[Extramedullary plasmocytoma. Report of 5 cases]. / Plasmocitomas extramedulares. Presentación de cinco casos.

The extramedullary plasmacytoma account for 1-2% of the total number of plasma-cell growths. 80 percent are originated on head and neck, beginning on submucous layer of the upper airways. Male are more frequent affected at sixth-seventh decade. Roentgentherapy chemotherapy is only worldwide accepted in cases of scattered disease, but when the cases are localizated the method is under assessment. Long tern follow up of patients is recommended, because there are cases which after many years of calm can evolve into a multiple myeloma. We report 5 cases: 3 women and 2 men, diagnosed as extramedullary plasmocytoma. In one of them, considered as nasal plasmacytoma, three years later was discovered an other plasmacytoma on a tibial epiphysis. The whole group was surgically treated with complementary röntgentherapy 4 of them. Afterwards no one showed multiple myeloma.

[Multi-dimensional analysis of vocal function. A case-control study]. / Análisis multidimensional de la función vocal. Estudio de casos y controles.

The aim of this study was to select the most appropriate methods for analyzing vocal function from an array of existing tests. A case-control study (64 patients and 64 controls) was made of teaching staff in Logroño, Spain. The 64 patients had 25 nodules, 7 polyps, 15 hyperfunctional dysphonia, 6 hypofunctional dysphonia, 6 submucosal suffusion and 5 chronic laryngitis. The study methods included anamnesis, ENT examination, videostrobolaryngoscopy, perceptual evaluation of hoarse voices, basic aerodynamic tests, the frequency range of phonation, physical analysis of the voice signal of the vowel /a/ and the sentence ìmi padre era castellanoî, and spectrographic analysis of Spanish vowels according to Yanagiharaís classification using Sound Scope 1.0 software. We found no single test that consistently differentiated between hoarse and normal voices; values always overlapped. In contrast the phonation quotient (PQ), maximum phonation time (MPT) of the vowel /a/, S/Z quotient (Eckel and Boone), frequency range of phonation, APQ (average perturbation quotient), HNR (harmonic-to-noise ratio), BR (breathiness, or the high-frequency content of the source wave), RAP (relative average perturbation), standard deviation (SD) of the fundamental frequency (F0) of the vowel /a/, intensity and SD of the sentence ìmi padre era castellanoî, and the sound spectrographic analysis of Spanish vowels disclosed statistically significant differences between hoarse and normal voices.

[Digital analysis of the acoustic signal in vocal pathology diagnosis. Sensitivity and specificity of shimmer and jitter measurements]. / El análisis digital de la señal acústica en el diagnóstico de la patología vocal. Sensibilidad y especificidad de las medidas del shimmer y del jitter.

OBJECTIVE: The aim of this study was to calculate the sensitivity and specificity of shimmer (APQ) and jitter (RAP) in the diagnosis of vocal pathology. PATIENTS AND METHODS: Digital audio tape (DAT) recorded voices of 64 hoarse patients (20 men and 44 women) and 64 persons without hoarseness (20 men and 44 women), all professional teachers, were analyzed acoustically. The vowel /a/ was analyzed physically using Sound Scope software. Eight parameters were examined using Sound Scope 1.0: amplitude of the perturbation quotient (APQ), harmonics-to-noise ratio (HNR), breathiness (BR), relative average perturbation (RAP), fundamental frequency (F0) and the standard deviation (SD) of F0, and intensity and its SD. RESULTS: Taking 5.5% as a normal APQ value for this algorithm, the sensitivity was 0.75 and the specificity was 0.64. Seventy percent of the normal teachers had a RAP below 0.40% in women and below 0.32% in men, and 85% of hoarse teachers had higher values than those reported by us. As for BR, taking 17.5 dB as a normal reference, this algorithm had a sensitivity of 0.73 and a specificity of 0.41. CONCLUSIONS: Individual study of these tests is interesting because each one measures a different aspect of vocal function. They are most useful when studied together.

[Prevalence of voice disorders among educational professionals. Factors contributing to their appearance or their persistence]. / Estudio de la prevalencia de los trastornos de la voz en los profesionales de la enseñanza. Factores que intervienen en su aparición o en su mantenimiento.

A study was made of the prevalence of voice disorders and their risk factors in teaching professionals of Logroño, Spain. A prevalence and case-control study was made, including interviews, ENT examination, videostrobolaryngoscopy, perceptual evaluation of hoarseness, basic aerodynamic tests, the physical range of phonation, and a physical analysis of the acoustic signal. The prevalence of voice disorders among Logroño teachers was 17.7% (confidence interval: 12.1-25%). Nodular lesions (8.1%) were the most frequent pathology, followed by hyperfunctional dysphonia (4.1%), chronic laryngitis (2.7%), polyps (1.4%), hypofunctional dysphonia (0.7%), and submucous suffusion (0.7%). Voice disorders were more prevalent in women (19.3%) than in men (15.6%), and among teachers of the lowest grades: 36.4% in nursery schools, 25% in elementary school, and 20.8% in junior school. The width and depth of classrooms, larger number of students, longer classroom hours, and noise level were related with the frequency of voice disorders.