Marco Aurélio Rocha Santos

Effects of hyperprolactinemia on plasma glucose and prolactin in rats exposed to ether stress

The present study was designed to characterize the effect of chronic hyperprolactinemia on plasma glucose and prolactin (PRL) during ether stress in male and female rats. Wistar rats of both sexes were divided into a hyperprolactinemic group (bearing pituitary grafts) and a control group (sham operated). They were exposed to ether during 10 min and had blood samples taken immediately before, and 5, 15, 40, and 70 min after ether exposure and assayed for glucose and PRL concentrations. Ether stress induced significant increase in plasma PRL of control rats at 5 min (male 171%, female 161%; P < 0.01), but only a mild PRL increase occurred in grafted rats (male 66%, female 62%; P < 0.05). Control male rats sustained elevated plasma PRL longer than females. There was a marked elevation of glucose levels at 5 min (P < 0.01) which peaked at 15 min in all groups. Grafted rats had glucose levels significantly above control at baseline (female 15%, P < 0.05) and at 40 min (male 25%, female 29%; P < 0.05). It is concluded that ether-induced PRL release produced a rapid and transient response, more intense in males than in females and which was impaired by previous hyperprolactinemia (pituitary grafts). There was an acute hyperglycemic response, plasma glucose being increased in grafted rats, supporting the hypothesis of a hyperglycemic effect of PRL.

Potencial evocado miogênico vestibular (Vemp): avaliação das respostas em indivíduos normais

BACKGROUND the Vestibular Evoked Myogenic Potential (Vemp) is formed by myogenic neurophysiologic responses activated by high-intensity sound stimulation. The response is registered through surface electromyography of the cervical muscles during muscle contraction. The acoustic stimuli activate the saccular macula, the vestibular inferior nerve and the pathways related to the vestibule-spinal descendant nerves. AIM to describe Vemp parameters in a normal population. METHODS thirty adults, 13 men and 17 women with no otoneurological complaints were selected. The stimuli were 200 tone burst, with a frequency of 1Hz and intensity of 118 dB Na, band-pass filter ranging from 10Hz to 1500Hz. The first potential biphasic P13-N23 wave was analyzed. RESULTS no significant difference was observed between the sides of stimulation in terms of latency and amplitude. However, a statistically significant difference was found for amplitude between genders. CONCLUSION Vemp demonstrated to be a reliable instrument in the clinical assessment of the vestibular function.

Vestibular-evoked myogenic potential (VEMP) to evaluate cervical myelopathy in human T-cell lymphotropic virus type I infection.

Study Design. Cross-seccional analysis. Objective. To define the clinical usefulness of vestibular-evoked myogenic potential (VEMP) in detecting cervical medullar involvement related to human T-cell lymphotropic virus type 1 (HTLV-1) associated myelopathy/tropical spastic paraparesis (HAM/TSP). Summary of Background Data. VEMP is generated by acoustic or galvanic stimuli, passing through the vestibulo-spinal motor tract, the spinal nerves and recorded by means of surface electrodes on the sternocleidomastoid muscle. HAM/TSP is a progressive inflammatory myelopathy with predominant lesions at the thoracic spinal cord level, although the cervical spine can be affected. VEMP may be of value to investigate cervical myelopathy. Methods. Seventy-two individuals were evaluated of whom 30 HTLV-1 were seronegative and 42 HTLV-1 seropositive (22 asymptomatic, 10 with complaints of walking difficulty without definite HAM/TSP and 10 with definite HAM/TSP). VEMP was recorded using monaural delivered short tone burst (linear rise-fall 1 millisecond, plateau 2 milliseconds, 1 KHz) 118 dB NA, stimulation rate of 5 Hz, analysis time of 60 milliseconds, 200 stimuli, band pass filtered between 10 and 1.500 Hz. Results. VEMP was normal in the seronegative group (30 controls). In the seropositive, abnormal VEMP was seen in 11 of 22 (50%) of the HTLV-1 asymptomatic carriers, in 7 of 10 (70%) of those with complaints of walking difficulty and in 8 of 10 (80%) of the HAM/TSP patients. In this last group, the pattern of response was different. No VEMP response was more frequent when compared with the HTLV-1 asymptomatic group (2-tailed P-value = 0.001). Conclusion. VEMP may possibly be useful to identify patients with cervical myelopathy and to distinguish variable degrees of functional damage. Minor injury would be related to latency prolongation and major injury to no potential-evoked response.

Analysis of aspects of quality of life in teachers' voice after discharged: longitudinal study

PURPOSE To evaluate the long-term effects of voice therapy on the life quality of teachers who were discharged or abandoned the voice therapy for dysphonia. METHODS This was a longitudinal study based on analysis of assessments with teachers of municipal schools in Belo Horizonte, who were referred to voice therapy and were discharged or abandoned the speech-language therapy for more than six months. A total of 33 teachers in the discharged group and 20 teachers in the abandoned group were contacted by phone and invited to participate in the study by answering the Voice activity and participation profile, which was forwarded to the researchers and sent via letter. RESULTS At the moment of the pre speech therapy, the discharged and abandoned groups were homogeneous, except in relation to daily communication parameter. Comparing the discharged group in the pre and post speech-language therapy, it was showed improvements in social communication parameter as well as in the total score. The discharged group presented worsening in self-perception parameter when comparing the average values in the post therapy and current moments, and the group abandoned presented worsening in work, social communication and total score when comparing to the average values in the pre therapy and current moments. The discharged and abandoned groups differ in the present moment in all investigated parameters. CONCLUSION Speech-language therapy for dysphonia have long term positive effects on life quality and voice of teachers who were soon discharged from the therapy and in a period of two years on average. Teachers who have abandoned treatment and did not obtain improvement in the voice showed negative impact in life quality and voice in a time of 2 years and 2 months on average.

Avaliação laríngea e vocal de pacientes com bulimia

UNLABELLED Bulimia is an eating disorder classified as a mental disorder according to DSM-IV. AIMS The aim of the study was to evaluate vocal and laryngeal abnormalities in patients with bulimia compared to a control group. MATERIALS & METHODS Study control group. Twenty-two women were evaluated, with an age range of 18 to 34 years old. Eleven diagnosed with purging bulimia and 11 in the control group. Both groups underwent an otolaryngological, perception and acoustic evaluation. The statistic analysis was done through a chi-square test and a Kruskall-Wallis non-parametric test, considering 5% as significance level. RESULTS The bulimic group presented a higher prevalence of laryngeal abnormalities compared to the control group (p=0.000). The group with bulimia had higher GRBSI values (p=0.000) and A (p=0.022) of the GRBASI scale. The results of vocal acoustics analysis of the jitter, shimmer, PPQ and APQ were higher in the bulimic group (p=0.033). No statistical significance difference in the fundamental frequency and NHR were found between both groups. CONCLUSION the bulimic patients in this study presented more laryngeal, acoustics and perception evaluation disorders when compared to a control group.

Disfonia e bulimia: avaliação dos sintomas e sinais vocais e laríngeos

PURPOSE: To describe vocal and laryngeal signs and symptoms in patients with bulimia. METHODS: A blind, descriptive, randomized, transversal study was carried out. Eleven female subjects with the diagnosis of purgative bulimia nervosa and ages ranging from 18 to 34 years underwent otorhinolaryngological and vocal evaluations. RESULTS: The most common vocal and laryngeal symptoms were throat clearing and globus faringeus, related by 10 subjects (90.9%). In the auditory-perceptive evaluation, the most common scores were characterized as light in all analyzed parameters. The accumulation of thick mucus over the larynx occurred in five patients (45.4%), followed by median-posterior triangular glottic chink and mucosal thickening at the interaytenoid region, in four patients (36.3%). CONCLUSION: The laryngeal and perceptual findings were less expressive than vocal and laryngeal complaints.

Osteoma of the middle ear

Osteomas are rare benign bone tumors of the bone lamellar portion, that usually originate from the paranasal sinuses where they are pedicled. In the temporal bone, they are usually found in the external auditory canal and are extremely rare in the middle ear. Temporal bone osteomas have a preference for the outermost portion of the external auditory canal, while exostoses affect its most internal portion. In the temporal bone, its presence has been described in the mastoid, in the squama and in the internal auditory canal, however with marked preference for the external auditory canal1. In the medical literature, there are 60 cases of temporal bone osteomas described, originating outside the external acoustic meatus2. According to Harley et al.3 only 12 of these osteomas were found in the middle ear; and they also reported that only five of these patients complained of hearing loss, while the others were diagnosed by chance. Unal et al.4 also spoke about the conduction hearing loss in cases of middle ear osteomas. Silver et al.5 are among the authors that stressed the lack of symptoms in middle ear osteomas and, on the other hand, Muraoka et al.6 showed how important CT scan is in otorhinolaryngology in general, most specially the 3D type. Hearing loss is conductive, unilateral and progressive. Temporal bone osteomas occur mostly in young patients, present as single-unilateral lesion, of unknown etiology. It is possible that they originate from the bone capsule connective tissue and they are histologically similar to those observed in the external acoustic canal. The goal of this paper is to report a case of middle ear osteoma associated with conductive hearing loss, for which the diagnosis hypothesis was of otosclerosis. CASE PRESENTATION

Graphic angle measure as an electrocochleography evaluation parameter

UNLABELLED To improve electrocochleographys diagnostic sensitivity in Meniéres disease - new assessment methods are being studied. AIM To determine whether or not graphic angle measurement is sensitive and specific to Menières disease laboratorial diagnosis and if there is an increase in the electrocochleographys sensitivity and specificity when graphic angle measurements are associated with Summating Potential-Action Potential ratio (SP/AP ratio). METHODS Electrocochleographys was used to analyze 71 ears from 55 subjects: 41 patients with clinical diagnosis of Menières disease (MD group), and 14 healthy individuals as control (Group C). Graphic results were analyzed initially to obtain the SP/AP ratio; afterwards, through another program graphic angle measurements were calculated. RESULTS Sensitivity and specificity values of angle measures, SP/AP ratio, and the association between them varied according to the cutoff point, the highest equilibrium between sensitivity and specificity was observed with the values of 166.25 for angle measurement and 27% for SP/AP relation; 62.79% / 60.71% and 74.42% / 67.86%, respectively. The association between measurements showed a sensitivity increase due to the specificity decrease; 88.37% and 50%, respectively. CONCLUSION Angle graphic measurement is not sensitive and specific enough for the laboratorial diagnosis of MD. Angle graphic measurement and SP/AP ratio association proved to be higher in sensitivity, in detriment of exam specificity.

Análise da qualidade vocal antes e após o uso profissional e social da voz

Purpose To analyze the effects of social and professional voice use in the voice quality of women in a time frame of two hours and 30 minutes using auditory-perceptual evaluation. Methods A case-control study with two groups: professional voice users, with 31 Belo Horizonte school teachers aged 28-59 years; social voice users, with 42 females aged 31-59 years with no occupational voice use. The data was collected at two time points, in the morning period, before starting the use of voice and after two hours and thirty minutes. The subjects were instructed to read sentences in their normal speaking voice. The same recording scheme was used for the group of social voice use, with normal use of the voice in the home of each participant. The voices were evaluated through an auditory-perceptual assessment by two experienced raters who compared the emissions before and after voice use and determined whether there was improvement, deterioration or similarity between time points. Results Both groups had a higher frequency of similarity between the voices before and after the vocal loading according to the auditory-perceptual evaluation. In subjects with changes in their vocal patterns, roughness was the auditory-perceptual parameter that changed the most for both groups, albeit with a low degree of deviance. Conclusion The social voice use and the professional voice use resulting from the teaching activity, both during two hours and thirty minutes, caused no changes in voice quality as evaluated by auditory-perceptual analysis.

Combined ocular and cervical vestibular evoked myogenic potential in individuals with vestibular hyporeflexia and in patients with Ménière's disease

INTRODUCTION The vestibular evoked myogenic potential is a potential of mean latency that measures the muscle response to auditory stimulation. This potential can be generated from the contraction of the sternocleidomastoid muscle and also from the contraction of extraocular muscles in response to high-intensity sounds. This study presents a combined or simultaneous technique of cervical and ocular vestibular evoked myogenic potential in individuals with changes in the vestibular system, for use in otoneurologic diagnosis. OBJECTIVE To characterize the records and analyze the results of combined cervical and ocular VEMP in individuals with vestibular hyporeflexia and in those with Ménières disease. METHODS The study included 120 subjects: 30 subjects with vestibular hyporeflexia, 30 with Ménières disease, and 60 individuals with normal hearing. Data collection was performed by simultaneously recording the cervical and ocular vestibular evoked myogenic potential. RESULTS There were differences between the study groups (individuals with vestibular hyporeflexia and individuals with Ménières disease) and the control group for most of wave parameters in combined cervical and ocular vestibular evoked myogenic potential. For cervical vestibular evoked myogenic potential, it was observed that the prolongation of latency of the P13 and N23 waves was the most frequent finding in the group with vestibular hyporeflexia and in the group with Ménières disease. For ocular vestibular evoked myogenic potential, prolonged latency of N10 and P15 waves was the most frequent finding in the study groups. CONCLUSION Combined cervical and ocular vestibular evoked myogenic potential presented relevant results for individuals with vestibular hyporeflexia and for those with Ménières disease. There were differences between the study groups and the control group for most of the wave parameters in combined cervical and ocular vestibular evoked myogenic potential.