Voice Formants in Individuals With Congenital, Isolated, Lifetime Growth Hormone Deficiency.

OBJECTIVE: To analyze the voice formants (F1, F2, F3, and F4 in Hz) of seven oral vowels, in Brazilian Portuguese, [a, ε, e, i, ɔ, o, and u] in adult individuals with congenital lifetime untreated isolated growth hormone deficiency (IGHD). STUDY DESIGN: This is a cross-sectional study. METHODS: Acoustic analysis of isolated vowels was performed in 33 individuals with IGHD, age 44.5 (17.6) years (16 women), and 29 controls, age 51.1 (17.6) years (15 women). RESULTS: Compared with controls, IGHD men showed higher values of F3 [i, e, and ε], P = 0.006, P = 0.022, and P = 0.006, respectively and F4 [i], P = 0.001 and lower values of F2 [u], P = 0.034; IGHD women presented higher values of F1 [i and e] P = 0.029 and P = 0.036; F2 [ɔ] P = 0.006; F4 [ɔ] P = 0.031 and lower values of F2 [i] P = 0.004. IGHD abolished most of the gender differences in formant frequencies present in controls. CONCLUSIONS: Congenital, severe IGHD results in higher values of most formant frequencies, suggesting smaller oral and pharyngeal cavities. In addition, it causes a reduction in the effect of gender on the structure of the formants, maintaining a prepubertal acoustic prediction.

Voice quality in short stature with and without GH deficiency.

OBJECTIVE: The aim of this study was to analyze the individual impact of short stature (SS) or untreated isolated growth hormone deficiency (IGHD) on voice quality and the influence of IGHD on voice aging. METHODS: A cross-sectional study was carried out on 73 adults: 33 IGHD, 10 SS, and 30 normal controls (CO), by evaluating vocal perception using Voice-Related Quality-of-Life (V-RQOL) scores and fundamental frequency (ƒ0). Analysis of variance with Bonferroni post-test was used to compare groups, and the Student t test was used to verify the influence of aging. RESULTS: Stature of the SS and IGHD groups was similarly reduced in comparison to CO. Cephalic perimeter (CP) in SS males was larger than CO (P<0.05), and this was larger than in IGHD (P<0.0001). CP was similar in SS and CO females, and both were larger than in IGHD (P<0.0001). V-RQOL scores were lower in IGHD than in SS and CO. ƒ0 (Hz) was similar in IGHD females and SS and higher than in CO (P<0.05). f0 of IGHD males was higher than in SS (P=0.01) and CO (P=0.001). IGHD abolished the effect of aging on ƒ0 exhibited by CO. CONCLUSIONS: Lower vocal perception and higher ƒ0 were found in IGHD in comparison to CO in both genders; in comparison to SS, higher ƒ0 was only found in IGHD males. Because SS males have higher CP than IGHD, this suggests that CP and craniofacial growth can influence voice in IGHD. Finally, IGHD seems to abolish the effects of aging on voice.

Impact of early postnatal androgen exposure on voice development.

BACKGROUND: The impact of early postnatal androgen exposure on female laryngeal tissue may depend on certain characteristics of this exposure. We assessed the impact of the dose, duration, and timing of early androgen exposure on the vocal development of female subjects who had been treated for adrenocortical tumor (ACT) in childhood. METHODS: The long-term effects of androgen exposure on the fundamental vocal frequency (F0), vocal pitch, and final height and the presence of virilizing signs were examined in 9 adult (age, 18.4 to 33.5 years) and 10 adolescent (13.6 to 17.8 years) female ACT patients. We also compared the current values with values obtained 0.9 years to 7.4 years after these subjects had undergone ACT surgery, a period during which they had shown normal androgen levels. RESULTS: Of the 19 subjects, 17 (89%) had been diagnosed with ACT before 4 years of age, 1 (5%) at 8.16 years, and 1 (5%) at 10.75 years. Androgen exposure (2 to 30 months) was sufficiently strong to cause pubic hair growth in all subjects and clitoromegaly in 74% (14/19) of the subjects, but did not reduce their height from the target value. Although androgen exposure induced a remarkable reduction in F0 (132 Hz) and moderate pitch virilization in 1 subject and partial F0 virilization, resulting in F0 of 165 and 169 Hz, in 2 subjects, the majority had normal F0 ranging from 189 to 245 Hz. CONCLUSIONS: Female laryngeal tissue is less sensitive to androgen exposure between birth and adrenarche than during other periods. Differential larynx sensitivity to androgen exposure in childhood and F0 irreversibility in adulthood are age-, concentration-, duration-, and timing-dependent events that may also be affected by exposure to inhibitory or stimulatory hormones. Further studies are required to better characterize each of these factors.

Improvements in insulin sensitivity and muscle blood flow in aerobic-trained overweight-obese hypertensive patients are not associated with ambulatory blood pressure.

To verify whether there are relationships between vascular and hormonal responses to aerobic training in hypertensive persons, sedentary hypertensive patients were randomized to an aerobic training or a callisthenic exercise group. The patients' 24-hour blood pressure, arterial compliance, forearm blood flow, and hormonal profile were evaluated at baseline and after 3-month training protocols. Mean maximal oxygen consumption (VO(2) max) increased by 8% in the aerobic group (P<.001), while no change was observed in the control group. There was a decrease in insulin resistance (homeostatic model assessment of insulin resistance, P=.039) and plasma cortisol (P=.006) in the aerobic group only, that also demonstrated an increase in forearm blood flow (P<.001) after training. No relationship was observed between change in blood pressure or change in body mass and other parameters. Aerobic training can promote a decrease in cardiovascular risk in hypertensive adults by improving vascular function and insulin resistance, despite no changes in ambulatory blood pressure after a 3-month intervention.

Características das vozes roucas, ásperas e normais: análise acústica espectrográfica comparativa / Characteristics of hoarse, rough and normal voices: acoustic spectrographic comparative analysis

Introduçäo: A avaliaçäo da qualidade vocal pode ser realizada pelos métodos perceptivo auditivo e acústico, e näo existem termos padronizados para a sua descriçäo. Entretanto, dois desses termos merecem atençäo quanto aos parâmetros que os distinguem: a aspereza e a rouquidäo, ambos denominados genericamente de rouquidäo na literatura. Objetivo: Avaliar comparativamente vozes roucas, ásperas e normais por meio da espectrografia. Forma de estudo: Prospectivo clínico randomizado. Material e método: Seis vozes roucas, seis ásperas e seis normais foram selecionadas por meio da avaliaçäo perceptivo auditiva, e analisadas espectrograficamente sob cinco parâmetros: análise da freqüência fundamental (f0), extensäo dos harmônicos, definiçäo de harmônicos, presença de ruído entre os harmônicos e acima deles. Resultados: As vozes roucas apresentaram f0 mais grave e as ásperas mais aguda quando comparadas com as vozes normais. Considerando o espectrograma de 0 a 5,4 kHz, o valor médio da freqüência que o harmônico mais alto alcançou foi 4.555 Hz para vozes normais, 2.125 Hz para vozes ásperas e 1.147 Hz para vozes roucas. O traçado dos harmônicos nas vozes roucas apresentou qualidade de definiçäo inferior aos outros dois tipos de vozes e maior quantidade de ruído entre e acima dos harmônicos. Conclusöes: Existem diferenças espectrográficas marcantes entre essas vozes. Os harmônicos estäo presentes em grande quantidade e com melhor definiçäo nas vozes normais, e decrescem em quantidade e qualidade nas vozes ásperas e roucas, respectivamente. Inversamente, o ruído está presente em grande quantidade e de modo difuso nas vozes roucas e em menor quantidade nas vozes ásperas e normais