Identificação perceptiva do posicionamento da língua na produção de [s] por acadêmicos em Fonoaudiologia / Identificación perceptiva del posicionamiento de la lengua de la producción de [s] por académicos en Fonoaudiología / Perceptual analysis of the tongue position in the production of [s] by SLP students

Introdução: a identificação visual do posicionamento dos articuladores e o resultado auditivo na produção de [s] são necessários para decisões clínicas e monitoramento de tratamento. Para avaliadores não treinados esta tarefa pode ser desafiadora. Objetivo: verificar se avaliadores não treinados são capazes de identificar visualmente posições normal e alterada da língua na produção do [s] e perceber, auditivamente, produções normais e alteradas; bem como buscar quais ajustes da língua são mais difíceis de serem percebidos visualmente e quais resultados auditivos são mais facilmente identificados. Método: dez acadêmicos de Fonoaudiologia analisaram 20 amostras de fala gravadas, 10 com produção normal e 10 alterada do fone [s], sendo as respostas comparadas a uma avaliação padrão-ouro. Na análise foi utilizada a concordância Kappa, o teste Qui-quadrado, o Anova de Medidas repetidas e o teste t Student, com 5% de significância. Resultados: houve associação e concordância com a avaliação padrão-ouro para a posição da língua, com porcentagem média de 40% de respostas corretas para a posição normal, 17,5% quando a língua estava contra os dentes e 10% quando interposta. No resultado auditivo, a maioria dos avaliadores não apresentou associação e concordância com o padrão-ouro, sendo a porcentagem média de 50% de respostas corretas na ausência de distorção e com redução significativa quando presente (18,5%). Conclusão: os acadêmicos tiveram dificuldade na identificação visual da posição da língua, particularmente, quando alterada, bem como na identificação auditiva das produções normal ou alterada, sendo maior quando a distorção estava presente.

Introduction: thevisual identification of articulator positioning and auditory perception in the phoneme [s] are needed for clinical decisions and treatment monitoring. This can be challenging for untrained evaluators. Objective: to verify whether untrained evaluators are able to visually identify typical and atypical tongue positions in the production of phoneme [s] and to auditorily perceive typical and atypical productions; as well as to understand which tongue adjustments are more difficult to be visually perceived and which auditory productions are more easily identified. Methods: ten speech-language pathology students analyzed 20 recorded speech samples, being 10 with typical speech production and 10 atypical speech production regarding the [s] movement, and the answers were compared with a gold-standard evaluation. The Kappa agreement, Chi-squared test, Anova repeated measures and Student ́s t-test were used with 5% of significance. Results: there was an association and agreement with the gold standard evaluation for tongue positioning, with a mean percentage of 40% for correct answers regarding typical position, 17.5% when the tongue was against the teeth and 10% when interposed. In the auditory perception; most evaluators did not show association and agreement with the gold standard evaluation, with an average percentage of 50% for correct answers in the absence of distortion and a significant reduction in the presence (18.5%). Conclusion: the students had difficulty in the visual identification of the tongue positioning for atypical speech productions, as well as in the auditory identification of typical or atypical productions, and the greater difficulty occurred when there was distortion.

Introducción: identificar visualmente el posicionamiento del articulador y el resultado auditivo en la producción del [s] son necesarios para tomar decisiones clínicas y monitorear el tratamiento. Objetivo:verificar si los evaluadores no capacitados pueden identificar visualmente las posiciones normales y alteradas de la lengua en la producción del [s] y percibir auditivamente las producciones normales y alteradas; además buscar qué ajustes de la lengua son más difíciles de percibir visualmente y qué resultados auditivos se identifican más fácilmente. Método: estudiantes de Fonoaudiología analizaron 20 muestras de habla grabadas, 10 con producción normal y 10 con producción del fono [s] alterado. Compararon las respuestas con una evaluación patrón oro. En el análisis utilizaron la concordancia Kappa, la prueba Chi-cuadrado, el Anova de Medidas repetidas y la prueba t de Student, con 5% de significancia. Resultados:hubo asociación y concordancia con la evaluación patrón oro para la posición de la lengua, con media de 40% de respuestas correctas para la posición normal, 17,5% con la lengua contra los dientes y 10% cuando interpuesta. En el resultado auditivo, la mayoría de los evaluadores no presentaron asociación y concordancia con el patrón oro, con media de 50% de aciertos en ausencia de distorsión y con reducción significativa cuando presente (18,5%). Conclusión: los estudiantes tuvieron dificultad en identificar visualmente la posición de la lengua, particularmente cuando alterada, y en la identificación auditiva de producciones normales o alteradas, siendo mayor con la distorsión presente.

Tongue Necrosis due to Giant Cell Arteritis / Necrose da língua por arterite de células gigantes

Giant Cell Arteritis is a vasculitis that mainly affects women over 50. The most common manifestations are headache, jaw claudication, and amaurosis. If not diagnosed early, it can lead to rare irreversible ischemic consequences, with tongue necrosis being one of these. We report a case of a previously undiagnosed patient with lateral tongue necrosis who responded well to oral corticosteroid treatment. The diagnosis is clinical, laboratory and histological and may be aided by imaging exams. Initial treatment is with oral corticosteroids, with methotrexate and tocilizumab as alternatives. Diagnostic suspicion and quick start of treatment favorably influence the prognosis of the disease (AU)

Apresentamos um caso de arterite de células gigantes com amaurose, seguida de necrose da língua, diagnosticado clinicamente com boa resposta terapêutica ao corticoide oral. Salientamos que os casos de necrose da língua são extremamente raros. A suspeita diagnóstica de arterite de células gigantes é de fundamental importância e mesmo na impossibilidade de realizar a biópsia de artéria temporal, não se deve retardar o início do tratamento sob pena de acarretar sequelas definitivas ou manifestações mais graves da doença (AU)

Significados, experiências e repercussões do cyberbullying: o que dizem os adolescentes do Brasil e Angola / Meanings, Experiences, and Repercussions of Cyberbullying: What Brazilian and Angolan Adolescents Say / Significados, vivencias y repercusiones del ciberacoso: lo que dicen los adolescentes de Brasil y Angola

O cyberbullying é um fenômeno presente em todo o mundo, com incalculáveis consequências para a vida dos envolvidos. Considerando que os estudos interculturais sobre o cyberbullying realizados com os países lusófo-nos se limitam a investigações que envolvem participan-tes do Brasil e Portugal, se evidencia a necessidade de ampliar o conhecimento e investigar as perspectivas de adolescentes em outros contextos. Deste modo, o presente estudo teve o objetivo de investigar os significados, experiências e repercussões do cyberbullyingem um grupo de adolescentes do Brasil e de Angola. Um total de 50 adolescentes participaram do estudo, sendo 23 brasileiros e 27 angolanos, com idades entre 11 e 17 anos (m= 13.58 anos; dp= 1.56), majoritariamente do sexo feminino (Brasil = 52.2 %; Angola = 55.6 %), do 6º ao 12° ano de escolaridade. Para a coleta de dados utilizamos entrevistas individuais semiestruturadas e a análise de conteúdo através de uma abordagem mista (categorizações dedutiva e indutiva) foi realizada para analisar os dados. Os resultados revelaram que, embora se verifiquem divergências e similaridades no que diz respeito às três perspectivas estudadas, os adolescentes de ambos os contextos atribuem significados ao cyberbu-llying que remetem a uma perspectiva comportamental e de causalidade do fenômeno. Além disso, os brasilei-ros apresentaram porcentagens mais elevadas em termos de experiências. De modo adicional, os participantes de ambos os contextos consideraram que as consequên-cias do cyberbullying são mais presentes na vida das vítimas (esfera escolar, social, psicológica-emocional e psiquiátrica). Os resultados são discutidos lançando luz sobre o caminho ainda por trilhar nesta temática atual e abrindo perspectivas para novas interrogações.

Cyberbullying is a phenomenon present across the globe, with incalculable consequences for the lives of those involved. Considering that intercultural cyberbullying studies conducted in Portuguese-speaking countries are limited to investigations involving participants from Brazil and Portugal, the need to expand this knowledge and investigate the perspectives of adolescents in other contexts is evident. Thus, the present study aimed to investigate the meanings, experiences, and repercus-sions of cyberbullying in a group of adolescents from Brazil and Angola. A total of 50 adolescents participated in the study, 23 Brazilians and 27 Angolans, aged 11 to 17 years (m= 13.58 years; sd = 1.56), mostly female (Brazil = 52.2 %; Angola = 55.6 %), from the sixth to the twelfth grade. For data collection, we used semi-structured individual interviews and content analysis through a mixed approach (deductive and inductive categorizations) was performed to analyze the data. Results revealed that, although there are divergences and similarities regarding the perspectives studied, adolescents from both contexts attribute meanings to cyberbullying that refer to behavioral and causal pers-pectives of the phenomenon. Moreover, Brazilians presented higher percentages in terms of experiences. Additionally, participants from both contexts con-sidered that the consequences of cyberbullying are more present in the lives of the victims (school, social, psychological-emotional, and psychiatric spheres). Re-sults are discussed, shedding light on the path still to be traveled regarding this current topic and opening perspectives for new questions.

El ciberacoso es un fenómeno presente en todo el mundo, con consecuencias incalculables para la vida de los implicados. Teniendo en cuenta que los estudios interculturales sobre el ciberacoso realizados con países hablantes de la lengua portuguesa se limitan a investigaciones con participantes de Brasil y Portugal, es necesario ampliar el conocimiento e investigar las perspectivas de los adolescentes en otros contextos. Por lo tanto, el presente estudio tuvo como objetivo investigar los significados, experiencias y repercusiones del ciberacoso en un grupo de adolescentes de Brasil y Angola. Participaron 50 adolescentes, 23 brasileños y 27 angoleños, con edades comprendidas entre los 11 y los 17 años (m = 13.58 años; dt = 1.56), mayoritariamente de género femenino (Brasil = 52.2 %; Angola = 55.6 %), del 6º al 12º año de escolaridad. Para la recogida de datos se utilizaron entrevistas individuales semiestructuradas y el análisis de con-tenido mediante un enfoque mixto (categorizaciones deductivas e inductivas), llevado a cabo para analizar los datos. Los resultados revelaron que, aunque existen divergencias y similitudes en relación con las tres perspectivas estudiadas, los adolescentes de ambos contextos atribuyen al ciberacoso significados que hacen referencia a una perspectiva conductual y a la causalidad del fenómeno. Además, los brasileños presentaron porcentajes más altos en cuanto a experiencias. Así mismo, los participantes de ambos contextos consideraron que las consecuencias del ciberacoso están más presentes en la vida de las víctimas (ámbito escolar, social, psicológico-emocional y psiquiátrico). Los hallazgos se discuten arrojando luz sobre el camino que queda por recorrer en este tema actual y abriendo perspectivas a nuevos interrogantes.

Ser joven andino quechua cerca y lejos de sus comunidades de origen / Being young, Andean and Quechua and both near and far from communities of origin / Ser jovem andino quechua perto e longe de suas comunidades de origen

Resumen (analítico) La investigación se pregunta cómo las y los «jóvenes¼ procedentes de comunidades quechuas surandinas del Perú construyen su «ser joven¼ en contextos de imposición neocolonial/neoliberal y, a la vez, de resistencias cerca y lejos de sus lugares de origen. Se realizó desde la postura decolonial con la metodología investigación-acción participativa adaptada al mundo de jóvenes de comunidades de Apurímac, Huancavelica y Ayacucho. Se constata que son afectados por imposiciones de la sociedad nacional, que a través de servicios y políticas públicas les proyectan una manera homogénea y hegemónica de ser joven que tiende a distanciarlos de sus familias y comunidades. La crianza en su cosmovisión será fuente de sus resistencias y les permitirá recuperar sus raíces por la vía de la lengua originaria y de la espiritualidad andina.

Abstract (analytical) This study asks how "young people" from the Quechua communities in Southern Peru construct "being young" in contexts involving neocolonial / neoliberal imposition and, at the same time, of acts of resistance both near and far from their places of origin. It was carried out using a decolonial position through the Participatory Action Research methodology adapted to the worlds of "young people" in the communities of Apurímac, Huancavelica and Ayacucho. The research identified that these young people are affected by impositions from Peruvian society, as government services and public policies project a homogeneous and hegemonic way of being young that tends to distance them from their families and communities. An upbringing based on their worldview will be the source of their resistance and will allow them to recover their roots through native language and Andean spirituality.

Resumo (analítico) A pesquisa questiona como os "jovens" das comunidades quíchuas do sul do Peru constroem seu "ser jovem" em contextos de imposição neocolonial / neoliberal e, ao mesmo tempo, de resistência perto e longe de seus lugares de origem. Foi realizado a partir da posição descolonial com a metodologia da Pesquisa-Ação Participativa adaptada ao mundo dos jovens das comunidades de Apurímac, Huancavelica e Ayacucho. Constata-se que são afetados por imposições da sociedade nacional, que por meio de serviços e políticas públicas os projetam de uma forma homogênea e hegemônica de ser jovem que tende a distanciarse de suas famílias e comunidades. A formação em sua visão de mundo será a fonte de sua resistência e permitirá que recuperem suas raízes por meio da língua nativa e da espiritualidade andina.

Hemangioma capilar lobular: granuloma piógeno en lengua / Lobular capillary hemangioma: pyogenic granuloma of tongue

El granuloma piógeno es una lesión benigna, reactiva y multifactorial que resulta de le- siones repetitivas, microtraumatismos e irritación local en piel o mucosas y cambio hormonal. Cuando aparece en la cavidad oral tiene predilección por la encía vestibular, pero es importante que el odontólogo esté consciente y familiarizado con el hecho de que puede estar localizado en otras áreas anatómicas. Clínicamente se presenta como lesión hiperplásica altamente vascularizada, de tamaño generalmente no mayor a 2 cm, pediculada en la base o sésil y de lento crecimiento. Sin mostrar preferencia por edad o sexo, tiende a aparecer principalmente en encías, labios y mucosa oral, siendo muy pocos los casos reportados en el área lingual. Es por ello que, en este artículo, nos referimos a un caso de ubicación inusual, en conjunto con una revisión de la literatura (AU)

Pyogenic granuloma is a benign, reactive, and multifactorial lesion caused by repetitive injuries, microtrauma and local irritation on the skin or mucous membranes, and hormonal change. When it appears in the oral cavity, it has a predilection for the vestibular gingiva, but the dentist must be aware and familiar with the fact that it can be present in other anatomi- cal areas. Clinically, it is presented as a hyperplasic injury highly vascular-related, with a size generally no bigger than 2 cm, pedunculated in base or sessile, and slow in growth. Without showing any preference in age or gender, it tends to appear mainly on the gums, lips, and oral mucosae, with very few, reported cases in the lingual area. Therefore, in this study, we refer to a case of unusual localization with a literature review (AU)

Morphometric analysis of the mandibular lingual foramina using cone-beam computed tomography in elderly Korean / Análisis morfométrico de los forámenes linguales mandibulares mediante tomografía computarizada de haz cónico en adultos mayores coreanos

SUMMARY: The aim of this study was to determine the morphologic characteristics of the lingual foramen and lateral lingual foramen using cone-beam CT in elderly Korean. Cone-beam CT images were obtained from 80 Korean older than 50 years (mean age, 65.2 years). The prevalence of the lingual and lateral lingual foramina at the lingual aspect of the mandible was determined. The diameter and height to the upper margin of the foramina from the mandibular inferior margin, and the bone height to the alveolar crest from the mandibular inferior margin were measured. In addition, the location of the lateral lingual foramen, the direction of its canal, and the presence of communication with the mandibular canal were evaluated. All of elderly Korean possessed at least one lingual foramen, with two or three foramina occurring in 77.5 % of Korean. A lateral lingual foramen was observed in 91.3 % of Korean, with the prevalence being highest at the second premolar in dentulous cases (21.6 %; 33/153). The very high frequencies of these foramina were attributable to high frequencies of relatively small-diameter inferior lingual foramen and lateral lingual foramen in the incisor region. The prevalence of a large-diameter (≥1 mm) superior lingual foramen was high, at 31.0 %. A large-diameter lateral lingual foramen in the premolar region occurred at a frequency of 17.0 %; communication with the mandibular canal was observed in 70.0 % of these cases. These quantitative data on the lingual and lateral lingual foramina of the mandible provide valuable information that could help to avoid surgical complications during implant placement in elderly Korean.

RESUMEN: El objetivo de este estudio fue determinar las características morfológicas del foramen lingual y del foramen lingual lateral mediante TC de haz cónico en adultos mayores coreanos. Se obtuvieron imágenes de TC de haz cónico de 80 coreanos mayores de 50 años (edad media, 65,2 años). Se determinó la prevalencia de los forámenes linguales y linguales laterales en la cara lingual de la mandíbula. Se midió el diámetro y la altura hasta el margen superior de los forámenes desde el margen inferior mandibular, y la altura ósea hasta la cresta alveolar desde el margen inferior mandibular. Además, se evaluó la ubicación del foramen lingual lateral, la dirección de su canal y la presencia de comunicación con el canal mandibular. Todos los adultos mayores coreanos tenían al menos un foramen lingual, con dos o tres forámenes en el 77,5 %. Se observó un foramen lingual lateral en el 91,3 %, siendo la prevalencia más alta en el segundo premolar en casos dentados (21,6 %; 33/ 153). Las mayores frecuencias de estos forámenes se atribuyeron a altas frecuencias de foramen lingual inferior y foramen lingual lateral de diámetro relativamente pequeño en la región de los incisivos. La prevalencia de un foramen lingual superior de gran diámetro (≥1 mm) fue alta, del 31,0 %. Un foramen lingual lateral de gran diámetro en la región premolar ocurrió con una frecuencia del 17,0 %; se observó comunicación con el canal mandibular en el 70,0 % de estos casos. Estos datos cuantitativos sobre los forámenes linguales y linguales laterales de la mandíbula proporcionan información valiosa que podría ayudar a evitar complicaciones quirúrgicas durante la colocación de implantes en adultos mayores coreanos.

Importance of the use of pre- and intra-operative imaging as a tool for planning foreign body removal in the floor of the mouth: a case report / Importancia del uso de la imagenología pre e intraoperatoria como herramienta para la planificación de remoción de cuerpo extraño en piso de boca: presentación de un caso

Introduction: Body piercings consist of small holes made with a needle in different parts of the skin or body to introduce a jewel or decorative element. In the oral cavity, most piercings are placed in the tongue. However, some complications may occur, and surgical techniques must be used for their removal. These complications present a certain degree of difficulty due to their position and may challenge the ability of the clinician to access the specific anatomical location. The different imaging techniques, from simple radiography to intraoperative techniques such as image intensifiers, have become an extremely useful tool for locating an object in the three dimensions of space, allowing safe location and extraction. Objective: The aim of this study is to report the case of a complication of a body piercing in the oral cavity and how the use of imaging was decisive for surgical planning and for the quick and effective resolution of the case. Material and Methods: A 14-year-old female patient came looking for treatment. Her mother reported the onset of the condition after the insertion of a needle-like metallic object while performing an artistic perforation in the lingual region. Since the girl was unable to extract the object, she sought medical advice at the Carlos Arvelo Military Hospital in Caracas, Venezuela. Subsequently, an imaging study was performed by means of a Computed Tomography to locate the metallic object. It was observed that the foreign body had migrated to the floor of the mouth/sublingual region, requiring the area to be surgically approached. It was also decided to use an intraoperative image intensifier. The removal of the object was performed satisfactorily. Conclusion: The extraction of foreign bodies placed in the lingual and sublingual region represents a challenge for the clinician due to the number of important anatomical structures that pass through that area. This makes clinicians plan their surgical removal using pre- and intraoperative imaging, to find a less traumatic location, reduce surgical time as well as the risk of damaging adjacent anatomical structures.

Introducción: Los body piercings consisten en producir perforaciones con una aguja en diferentes localizaciones de la piel con el fin de introducir una joya o elemento decorativo a través del agujero producido previamente. En la cavidad oral, la lengua es el sitio de mayor elección; sin embargo, en ciertas ocasiones suelen presentarse ciertas complicaciones, por lo cual se debe recurrir a técnicas quirúrgicas para su remoción presentando cierto grado de dificultad para su localización y la capacidad del clínico para acceder al espacio anatómico. Las diferentes técnicas imagenológicas desde una radiografía simple hasta técnicas intraoperatorias como los intensificadores de imágenes se han convertido en una herramienta sumamente útil para la ubicación de un objeto en las tres dimensiones del espacio, permitiendo una localización y extracción segura para el clínico y el paciente. Objetivo: El propósito de este trabajo es reportar un caso de una complicación de esta práctica en la región bucal y cómo el uso de la imagenología fue determinante para la planificación quirúrgica y la resolución del caso de manera rápida y efectiva. Material y Métodos: Se presenta a consulta una paciente femenina de 14 años de edad, quien madre refiere inicio de enfermedad actual posterior a introducirse objeto metálico tipo aguja de compás con la finalidad de realizar perforación artística en región lingual, al no poder extraer dicho objeto, acude a evaluación en el Hospital Militar Carlos arvelo de Caracas; posterior se realiza estudio imagenológico tipo Tomografía Computarizada para la ubicación del objeto metálico donde se observa que el cuerpo extraño habría migrado hacia el piso de boca/región sublingual, teniendo la necesidad de abordar quirúrgicamente la zona y elegir el uso de intensificador de imagen transoperatorio para retiro del mismo el cual se dio de manera satisfactoria. Conclusión: Los cuerpos extraños desplazados a la región lingual y sublingual representan un desafío para el clínico al momento de extraerlos, esto se debe a la cantidad de estructuras anatómicas importantes que pasan por dicha zona, lo que hace que el clínico opte en su planificación quirúrgica por el uso de imagenología pre y transoperatoria obteniendo así una localización menos traumática, menor tiempo operatorio y menor riesgo de lesión de estructuras anatómicas adyacentes.

Oral manifestations of systemic fungal infections: 25-year experience in an endemic region

Some mycoses are endemic. They develop through hematogenous spread, causing a generalized infection, usually with secondary mucosal involvement.The aim of this observational and retrospective study was to report the prevalence and characteristics of oral lesions in patients diagnosed with systemic fungal infections (SFI) over a 25-year period in southern Brazil. Demographic (age, sex, ethnicity, occupation) and clinical (anatomical location, symptoms,histopathological diagnosis and management) data from the medical records of patients with SFI were collected from 1995 to 2019. 34 cases of SFI were found, of which 31 (91.18%) were diagnosed as paracoccidioidomycosis (PCM) and 3 (8.82%) as histoplasmosis. Men were much more affected (n = 31; 91.18%), with an average age of 46.9 years. Most patients (n = 18; 58.06%) were Caucasian; 48% (n = 15) were farm/rural workers and the most affected region was the jugal mucosa (n = 13; 25.49%) followed by the alveolar ridge (n = 12; 23.52%). All patients with histoplasmosis were immunocompetent men (mean age: 52.67 years), and the palate was the most affected. All patients underwent incisional biopsy and were referred to an infectologist. The dentist has an essential role in the recognition of SFI, whose oral manifestations may be the first sign. SFI should be included in differential diagnosis in patients from endemic areas. In addition, the inevitable human mobility and globalization make knowledge of these mycosesnecessary worldwide, especially since advanced cases in immunocompromised patients can be fatal.

Equivalência da escala de luto perinatal para escala de luto parental após a perda de um filho / Equivalencia de la escala de duelo perinatal para escala de duelo parental ante la pérdida de un hijo / Equivalence from the perinatal grief scale to the parental grief scale after the loss of a child

RESUMO Introdução: a manifestação mais comum do luto complicado é diante da morte de um filho. Neste contexto, observa-se a emergência da utilização de escalas direcionadas para pais na identificação do luto parenteral. Objetivo: realizar equivalência da Escala de Luto Perinatal para Escala de Luto Parental após a perda de um filho. Método: trata-se de um estudo metodológico, que envolve a coleta e análise dos dados através da equivalência linguística, semântica, cultural, conceitual e coloquial da escala de luto perinatal (EL Perinatal) para escala de luto parental (EL Parental) na língua portuguesa do Brasil. Resultados: para equivalência da EL Perinatal para EL Parental foi realizada a proposta de alteração da palavra "bebê" para "filho(a)" e as palavras do gênero feminino também foram possibilitadas para o gênero masculino na abordagem aos pais. O comitê de juízes especialistas participantes na adaptação transcultural e validação da EL Perinatal concordou em 100% das modificações. Conclusão: a proposta da EL Parental amplia a investigação do luto complicado para os pais que perderam seus filhos em todas as faixas etárias.

RESUMEN Introducción: la manifestación más común del duelo complicado es ante la muerte de un hijo. En este contexto, se observa la emergencia de la utilización de escalas dirigidas a padres en la identificación del luto parenteral. Objetivo: realizar equivalencia de la Escala de Luto Perinatal para Escala de Luto Parental después de la pérdida de un hijo. Método: se trata de un estudio metodológico, que involucra la recolección y el análisis de los datos a través de la equivalencia lingüística, semántica, cultural, conceptual y coloquial de la escala de luto perinatal (ELPerinatal) para escala de luto parental (ELParental) en la lengua portuguesa de Brasil. Resultados: para la equivalencia de ELPerinatal para ELParental fue realizada la propuesta de alteración de la palabra "bebé" para "hijo(a)" y las palabras del género femenino también fueron posibilitadas para el género masculino en el abordaje a los padres. El comité de jueces expertos que participaron en la adaptación transcultural y validación de ELPerinatal estuvieron el 100% de acuerdo con las modificaciones. Conclusión: la propuesta de ELParental amplía la investigación del luto complicado para los padres que perdieron a sus hijos en todas las edades.

ABSTRACT Introduction: The most common manifestation of complicated grief comes with the death of a child. In this context, there is an urgent need for using scales aimed at parents in order to identify parental grief. Objective: To establish an equivalence from the Perinatal Grief Scale to the Parental Grief Scale after the loss of a child. Method: This is a methodological study involving data collection and analysis by means of a linguistic, semantic, cultural, conceptual and colloquial equivalence from the perinatal grief scale (Perinatal GS) to the parental grief scale (Parental GS) in Brazilian Portuguese. Results: For the equivalence from the Perinatal GS to the Parental GS, one proposal, applied to Brazilian Portuguese, and bearing in mind that the latter is a language with gendered words, was to replace bebê (baby) with filho(a) (son/daughter), and both feminine and masculine words were used when referring to parents. The committee of expert judges participating in the cross-cultural adaptation and validation of the Perinatal GS agreed on 100% of the changes. Conclusion: The proposal of the Parental GS expands the investigation of complicated grief for parents who have lost their children in all age groups.

Malformação venolinfática em borda lateral de língua: relato de caso / Venolymphatic malformation in lateral edge of the tongue: case report

Resumo As malformações vasculares são anomalias que podem acometer veias, vasos linfáticos e artérias de forma isolada ou mista. Quando se apresentam de forma mista, com componentes venosos e linfáticos, são denominadas malformação venolinfática ou linfático-venosa, de acordo com sua constituição predominante. Embora seja um distúrbio benigno de bom prognóstico, é localmente invasivo, podendo levar a deformidade e havendo, ainda, a propensão de recorrência local. O presente artigo traz um caso de malformação venolinfática com localização incomum em borda lateral de língua, abordando-se a conduta clínica e o referencial teórico vigente.

Abstract Vascular malformations are vascular anomalies that can affect veins, lymphatic vessels, and/or arteries in isolated or mixed form. When they present in the mixed form with venous and lymphatic involvement, they are called venolymphatic or lymphatic-venous malformations, depending on their predominant component. Although these are benign disorders with good prognosis, they are locally invasive and may lead to deformity, while there is also a propensity for local recurrence. This article presents a case of venolymphatic malformation with unusual localization on the lateral border of the tongue, addressing the clinical conduct and the current theoretical framework.

Histomorphometrical study of the tongue epithelium of the peregrine falcon (Falco peregrinus) / Estudo histomorfométrico do epitélio da língua do falcão peregrino (Falco peregrinus)

The aim of this study is to examine the dorsal lingual epithelium of the peregrine falcon (Falco peregrinus) of the family Falconidae. The tongue in its dorsal, lateral and ventral surfaces is covered with a non-keratinized multilayered stratified squamous epithelium. Lamina propria is present beneath the epithelial layers. Morphometrically, thickness of the apex tongue epithelium is more than that in the tongue body. Thickness of the ventral surface of the tongue is less than that in the dorsal one. Thickness of the lateral surface of the tongue was thicker than that in the ventral one and tongue body. Large and small conical papillae appeared on the posterior dorsal surface of the lingual body. There are lingual glands in certain areas of tongue body with numerous openings through the dorsal surface.

O objetivo deste estudo é examinar o epitélio lingual dorsal do falcão peregrino (Falco peregrinus) da família Falconidae. A língua em suas superfícies dorsal, lateral e ventral é coberta por um epitélio escamoso estratificado de múltiplas camadas não queratinizado. A lâmina própria está presente abaixo das camadas epiteliais. Morfometricamente, a espessura do epitélio do ápice da língua é maior do que a do corpo da língua. A espessura da superfície ventral da língua é menor do que a dorsal. A espessura da face lateral da língua foi mais espessa do que na ventral e no corpo da língua. Papilas cônicas grandes e pequenas apareceram na superfície posterior dorsal do corpo lingual. Existem glândulas linguais em certas áreas do corpo da língua com numerosas aberturas na superfície dorsal.

Pathological Change of Chronic Hepatitis B Patients with Different Tongue Coatings by Circular Multi-Omics Integrated Analysis / 中国结合医学杂志

OBJECTIVE@#To compare the circular pathological changes of chronic hepatitis B (CHB) patients according to the tongue diagnosis.@*METHODS@#Totally 41 CHB patients with typical white tongue coating (WTC) or yellow tongue coating (YTC) were enrolled and 14 healthy volunteers with normal tongue manifestation served as controls. The mRNA expression of peripheral leukocytes was detected by GeneChips, and 9 genes were randomly selected for expression validation. Circular metabolites were detected by gas chromatographymass spectrometry. Biological information was analyzed based on ingenuity pathways analysis or metabolomics database and the integrated networks were constructed by ClueGO.@*RESULTS@#A total of 945 and 716 differentially expressed genes were found in patients with WTC and YTC relative to healthy volunteers respectively. The biological information analysis indicated that CHB patients had obviously increased functions in cell death, apoptosis and necrosis (Z-score ⩾2, P<0.05) and decreased activation in T lymphocytes (Z-score ⩽-2, P<0.05), regardless of the tongue manifestation. Compared to patients with WTC, the YTC patients were predicted to be more active in functions related to virus replication (Z-score ⩾2, P<0.05), and the content of circular fatty acids, such as oleic acid (P=0.098) and lauric acid (P=0.035), and citric acid cycle-related metabolites were higher in the YTC patients (P<0.1). The integrated analysis based on differential genes and metabolites indicated that the most difference in the biological function network between the WTC and YTC patients was tumor necrosis factor receptor associated factor 6 mediated-nuclear factor kappa-B activation process.@*CONCLUSIONS@#CHB patients with YTC had more severe inflammation and fatty acids metabolism aberrant than patients with WTC. The results facilitate the modern pathological annotation of Chinese medicine tongue diagnosis theory and provide a reference for the interpretation of pharmacological mechanisms of Chinese medicine treatment.

Transoral robotic surgery for treatment of lingual thyroglossal duct cyst / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the feasibility, safety and efficacy of transoral robotic surgery (TORS) in the treatment of lingual thyroglossal duct cyst (LTGDC). Methods: The clinical data of 10 patients with LTGDC treated with TORS in Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from May 2017 to November 2020 were analyzed retrospectively,including 6 males and 4 females, aged 5-44 years. The cysts were fully exposed, and resection usually started from the cephalic side of lesions. The range of resection was 3 to 5 mm away from the lesions, and partial hyoid bone was removed if necessary. Intra-operative robotic set-up time,operation time and estimated blood loss,and post-operative local bleeding, dyspnea and recovery time for oral intake were analyzed. SPSS 12.0 software was used for statistical analysis. Results: The cysts in all 10 patients were successfully resected by TORS with da Vinci Si surgical system. The mean robotic set-up and exposure time, operation time, estimated intraoperative blood loss and recovery time for oral intake were (15.5±7.1) min, (17.6±7.4) min, (8.9±6.4)ml and (2.3±2.2)days, respectively. No patient required tracheostomy intra-or post-operatively, and no symptoms of airway obstruction, postoperative bleeding, pharyngeal fistula, hoarseness and neurological impairment occurred after operation. The patients were followed up for 5 to 47 months, with median follow-up time of 17 months, and no recurrence was observed. Conclusion: TORS is safe and feasible for resection of LTGDC, with rapid recovery and low recurrence rate.

Effects of acid stimulation on saliva flow rate and compositions of human parotid and submandibular glands / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effect of acid stimulation on salivary flow rate and compositions of human parotid and submandibular glands, so as to provide basis for comprehensive evaluation of salivary gland function in both health and disease status.@*METHODS@#In the study, 210 healthy participants' whole saliva samples were collected under passive drooling, and their parotid gland and submandibular gland secretions were collected by negative pressure suction. 2% citric acid was dropped on the tip of tongue every 1 min for acid stimulation for a total of 5 times to collect stimulated whole saliva, parotid and submandibular gland saliva. The collected saliva was weighed and saliva flow rate was calculated. The K+, Na+, Cl-, Ca2+, total protein, total phosphorus and α-amylase in saliva samples were detected by biochemical analyzer, and the changing features of flow rate and compositions of different kinds of saliva were compared and analyzed.@*RESULTS@#After acid stimulation, saliva flow rate significantly increased. The increase proportion of parotid gland saliva (10.7 folds) was much higher than that of submandibular gland saliva (2.9 folds). The concentrations of Na+, Cl-, Ca2+, total protein and α-amylase in parotid gland saliva increased significantly (P < 0.05), but there was no significant difference in total phosphorus and K+ (P=0.89, P=0.34). The concentration of Na+ and Ca2+ in saliva of submandibular gland increased significantly(P < 0.05), the concentration of total phosphorus decreased significantly(P < 0.05), and the concentration of Cl- increased, but the difference was not significant(P=0.068). There was no significant difference in total protein, K+ and α-amylase (P=0.85, P=0.07, P=0.95). The compound secretion rate of total phosphorus in saliva of submandibular gland remained unchanged(P=0.066), while the secretion rate of K+, Na+, Cl-, Ca2+, total protein and α-amylase significantly increased(P < 0.01). The compound secretion rate of K+, Na+, Cl-, Ca2+, total protein and total phosphorus and α-amylase in parotid gland saliva increased(P < 0.01). The concentrations of Na+, Cl-, K+, total phosphorus, total protein and α-amylase in parotid were higher than those in submandibular gland (P < 0.01), and the concentration of Ca2+ in submandibular gland saliva was significantly higher than that in parotid (P < 0.001).@*CONCLUSION@#The response of parotid to acid stimulation is stronger, and the secretion of submandibular gland is more stable. Acid stimulation significantly influences the concentrations of electrolytes in saliva, and the composited secretion rate is an evaluation index to reflect both flow rate and composition concentration of saliva. The parotid gland plays an important role in the secretion of total protein, total phosphorus and α-amylase in saliva, and the submandibular gland is the main source of Ca2+ in saliva.

Schwannoma lingual: presentación de un caso y breve revisión de la literatura / Lingual schwannoma: case report and brief review of the literature

Objetivo: Reportar un caso de schwannoma lingual, así como revisar las características diagnósticas (clínicas, por imágenes e histopatológicas) y terapéuticas de esta patología mediante las publicaciones disponibles. Caso clínico: Se presenta un caso de schwannoma in- traoral en un hombre de 26 años de edad con un tumor ubica- do en el tercio anterior de la lengua. Se resolvió mediante un único procedimiento quirúrgico bajo anestesia local sin obser- varse recidivas ni secuelas al menos a 12 meses de seguimien- to a distancia. El schwannoma de la lengua es poco frecuente pero sus características clínico-imagenológicas presentan ras- gos benignos que favorecen la resolución mediante una única biopsia quirúrgica total cuando el tamaño y la ubicación sean propicios para ello (AU)

To describe a case of lingual schwannoma, and through a literature review, to provide data on clinical, imaging and pathological features, as well as treatment methods. Clinical case: A 26-year-old male patient with a swelling in the tip of the tongue was diagnosed as having oral schwannoma. A single surgery was performed, without recurrence or postoperative complications at least during a 12-month follow-up. Lingual schwannoma is a rare entity with benign clinical and imaging characteristics that ena- ble surgical removal without prior biopsy when size and oral location are favorable (AU))

Ultrassonografia dos movimentos de língua na avaliação e terapia do ceceio anterior: um estudo de caso / Ultrasonography of tongue movements in the assessment and therapy of anterior lisp: a case study / Ecografía de los movimientos de la lengua en la evaluación y la terapia del ceceo anterior: un estudio de caso

Introdução: O ceceio é um tipo de transtorno dos sons da fala decorrente de alterações nas estruturas orofaciais. Os métodos perceptivo-auditivos de avaliação fonoaudiológica podem gerar dúvidas quanto à natureza do transtorno e, portanto, as avaliações instrumentais são recomendadas para obter um diagnóstico mais preciso e completo. A ultrassonografia dos movimentos de língua permite a visualização em tempo real do movimento da língua durante a fala podendo contribuir na fonoterapia como biofeedback visual ultrassonográfico (BVU). Objetivos: Descrever os gestos articulatórios das fricativas /s/, /z/, /ʃ/ e /Æ·/ pré e pós-terapia fonoaudiológica com BVU em uma criança com ceceio anterior. Métodos: Foram avaliados diversos aspectos da fala de uma menina de oito anos com ceceio anterior, e coletadas imagens ultrassonográficas antes e após cinco sessões de terapia utilizando BVU. Foram comparadas as imagens da língua na produção dos sons /s, z, ʃ, Æ·/ pré e pós a intervenção fonoaudiológica com BVU. Resultados: Antes do tratamento, a paciente anteriorizava sem elevar a ponta de língua em /s/ e /z/; e em /ʃ/ e /Æ·/ também havia anteriorização de ponto articulatório, mas sem interposição. Após a fonoterapia, houve ajuste do ponto articulatório e aquisição da elevação de ponta de língua em /s/ e /z/ resultando em maior constrição de língua em /ʃ/ e /Æ·/. Conclusão: A ultrassonografia mostrou-se importante para a caracterização e descrição do ceceio anterior, e o seu uso como BVU permitiu melhora expressiva na produção articulatória por proporcionar automonitoramento durante a fala, num curto período de atendimento.

Introduction: lisping is a type of speech disorder resulting from changes in orofacial structures. The auditory-perceptual methods of speech-language assessment can raise doubts as to the nature of the disorder and, therefore, instrumental assessments are recommended to obtain a more accurate diagnosis. Ultrasonography of tongue movements allows real-time visualization of tongue movement during speech and may contribute to speech therapy as visual biofeedback. Objectives: To describe the articulatory gestures of fricatives /s/, /z/, /ʃ/ e /Ʒ/ before and after speech therapy with visual ultrasound biofeedback in a child with anterior lisp. Methods: Several aspects of the speech of an eight-year-old girl with previous lisp were evaluated, and ultrasound images were collected before and after 05 therapy sessions using ultrasound as instrumental biofeedback. The images of the tongue in the production of sounds /s, z, ʃ, Ʒ/ were compared before and after the speech therapy intervention. Results: Before treatment, the patient anteriorized without raising the tip of the tongue in /s/ and /z/; in /ʃ/ and /Ʒ/ there was anteriorization of the articulation point, but without interposition. After speech therapy, he adjusted the articulation point and acquired tongue tip elevation in /s/ and /z/ and presented greater tongue constriction in /ʃ/ and /Ʒ/. Conclusion: Ultrasonography proved to be important for the diagnosis and description of the previous lisp, and its use as biofeedback allowed a significant improvement in articulatory production due to its self-monitoring during speech, in a short period of care.

Introducción: el ceceo es un tipo de trastorno del habla resultante de cambios en las estructuras orofaciales. Los métodos auditivo-perceptivos de evaluación del habla y el lenguaje pueden generar dudas sobre la naturaleza del trastorno y, por lo tanto, se recomiendan evaluaciones instrumentales para obtener un diagnóstico más preciso. La ecografía de los movimientos de la lengua permite la visualización en tiempo real del movimiento de la lengua durante el habla y puede contribuir a la terapia del habla como biorretroalimentación visual. Objetivos: Describir los gestos articulatorios involucrados en la producción del habla de un niño con ceceo previo y compararlos antes y después de la logopedia con biofeedback visual por ultrasonido. Métodos: Se evaluaron varios aspectos del habla de una niña de ocho años con ceceo previo, y se recolectaron imágenes de ultrasonido antes y después de 05 sesiones de terapia utilizando ultrasonido como biofeedback instrumental. Se compararon las imágenes de la lengua en la producción de sonidos /s, z, ʃ, Æ·/ antes y después de la intervención logopédica. Resultados: antes del tratamiento, el paciente realizó una anteriorización sin levantar la punta de la lengua en /s/ y /z/; en /ʃ/ y /Æ·/ hubo anteriorización del punto de articulación, pero sin interposición. Después de la logopedia, ajustó el punto de articulación y adquirió elevación de la punta de la lengua en /s/ y /z/ y presentó mayor constricción de la lengua en /ʃ/ y /Æ·/. Conclusión: La ecografía demostró ser importante para el diagnóstico y descripción del ceceo previo, y su uso como biofeedback permitió una mejora significativa en la producción articulatoria debido a su autocontrol durante el habla, en un corto período de atención.

El conocimiento del Kichwa, segunda lengua oficial del Ecuador ¿compromete la comunicación médico/odontólogo-paciente? / Knowledge of the Kichwa, second official language of Ecuador, compromises the dentist/medical-patient communication?

Con el propósito de analizar el comportamiento de las relaciones entre médico/odontólogo y paciente, mediadas por la comunicación intercultural, se realizó un estudio que contó con la participación de 200 indígenas de la etnia Kichwa Salasaka y 33 profesionales sanitarios. Mediante la aplicación de encuestas fueron explorados elementos esenciales como los idiomas que ambos grupos dominan; asistencia a consulta de los indígenas; calidad de la atención; formación bilingüe del odontólogo y percepción de la comprensión por parte de ambos grupos. Entre los resultados obtenidos se encuentra la no comprensión de los pacientes de las orientaciones que reciben en la consulta, insuficiente conocimiento la lengua Kichwa por parte del equipo de salud y en consecuencia insuficiente transferencia de la información. Identificada la problemática comunicacional médico/odontólogo - paciente, se recomienda la implementación de políticas de salud sustentadas en el enfoque intercultural(AU)

With the purpose of analyzing the behavior of the medical/dentist-patient relations, mediated by the intercultural communication, a study was carried out that counted on the participation of 70 indigenous people of the ethnic Kichwa Salasaca and 33 doctors and dentist. Through the application of surveys, essential elements were explored such as the languages that both groups dominate; assistance to indigenous consultation; Quality of care; Bilingual training of the dentist and perception of the understanding on the part of both groups. Among the results obtained is the non-comprehension of the patients of the orientations they receive in the consultation, insufficient knowledge the Kichwa language by the health team and consequently insufficient transfer of the information. Identified the communicational problems medical/entist-patient, we recommend the implementation of health policies based on the intercultural approach(AU)

Cambios histológicos del tejido muscular estriado lingual en ratas Sprague Dawley (Rattus norvegicus) para estimar el intervalo postmortem / Histological changes of lingual striated muscle tissue in Sprague Dawley rats (Rattus norvegicus) for estimating the postmortem interval

RESUMEN: El intervalo postmortem (IPM) equivale al tiempo que ha transcurrido desde que un ser humano ha muerto hasta su examinación postmortem. Después de la muerte, el cuerpo experimenta modificaciones en su composición física y química denominados cambios postmortem expresados por signos que pueden ser analizados para el cálculo del IPM. El objetivo del estudio fue describir los cambios histológicos presentes en la musculatura estriada lingual de rata en diferentes IPM. Se utilizaron 10 ratas machos Sprague dawley de dos meses de edad. Los animales fueron eutanasiados y dejados a temperatura ambiente (4 - 14 ?C) para tomar muestras de la lengua a distintos IPM (0, 6, 12, 24, 48, 72, 96 y 120 horas postmortem). El estudio se llevó a cabo considerando las recomendaciones de la Guía para el Cuidado y Uso de Animales de Laboratorio. Las muestras fueron fijadas en formaldehido tamponado a 10 % y procesadas para su inclusión en paraplast. Se realizaron cortes de 5 μm de grosor y fueron teñidas con HE para su análisis con microscopía óptica. Los cambios histológicos en las células musculares estriadas de la lengua estaban asociados a los distintos IPM. A las 6 horas postmortem, hubo cambios iniciales en la morfología nuclear y su pigmentación. A las 12 y 24 horas postmortem, se observaron cambios en las estrías musculares y aumento en el número de casos con alteraciones nucleares. A las 48 y 72 horas postmortem, eran evidentes las vacuolas citoplasmáticas, cambios en la coloración de las miofibras y aumento en las alteraciones nucleares. A las 92 y 120 horas postmortem, se observó disminución de las estrías musculares y núcleos celulares. Los núcleos eran picnóticos y puntiformes; hubo pérdida de la morfología celular y presencia de musculo liso. En conclusión, los cambios de la histología del músculo estriado lingual de rata permiten estimar el IPM. Este modelo podría ser aplicable a la medicina forense.

SUMMARY: The postmortem interval (PMI) equals the time that has elapsed since a human being has died until his postmortem examination. After death, the body experiences modifications in its physical and chemical composition know as postmortem changes expressed by signs that can be analyzed for the calculation of the MPI. The aim of the study was to describe the histological changes present in rat lingual striated musculature in different PMIs. 10 two-month-old male Sprague dawley rats were used. The animals were euthanized and left at room temperature (4-14 ?C) to sample the tongue at different PMIs (0, 6, 12, 24, 48, 72, 96 and 120 hours postmortem). The study was carried out considering the recommendations of the Guide for the Care and Use of Laboratory Animals. The samples were fixed in 10% buffered formaldehyde and processed for inclusion in paraplast. 5 μm thick sections were made and stained with HE for análisis with light microscopy. Histological changes in the striated muscle cells of the tongue were associated with the different PMIs. At 6 hours postmortem, there were initial changes in nuclear morphology and its pigmentation. At 12 and 24 hours postmortem, changes in muscle striae and an increase in the number of cases with nuclear alterations were observed. At 48 and 72 hours postmortem, cytoplasmic vacuoles, changes in myofiber coloration, and increased nuclear alterations were evident. At 92 and 120 hours postmortem, a decrease in muscle striae and cell nuclei was observed. The nuclei were pyknotic and pinpoint; there was loss of cell morphology and presence of smooth muscle. In conclusion, changes in the histology of rat lingual skeletal muscle make it possible to estimate MPI. This model could be applicable to forensic medicine.

Anafilaxia ao ácido poli-L-láctico / Poly-L-lactic acid anaphylaxis

Paciente feminina, 47 anos, previamente hígida, apresentou reação anafilática associada ao uso do ácido poli-L-láctico (PLLA). Imediatamente após a administração do bioestimulador, a paciente referiu edema de face que evoluiu para urticária generalizada, edema em membros inferiores e tremores. Posteriormente, apresentou edema de língua e dificuldade para falar. Teste de puntura com extratos de PLLA na concentração pura 1:1 e testes intradérmicos na diluição 1:10 e 1:100 mostrou-se positivo. Paciente negou cofatores no dia do procedimento e alergias prévias. O presente artigo descreve o primeiro caso da literatura de anafilaxia ao PLLA, onde se discute aspectos da reação anafilática e exames usados para o diagnóstico.

A previously healthy 47-year-old woman had an anaphylactic reaction caused by poly-L-lactic acid (PLLA). Immediately after the administration of the biostimulating agent, the patient reported facial edema, which progressed to generalized urticaria, lower extremity edema, and tremors. Then she had tongue edema and difficulties to talk. A prick test with pure PLLA extracts (1:1) and intradermic tests (1:10 and 1:100 dilutions) were positive. The patient denied cofactors on procedure day as well as previous allergies. This is the first case report of anaphylaxis due to PLLA and includes a discussion of aspects of the anaphylactic reaction and tests that were used to provide the diagnosis.