 ×106 µm3. O tempo mínimo de enchimento e evacuação foi de 60 minutos. As porcentagens intestinais em sua repleção máxima para cada tratamento foram T1: 5,55%, T2: 8,62% T3: 10,53% e T4: 8,08%. Em consequência, o tempo ideal para fornecer o rotífero B. calyciflorus como alimento vivo na larvicultura é de 105 - 225 minutos, após o início da ingesta da microalga.

Análisis cepstral de la voz normal y patológica en adultos españoles. Medida de la prominencia del pico cepstral suavizado en vocales sostenidas versus habla conectada / Cepstral analysis of normal and pathological voice in Spanish adults. Smoothed cepstral peak prominence in sustained vowels versus connected speech

INTRODUCCIÓN Y OBJETIVOS: En los últimos años se ha incrementado el uso de medidas cepstrales para la evaluación acústica de la voz. Uno de los parámetros más investigados es la prominencia del pico cepstral suavizado (CPPs). Los objetivos de este trabajo son conocer la utilidad de esta medida acústica en la evaluación objetiva de las alteraciones de la voz en español y determinar qué tipo de muestra de voz (vocales sostenidas o habla conectada) es la más sensible para evaluar la severidad de la disfonía. MÉTODO: En este estudio participaron 40 sujetos, 20 normofónicos y 20 con disfonía. Se grabaron 2 muestras de voz para cada sujeto (una/a/sostenida y 4 frases fonéticamente balanceadas) y se calculó la CPPs con el programa Praat. Tres expertos valoraron perceptivamente la voz de la muestra con el parámetro grado de la escala GRABS. RESULTADOS: Se encontraron valores significativamente menores en las voces disfónicas, tanto para la/a/(t[38] = 4,85, p < 0,000) como para las frases (t[38] = 5,75, p < 0,000). En relación con el tipo de muestra de voz más indicado para evaluar la severidad de las alteraciones de la voz se encontró una fuerte correlación con la escala acústico-perceptiva de la CPPs calculada a partir del habla conectada (rs = -0,73) y moderada con la calculada a partir de la vocal sostenida (rs= -0,56). CONCLUSIÓN: Los resultados de este estudio preliminar apuntan a que la CPPs es una buena medida para detectar la disfonía y para evaluar objetivamente el grado de severidad de las alteraciones en la voz

INTRODUCTION AND OBJECTIVES: In recent years, the use of cepstral measures for acoustic evaluation of voice has increased. One of the most investigated parameters is smoothed cepstral peak prominence (CPPs). The objectives of this paper are to establish the usefulness of this acoustic measure in the objective evaluation of alterations of the voice in Spanish and to determine what type of voice sample (sustained vowels or connected speech) is the most sensitive in evaluating the severity of dysphonia. METHOD: Forty subjects participated in this study 40, 20 controls and 20 with dysphonia. Two voice samples were recorded for each subject (one sustained vowel/a/and four phonetically balanced sentences) and the CPPs was calculated using the Praat programme. Three raters perceptually evaluated the voice sample with the Grade parameter of GRABS scale. RESULTS: Significantly lower values were found in the dysphonic voices, both for/a/(t[38] = 4.85, P < .000) and for phrases (t[38] = 5,75, P < .000). In relation to the type of voice sample most suitable for evaluating the severity of voice alterations, a strong correlation was found with the acoustic-perceptual scale of CPPs calculated from connected speech (rs = -0.73) and moderate correlation with that calculated from the sustained vowel (rs = -0,56). CONCLUSION: The results of this preliminary study suggest that CPPs is a good measure to detect dysphonia and to objectively assess the severity of alterations in the voice

Hereditary angioedema: quality of life in Brazilian patients.

OBJECTIVE: Hereditary angioedema is a serious medical condition caused by a rare autosomal dominant genetic disorder and it is associated with deficient production or dysfunction of the C1 esterase inhibitor. In most cases, affected patients experience unexpected and recurrent crises of subcutaneous, gastrointestinal and laryngeal edema. The unpredictability, intensity and other factors associated with the disease impact the quality of life of hereditary angioedema patients. We evaluated the quality of life in Brazilian hereditary angioedema patients. METHODS: Patients older than 15 years with any severity of hereditary angioedema and laboratory confirmation of C1 inhibitor deficiency were included. Two questionnaires were used: a clinical questionnaire and the SF-36 (a generic questionnaire). This protocol was approved by the Ethics Committee of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. RESULTS: The SF-36 showed that 90.4% (mean) of all the patients had a score below 70 and 9.6% had scores equal to or higher than 70. The scores of the eight dimensions ranged from 51.03 to 75.95; vitality and social aspects were more affected than other arenas. The internal consistency of the evaluation was demonstrated by a Cronbach's alpha value above 0.7 in seven of the eight domains. CONCLUSIONS: In this study, Brazilian patients demonstrated an impaired quality of life, as measured by the SF-36. The most affected domains were those related to vitality and social characteristics. The generic SF-36 questionnaire was relevant to the evaluation of quality of life; however, there is a need for more specific instruments for better evaluation.

High-frequency ultrasound imaging for longitudinal evaluation of non-alcoholic fatty liver disease progression in mice.

Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of hepatic damage in developed countries. For this reason, mouse models of NAFLD have been developed to show progression of the disease because it perfectly resembles the human pathology. Here we show that diagnostic high-frequency ultrasound imaging (US) may be used as an effective method for monitoring the progression of liver disease, from steatosis to hepatocellular carcinoma in the methionine adenosyl transferase and glycine N-methyltransferase-deficient mice models. US reliably detected murine liver lesions associated with NAFLD in the two mice strains tested, with excellent agreement among US images, gross pathology and histological sections. Our results suggest US as a relevant approach for the study of NAFLD in mice, with interesting technical and therapeutic implications.

Hereditary angioedema: quality of life in Brazilian patients

OBJECTIVE: Hereditary angioedema is a serious medical condition caused by a rare autosomal dominant genetic disorder and it is associated with deficient production or dysfunction of the C1 esterase inhibitor. In most cases, affected patients experience unexpected and recurrent crises of subcutaneous, gastrointestinal and laryngeal edema. The unpredictability, intensity and other factors associated with the disease impact the quality of life of hereditary angioedema patients. We evaluated the quality of life in Brazilian hereditary angioedema patients. METHODS: Patients older than 15 years with any severity of hereditary angioedema and laboratory confirmation of C1 inhibitor deficiency were included. Two questionnaires were used: a clinical questionnaire and the SF-36 (a generic questionnaire). This protocol was approved by the Ethics Committee of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. RESULTS: The SF-36 showed that 90.4% (mean) of all the patients had a score below 70 and 9.6% had scores equal to or higher than 70. The scores of the eight dimensions ranged from 51.03 to 75.95; vitality and social aspects were more affected than other arenas. The internal consistency of the evaluation was demonstrated by a Cronbach's alpha value above 0.7 in seven of the eight domains. CONCLUSIONS: In this study, Brazilian patients demonstrated an impaired quality of life, as measured by the SF-36. The most affected domains were those related to vitality and social characteristics. The generic SF-36 questionnaire was relevant to the evaluation of quality of life; however, there is a need for more specific instruments for better evaluation.

Heterotopic gastric mucosa: a significant clinical entity.

OBJECTIVE: Despite the apparent lack of clinical interest in the inlet patches of heterotopic gastric mucosa (HGM) in the upper esophagus, the literature contains reports of complications associated with HGM. The aim of this study was to determine the prevalence and clinical importance of HGM in patients referred for upper gastrointestinal endoscopy (UGE). MATERIAL AND METHODS: A total of 1033 consecutive outpatients referred for UGE were prospectively evaluated. Clinical, endoscopic and histologic findings were analyzed and 24-h double-channel pH-metry was performed on 20 patients with HGM. RESULTS: Fifty-three patients (5.1%) had HGM lesions. Dysphagia was significantly more frequent in HGM patients (21% versus 4%; p<0.001). Five of the 20 patients who underwent pH-metry presented with acid secretion from HGMs. These five patients had inlet patches of greater size. CONCLUSIONS: HGMs of the upper esophagus are not infrequent, although generally small and asymptomatic. In cases of large HGMs, acid secretion capacity may cause upper esophageal disorders.