RESUMO
OBJECTIVES: To evaluate whether the overall dysphonia grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, and the Consensus Auditory Perceptual Evaluation-Voice (CAPE-V) scale show the same reliability and consensus when applied to the same vocal sample at different times. STUDY DESIGN: Observational cross-sectional study. METHODS: Sixty subjects had their voices recorded according to the tasks proposed in the CAPE-V scale. Vowels /a/ and /i/ were sustained between 3 and 5 seconds. Reproduction of six sentences and spontaneous speech from the request "Tell me about your voice" were analyzed. For the analysis of the GRBAS scale, the sustained vowel and reading tasks of the sentences was used. Auditory-perceptual voice analyses were conducted by three expert speech therapists with more than 5 years of experience and familiar with both the scales. RESULTS: A strong correlation was observed in the intrajudge consensus analysis, both for the GRBAS scale as well as for CAPE-V, with intraclass coefficient values ranging from 0.923 to 0.985. A high degree of correlation between the general GRBAS and CAPE-V grades (coefficient=0.842) was observed, with similarities in the grades of dysphonia distribution in both scales. The evaluators indicated a mild difficulty in applying the GRBAS scale and low to mild difficulty in applying the CAPE-V scale. The three evaluators agreed when indicating the GRBAS scale as the fastest and the CAPE-V scale as the most sensitive, especially for detecting small changes in voice. CONCLUSIONS: The two scales are reliable and are indicated for use in analyzing voice quality.
Assuntos
Disfonia/diagnóstico , Percepção da Fala , Medida da Produção da Fala/métodos , Qualidade da Voz , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Consenso , Estudos Transversais , Disfonia/fisiopatologia , Disfonia/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Acústica da Fala , Fatores de Tempo , Adulto JovemRESUMO
Apatogenia da rinossinusite crônica não está completamente estabelecida e existem algumas explicações para essa doença, como a osteíte, os superantígenos, a hipersensibilidade mediada por fungos e, mais recentemente, o biofilme. Não existem publicações na língua portuguesa sobre biofilmes na rinossinusite crônica. Objetivo: Reproduzir um método para evidenciar a presença de biofilmes em pacientes com rinossinusite crônica com polipose nasossinusal. Material e método: Amostras de bula etmoidal de nove pacientes com rinossinusite crônica com polipose nasossinusal sem resposta ao tratamento clínico submetidos à cirurgia foram analisadas com microscopia eletrônica de varredura para evidenciar o biofilme. Desenho do estudo: Estudo de coorte contemporânea com corte transversal. Resultados: Observamos o biofilme em 55,56 por cento (5/9) dos pacientes, através da visualização da estrutura tridimensional, de estruturas esféricas envolvidas por uma matriz amorfa e dos canais de água. Conclusão: Reproduzimos um método de visualização de biofilme bacteriano através da microscopia eletrônica de varredura e evidenciamos a sua presença nos pacientes com rinossinusite crônica com polipose nasossinusal.
Chronic rhinosinusitis pathogenesis is not completely established and there are some explanations for this disease, such as osteitis, superantigens, fungal-mediated hypersensitivity and, more recently, biofilms. There are no reports in Portuguese about biofilms in chronic rhinosinusitis. AIM: To reproduce a method for visualization of biofilms in patients with chronic rhinosinusitis and nasal polyps. Patients and methods: Samples of ethmoid bulla of nine patients with chronic rhinosinusitis with nasal polyps without response to clinical treatment who underwent surgery were analyzed with scanning electron microscopy to evidence bacterial biofilms. Study design: A contemporary cross-sectional cohort study Results: In 55.56 percent (5/9) of the patients we observed biofilms by seeing three-dimensional structures, spherical structures surrounded by an amorphous matrix and water-channels. Conclusion: We reproduced a method for visualization of bacterial biofilms by scanning electron microscopy and evidenced its presence in chronic rhinosinusitis with nasal polyps.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Biofilmes , Mucosa Nasal/microbiologia , Pólipos Nasais/microbiologia , Rinite/microbiologia , Sinusite/microbiologia , Doença Crônica , Estudos de Coortes , Estudos Transversais , Microscopia Eletrônica de Varredura , Mucosa Nasal/ultraestrutura , Pólipos Nasais/cirurgia , Projetos Piloto , Reprodutibilidade dos Testes , Rinite/cirurgia , Sinusite/cirurgiaRESUMO
UNLABELLED: Chronic rhinosinusitis' pathogenesis is not completely established and there are some explanations for this disease, such as osteitis, superantigens, fungal-mediated hypersensitivity and, more recently, biofilms. There are no reports in Portuguese about biofilms in chronic rhinosinusitis. AIM: To reproduce a method for visualization of biofilms in patients with chronic rhinosinusitis and nasal polyps. PATIENTS AND METHODS: Samples of ethmoid bulla of nine patients with chronic rhinosinusitis with nasal polyps without response to clinical treatment who underwent surgery were analyzed with scanning electron microscopy to evidence bacterial biofilms. STUDY DESIGN: A contemporary cross-sectional cohort study RESULTS: In 55.56% (5/9) of the patients we observed biofilms by seeing three-dimensional structures, spherical structures surrounded by an amorphous matrix and water-channels. CONCLUSION: We reproduced a method for visualization of bacterial biofilms by scanning electron microscopy and evidenced its presence in chronic rhinosinusitis with nasal polyps.
Assuntos
Biofilmes , Mucosa Nasal/microbiologia , Pólipos Nasais/microbiologia , Rinite/microbiologia , Sinusite/microbiologia , Adulto , Doença Crônica , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Microscopia Eletrônica de Varredura , Pessoa de Meia-Idade , Mucosa Nasal/ultraestrutura , Pólipos Nasais/cirurgia , Projetos Piloto , Reprodutibilidade dos Testes , Rinite/cirurgia , Sinusite/cirurgiaRESUMO
Introdução: As neoplasias de glândulas salivares representam um raro e variado grupo de tumores com diferentes características. A programação terapêutica depende de um adequado diagnóstico a fim de se evitar complicações ou procedimentos desnecessários. Objetivo: Revisão da literatura com ênfase nos mais recentes avanços diagnósticos e terapêuticos. Método: Foi realizada consulta eletrônica nas bases de dados MEDLINE, OVID, PubMed e SciELO para artigos publicados entre os anos de 1997 e 2007. Conclusão: O adequado diagnóstico das neoplasias de glândulas salivares é complexo e cabe ao otorrinolaringologista/cirurgião de cabeça e pescoço a investigação do subtipo histológico para o adequado tratamento. Muitas vezes os exames diagnósticos se confrontam, exigindo avaliação cuidadosa caso-a-caso.
Introduction: Salivary glands neoplasms represent a rare and diverse group of tumors with different characteristics. To avoid complications and unnecessary procedures, the treatment depends on an accurate diagnosis. Objective: Review the literature emphasizing the latest advances in diagnosis and treatment. Method: An electronic research was performed on MEDLINE, OVID, PubMed and SciELO databases articles in a period between 1997 and 2007. Conclusion: The proper diagnosis of salivary glands neoplasms is complex, and the otorhinolaryngologist/head and neck surgeon needs to investigate the histological subtype to ensure ideal treatment. Frequently, diagnostic exams conflict, and careful case by case evaluation is required.