Factores favorecedores de disfonía en niños en edad preescolar: diferencias entre niños con y sin disfonía / Aggravating factors of dysphonia in preschool children: differences between children with and without dysphonia

RESUMEN Objetivo Determinar si existen diferencias en factores favorecedores de disfonía, en un grupo de niños preescolares con voz saludable y otro con disfonía. Método En esta investigación se evalúo a un total de 96 niños entre los 2 y 5 años, de los cuales 17 presentaban disfonía y 79, voz saludable. Se comparó la presencia de factores favorecedores de disfonía entre ambos grupos, mediante un cuestionario dirigido a sus padres o cuidadores creado y validado especialmente para esta investigación. El análisis estadístico se realizó mediante análisis de muestras independientes para extraer el valor de p. Resultados Los resultados muestran una diferencia significativa en los valores del cuestionario (p=0,000) entre ambos grupos. El 91,6% de las preguntas se comportaron diferentes entre los grupos con y sin disfonía. Conclusión En esta investigación se encontraron diferencias entre la presencia de factores favorecedores de disfonía en niños preescolares con y sin disfonía. Los factores que tienen más diferencias tienen relación con causas físicas, ambientales y psicológicas.

ABSTRACT Objective To determine if there are differences in factors favoring dysphonia in a group of preschool children with healthy voice and another with dysphonia. Method In this research a total of 96 children between 2 and 5 years old were evaluated, of which 17 had dysphonia and 79 had a healthy voice. The presence of factors favoring dysphonia was compared between both groups, by means of a questionnaire addressed to their parents or caregivers created and validated especially for this research. Statistical analysis was performed by independent samples analysis to extract the p value. Results The results show a significant difference in the values of the questionnaire (p=0.000) between the two groups. The 91.6% of the questions behaved differently between the groups with and without dysphonia. Conclusion In this research, differences were found between the presence of factors favoring dysphonia in preschool children with and without dysphonia. The factors that have more differences are related to physical, environmental and psychological causes.

[Aggravating factors of dysphonia in preschool children: differences between children with and without dysphonia]. / Factores favorecedores de disfonía en niños en edad preescolar: diferencias entre niños con y sin disfonía.

OBJECTIVE: To determine if there are differences in factors favoring dysphonia in a group of preschool children with healthy voice and another with dysphonia. METHOD: In this research a total of 96 children between 2 and 5 years old were evaluated, of which 17 had dysphonia and 79 had a healthy voice. The presence of factors favoring dysphonia was compared between both groups, by means of a questionnaire addressed to their parents or caregivers created and validated especially for this research. Statistical analysis was performed by independent samples analysis to extract the p value. RESULTS: The results show a significant difference in the values of the questionnaire (p=0.000) between the two groups. The 91.6% of the questions behaved differently between the groups with and without dysphonia. CONCLUSION: In this research, differences were found between the presence of factors favoring dysphonia in preschool children with and without dysphonia. The factors that have more differences are related to physical, environmental and psychological causes.

OBJETIVO: Determinar si existen diferencias en factores favorecedores de disfonía, en un grupo de niños preescolares con voz saludable y otro con disfonía. MÉTODO: En esta investigación se evalúo a un total de 96 niños entre los 2 y 5 años, de los cuales 17 presentaban disfonía y 79, voz saludable. Se comparó la presencia de factores favorecedores de disfonía entre ambos grupos, mediante un cuestionario dirigido a sus padres o cuidadores creado y validado especialmente para esta investigación. El análisis estadístico se realizó mediante análisis de muestras independientes para extraer el valor de p. RESULTADOS: Los resultados muestran una diferencia significativa en los valores del cuestionario (p=0,000) entre ambos grupos. El 91,6% de las preguntas se comportaron diferentes entre los grupos con y sin disfonía. CONCLUSIÓN: En esta investigación se encontraron diferencias entre la presencia de factores favorecedores de disfonía en niños preescolares con y sin disfonía. Los factores que tienen más diferencias tienen relación con causas físicas, ambientales y psicológicas.

Calentamiento vocal en locutores comerciales / Vocal warm-up for commercial announcers

Introducción: Los locutores son profesionales de la voz que se caracterizan por presentar una alta exigencia vocal. El objetivo de esta investigación fue medir los cambios acústicos que podrían ser atribuidos a una rutina de calentamiento vocal sobre la calidad de la voz en locutores comerciales de radio y televisión en Chile. Material y método: Se seleccionaron 13 locutores comerciales, a quienes se le aplicó un programa de calentamiento vocal. Se midieron los parámetros de frecuencia fundamental, perturbación (jitter y shimmer), ruido, tiempo máximo de fonación y agilidad articulatoria. Todos los parámetros se midieron antes y después de la rutina de ejercicios. Por otra parte, 6 expertos fonoaudiólogos analizaron, mediante una escala visual análoga, los cambios en los espectrogramas de banda estrecha de las emisiones antes y después de la rutina de calentamiento vocal. Resultados: Se encontraron cambios significativos en la frecuencia fundamental y el tiempo máximo de fonación. En el análisis de los espectrogramas que realizaron los expertos, en 11 casos se observó mejoría entre el antes y el después de la rutina. Sumado a lo anterior, en 6 de estos casos los cambios fueron significativos. Conclusiones: El calentamiento vocal puede ser una eficaz herramienta para el cuidado de la voz en locutores comerciales

Introduction: The announcers are professionals of the voice that are characterized by presenting high vocal demand. The objective of this research was to measure the acoustic changes that could be attributed to a routine of vocal warm-up on the quality of the voice in commercial radio and television announcers in Chile. Material and method: Thirteen commercial announcers were selected and a vocal warm-up routine was applied. The parameters of fundamental frequency, jitter, shimmer, noise, maximum time of phonation and articulatory agility were measured. All parameters were measured before and after the exercise routine. On the other hand, 6 experts voice therapist analyzed through a visual analog scale changes in the narrow band spectrograms of the emissions before and after the vocal warm-up routine. Results: Significant changes were found in the fundamental frequency and maximum phonation time. In the analysis of the spectrograms performed by the experts, in 11 cases there was improvement between the before and after the routine. In addition to the above, in 6 of these cases the changes were significant. Conclusions: The vocal warm-up can be an effective tool for the care of the voice in commercial announcers

Perfil vocal y psicosocial de los sujetos con puberfonía / Vocal and psychological profile of subjects with puberphonia

Introducción. El proceso de muda vocal en varones no siempre se realiza con normalidad, y hay ocasiones en que el cambio de voz no se efectúa. Las causas son múltiples y pueden obedecer a desórdenes funcionales, orgánicos y ambientales. Esta investigación tiene por objetivo valorar el impacto vocal y psicosocial en los sujetos con puberfonía. Material y método. Mediante un diseño de casos y controles, se estudió una población de hombres mayores de 15 años con frecuencia fundamental sobre 165Hz. A estos sujetos se les aplicó una encuesta de evaluación de la muda vocal (PEMUV) validada por juicio de expertos y pilotaje. Resultados. Se realizó análisis estadístico con los softwares SSPS y Atlas TI. Ingresaron al estudio 26 casos y 107 controles. Los resultados de la encuesta indican que los sujetos con trastornos de la muda vocal presentan valoración negativa de la voz, tienden a confundirlos con alguien menor de edad, y usan el teléfono menos de lo que desearían. Además, se destaca el desmedro en el ámbito laboral. Conclusiones. La presente investigación permitió establecer un perfil del sujeto con puberfonía. El PEMUV fue un instrumento sensible que permitió valorar las molestias psicosociales que puede desencadenar esta alteración

Introduction. Voice mutation in men is a process not always normally achieved, sometimes this voice change is not fully developed. The causes are multiple and might follow functional, organic, and environmental disorders. This research intends to measure the vocal and psychosocial impact on subjects with puberphonia. Material and method. Through an analytic case control design, a population of men older than 15 years old, with a fundamental frequency higher than 165Hz, was studied. These subjects responded to a vocal mutation evaluation survey (PEMUV), validated through pilotage and experts opinion. Results. The study group comprised 26 cases and 107 controls; the survey results indicate that subjects with voice change disorders show a negative perception of their voices, tend to confuse them with a minor, use the telephone less than they would wish and difficulties in their jobs. Statistical analysis was performed with SSPS and Atlas TI software. Conclusions. This research led to the establishment of a puberphonia subject profile. The PEMUV was a sensitive instrument that permitted the measurement of the psychological discomfort this disturbance may trigger

Rationale and design of a long term follow-up study of women who did and did not receive HPV 16/18 vaccination in Guanacaste, Costa Rica.

The Costa Rica Vaccine Trial (CVT) was a randomized clinical trial conducted between 2004 and 2010, which randomized 7466 women aged 18 to 25 to receive the bivalent HPV-16/18 vaccine or control Hepatitis-A vaccine. Participants were followed for 4 years with cross-over vaccination at the study end. In 2010 the long term follow-up (LTFU) study was initiated to evaluate the 10-year impact of HPV-16/18 vaccination, determinants of the immune response, and HPV natural history in a vaccinated population. Herein, the rationale, design and methods of the LTFU study are described, which actively follows CVT participants in the HPV-arm 6 additional years at biennial intervals (3 additional study visits for 10 years of total follow-up), or more often if clinically indicated. According to the initial commitment, women in the Hepatitis-A arm were offered HPV vaccination at cross-over; they were followed 2 additional years and exited from the study. 92% of eligible CVT women accepted participation in LTFU. To provide underlying rates of HPV acquisition and cervical disease among unvaccinated women to compare with the HPV-arm during LTFU, a new unvaccinated control group (UCG) of women who are beyond the age generally recommended for routine vaccination was enrolled, and will be followed by cervical cancer screening over 6 years. To form the UCG, 5000 women were selected from a local census, of whom 2836 women (61% of eligible women) agreed to participate. Over 90% of participants complied with an interview, blood and cervical specimen collection. Evaluation of comparability between the original (Hepatitis-A arm of CVT) and new (UCG) control groups showed that women's characteristics, as well as their predicted future risk for cervical HPV acquisition, were similar, thus validating use of the UCG. LTFU is poised to comprehensively address many important questions related to long-term effects of prophylactic HPV vaccines.