ABSTRACT
PURPOSE: To verify the efficiency of thermotherapy perceptively and acoustically with hot vapor in the treatment of acute laryngitis. METHODS: This is a pre and post test quasi-experimental study without a control group, approved by the ethics committee. Its sample counted with 65 singers - 37 females (56.9%) and 28 males (43.1%), mean age 33.7 years (±7.9) years, nonsmokers, with dysphonia due to acute laryngitis. They were submitted to videolaryngostroboscopy and perceptive-acoustic assessment of the voice before and 30 minutes after applying the inhalation of hot vapor. The appropriate statistical tests were used, adopting the significance level lower than 0.05. RESULTS: In the acoustic assessment, there was a statistically significant improvement in jitter and shimmer for vowels A and E, P < 0.001. The F0 assessed separately per sex, as it presented a significant difference, P < 0.001. The women's F0 results before and after the heat were higher than the men's. In the analysis of the acoustic results based on harmonics-to-noise ratio and normalized noise energy, there was significant improvement after the heat. All the mean values increased after the heat. There was a statistically significant decrease in the parameters related to the perceptive-auditory assessment for G (grade of hoarseness), R (roughness), B (breathiness), and S (strain). Of the 47 singers that scored 2 for G, 28 (59.6%) reduced it to 1 after the heat, P < 0.001. All the 45 that scored 2 for R reduced it to 1, P = 0.011. Of the 8 who scored 2 for B, 6 (75%) reduced it to 1, P = 0.020. All the 28 singers that scored 1 for S reduced it to 0, P < 0.001. Only for A (asthenia), there was no significant improvement, P = 0.513. The results of the videolaryngostroboscopy revealed a statistically significant difference in all parameters analyzed, such as hyperemia, edema, muco-undulatory movement, and glottal coaptation. CONCLUSION: The thermotherapy with using humid heat, provide symptomatic benefits in the treatment of dysphonia caused by laryngitis, demonstrating that the hyperthermoterapy is a potential auxiliary therapeutic resource for the treatment of acute dysphonia due to laryngitis since the intervention with the technique proposed increased the voice quality. It is suggested that this method be used in speech-language clinical practice and that new studies be conducted with stronger designs for its efficacy to be confirmed.
ABSTRACT
Resumo: Introdução: Este estudo teve como objetivos traduzir, adaptar e avaliar as propriedades psicométricas do Tool for Assessing Cultural Competence Training (TACCT) para o português falado no Brasil. Métodos: Os itens do TACCT foram adaptados transculturalmente por meio das etapas de tradução, reconciliação, retrotradução, revisão da retrotradução, revisores independentes, etapa Delphi, pré-teste e incorporação dos resultados do pré-teste no processo de tradução. A versão final do instrumento para a língua portuguesa foi autoaplicada em 320 estudantes de uma escola médica. Para verificar a precisão da escala, adotou-se a análise de confiabilidade. Utilizamos a análise fatorial confirmatória para avaliação da validade de construto e dimensionalidade do instrumento. Resultado: A versão final do TACCT mostrou-se adequada e teve sua validade e confiabilidade confirmadas. Conclusão: A versão brasileira do TACCT é válida e confiável e tem potencial para ser utilizada no processo de implantação, revisão ou aprimoramento de currículos de escolas médicas brasileiras.
Abstract: Introduction: To translate, adapt and evaluate the psychometric properties of the Tool for Assessing Cultural Competence Training (TACCT) to Brazilian Portuguese. Methods: The TACCT items were transculturally adapted through several stages, namely: translation, reconciliation, backtranslation, revision of backtranslation, independent reviews, Delphi stage, pretest, and incorporation of the pretest results into the translation process. The final Portuguese version of the instrument was self-applied by 320 medical students. The scale accuracy was verified using reliability analysis. We employed confirmatory factor analysis to assess the construct validity and instrument dimensionality. Results: The final version of the TACCT was adequate, and its validity and reliability were confirmed. Conclusion: The Brazilian Portuguese version of the TACCT is valid and reliable, and it can be used to implement, review, and improve new curriculum content of Brazilian medical schools.
ABSTRACT
UNLABELLED: Acute dysphonia is a frequent condition in clinical practice. Its treatment, especially in adults, is not well established in the literature. Steroids are the most recommended drug treatment. However, the existing studies are not enough to establish superiority among the different steroids and the best route of administration. OBJECTIVE: This prospective clinical study aimed at comparing the effect of inhaling steroids as a dry powder with the effect of oral steroids to treat acute dysphonia. METHOD: We assessed 32 adult patients, broken down into two groups of 16 patients in each one of the treatments, before and seven days after the use of the medication. The patients were submitted to videolaryngoscopy and perceptive and acoustic voice assessment. RESULT: Oral and inhalation treatment significantly reduced hyperemia and edema, and improved the muco-ondulatory movement; nonetheless, edema reduction was statistically more significant (p = 0.012) in the patients treated with the inhalation form of the drug. However, comparing the values of the auditory perceptive analysis and the acoustic measures after treatment between the groups was not statistically significant. CONCLUSION: There was a significant improvement in the acute laryngitis concerning the assessments carried out in all the patients assessed, concerning the two treatments. The inhalation steroid treatment was significantly more effective in reducing the edema.
Subject(s)
Androstadienes/administration & dosage , Anti-Inflammatory Agents/administration & dosage , Dysphonia/drug therapy , Laryngitis/drug therapy , Prednisolone/administration & dosage , Acute Disease , Administration, Inhalation , Administration, Oral , Adult , Dysphonia/etiology , Female , Fluticasone , Humans , Laryngitis/complications , Male , Middle Aged , Prospective Studies , Treatment OutcomeABSTRACT
A disfonia aguda é um quadro comum na prática clínica. Seu tratamento, principalmente em adultos, não é bem definido na literatura. O corticoide é o tratamento medicamentoso mais recomendado. Os estudos existentes, entretanto, não são suficientes para a determinação da superioridade entre diferentes corticoides e a melhor forma de administração. OBJETIVO: Este estudo clínico prospectivo teve como objetivo comparar o efeito do corticoide inalatório na forma de pó seco com o efeito do corticoide oral, no tratamento da disfonia aguda. MÉTODO: Foram avaliados 32 pacientes adultos, divididos em dois grupos de 16 pacientes para cada um dos tratamentos, antes e após sete dias do uso da medicação. Os pacientes foram submetidos à videolaringosocpia e avaliação perceptiva e acústica da voz. RESULTADOS: O tratamento inalatório e oral reduziram significativamente a hiperemia, o edema e melhorou o movimento muco-ondulatório; entretanto, a redução do edema foi estatisticamente mais significativa (p = 0,012) nos pacientes tratados com a forma inalatória. A comparação dos valores da análise perceptiva auditiva e das medidas acústicas após tratamento entre os grupos, entretanto, não apresentou significância estatística. CONCLUSÃO: Houve melhora significativa da laringite aguda nas avaliações realizadas, em todos os pacientes estudados, com os dois tratamentos. O tratamento com corticoide inalatório foi significativamente mais efetivo na redução do edema.
Acute dysphonia is a frequent condition in clinical practice. Its treatment, especially in adults, is not well established in the literature. Steroids are the most recommended drug treatment. However, the existing studies are not enough to establish superiority among the different steroids and the best route of administration. OBJECTIVE: This prospective clinical study aimed at comparing the effect of inhaling steroids as a dry powder with the effect of oral steroids to treat acute dysphonia. METHOD: We assessed 32 adult patients, broken down into two groups of 16 patients in each one of the treatments, before and seven days after the use of the medication. The patients were submitted to videolaryngoscopy and perceptive and acoustic voice assessment. RESULT: Oral and inhalation treatment significantly reduced hyperemia and edema, and improved the muco-ondulatory movement; nonetheless, edema reduction was statistically more significant (p = 0.012) in the patients treated with the inhalation form of the drug. However, comparing the values of the auditory perceptive analysis and the acoustic measures after treatment between the groups was not statistically significant. CONCLUSION: There was a significant improvement in the acute laryngitis concerning the assessments carried out in all the patients assessed, concerning the two treatments. The inhalation steroid treatment was significantly more effective in reducing the edema.
