Alterações estruturais mínimas de pregas vocais / Minor structural alterations of the vocal folds

As alterações estruturais mínimas (AEM) da cobertura das pregas vocais são causas frequentes de alterações vocais. Podem ser de diagnóstico difícil, e expressar-se de modo variável. O cisto intracordal, o sulco vocal, a ponte de mucosa, o microdiafragma e laríngea e a ectasia vascular constituem o grupo das AEM da cobertura das pregas vocais pesquisadas nesse estudo. Sua etiopatogenia e epidemiologia não são bem conhecidas. O objetivo desse trabalho é fazer um revisão bibliográfica das características anatômicas e funcionais da laringe, bem como das disfonias causadas por AEM, e os respectivos métodos diagnósticos e terapêuticos.

Amiodarone-induced thyroid dysfunction in a tertiary center in south Brazil

Amiodarone, used in the treatment of cardiac arrhythmias, is associated with thyroid dysfunction. No reports exist on its frequency in southern Brazil, nor studies evaluating the usefulness of clinical scores to diagnose thyroid abnormalities in these patients. This study aimed at determining the prevalence of amiodarone-induced thyroid dysfunction in a representative sample from a tertiary center, to study the conditions associated to this dysfunction and to evaluate the reliability of clinical scores of hypo and hyperthyroidism. One hundred ninety-five amiodarone users were submitted to a clinical and laboratory evaluation. Of these, 2.1 percent were hyperthyroid, 25.1 percent hypothyroid and 9.2 percent had only a high T4. Considering thyroid dysfunction variables researched, thyroid autoimmunity was positively associated (OR 4.8; p= 0.02), and male gender had a trend to a positive association (OR 1.86; p= 0.06). Clinical scores were highly sensitive for hyperthyroidism (100 percent), but not for hypothyroidism (8 percent). The low prevalence of amiodarone-induced hypothyroidism suggests that this specific region is iodine-sufficient. All patients receiving chronic amiodarone therapy should be checked for clinical scores for hyperthyroidism and laboratory evaluation should be performed, as a screening for thyroid dysfunction, especially if they are male or have positive microsomal antibodies.

Dose-dependent autonomic dysfunction in chronic L-NAME-hypertensive diabetic rats.

This study investigated the effects of varying doses of L-NAME on arterial pressure (AP), baroreflex control, and heart rate (HR)/AP variability in the STZ-diabetic rat. Fifty-two male Wistar rats were injected with 50 mg/kg IV STZ (diabetes, D, n = 24) or citrate (controls, C, n = 28) 30 days before recordings. After 16 days, they received 14 days of oral L-NAME, 10 (H10) or 30 (H30) mg/kg, or water. Catheters were implanted into the femoral artery and vein (PE-10) for measurements in conscious rats; recorded data were analyzed on a beat-to-beat basis. Mean AP was higher in CH30 versus C and in DH10 and DH30 versus D rats. Reflex tachycardia was blunted in CH30 and DH30 rats (b = -1.81, -1.41, -0.48 in C, CH10, and CH30, respectively, P < 0.05 and b = -1.45, -1.19, -0.28 in D, DH10, and DH30, respectively, P < 0.05). Although HR and AP variability were reduced in CH30 and DH30 rats versus C and D rats, the DH30 rat had more accentuated dysfunction. All doses of L-NAME produced similar AP responses in experimental versus control groups, independent of the disease state (diabetes). Thus, autonomic dysfunction is more related to the L-NAME dose used and to the association of diabetes and hypertension than to AP values.

Amiodarone-induced thyroid dysfunction in a tertiary center in south Brazil.

Amiodarone, used in the treatment of cardiac arrhythmias, is associated with thyroid dysfunction. No reports exist on its frequency in southern Brazil, nor studies evaluating the usefulness of clinical scores to diagnose thyroid abnormalities in these patients. This study aimed at determining the prevalence of amiodarone-induced thyroid dysfunction in a representative sample from a tertiary center, to study the conditions associated to this dysfunction and to evaluate the reliability of clinical scores of hypo and hyperthyroidism. One hundred ninety-five amiodarone users were submitted to a clinical and laboratory evaluation. Of these, 2.1% were hyperthyroid, 25.1% hypothyroid and 9.2% had only a high T4. Considering thyroid dysfunction variables researched, thyroid autoimmunity was positively associated (OR 4.8; p= 0.02), and male gender had a trend to a positive association (OR 1.86; p= 0.06). Clinical scores were highly sensitive for hyperthyroidism (100%), but not for hypothyroidism (8%). The low prevalence of amiodarone-induced hypothyroidism suggests that this specific region is iodine-sufficient. All patients receiving chronic amiodarone therapy should be checked for clinical scores for hyperthyroidism and laboratory evaluation should be performed, as a screening for thyroid dysfunction, especially if they are male or have positive microsomal antibodies.

Emissões otoacústicas: tipo e utilidades clínicas / Otoacoustic emissions: types and clinical utilities

Objetivos: Os autores apresentam revisão de literatura sobre emissões otoacústicas. Métodos: Revisão bibliográfica de livros-texto e artigos publicados nos últimos 5 anos no Medline. Conclusão: As emissões Otoacústicas representam método de avaliação auditiva objetivo, rápido e não invasivo. São reprodutíveis para cada indivíduo e podem ser utilizadas para triagem auditiva infantil, monitorização de drogas ototóxicas e exposição a ruídos