Simone Echeveste

Influence of gustatory and olfactory perception in the oral phase of swallowing in smokers

PURPOSE To analyze the difference between nonsmokers and smokers on the changes in the perceptions of smell and taste and to verify the influence of these aspects in the emergence of compensatory movements during swallowing. METHODS To evaluate these aspects, capabilities of olfactory and gustatory recognition were observed, as well as the compensation swallowing. Twenty-four patients were evaluated in each study group aged from 18 years, grouped in a stratified way. The olfactory evaluation consisted in presenting seven essences and one of three options should be chosen. For the taste test, 16 flavors were offered in a non-sequential and decreasing way in amount of solute. Swallowing solid and liquid was evaluated, in which aspects of compensation perioral muscles were observed. RESULTS Worst performance in olfactory and gustatory tests among smokers (p≤0.01) was found. Through the results of χ2 and Fishers exact tests, it was found that the contraction of the mentalis muscle is less observed in non-smokers, and smokers have an average degree of statistically significant change compared to nonsmokers. Furthermore, through the Spearman correlation coefficient, it was found that the worsening in the sensory tests implies increased compensation during swallowing in smokers. CONCLUSION These data allowed us to verify that the sensory changes have influence on swallowing pattern, indicating that these changes are aspects that should be considered in the differential diagnosis of changes in swallowing.PURPOSE To identify the immediate effects of voiced vibration and vocal fry exercises on healthy subjects by means of acoustic parameters and high-speed kymography. METHODS Thirty healthy subjects (18 women and 12 men, aged from 19 to 45 years old) participated in this study. The voices were recorded at the range of 44.100 samples/second, before and after of the vocal exercises. We developed a computational routine to extract jitter and shimmer. High-speed kymography was generated from laryngeal images for the analysis of the phase times: closed (CPh), open (OPh), of closing (cPh) and of opening (oPh) and used the paired t-Student test and the Mann-Whitney test, with a significance level of 0.05. RESULTS After voiced vibrations, acoustic parameters showed reduced jitter for both genders (p=0.018 for men and p<0.01 for women) and reduced shimmer for female voices (p<0.01). There was a decrease in CPh (p=0.046) and cPh (p=0.026) and an increase in OPh (p=0.05) in female vocal folds. After vocal fry, we identified decreased jitter (p<0.01) in female voices and cPh (p=0.026) in male vocal folds. CONCLUSION We observed more positive immediate effects of the voiced vibrations, mainly in voice quality and vocal folds among females. Nevertheless, studies with larger male sample and investigation of the appropriate time of vocal fry are necessary to confirm the results of this search.

Fratura do quadril: avaliação pós-operatória do resultado clínico e funcional

ABSTRACT Objective: To evaluate the clinical and functional outcomes of patients submitted to surgery for hip fracture through the ASA score and time for definitive surgical treatment. Method: During one year, 154 patients with hip fractures, aged 65 years and over, were operated on. Data from the pre-operative ASA score and time awaiting operation were obtained. Two years after the operation, Zuckerman´s Functional Recovery Score (FRS) questionnaire was used to assess the current functional capacity of the patients. Results: Mortality in the first post-operative year was different between patients with an ASA 3 or 4 compared to those classified as ASA 1 or 2 group (significant data p 0.05). There was no significant difference between the group operated within 48 hours of admission and the group operated after 48 hours in relation to mortality or current functional capacity (p>0.05). The group aged 80 and over showed significantly higher mortality than the group aged 65 to 79 years through the end of the second post-operative year (p>0.05). Conclusion: A preoperative ASA score and an age of 80 or over may be considered factors associated with higher mortality two years post-operatively after hip fracture. In isolation, time awaiting surgery was not significant.

Influência da percepção olfativa e gustativa na fase oral da deglutição de indivíduos tabagistas

PURPOSE To analyze the difference between nonsmokers and smokers on the changes in the perceptions of smell and taste and to verify the influence of these aspects in the emergence of compensatory movements during swallowing. METHODS To evaluate these aspects, capabilities of olfactory and gustatory recognition were observed, as well as the compensation swallowing. Twenty-four patients were evaluated in each study group aged from 18 years, grouped in a stratified way. The olfactory evaluation consisted in presenting seven essences and one of three options should be chosen. For the taste test, 16 flavors were offered in a non-sequential and decreasing way in amount of solute. Swallowing solid and liquid was evaluated, in which aspects of compensation perioral muscles were observed. RESULTS Worst performance in olfactory and gustatory tests among smokers (p≤0.01) was found. Through the results of χ2 and Fishers exact tests, it was found that the contraction of the mentalis muscle is less observed in non-smokers, and smokers have an average degree of statistically significant change compared to nonsmokers. Furthermore, through the Spearman correlation coefficient, it was found that the worsening in the sensory tests implies increased compensation during swallowing in smokers. CONCLUSION These data allowed us to verify that the sensory changes have influence on swallowing pattern, indicating that these changes are aspects that should be considered in the differential diagnosis of changes in swallowing.PURPOSE To identify the immediate effects of voiced vibration and vocal fry exercises on healthy subjects by means of acoustic parameters and high-speed kymography. METHODS Thirty healthy subjects (18 women and 12 men, aged from 19 to 45 years old) participated in this study. The voices were recorded at the range of 44.100 samples/second, before and after of the vocal exercises. We developed a computational routine to extract jitter and shimmer. High-speed kymography was generated from laryngeal images for the analysis of the phase times: closed (CPh), open (OPh), of closing (cPh) and of opening (oPh) and used the paired t-Student test and the Mann-Whitney test, with a significance level of 0.05. RESULTS After voiced vibrations, acoustic parameters showed reduced jitter for both genders (p=0.018 for men and p<0.01 for women) and reduced shimmer for female voices (p<0.01). There was a decrease in CPh (p=0.046) and cPh (p=0.026) and an increase in OPh (p=0.05) in female vocal folds. After vocal fry, we identified decreased jitter (p<0.01) in female voices and cPh (p=0.026) in male vocal folds. CONCLUSION We observed more positive immediate effects of the voiced vibrations, mainly in voice quality and vocal folds among females. Nevertheless, studies with larger male sample and investigation of the appropriate time of vocal fry are necessary to confirm the results of this search.