nódulos de las cuerdas vocales revisión bibliográfica
Transcription
nódulos de las cuerdas vocales revisión bibliográfica
NÓDULOS DE LAS CUERDAS VOCALES REVISIÓN BIBLIOGRÁFICA INSTITUTO DE SALUD CARLOS III Noviembre, 2010 Nodulos de las cuerdas vocales: revisión bibliográfica Índice de contenido Objetivo....................................................................................... 3 Estrategias de búsqueda.............................................................. 4 Identificación de términos.................................................................................. 4 Diseño de estrategias..................................................................6 Límites............................................................................................................ 6 Bases de datos utilizadas............................................................. 8 MEDLINE......................................................................................................... 9 EMBASE......................................................................................................... 10 The Cochrane Library.......................................................................................10 CRD Databases............................................................................................... 10 IBECS............................................................................................................ 11 Portal Dialog................................................................................................... 11 CISDOC......................................................................................................... 12 OSH-UPDATE (Occupational Safety and Health) ..................................................13 Presentación de los resultados..................................................15 Tabla búsqueda general:.................................................................................. 15 ANEXOS: • ANEXO I: Protocolo de búsqueda OSTEBA • ANEXO II: Estrategias de búsqueda • ANEXO III: Resultado búsqueda general • ANEXO IV: Resultado búsqueda en Dialog Instituto de Salud Carlos III, 2010 2 Nodulos de las cuerdas vocales: revisión bibliográfica Objetivo El objetivo del presente proyecto es la búsqueda sistemática y exhaustiva de la evidencia científica existente para la elaboración de una guía basada en la evidencia para la mejora del manejo clínico, de determinación de contingencia y de valoración médica de la incapacidad de los Nódulos de las cuerdas vocales a causa de los esfuerzos sostenidos de la voz por motivos profesionales. Instituto de Salud Carlos III, 2010 3 Nodulos de las cuerdas vocales: revisión bibliográfica Estrategias de búsqueda Se define la pregunta de investigación, la traducción al lenguaje documental, y el diseño y desarrollo de filtros metodológicos que aumenten la calidad de las búsquedas en cuanto a exhaustividad y precisión. Definición de la pregunta de investigación Evidencia científica sobre el manejo clínico, determinación de contingencia y valoración médica de la incapacidad de los nódulos de las cuerdas vocales a causa de esfuerzos sostenidos de la voz por motivos profesionales. Traducción al lenguaje documental Transformación de la pregunta de investigación en pregunta estratégica a través de la pregunta PICO1, identificando los términos y combinación de los mismos, y determinando la utilización de límites (geográficos, temporales, etc.) y uso de filtros metodológicos. Identificación de términos Se realizó una búsqueda preliminar, muy precisa, con texto libre y limitada al título de las publicaciones, para la identificación de los términos iniciales. Fueron los siguientes: pathological voice; voice disorders; voice loss; voice therapy; occupational diseases; voice professionals; vocal professions; professional singers; Identificación de una serie de componentes para la búsqueda bibliográfica: 1 Patients (pacientes o población de estudio), Intervention (Intervención y tipo de intervención), Comparison (comparador), y Outcomes (resultados) Instituto de Salud Carlos III, 2010 4 Nodulos de las cuerdas vocales: revisión bibliográfica speech professions; teachers; vocalist; speech occupations; teachers; occupational voice disorders; vocal cords; vocal apparatus; vocal cord paralysis; vocal cord nodes; vocal fold nodules; nodose formations; kissing nodules; vocal nodules Instituto de Salud Carlos III, 2010 5 Nodulos de las cuerdas vocales: revisión bibliográfica Diseño de estrategias Se ha diseñado y desarrollado una estrategia general y posteriormente se ha adaptado a cada recurso de información seleccionado en función de: Base de datos general / específica (cobertura temática) Extensión de la base de datos (cantidad de referencias bibliográficas) Existencia de tesauro o lenguaje controlado Lengua (de las referencias bibliográficas) Límites Los límites utilizados han sido los siguientes: Lengua de las publicaciones: no se han establecido límites. Fecha de publicación: no se han establecido límites en fechas de publicación. Población de estudio: personas con profesiones en las que utilizan la voz como herramienta de trabajo: profesores, cantantes, etc. Filtros metodológicos de búsqueda Algunas bases de datos bibliográficas que se han consultado para la recuperación de la literatura científica contienen un gran número de referencias bibliográficas, como el caso de Medline (más de 20 millones) o Embase (cerca de 24 millones). El resultado en estas fuentes de información suele ser exhaustivo, aunque acompañado frecuentemente de excesivo ruido documental (elevado número de referencias bibliográficas no relevantes). Para la búsqueda en las bases de datos generales seleccionadas, se han utilizado filtros metodológicos temáticos con la finalidad de aumentar la especificidad o Instituto de Salud Carlos III, 2010 6 Nodulos de las cuerdas vocales: revisión bibliográfica sensibilidad en su resultado. Estos filtros metodológicos han consistido en la combinación de una serie de términos (en su mayoría descriptores) relacionados con la Medicina del Trabajo. Se ha tomado como base el filtro metodológico creado por Sanz-Valero J, et al. con el fin de conocer la producción científica española sobre Medicina del Trabajo en la base de datos MEDLINE2. Ha sido modificado buscando un resultado más exhaustivo; entre otras modificaciones la de sustituir la propiedad de Major topic (grupo de descriptores principales de una referencia) por la de Descriptor simple (descriptor del documento sin necesidad de ser una de sus materias principales), también añadir y/o eliminar algunos de los términos con el fin de adaptarlos a cada recurso de información específico. El filtro metodológico base adaptado y desarrollado ha sido el siguiente: “Occupational Health Services” OR “Occupational Health Nursing” OR “Occupational Health Physicians” OR “Occupational Exposure” OR “Occupational Therapy” OR “Occupational Medicine” OR “Occupational Dentistry” OR “Occupational Diseases” OR “Noise, Occupational” OR “Occupational Health” OR “Occupational Therapy Department, Hospital” OR “Dermatitis, Occupational” OR “Accidents, Occupational” OR “Air Pollutants, Occupational” Para su utilización en las base de datos ha sido necesaria su adaptación al lenguaje controlado de cada una de ellas. En las estrategias de búsquedas incluidas en el Anexo 1 se especifica detalladamente. “Los filtros metodológicos: aplicación a la búsqueda bibliográfica en la medicina 2 del trabajo española”. Sanz-Valero J, et al. Med Segur Trab 2008; (LIV)211:75-83. Instituto de Salud Carlos III, 2010 7 Nodulos de las cuerdas vocales: revisión bibliográfica Bases de datos utilizadas Se ha desarrollado un protocolo para la selección de los recursos de información consistente en: Identificación de las bases de datos. Jerarquizar las bases de datos y establecer un orden de preferencias. Se ha tomado como base el protoloco propuesto por Güemes en Desarrollo de protocolos de búsqueda bibliográfica de la literatura adaptándolos a los diferentes productos de evaluación3 y que se incorpora en este documento como Anexo 2. Dicha propuesta se basa a su vez en el protocolo COSI creado por la agencia neozelandesa NZHTA (New Zealand Health Technology Assessment) y DACEHTA (Danish Centre for Evaluation and Health Technology Assessment) y que consiste en una aproximación para seleccionar las fuentes de información relevantes entre tres agrupaciones de bases de datos dependientes de la relevancia de las bases de datos y tiempo marco dispoble para el acceso: búsqueda Core, Standard e Ideal. Se han tenido en cuenta una serie de factores entre los que se encuentran el tema de estudio, la tipología de estudios por su metodología a recuperar, accesibilidad de los recursos de información y documentos a texto completo, o las coberturas geográficas y temporales. Con todo ello, la selección de fuentes de información a consultar ha sido la siguiente: Güemes Careaga I, Gutiérrez Ibarluzea I y el grupo AUnETS de documentación. 3 Desarrollo de protocolos de búsqueda bibliográfica de la literatura adaptándolos a los diferentes productos de evaluación. Madrid: Plan Nacional para el SNS del MSC. Servicio de Evaluación de Tecnologías Sanitarias del País Vasco (Osteba); 2006. Informes de Evaluación de Tecnologías Sanitarias: OSTEBA No 2006/03. Instituto de Salud Carlos III, 2010 8 Nodulos de las cuerdas vocales: revisión bibliográfica Bases de datos generales: Medline (interface PubMed) Embase IBECS Bases de datos específicas CRD Databases The Cochrane Library Bases de datos de Salud Laboral IBSST (Índice Bibliográfico de Salud y Seguridad en el Trabajo) EINECS PLUS La búsqueda bibliográfica se completa con la exploración de recursos de información recogidos en diversos portales generales y/o de organizaciones de Medicina del Trabajo de otros países. Portales de bases de datos Datastar Portal OSH-UPDATE (Occupational Safety and Health) Bases de datos generales MEDLINE Base de datos general producida por la National Library of Medicine de Estados Unidos con aproximadamente 20 millones de referencias bibliográficas de literatura de revistas de ciencias de la salud. De cobertura internacional con referencias desde 1964 a la actualidad. El lenguaje controlado utilizado es MeSH Instituto de Salud Carlos III, 2010 9 Nodulos de las cuerdas vocales: revisión bibliográfica (Medical Sub-headings). Además de MEDLINE, se ha realizado la búsqueda en otras las bases que permiten la interrogación mediante MeSH Terms (Tesauro de la U.S. National Library of Medicine), o utilizando los DeCS (Descriptores de Ciencias de la Salud de BIREME/OPS): traducción al español de los MeSH Terms. EMBASE Base de datos general con más de 24 millones de referencias bibliográficas pertenecientes a aproximadamente 7.500 revistas biomédicas, muchas de ellas peer review. Cobertura geográfica internacional, incluye registros desde 1947 a la actualidad. Cuenta con el lenguaje controlado EMTREE. Bases de datos específicas The Cochrane Library La Cochrane Library permite el acceso a seis bases de datos de diferente tipología: revisiones sistemáticas, ensayos clínicos, etc. Se ha realizado una búsqueda sistemática en las siguientes: Cochrane Database of Systematic Reviews: Recurso de información principal que incluye todas los Revisiones Cochrane (y protocolos), preparado por losGrupos de revisión Cochrane. Contiene más de 6.4000 revisiones sistemáticas. Cochrane Central Register of Controlled Trials: Contiene aproximadamente 635.000 artículos recolpilados de diferentes recursos de información (Medline o Embase entre otros). CRD Databases El Centre for Reviews and Dissemination (CRD) es parte del National Institute for Health Research (NIHR), de la Universidad de York. Produce las bases de datos Instituto de Salud Carlos III, 2010 10 Nodulos de las cuerdas vocales: revisión bibliográfica de DARE, NHS EED y HTA Databases. Database of Abstracts of Reviews of Effects: contiene más de 13.500 resúmenes de revisiones sistemáticas que se han evaluado. Cada resumen incluye un resumen de la revisión junto con un comentario crítico sobre la calidad metodológica. Health Technology Assessment Database: Contiene unos 89.000 productos de Agencias de Evaluación de Tecnologías Sanitarias (publicados o en curso) NHS Economic Evaluation Database: Más de 28.900 estudios económicos del área de la Salud. IBECS El Índice Bibliográfico Español en Ciencias de la Salud (IBECS) contiene referencias de artículos de revistas científico-sanitarias editadas en España e incluye contenidos de las diferentes ramas de las ciencias de la salud tales como Medicina (incluyendo Salud Pública, Epidemiología y Administración Sanitaria), Farmacia, Veterinaria, Psicología, Odontología y Enfermería. Portales de recursos de información general Portal Dialog El portal de DialogWeb proporciona acceso al contenido de más de 600 bases de datos multidisciplinares. Dialog genera un informe PDF con el resultado de la búsqueda bibliográfica (Anexo 3). Los recursos seleccionados para la búsqueda son los siguientes: BIOSIS Previews® Global Health SciSearch® - a Cited Reference Science Database - 1990- Allied and Complementary Medicine(TM) Instituto de Salud Carlos III, 2010 11 Nodulos de las cuerdas vocales: revisión bibliográfica Dissertation Abstracts Online EMCare® Federal Research in Progress (FEDRIP) Inside Conferences New Scientist Elsevier Biobase Science CA SEARCH® - Chemical Abstracts® (1967- present) General Science Abstracts SciSearch® - a Cited Reference Science Database - 1974-1989 NewsRX Weekly Reports New England Journal of Medicine Physical Education Index The Lancet® PASCAL ExtraMED(TM) Gale Group Health & Wellness Database(SM) BIOSIS Previews® (1969-present) BIOSIS Previews® (1926-1968) TOXFILE CANCERLIT® Bases de datos de Salud Laboral CISDOC Base de datos bibliográfica del Centro Internacional de Información sobre Seguridad y Salud en el Trabajo (CIS), de la Organización Internacional del Trabajo (OIT). Contiene alrededor de 65.000 referencias de documentos que tratan de algún aspecto relativo a la seguridad y salud en el trabajo: accidentes de trabajo, las enfermedades profesionales y las medidas para prevenirlos. Lenguaje controlado: Thesaurus CIS. Instituto de Salud Carlos III, 2010 12 Nodulos de las cuerdas vocales: revisión bibliográfica OSH-UPDATE (Occupational Safety and Health) Recurso de información que da acceso desde una única interfaz a 19 bases de datos y/o recurso de información sobre salud y seguridad laboral. Los recursos, de cobertura internacional, son los siguientes: BSI Standards (British Standards Institution (BSI)) CCOHS (Canadian Centre for Occupational Health and Safety) CISDOC (The Health and Safety Information Centre of The International Labour Office) EU Legislation Full Text (Office of the Official Publications of the European Communities) European Agency Publications (European Agency for Safety and Health at Work Publications) HSELINE (UK Health and Safety Executive Information Services) ILO Conventions, Protocols and Recommendations (International Labour Office) International Bibliographic (Produced by Sheila Pantry Associates Ltd) International Full Text Collection (Full text documents from many worldwide authoritative sources) Irish Full Text Collection (Full text documents from the HSA, other Irish government departments and selected Irish organisations) Irish Legislation Full Text (Full text of Irish Acts and SIs relevant to safety, health and welfare) IRSST (Institut de recherche Robert-Sauvé en santé et en sécurité du travail) NSAI Bibliographic (References to all Irish Standards published by the NSAI) NSAI Full Text (Full text of Irish Standards on Health and Safety) NIOSHTIC (US National Institute for Occupational Safety and Health) NIOSHTIC-2 (US National Institute for Occupational Safety and Health) RILOSH (Ryerson International Labour Occupational Safety and Health) Instituto de Salud Carlos III, 2010 13 Nodulos de las cuerdas vocales: revisión bibliográfica RoSPA (UK Royal Society for the Prevention of Accidents Information Services) UK Legislation Full Text (Full text of UK Acts and SIs relevant to safety, health and welfare.) Instituto de Salud Carlos III, 2010 14 Nodulos de las cuerdas vocales: revisión bibliográfica Presentación de los resultados Resultados El resultado de la búsqueda bibliográfica se presenta como tabla y se incorpora la relación de referencias bibliográficas al final del documento como Anexo 3 (referencias tabla búsqueda general 1) y Anexo 4 (referencias tabla búsqueda Dialog) Tabla búsqueda general: Tabla general de resultados con los totales de las bases de datos consultadas, el proceso de eliminación de duplicados y el total acumulado: Referencias Nuevas TOTAL Medline 336 336 336 Embase 228 90 426 Cochrane Library 54 43 469 CRD Database 7 3 472 CISDOC 25 21 493 OSH-Update 44 20 513 IBECS 37 19 532 Tabla búsqueda general La base de datos global está compuesta por un total de 532 referencias bibliográficas. Principalmente de las bases de datos generales con cobertura geográfica internacional: 336 referencias de Medline (63%) y 228 referencias de Instituto de Salud Carlos III, 2010 15 Nodulos de las cuerdas vocales: revisión bibliográfica Embase (42%). Presencia de cada recurso de información en el conjunto global de referencias bibliográficas (en porcentaje): Medline 63% Embase 42.8% Cochrane Library 10.2% CRD Database 1.3% CISDOC 4.7% OSH-Update 4.3% IBECS 7% Porcentaje de referencias del total Tabla para las consultas de las bases de datos del portal Dialog. El listado de referencias completo se encuentra como Anexo 4 al final del documento. Dialog Referencias Nuevas TOTAL 220 155 155 Tabla búsqueda Dialog Selección de referencias Realizada la búsqueda sistemática de la bibliografía, se procede a la lectura crítica de los documentos. Una primera lectura de la referencia bibliográfica completa (siempre que tenga abstract) permite a través de los criterios de exclusión previamente establecidos descartar un grupo de documentos poco o nada relevantes. Este grupo de documentos es mayor o menor en función del tipo de búsqueda, las bases de Instituto de Salud Carlos III, 2010 16 Nodulos de las cuerdas vocales: revisión bibliográfica datos consultadas y el tema tratado. La búsqueda para el presente proyecto ha contado con las siguientes peculiaridades: Pregunta de investigación acotada al área de la medicina del trabajo: enfoque en enfermedad/es profesional/es. Selección de recursos de información específicos de un área determinada y no prefiltrados, menos sistemáticos en estructura y calidad del contenido. Consulta a portales de información, también peor estructurados y con menos contenido. Todo ello ha hecho que el grupo de referencias posibles a descartar con criterios de exclusión en una primera lectura de título y abstract sea pequeño, habiendo sido necesario la obtención del los documentos originales y la lectura a texto completo de la mayor parte de los mismos. Además de la búsqueda bibliográfica de manera sistemática ya automatizada, ha habido una búsqueda manual a partir de las referencias consultadas. Instituto de Salud Carlos III, 2010 17 ANEXO I: Protocolo búsqueda ANEXO I Selección de fuentes de información propuestas para protocolo de búsqueda OSTEBA En: Güemes Careaga I, Gutiérrez Ibarluzea I y el grupo AUnETS de documentación. Desarrollo de protocolos de búsqueda bibliográfica de la literatura adaptándolos a los diferentes productos de evaluación. Madrid: Plan Nacional para el SNS del MSC. Servicio de Evaluación de Tecnologías Sanitarias del País Vasco (Osteba); 2006. Informes de Evaluación de Tecnologías Sanitarias: OSTEBA No 2006/03. Revisiones sistemáticas 1. INAHTA 2. DARE (Database of Reviews of effects) 3. COCHRANE LIBRARY 4. CLINICAL EVIDENCE 5. HEN Ensayos clínicos 1. NATIONAL RESEARCH REGISTER 2. CLINICAL TRIALS. GOV 3. CENTER WATCH CLINICAL TRIALS 4. CURRENT CONTROLLED TRIALS 5. CLINICAL STUDY RESULTS.ORG Evaluaciones económicas 1. NHS ECONOMIC EVALUATION DATABASE-CRD YORK 2. EUROPEAN NETWORK OF HEALTH ECONOMICS EVALUATION DATABASE 3. WHO-CHOICE 4. INSTITUTE FOR HEALTH ECONOMICS Tecnologías emergentes 1. EUROSCAN Bases de datos genéricas 1. MEDLINE 2. EMBASE 3. WEB OF SCIENCE 4. PASCAL BIOMED 5. IBECS 6. LILACS 7. IME Guías de práctica clínica 1. NATIONAL GUIDELINES CLEARINGHOUSE 2. NEW ZEALAND GUIDELINES CLEARINGHOUSE 3. AUSTRALIAN NATIONAL HEALTH AND MEDICAL RESEARCH 4. COUNCIL PRACTICE 5. E-GUIDELINES 6. UK CLEARINGHOUSE ON HEALTH OUTCOMES 7. GUIASALUD 8. MONASH INSTITUTE OF HEALTH SERVICES RESEARCH ANEXO II: Estrategias de búsqueda ANEXO II Estrategias de búsqueda Leyenda: / - tras un término o términos indica que es un descriptor del lenguaje controlado propio de la base de datos consultada. Ejemplo: Descriptor/ = Descriptor[MeSH] (descriptor del Medical SubHeadings) / - tras un intervalo numérico y delante de un operador boobleano indica la utilización de dicho operador en la secuencia: Ejemplo: 1-3/OR = 1 OR 2 OR · .ti = búsqueda en campo título .ab = búsqueda en campo abstract o resumen .kw = búsqueda en campo keywords, materias, temas, descriptores, etc. .tw = búsqueda en campos de texto * = término truncado $ = término truncado Estrategia IBSST Fecha de búsqueda: noviembre de 2010 Límites: Sin límites Resultado: 9 referencias bibliográficas Estrategia: 1. voz 2. vocal* 3. 1 OR 2 Estrategia CISDOC Fecha de búsqueda: noviembre de 2010 Límites: Sin límites Resultado: 35 referencias bibliográficas Estrategia: 1. vocal OR voice* 2. node* OR nodule* OR nodos* 3. 1 AND 2 4. singer* OR teacher* OR vocalist* OR speech* OR speaker* 5. 1 AND 4 6. voice loss 7. voice professionals 8. voice disorder* 9. pathological voice 10. 6 – 9 / OR 11. 3 OR 5 OR 10 Estrategia Portal OSH-UPDATE Fecha de búsqueda: noviembre de 2010 Límites: Sin límites Resultado: 39 referencias bibliográficas Estrategia: 1. vocal* OR voice* 2. node* OR nodul* Or nodos* 3. 1 AND 2 4. VOICE LOSS/ 5. VOICE THERAPY/ 6. VOICE AND SPEECH PROFESSIONALS/ 7. OCCUPATIONAL VOICE DISORDERS/ 8. 4 – 7 / OR 9. 3 OR 8 Estrategia MEDLINE Interface: PubMed Fecha de búsqueda: noviembre de 2010 Límites: Sin límites Resultado: 336 referencias bibliográficas Estrategia: 1. vocal cords/ 2. vocal cords.ti 3. larynx.ti 4. vocal cord dysfunction.ti 5. vocal nodules.ti 6. vocal fold nodules.ti 7. vocal cord nodes.ti 8. nodose formations.ti 9. Voice Disorders/ 10. Voice Fatigues .ti 11. Voice Disorder .ti 12. Dysphonia .ti 13. vocal fatigue.ti 14. vocal disorder*.ti 15. vocal cord dysfunction.ti 16. 1 - 15 / OR 17. voice/ 18. singer*.ti 19. voice professional*.ti 20. vocal profession*.ti 21. specch profession*.ti 22. speech professional*.ti 23. teach*.ti 24. vocalist*.ti 25. speech occupation*.ti 26. telephone operator*.ti 27. 18 - 26 / OR 28. Occupational Health Services/ 29. Occupational Health Physicians/ 30. Occupational Exposure/ 31. Occupational Therapy/ 32. Occupational Medicine/ 33. Occupational Diseases/ 34. Noise, Occupational/ 35. Occupational Health/ 36. Occupational Therapy Department, Hospital/ 37. 28 - 36 /OR 38. 16 AND 27 39. 16 AND 37 40. 17 AND 27 AND 37 41. 38 OR 39 OR 40 Estrategia EMBASE Fecha de búsqueda: noviembre de 2010 Límites: Sin límites Resultado: 228 referencias bibliográficas Estrategia: 1. vocal-cords/ 2. vocal-cords-disorder/ 3. dysphonia/ 4. vocal cords.ti 5. larynx.ti 6. vocal cord dysfunction.ti 7. vocal nodules.ti 8. vocal fold nodules.ti 9. vocal cord nodes.ti 10. nodose formations.ti 11. Voice Disorders/ 12. Voice Fatigues .ti 13. Voice Disorder .ti 14. Dysphonia .ti 15. vocal fatigue.ti 16. vocal disorder*.ti 17. vocal cord dysfunction.ti 18. 1 - 17 / OR 19. singer*.ti 20. voice professional*.ti 21. vocal profession*.ti 22. specch profession*.ti 23. speech professional*.ti 24. teach*.ti 25. vocalist*.ti 26. speech occupation*.ti 27. telephone operator*.ti 28. 19 - 27 / OR 29. Occupational-Health-Services/ 30. Occupational-Physician/ 31. Occupational-Exposure/ 32. Occupational-Therapy/ 33. Occupational-Medicine/ 34. Occupational-Diseases/ 35. Occupational-Safety/ 36. Occupational-Health/ 37. Occupational noise.tw 38. 29 - 37 /OR 39. 18 AND 28 40. 18 AND 38 41. 39 OR 40 Estrategia THE COCHRANE LIBRARY Fecha de búsqueda: noviembre de 2010 Límites: Sin límites Resultado: 54 referencias bibliográficas Estrategia: 1. vocal cords/ 2. vocal cords.ti.ab.tw 3. larynx.ti.ab.tw 4. vocal cord dysfunction.ti.ab.tw 5. vocal nodules.ti.ab.tw 6. vocal fold nodules.ti.ab.tw 7. vocal cord nodes.ti.ab.tw 8. nodose formations.ti.ab.tw 9. Voice Disorders/ 10. Voice Fatigues .ti.ab.tw 11. Voice Disorder .ti.ab.tw 12. Dysphonia .ti.ab.tw 13. vocal fatigue.ti.ab.tw 14. vocal disorder*.ti.ab.tw 15. vocal cord dysfunction.ti.ab.tw 16. 1 - 15 / OR 17. singer*.ti.ab.tw 18. voice professional*.ti.ab.tw 19. vocal profession*.ti.ab.tw 20. specch profession*.ti.ab.tw 21. speech professional*.ti.ab.tw 22. teach*.ti.ab.tw 23. vocalist*.ti.ab.tw 24. speech occupation*.ti.ab.tw 25. telephone operator*.ti.ab.tw 26. 17 - 25 / OR 27. Occupational Health Services/ 28. Occupational Health Physicians/ 29. Occupational Exposure/ 30. Occupational Therapy/ 31. Occupational Medicine/ 32. Occupational Diseases/ 33. Noise, Occupational/ 34. Occupational Health/ 35. Occupational Therapy Department, Hospital/ 36. (OCCUPATIONAL):ti,ab,kw 37. 27 - 36 /OR 38. 16 AND 26 39. 16 AND 37 40. 38 OR 39 Estrategia CRD Databases (CENTRE FOR REVIEWS AND DISSEMINATION) Fecha de búsqueda: noviembre de 2010 Límites: Sin límites Resultado: 7 referencias bibliográficas Estrategia: 1. vocal cords/ 2. vocal cords.ti.ab.tw 3. larynx.ti.ab.tw 4. vocal cord dysfunction.ti.ab.tw 5. vocal nodules.ti.ab.tw 6. vocal fold nodules.ti.ab.tw 7. vocal cord nodes.ti.ab.tw 8. nodose formations.ti.ab.tw 9. Voice Disorders/ 10. Voice Fatigues .ti.ab.tw 11. Voice Disorder .ti.ab.tw 12. Dysphonia .ti.ab.tw 13. vocal fatigue.ti.ab.tw 14. vocal disorder*.ti.ab.tw 15. vocal cord dysfunction.ti.ab.tw 16. 1 - 15 / OR 17. singer*.ti.ab.tw 18. voice professional*.ti.ab.tw 19. vocal profession*.ti.ab.tw 20. specch profession*.ti.ab.tw 21. speech professional*.ti.ab.tw 22. teach*.ti.ab.tw 23. vocalist*.ti.ab.tw 24. speech occupation*.ti.ab.tw 25. telephone operator*.ti.ab.tw 26. 17 - 25 / OR 27. Occupational Health Services/ 28. Occupational Health Physicians/ 29. Occupational Exposure/ 30. Occupational Therapy/ 31. Occupational Medicine/ 32. Occupational Diseases/ 33. Noise, Occupational/ 34. Occupational Health/ 35. Occupational Therapy Department, Hospital/ 36. (OCCUPATIONAL):ti,ab,kw 37. 27 - 36 /OR 38. 16 AND 26 39. 16 AND 37 40. 38 OR 39 Estrategia IBECS (Índice Bibliográfico Español en Ciencias de la Salud) Fecha de búsqueda: noviembre de 2010 Límites: Sin límites Resultado: 19 referencias bibliográficas Estrategia: 1. voice 2. vocal$ 3. voz 4. 1 - 3 / OR 5. node$ 6. nodule$ 7. nodos$ 8. disease$ 9. disorder$ 10. pathological 11. 5 – 10 / OR 12. singer$ 13. teacher$ 14. vocalist$ 15. speech$ 16. professional$ 17. profession$ 18. 12 – 18 / OR 19. 4 AND 11 AND 18 Estrategia DIalog (Índice Bibliográfico Español en Ciencias de la Salud) Fecha de búsqueda: noviembre de 2010 Límites: Sin límites Resultado: 220 referencias bibliográficas Estrategia: 1. Occupational 2. professional$ 3. profession 4. profession$ 5. 1 – 4 / OR 6. voice 7. vocal$ 8. 7 OR 8 9. disorder$ 10. disease$ 11. node$ 12. nodule$ 13. 9 – 12 / OR 14. 5 AND 8 AND 13 ANEXO 4: Referencias búsqueda general ANEXO III Referencias bibliográficas búsqueda general (1) Amour J, Le-Manach YL, Borel M et al. Comparison of single-use and reusable metal laryngoscope blades for orotracheal intubation during rapid sequence induction of anesthesia: a multicenter cluster randomized study. Anesthesiology 2010;112:325-332. Ref ID: 429 Abstract: BACKGROUND: Single-use metal laryngoscope blades are cheaper and carry a lower risk of infection than reusable metal blades. The authors compared single-use and reusable metal blades during rapid sequence induction of anesthesia in a multicenter cluster randomized trial. METHODS: One thousand seventy-two adult patients undergoing general anesthesia under emergency conditions and requiring rapid sequence induction were randomly assigned on a weekly basis to either single-use or reusable metal blades (cluster randomization). After induction, a 60-s period was allowed to complete intubation. In the case of failed intubation, a second attempt was performed using the opposite type of blade. The primary endpoint was the rate of failed intubation, and the secondary endpoints were the incidence of complications (oxygen desaturation, lung aspiration, and/or oropharynx trauma) and the Cormack and Lehane score. RESULTS: Both groups were similar in their main characteristics, including the risk factors for difficult intubation. The rate of failed intubation was significantly decreased with single-use metal blades at the first attempt compared with reusable blades (2.8 vs. 5.4%, P < 0.05). In addition, the proportion of grades III and IV in Cormack and Lehane score were also significantly decreased with single-use metal blades (6 vs. 10%, P < 0.05). The global complication rate did not reach statistical significance, although the same trend was noted (6.8% vs. 11.5%, P = not significant). An investigator survey and a measure of illumination pointed that illumination might have been responsible for this result. CONCLUSIONS: The single-use metal blade was more efficient than a reusable metal blade in rapid sequence induction of anesthesia (2) Awan SN, Ensslen AJ. A comparison of trained and untrained vocalists on the dysphonia severity index. J Voice 2010;24:661-666. Ref ID: 10 Abstract: The purposes of this study were (1) to compare trained and untrained singers on the Dysphonia Severity Index (DSI) and its component measures, and (2) to contribute to normative DSI data for trained singers. This study included 36 untrained participants (15 males and 21 females) and 30 participants (15 males and 15 females) with singing experience between the ages of 18 and 30 years. Measures of maximum phonation time (MPT), highest phonational frequency, lowest intensity, and jitter were obtained for each subject and incorporated into the previously published multivariate DSI formula. Results indicated that vocally trained subjects have significantly higher DSI scores than untrained subjects (mean DSI: 6.48 vs 4.00, respectively), with significant differences observed between trained and untrained groups for three of the four components of the DSI (F(0) high; I low; jitter). The findings of this study are consistent with previous reports that indicate significant increases in the DSI with vocal training, and with various studies that have observed increased vocal capability in trained singers versus their untrained counterparts. The results of this study indicate that alternative normative expectations for the DSI may need to be taken into account when using the DSI with patients who have participated in directed vocal training, such as choral participation and voice/singing lessons (3) Bassi IB, Assuncao AA, de Medeiros AM, de Menezes LN, Teixeira LC, Cortes Gama AC. Quality of Life, Self-Perceived Dysphonia, and Diagnosed Dysphonia Through Clinical Tests in Teachers. J Voice 2010. Ref ID: 9 Abstract: OBJECTIVES: To examine the impact of voice on the quality of life of teachers and to assess whether the degree of dysphonia and otorhinolaryngologists' (ORL) diagnostics are correlated with the quality of life. METHODS: Eighty-eight female teachers from the municipal schools of Belo Horizonte who were in speech therapy at the Speech Therapy Clinic of the Hospital das Clinicas of Minas Gerais participated in the study. The variables studied were age, ORL diagnosis, perceptual-hearing assessment of voice through GRBAS scale, and vocal activities and participation profile (VAPP) protocol. Statistical analysis was performed through the descriptive analysis of the data and the Spearman coefficient of correlation. RESULTS: The average age of the participants was 38 years. Vocal deviation: degree 156 teachers (63.6%); degree 2-27 teachers (30.6%); and without vocal deviation-five teachers (5.6%). It was found that 57.9% of the teachers presented combined ORL diagnosis. No statistically significant relationship was observed among the ORL diagnosis, the degree of dysphonia, and the parameter values of quality of life assessed by VAPP. CONCLUSIONS: The examined participants of this study presented light degree of vocal deviation and ORL combined diagnosis. According to the figures obtained by VAPP, there was negative impact of voice on the quality of life of female teachers, but these impacts were not correlated with ORL diagnosis and grade of dysphonia (4) Bermudez de Alvear RM, Baron FJ, Martinez-Arquero AG. School Teachers' Vocal Use, Risk Factors, and Voice Disorder Prevalence: Guidelines to Detect Teachers with Current Voice Problems. Folia Phoniatr Logop 2010;63:209215. Ref ID: 3 Abstract: Teachers' voice problems are widely recognized as a consequence of their work. The measurement of vocal demands and risk factors is essential for adjusting occupational safety and health services to this population's needs. Objectives: To correlate vocal behavior and symptomatology with risk factors and voice disorders, and to further analyze gender influence on these variables. Subjects and Methods: 282 kindergarten and elementary education teachers were surveyed in a cross-sectional study using a self-administered questionnaire. For the purpose of this study, voice disorder prevalence was estimated based on the presence of a vocal effort plus 2 frequent symptoms. Results: 81.5% of teachers reported some degree of vocal effort; more than 60% of subjects evidenced frequent throat paresthesias or vocal fatigue at the end of a working day, and about 55% reported hoarseness. Voice disorder prevalence was 59%. Multivariate logistic regression analysis revealed that female gender, time required to alleviate vocal symptoms, perceived general state of health, prolonged use of the voice, and pupils' indiscipline significantly increased the odds of having vocal problems. Conclusions: Voice disorders affected most teachers and had a multifactorial nature. Vocal health care is particularly necessary for those subjects reporting vocal effort and more than 2 frequent symptoms (5) Blackwood B, Alderdice F, Burns-Karen EA, Cardwell CR, Lavery G, O'Halloran P. Protocolized versus non-protocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients. Blackwood Bronagh , Alderdice Fiona , Burns Karen EA, Cardwell Chris R, Lavery Gavin , O'Halloran Peter Protocolized versus non protocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients Cochrane Database o 2010. Ref ID: 431 Abstract: BACKGROUND: Reducing weaning time is desirable in minimizing potential complications from mechanical ventilation. Standardized weaning protocols are purported to reduce time spent on mechanical ventilation. However, evidence supporting their use in clinical practice is inconsistent. OBJECTIVES: To assess the effects of protocolized weaning from mechanical ventilation on the total duration of mechanical ventilation for critically ill adults; ascertain differences between protocolized and non-protocolized weaning in terms of mortality, adverse events, quality of life, weaning duration, intensive care unit (ICU) and hospital length of stay (LOS); and explore variation in outcomes by type of ICU, type of protocol and approach to delivering the protocol. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2010), MEDLINE (1950 to 2010), EMBASE (1988 to 2010), CINAHL (1937 to 2010), LILACS (1982 to 2010), ISI Web of Science and ISI Conference Proceedings (1970 to 2010), Cambridge Scientific Abstracts (inception to 2010) and reference lists of articles. We did not apply language restrictions. SELECTION CRITERIA: We included randomized and quasi-randomized controlled trials of protocolized weaning versus non-protocolized weaning from mechanical ventilation in critically ill adults. DATA COLLECTION AND ANALYSIS: Three authors independently assessed trial quality and extracted data. A priori subgroup and sensitivity analyses were performed. We contacted study authors for additional information. MAIN RESULTS: Eleven trials that included 1971 patients met the inclusion criteria. The total duration of mechanical ventilation geometric mean in the protocolized weaning group was on average reduced by 25% compared with the usual care group (N = 10 trials, 95% CI 9% to 39%, P = 0.006); weaning duration was reduced by 78% (N = 6 trials, 95% CI 31% to 93%, P = 0.009); and ICU LOS by 10% (N = 8 trials, 95% CI 2% to 19%, P = 0.02). There was significant heterogeneity among studies for total duration of mechanical ventilation (I2 = 76%, P < 0.01) and weaning duration (I2 = 97%, P < 0.01), which could not be explained by subgroup analyses based on type of unit or type of approach. AUTHORS' CONCLUSIONS: There is some evidence of a reduction in the duration of mechanical ventilation, weaning duration and ICU LOS with use of standardized protocols, but there is significant heterogeneity among studies and an insufficient number of studies to investigate the source of this heterogeneity. Although some study authors suggest that organizational context may influence outcomes, these factors were not considered in all included studies and therefore could not be evaluated. THE USE OF STANDARDIZED PROTOCOLS IN WEANING COMPARED TO USUAL WEANING PRACTICE FOR REDUCING THE TIME CRITICALLY ILL ADULT PATIENTS SPEND ON MECHANICAL VENTILATION: Helping patients to breathe with the use of a mechanical ventilator can be life saving. Yet as the duration of ventilation increases so does the likelihood of harmful effects such as (1) mechanical 3 injury to the throat or vocal cords, (2) injury to or infection of the lungs and (3) complications of prolonged patient immobility such as clots in the legs or lungs and various infections (for example in the urinary tract). It is important therefore to recognize straight away when patients are ready to breathe for themselves so that the ventilator support can be reduced and stopped (this is known as weaning) as soon as possible. Usually weaning decisions are left to the judgement of the staff but recently protocols (or written guidelines) for weaning have been found to be both safe for patients and useful for staff. Some studies claimed that using protocols led to better practice, but there was no clear evidence that using them actually produced beneficial results for patients.This review looked at the results of 11 studies involving 1971 critically ill patients. The studies compared the use of protocols to wean patients from the ventilator against usual practice and were conducted in America, Europe and Australia. The varied intensive care units cared for patients with heart conditions, breathing difficulties, head injuries, trauma and following major surgery. In eight studies, intensive care staff followed protocol guidelines to reduce the ventilator support; in three studies ventilator support was reduced by programmed computers according to a protocol. Overall, results showed that in comparison with usual practice, the average total time spent on the ventilator was reduced by 25%. The duration of weaning was reduced by 78% and length of stay in the intensive care unit reduced by 10%. However, these reductions were not consistent across all studies.Among the 11 studies, there was considerable variation in the types of protocols used, the criteria for considering when to start weaning, the methods of weaning (by professionals or computers), the medical conditions of the patients and usual practice in weaning. There were insufficient studies to enable us to explore whether or not these factors were responsible for inconsistencies in individual studies. Caution will need to be applied when generalizing our findings to other intensive care units (6) Cheng J, Woo P. Correlation between the Voice Handicap Index and voice laboratory measurements after phonosurgery. Ear Nose Throat J 2010;89:183-188. Ref ID: 8 Abstract: Phonosurgery is an effective treatment for some vocal fold pathologies, and the Voice Handicap Index (VHI) survey has been shown to be a useful instrument for evaluating treatment effectiveness. We conducted a nonrandomized, prospective study of 21 patients who underwent phonosurgery for the treatment of non-neoplastic vocal fold lesions at our academic tertiary-care referral center. Our goals were to compare pre- and postoperative VHI scores (subjective assessments) and pre- and postoperative results of acoustic and aerodynamic tests (objective assessments). We sought to determine if there was any correlation between the subjective and objective findings. We looked for differences between professional voice users (n = 10) and nonprofessional voice users (n = 11) in both subjective and objective measures. We found statistically significant differences between pre- and postoperative values in three of four VHI parameters, but in only one of 13 objective measures. There was no correlation between preoperative VHI scores and preoperative acoustic and aerodynamic test results. The professional voice users expressed greater postoperative improvement as reflected by lower VHI scores than did the nonprofessional voice users, confirming that the former are more negatively affected by a voice disability (7) Chong E, Chan A. Subjective health complaints of teachers from primary and secondary schools in Hong Kong. Int J Occup Saf Ergon 2010;16:23-39. Ref ID: 358 Abstract: This study aimed to investigate the subjective health complaints (SHC) in the teaching profession of Hong Kong. On the basis of the SHC inventory, a questionnaire was prepared for data collection through a mail survey. A total of 1710 usable questionnaires were returned by the primary or secondary school teachers. The results showed that 99.5% (n = 1702) of respondents suffered at least one type of the 39 single health problems on the total SHC scale during the preceding 30 days. The 10 most frequently reported health complaints among the teachers were tiredness, eyestrain, anxiety, sleep problems, voice disorder, shoulder pain, neck pain, headache, cold/flu, and lower-back pain. With the exception of the category of pseudoneurological complaints, primary school teachers showed a statistically higher prevalence in reporting problems in 6 of 7 subscales. The 5 most severe complaints were tiredness, eyestrain, sleep problems, shoulder pain, and voice disorder (8) Cloud L, Jinnah HA. Treatment strategies for dystonia. Expert Opin Pharmacother 2010;11:5-15. Ref ID: 359 Abstract: Importance of the field: Dystonia is a neurological syndrome characterized by involuntary twisting movements and unnatural postures. It has many different manifestations and causes, and many different treatment options are available. These options include physical and occupational therapy, oral medications, intramuscular injection of botulinum toxins, and neurosurgical interventions. Areas covered in this review: In this review, we first summarize the treatment options available, then we provide suggestions from our own experience for how these can be applied in different types of dystonia. In preparing this review article, an extensive literature search was undertaken using PubMed. Only selected references from 1970 to 2008 are cited. What the reader will gain: This review is intended to provide the clinician with a practical guide to the treatment of dystonia. Take home message: Treatment of dystonia begins with proper diagnosis and classification, followed by an appropriate search for underlying etiology, and an assessment of the functional impairment associated with the dystonia. The therapeutic approach, which is usually limited to symptomatic therapy, must then be tailored to the individual needs of the patient (9) Da C, V, Prada E, Roberts A, Cohen S. Voice Disorders in Primary School Teachers and Barriers to Care. J Voice 2010. Ref ID: 2 Abstract: INTRODUCTION: Teachers have an increased prevalence of voice disorders that result in reduced activities, missed workdays, and occupation changes. However, only a small fraction of these teachers have sought professional help for their disorders. The purpose of this study was to elucidate some of the barriers to care that teachers may face. STUDY DESIGN: Cross-sectional survey. METHODS: One thousand subjects were randomly selected from a list of 95, 364 Kindergarten-12 teachers in North Carolina. Teachers were mailed a 43-item survey, with domains including demographics, personal voice health, and barriers to care using a five-point Likert scale. Results were tabulated, and statistical analysis was performed using the chi-square test. RESULTS: Two hundred forty-three responses were 5 received; 237 were complete. Twenty-two percent were currently hoarse. Fifty-eight percent had been hoarse at one point. Twenty-three percent had missed work for hoarseness. Only one-third (32.6%) had sought professional help. Women and those older than 45 years were more likely to seek help (P<0.001 and P=0.008, respectively). Fewer than half were aware of voice therapy or believed that a doctor could help. Thirty percent believed that hoarseness was normal in teaching. CONCLUSIONS: There are multiple barriers to care for the dysphonic teacher, including the lack of awareness of the availability of professional help. Further studies should evaluate teacher education and reducing barriers to care (10) de Alvear RM, Martinez-Arquero G, Baron FJ, Hernandez-Mendo A. An interdisciplinary approach to teachers' voice disorders and psychosocial working conditions. Folia Phoniatr Logop 2010;62:24-34. Ref ID: 11 Abstract: OBJECTIVES: The goals of this epidemiological paper are focused on studying teachers' vocal complaints, their voice pattern, and the impact of voice disorders on psychosocial working conditions. PATIENTS: A representative stratified random sample of 282 teachers from kindergartens and elementary schools was studied. Two types of self-report questionnaires were applied: an inquiry about teachers' occupational voice profile, and the adapted Spanish version of the Copenhagen Psychosocial Questionnaire (ISTAS-21). Pearson's chi(2) test was performed to search for statistical associations. RESULTS: 62.7% of subjects were experiencing occupational voice disorders; these teachers showed significantly worse psychosocial conditions than their healthy voice colleagues. CONCLUSIONS: Occupational voice disorders affect more than 60% of teachers and have an impact on their psychosocial working conditions. Interdisciplinary work is essential to shed light on these multifactor mechanisms and effects (11) Delgado MR, Hirtz D, Aisen M et al. Practice Parameter: Pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology 2010;74:336-343. Ref ID: 362 Abstract: OBJECTIVE: To evaluate published evidence of efficacy and safety of pharmacologic treatments for childhood spasticity due to cerebral palsy. METHODS: A multidisciplinary panel systematically reviewed relevant literature from 1966 to July 2008. RESULTS: For localized /segmental spasticity, botulinum toxin type A is established as an effective treatment to reduce spasticity in the upper and lower extremities. There is conflicting evidence regarding functional improvement. Botulinum toxin type A was found to be generally safe in children with cerebral palsy; however, the Food and Drug Administration is presently investigating isolated cases of generalized weakness resulting in poor outcomes. No studies that met criteria are available on the use of phenol, alcohol, or botulinum toxin type B injections. For generalized spasticity, diazepam is probably effective in reducing spasticity, but there are insufficient data on its effect on motor function and its side-effect profile. Tizanidine is possibly effective, but there are insufficient data on its effect on function and its side-effect profile. There were insufficient data on the use of dantrolene, oral baclofen, and intrathecal baclofen, and toxicity was frequently reported. RECOMMENDATIONS: For localized/segmental spasticity that warrants treatment, botulinum toxin type A should be offered as an effective and generally safe treatment (Level A). There are insufficient data to support or refute the use of phenol, alcohol, or botulinum toxin type B (Level U). For generalized spasticity that warrants treatment, diazepam should be considered for short-term treatment, with caution regarding toxicity (Level B), and tizanidine may be considered (Level C). There are insufficient data to support or refute use of dantrolene, oral baclofen, or continuous intrathecal baclofen (Level U). Copyright ® 2010 by AAN Enterprises, Inc (12) Hilger C, Swiontek K, Hentges F, Donnay C, De B, Pauli G. Occupational inhalant allergy to pork followed by food allergy to pork and chicken: Sensitization to hemoglobin and serum albumin. Int Arch Allergy Immunol 2010;151:173-178. Ref ID: 374 Abstract: Background: Animal-derived proteins are implicated in primary food allergies, but also in inhalant allergies with secondary food allergy symptoms. The objective of this study was to define the allergen(s) implicated in a case of food allergy to chicken meat, which developed in a person previously sensitized to pork after occupational exposure. Methods: A 42-year-old female with a history of occupational inhalant allergy to pork reported rhinitis, asthma, dysphonia and conjunctivitis 30 min after ingestion of chicken. Skin tests were positive to chicken meat. Protein extracts were prepared from chicken meat. Allergens were characterized by IgE immunoblotting, Nterminal sequencing and ELISA. Results: The patient showed specific IgE binding to chicken meat proteins at 12, 14, 26, 55 and 65 kDa. N-terminal amino acid sequencing identified the 12- and 14-kDa proteins as the alphaand beta-chain of hemoglobin. ELISA and immunoblot showed specific IgE binding to hemoglobin purified from chicken blood. IgE antibodies to chicken serum albumin were detected by ELISA. Inhibition studies with chicken and porcine hemoglobin as well as with serum albumins demonstrated crossreactive IgE antibodies. Conclusions: We report a case of confirmed occupational inhalant allergy due to pork followed by food allergy to pork and 3 years later by food allergy to chicken. Porcine and chicken hemoglobin were found to be cross- reactive allergens. Cross-reactivity between porcine and chicken serum albumin was possibly linked to a prior sensitization to cat serum albumin. Copyright ® 2009 S. Karger AG, Basel (13) Howell R, Davolos A, Clary M, Frake P, Joshi A, Chaboki H. Miller fisher syndrome presents as an acute voice change to hypernasal speech. Laryngoscope 2010;120:978-980. Ref ID: 375 Abstract: The authors describe a 38-year-old man who presented with hypernasality, perioral and acroparesthesia, dyspnea, and dysphagia. Further evaluation revealed a diagnosis of Miller-Fisher syndrome (MFS). MFS is a variant of Guillain-Barrq syndrome previously described in neurology and critical care journals; however, there is a paucity of work concerning this disease in the otolaryngology literature. An acute change in voice usually occurs secondary to inflammatory processes as seen after intubation and infection, but can occur as part of a more complex disease entity such as Guillain-Barrq or Miller-Fisher syndrome. As such, clinicians should consider this in their evaluation of rhinolalia aperta. ® 2010 The American Laryngological, Rhinological and Otological Society, Inc 7 (14) Lee SY, Lao XQ, Yu IT. A Cross-sectional Survey of Voice Disorders among Primary School Teachers in Hong Kong. J Occup Health 2010. Ref ID: 4 Abstract: Objective: The purpose of the study was to investigate the prevalence of voice disorders and associated risk factors among primary school teachers in Hong Kong. Methods: A cross-sectional survey was conducted based on a random sample of 20 primary schools in Hong Kong. A total of 714 full-time primary school teachers were invited to participate in the survey. Data were collected through a self-administered questionnaire addressing the prevalence of voice disorders and potential risk factors. Stepwise logistic regression was used to assess the associations between voice disorders and the different risk factors. Results: The response rate for the questionnaire was 69.7% (498/714). Among the teachers who responded, 348 (69.9%) had suffered from a voice disorder in the past 12 mo. Thirty-one teachers (8.9%) rated their voice disorders as minimal, 124 (35.6%) as mild, 151 (43.4%) as moderate, and 42 (12.1%) as severe. Of the 348 teachers reporting voice disorders, 215 (61.8%) had sought professional help for their voice problems. The univariate analyses showed that the factors significantly associated with voice disorders included talking quietly (p=0.018), using a microphone (p=0.002), speaking against background noise (p<0.001), consuming alcohol (p=0.027), and having a history of asthma (p=0.001), colds (p=0.012), sinusitis (p=0.039), or laryngitis (p<0.001). After adjusting for potential confounds, the significant risk factors included speaking against background noise (adjusted OR=1.8), alcohol consumption (adjusted OR=0.40), history of asthma (adjusted OR=3.3), or laryngitis (adjusted OR=4.2). Conclusions: Approximately 70% of the sampled primary school teachers were affected by voice disorders. A substantial proportion of the effected teachers suffered both functional and psychological adverse effects. The findings indicate an urgent need for further investigation to identify the risk factors for voice disorders and to develop preventive strategies for primary school teachers (15) Machalicek W, Sanford A, Lang R, Rispoli M, Molfenter N, Mbeseha MK. Literacy interventions for students with physical and developmental disabilities who use aided AAC devices: a systematic review. 2010;22(3):219-240. Ref ID: 472 (16) Marszalek S, Niebudek-Bogusz E, Woznicka E, Kowalska MS. [The application of physiotherapeutic and ostheopatic diagnostics in ocuppational voice disorders]. Med Pr 2010;61:205-211. Ref ID: 7 Abstract: The article presents the role of a physiotherapist and an ostheopath in the multidimensional management of occupational voice disorders. The influence ofbiomechanical characteristics of the musculo-fascial system on vocal apparatus is described. The visual and palpating methods used in physiotherapeutic/ostheopatic diagnostics, including the assessment of joint mobility and ergonomics in dynamic and static situations are also outlined (17) Povey AC, Rees HG, Thompson JP, Karalliedde L. Prospective cohort study of sheep dip exposure and 'dipper's flu'. 2010. HSE Research Report RR775. Ref Type: Report Ref ID: 473 Abstract: A prospective study was carried out to investigate the nature, frequency and signs of ill-health among farmers treating sheep for ectoparasites. Farmers were interviewed by a study nurse before and after treatment and also kept a symptom diary and measured their body temperature for 7 days following treatment. Blood and urine samples were collected. Blood samples were analysed for butyrylcholinesterase activity, clinical biochemistry and haematology parameters as well as serology for infectious pathogens. Urine samples were analysed for pesticide metabolites. Farmers reporting and not reporting symptoms following treatment were compared to examine the extent to which pesticide and other exposures were associated with ill-health (18) Richter B, Echternach M. Diagnostics and therapy in professional voice-users. HNO 2010;58:-398. Ref ID: 397 Abstract: Voice is one of the most important instruments for expression and communication in humans. Dysphonia remains very frequent. Generally people in voice-intensive professions, such as teachers, call center employees, singers and actors suffer from these complaints. In recent years methods have been developed which facilitate appropriate diagnosis and therapy, based on the criteria of evidence based medicine, in voice patients appropriate to their degree of disease. The basic protocol of the European Laryngological Society offers a standardized evaluation of multidimensional voice parameters. In our own patient collective there were statistically significant improvements in voice quality, according to a pre/post mean value comparison, in both phonomicrosurgical (n=45) and voice therapy (n=30) patients in relation to RBH, DSI and VHI. ® 2010 Springer Medizin Verlag (19) Romanenko SG, Pavlikhin OG. [Treatment of chronic tonsillitis in singers]. Vestn Otorinolaringol 2010;60-62. Ref ID: 6 Abstract: A total of 74 professional vocalists aged from 20 to 64 years with different forms of chronic tonsillitis were examined. Results of the study were used to develop recommendations for the treatment of chronic tonsillitis in patients of this category (20) Van HE, Claeys S, Wuyts F, Van LK. The Impact of Voice Disorders Among Teachers: Vocal Complaints, Treatment-Seeking Behavior, Knowledge of Vocal Care, and Voice-Related Absenteeism. J Voice 2010. Ref ID: 5 Abstract: OBJECTIVES: Teachers are at increased risk for developing voice disorders. Occupational risk factors have been extensively examined; however, little attention has been paid to the consequences of the vocal complaints. The objective of this study was to investigate the knowledge that teachers have about vocal care, treatment-seeking behavior, and voicerelated absenteeism. METHODS: The study group comprised 994 teachers and 290 controls whose jobs did not involve vocal effort. All participants completed a questionnaire inquiring about vocal complaints, treatmentseeking behavior, voice-related absenteeism, and knowledge about vocal care. Comparisons were made between teachers with and without vocal complaints and with the control group. RESULTS: Teachers reported significantly more voice problems than the control population (51.2% vs 27.4%) (chi(2)=50.45, df=1, P<0.001). Female teachers reported 9 significantly higher levels of voice disorders than their male colleagues (38% vs 13.2%, chi(2)=22.34, df=1, P<0.001). Teachers (25.4%) sought medical care and eventually 20.6% had missed at least 1 day of work because of voice problems. Female teachers were significantly more likely to seek medical help (chi(2)=7.24, df=1, P=0.007) and to stay at home (chi(2)=7.10, df=1, P=0.008) in comparison with their male colleagues. Only 13.5% of all teachers received information during their education. CONCLUSIONS: Voice disorders have an impact on teachers' personal and professional life and imply a major financial burden for society. A substantial number of teachers needed medical help and was obligated to stay at home because of voice problems. This study strongly recommends the implementation of vocal education during the training of teacher students to prepare the vocal professional user (21) Wang G, Han YY, Li F et al. [Voice fatigue test analysis in secondary school teachers.]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010;45:713718. Ref ID: 1 Abstract: OBJECTIVE: To investigate the status of voice fatigue and throat disease in the secondary school teachers in Urumqi. METHODS: This study included 11 689 teachers from 109 secondary schools offered by Teaching and Researching Center of Urumqi as the second-stage random sampling. Among them, 3217 teachers were selected to carry out voice fatigue test and routine examination of throat. For those with abnormal routine inspection results, the stroboscopic laryngoscopy were added. RESULTS: The failure rate difference of 3217 secondary school teachers voice fatigue tests during different periods had statistical significance (F = 202.653, P < 0.05). The failure rate difference of voice fatigue test among different throat diseases groups had statistical significance (F = 9.516, P < 0.05). There was statistical significance in failure rates of the voice fatigue tests between 908 cases of disease group and 2309 cases of normal group among different genders and periods (P < 0.05). Female teachers had higher failure rates than male teachers in voice fatigue tests. High failure rates appeared when high volume required for male and female teachers in voice fatigue tests. There was statistical significance in mean value sound pressure level (MVSPL) and mean value fundamental frequency (MVF0) of the voice fatigue tests between different gender and periods (P < 0.05). Male teachers had higher MVSPL than female teachers, female teachers had higher MVF0 than male teachers. There was statistical significance in failure rates of the voice fatigue tests among teachers from different tribes in different periods (P < 0.05). The Uighur had the highest failure rate, while Han had the lowest. Make further pairwise comparisons, failure rates difference of the Han and the Uighur in the voice fatigue tests during different periods had statistical significance. Comparison among other tribes had no statistical significance (P > 0.05). CONCLUSIONS: Voice fatigue is common in secondary school teachers. Female teachers tend to get voice fatigue more easily, when required high volume, the voice fatigue is more serious. Uighurs teachers have highest degree of voice fatigue (22) Ziegler A, Gillespie AI, Abbott KV. Behavioral treatment of voice disorders in teachers. Folia Phoniatr Logop 2010;62:9-23. Ref ID: 12 Abstract: INTRODUCTION: The purpose of this paper is to review the literature on the behavioral treatment of voice disorders in teachers. The focus is on phonogenic disorders, that is voice disorders thought to be caused by voice use. METHODS: Review of the literature and commentary. RESULTS: The review exposes distinct holes in the literature on the treatment of voice problems in teachers. However, emerging trends in treatment are noted. For example, most studies identified for review implemented a multiple-therapy approach in a group setting, in contrast to only a few studies that assessed a single-therapy approach with individual patients. Although the review reveals that the evidence around behavioral treatment of voice disorders in teachers is mixed, a growing body of data provides some indicators on how effectively rehabilitation of teachers with phonogenic voice problems might be approached. Specifically, voice amplification demonstrates promise as a beneficial type of indirect therapy and vocal function exercises as well as resonant voice therapy show possible benefits as direct therapies. Finally, only a few studies identified even remotely begin to meet guidelines of the Consolidated Standards of Reporting Trials statement, a finding that emphasizes the need to increase the number of investigations that adhere to strict research standards. CONCLUSIONS: Although data on the treatment of voice problems in teachers are still limited in the literature, emerging trends are noted. The accumulation of sufficient studies will ultimately provide useful evidence about this societally important issue (23) MEANING OF DISABILITY WIDENED. OCCUPATIONAL HEALTH AT WORK 2009. Ref ID: 476 Abstract: Details the House of Lords decision in the case of SCA Packaging v Boyle [2009] UKHL 37 which determined whether someone with a physical or mental impairment is covered by the Disability Discrimination Act 1995 (DDA). The judgement means that an individual will be 'disabled' if their condition is likely to become substantial in the future, with 'likely' meaning 'could well happen' rather than 'probable' - a change to previous guidance. Covers the case history of Elizabeth Boyle, who suffered from nodules on her vocal cords, indicating the reasons for the decision. Cites Susie Uppal from the Equality and Human Right Commission (EHRC) and the implications of the ruling (24) LORDS EXTEND DISCRIMINATION PROTECTION TO CASES OF FLUCTUATING DISABILITY. Occup Health 2009. Ref ID: 475 Abstract: Refers to the case of Boyle v SCA Packaging Ltd, in which the House of Lords concluded whether someone with a physical or mental disability is covered by the Disability Discrimination Act 1995. Decision means that an individual with an impairment that 'could' well become substantial in the future will now be covered by the legislation, rather than the present 'more likely than not' guidelines. Mentions that the case may have implications for workers with conditions such as diabetes or epilepsy, whose disability is concealed from view so long as it controlled by medication. Reviews the case history of Elizabeth Boyle, who suffered from nodules on her vocal chords, and cites comments from the Law Lords concerned with the case (25) Engineered nanomaterials: A review of the toxicology and health hazards. 2009. Ref Type: Report Ref ID: 474 Abstract: This review reports the current understanding of the toxicology and 11 health hazards associated with engineered nanomaterials, and the implications in regard to health hazards in occupational settings (i.e. during manufacture, handling, and use). It updates a previous review by the Australian Safety and Compensation Council. The information in this review is based on scientific literature published from 2006 to 2008, however, during the editorial phase some important publications from the first half of 2009 have been incorporated (26) Partial laryngectomy - Occupational handicap due to voice disorder. Laryngo Rhino Otol 2009;88:692-693. Ref ID: 338 (27) Angelillo M, Di MG, Costa G, Angelillo N, Barillari U. Prevalence of occupational voice disorders in teachers. J Prev Med Hyg 2009;50:26-32. Ref ID: 16 Abstract: INTRODUCTION: In Italy the number of teachers among private and public schools is around one million. Voice disorders are thought to be one of the major occupational hazards of school teaching; in fact the teachers often use their voice with high-intensity, in noisy classes, for a long time and without suitable breaks. The aim of the study was to assess the prevalence of voice problems in teachers of Naples district, identifying risk factors for developing voice pathology. METHODS: In this study we evaluated 504 teachers (322 F-182 M) with an age ranging between 24 and 62 years, randomly choiced in 28 schools of the district of Naples submitted to a questionnaire to determine the prevalence of voice disorders. In our study we have also introduced a comparison group of not-teachers workers of 402 subjects (244 F-158 M); they were in the same age range as the teacher sample (range: 22-65 years). The control group was also submitted to a questionnaire regarding sociodemographic characteristics, smoking and alcohol use, a self-report of voice problems, voice symptoms, frequency of acute and chronic voice problems, absenteeism due to voice problems. RESULTS: The prevalence of reporting a current voice problem was significantly greater in teachers compared with not-teachers (8.7% vs 2.9%), as the prevalence of voice disorders during their lifetime too (51.4% vs 25.9%), chi2 = 86.672, p < 0.001. Women, compared with men had a higher lifetime prevalence of voice disorders. An other important data evidenced, is that 116 workers of the teachers group (23.01%) have been forced, during their professional activity, to miss job for problems related to voice; only 22 subjects of control group (5.47%) instead, missed job for voice troubles. DISCUSSION AND CONCLUSIONS: This study confirms that teachers have a higher rate of self-reported voice problems than subjects working in other occupations. Teachers, compared with not-teachers, were significantly more likely to have experienced multiple voice symptoms including hoarseness, discomfort while using their voice, difficulty projecting their voice and tiring or change in voice quality after short use. Large proportion of these problems may be preventable and prevention programs need to be developed and evaluated. Italian teachers do not receive any preventive voice training; that, in combination with poor hygienic work conditions, could increase health problems. Thus, voice training of teachers and teacher college students in some cases should be considered as a useful tool to prevent voice disorders (28) Behlau M, Oliveira G. Vocal hygiene for the voice professional. Curr Opin Otolaryngol Head Neck Surg 2009;17:149-154. Ref ID: 20 Abstract: PURPOSE: This article presents the current state of knowledge regarding vocal hygiene for the voice professional. RECENT FINDINGS: Research regarding vocal hygiene has primarily focused on two areas: vocal hygiene as a preventive strategy, and vocal hygiene as a management technique for individuals with voice disorders. It is difficult to assess the effectiveness of vocal hygiene as a preventive tool as programs are often expensive leading to limited data. Vocal hygiene as a sole strategy for the treatment of voice disorders has shown minimal, but favorable results. As a component of a comprehensive therapeutic program, it is difficult to isolate the influence of vocal hygiene. However, limited components of vocal hygiene including hydration and vocal rest have been associated with improved therapeutic outcomes. In addition, the current literature proposes a paradigm shift away from more restrictive therapy approaches to a holistic approach to vocal well being. SUMMARY: Vocal hygiene should be considered only as a component of a broad vocal rehabilitation program. The role of vocal hygiene as a means to prevent voice disorders remains unproven. Additionally, some of the findings may be applied to both dysphonic and healthy individuals in order to facilitate vocal well being (29) Braun-Janzen C, Zeine L. Singers' interest and knowledge levels of vocal function and dysfunction: survey findings. J Voice 2009;23:470-483. Ref ID: 33 Abstract: A questionnaire investigating the levels of interest in and knowledge of vocal function and dysfunction was completed by 129 singers. Those with professional singing experience indicated significantly greater interest and higher perceived knowledge levels than amateurs in areas of vocal anatomy and physiology, vocal hygiene, and functional vocal pathologies. Greater interest levels, but not higher perceived knowledge levels were reported by professional singers (PSs) in the area of the role of the speech-language pathologist (SLP) and the voice. Professionals answered significantly more knowledge-based questions correctly than amateurs in all areas except the role of the SLP and the voice. However, findings indicated wide variability in knowledge levels of both groups. Singing teachers (STs) within the group significantly outperformed the remainder of the group in areas of vocal anatomy and physiology, vocal hygiene, and functional vocal pathologies. Scores of the choir directors (CDs) within the group were not significantly superior to the remainder of the group except in the area of functional vocal pathologies. Implications for a preventative approach to vocal health are discussed (30) Burns JA, Hillman RE, Stadelman-Cohen T, Zeitels SM. Phonomicrosurgical treatment of intracordal vocal-fold cysts in singers. Laryngoscope 2009;119:419-422. Ref ID: 24 (31) Charbotel B, Croidieu S, Vohito M et al. Working conditions in call-centers, the impact on employee health: A transversal study. Part II. Int Arch Occup Environ Health 2009;82:747-756. Ref ID: 357 Abstract: Purpose: The present study sought to assess the impact of telephone call center employees' working conditions on health by identifying at- risk employment situations. Methods: A transversal study was performed 13 in companies followed by 47 occupational physicians taking part (working conditions have been previously described). A self- administered medical questionnaire was used to collect data on absence due to sick leave, hearing and visual problems, musculoskeletal disorders, psychotropic drug use, etc. An analog-scale self-assessment of health status and a general health questionnaire (GHQ-12) were used. Personal or familial events that might underlie health problems and affect GHQ-12 results were quantified and taken into account in a logistic regression. Results: A total of 2,130 call-handlers were included. Workers who had availed sick leave during the previous 12 months were 60%. The most frequent musculoskeletal complaints over the previous 12-month period concerned the cervical region (59%). During the same period, 77.3% of subjects experienced visual fatigue, 50% reported auditory fatigue signs and 47% vocal disturbance or fatigue. According to the Likert scale, 39.4% of workers had showed psychological distress. Almost 24% of the workers had used psychoactive medication during the previous 12 months. A significant association was found between psychological distress and the frequency of musculoskeletal disorders. Psychological distress and musculoskeletal disorders were significantly greater in workers with Job Strain and Iso Strain. After taking non-occupational factors into account, some occupational factors were found to increase the risk of psychological distress (Likert >12): imposed full-time schedule, being unable to simultaneously meet both quality and quantity requirements, situations of tension with clients, negative comments from superiors, and lack of recognition from superiors. Conclusions: This survey of over 2,000 call center employees highlighted the high frequency of psychological distress in this population and the health impact of working conditions. ® Springer-Verlag 2008 (32) Day K, Salamanca B, Regan T, Boswell K, Seal B, Reeder G. Asthma disease burden and formulary decision making: MCO and employer perspectives. Drug Benefit Trends 2009;21:43-49. Ref ID: 361 Abstract: Asthma affects approximately 22 million adults and children in the United States and poses a significant economic burden on the health care system and on employers. According to the National Heart, Lung, and Blood Institute, direct and indirect costs for all forms of asthma totaled $19.7 billion in 2007. Prescription drugs represented the largest single direct cost at $6.2 billion. To gather information about asthma burden and any evidentiary requirements and product attributes that may influence formulary decision making for an emerging inhaled corticosteroid (ICS) asthma therapy, decision makers at 10 MCOs and 8 employers with more than 51 million members were interviewed. MCO decision makers reported that the economic impact of asthma was most notable in hospitalizations, emergency department visits, and prescription drugs, followed by physician office visits and medication adverse events. Employers indicated the impact of asthma on absenteeism, productivity, presenteeism, and employer health care costs. Efficacy, safety, cost, and adherence were found to be the primary factors that influence formulary decision makers when they evaluate emerging ICS asthma therapies (33) Gaskill C, Weems W. Occupational vocal health: an emerging workplace wellness issue. Occup Health Saf 2009;78:44-46. Ref ID: 367 (34) Grell A, Sundberg J, Ternstrom S, Ptok M, Altenmuller E. Rapid pitch correction in choir singers. J Acoust Soc Am 2009;126:407-413. Ref ID: 18 Abstract: Highly and moderately skilled choral singers listened to a perfect fifth reference, with the instruction to complement the fifth such that a major triad resulted. The fifth was suddenly and unexpectedly shifted in pitch, and the singers' task was to shift the fundamental frequency of the sung tone accordingly. The F0 curves during the transitions often showed two phases, an initial quick and large change followed by a slower and smaller change, apparently intended to fine-tune voice F0 to complement the fifth. Anesthetizing the vocal folds of moderately skilled singers tended to delay the reaction. The means of the response times varied in the range 197- 259 ms depending on direction and size of the pitch shifts, as well as on skill and anesthetization (35) Hazlett DE, Duffy OM, Moorhead SA. Occupational voice demands and their impact on the call-centre industry. BMC Public Health 2009;9:108. Ref ID: 370 Abstract: BACKGROUND: Within the last decade there has been a growth in the call-centre industry in the UK, with a growing awareness of the voice as an important tool for successful communication. Occupational voice problems such as occupational dysphonia, in a business which relies on healthy, effective voice as the primary professional communication tool, may threaten working ability and occupational health and safety of workers. While previous studies of telephone call-agents have reported a range of voice symptoms and functional vocal health problems, there have been no studies investigating the use and impact of vocal performance in the communication industry within the UK. This study aims to address a significant gap in the evidence-base of occupational health and safety research. The objectives of the study are: 1. to investigate the work context and vocal communication demands for callagents; 2. to evaluate call-agents' vocal health, awareness and performance; and 3. to identify key risks and training needs for employees and employers within call-centres. METHODS AND DESIGN: This is an occupational epidemiological study, which plans to recruit call-centres throughout the UK and Ireland. Data collection will consist of three components: 1. interviews with managers from each participating call-centre to assess their communication and training needs; 2. an online biopsychosocial questionnaire will be administered to investigate the work environment and vocal demands of call-agents; and 3. voice acoustic measurements of a random sample of participants using the Multi-dimensional Voice Program (MDVP). Qualitative content analysis from the interviews will identify underlying themes and issues. A multivariate analysis approach will be adopted using Structural Equation Modelling (SEM), to develop voice measurement models in determining the construct validity of potential factors contributing to occupational dysphonia. Quantitative data will be analysed using SPSS version 15. Ethical approval is granted for this study from the School of Communication, University of Ulster. DISCUSSION: The results from this study will provide the missing element of voice-based evidence, by appraising the interactional dimensions of vocal health and communicative performance. This information will be used to inform training for call-agents and to contribute to health policies within the workplace, in order to enhance vocal health 15 (36) Ilomaki I, Leppanen K, Kleemola L, Tyrmi J, Laukkanen AM, Vilkman E. Relationships between self-evaluations of voice and working conditions, background factors, and phoniatric findings in female teachers. Logoped Phoniatr Vocol 2009;34:20-31. Ref ID: 21 Abstract: Self-evaluations of voice, working conditions, and results of phoniatric examination were studied in 78 female primary school teachers. Most teachers evaluated their vocal capabilities as 'normal'; nevertheless 1/3 reported two or more weekly symptoms. Unsatisfactory air quality, background noise, and stressful working conditions were seen as the most harmful environmental factors. A total of 14% of the subjects had organic laryngeal changes, 37% had mild changes, and 49% were found to be healthy. These findings did not correlate with self-evaluation of voice, vocal symptoms, or voice-related quality of life. Teaching experience or teaching hours per week did not correlate with laryngeal findings or symptoms. The results illustrate the complex nature of voice assessment and the need of assessment tools specially suited for functionally healthy voice professionals (37) Jahn A. Medical management of the professional singer; An Overview. Med Probl Perform Artists 2009;24:3-9. Ref ID: 376 Abstract: Caring for the professional singer, whether an operatic performer or serious amateur, involves careful consideration of both physical and emotional components, as it does in other performing artists. However, because the head and neck contain representatives of other major organ systems in close proximity to the phonating larynx, singing is additionally vulnerable to a range of diseases of the respiratory, gastrointestinal, and endocrine systems. This review provides an overview of the conditions typically encountered in singers These include occupational disorders (muscle tension dysphonia, vocal nodules, vocal hemorrhage and polyps, chronic voice deterioration), general health issues with vocal implications (respiratory diseases, gastric reflux, endocrine problems, medication usage), as well as lifestyle considerations (38) Kob M, Dejonckere P. "Advanced Voice Function Assessment"-Goals and activities of COST Action 2103. Biomed Signal Process Control 2009;4:173175. Ref ID: 378 Abstract: The COST Action 2103 "Advanced Voice Function Assessment" is a joint initiative of speech processing teams (engineers and physicists) and the European Laryngological Research Group (ELRG) (laryngologists /phoniatricians). The Action officially started in December 2006, and is running till the end of 2010. 17 European countries are involved. A main objective is a better understanding of the relationship between biomechanical changes at the level of the vocal folds - as induced by pathology and tissue reaction to strain - and alterations of the acoustical voice signal. This needs to result in developing accurate, objective and clinically useful methods of investigation of voice quality in patients, and of strategies for preventing occupational voice disorders in professional speakers. Modelling is an essential tool in this process. ® 2009 Elsevier Ltd. All rights reserved (39) Kuzanska A, Niebudek-Bogusz E, Woznicka E, Kopczynska J, SliwinskaKowalska M. [Comparison of VHI scores in teachers with voice disorders and the non-professional dysphonic population]. Med Pr 2009;60:283-288. Ref ID: 14 Abstract: BACKGROUND: The aim of this study was to assess the application of Voice Handicap Index (VHI) in the diagnosis of occupational voice disorders in teachers as compared with the dysphonic non-teachers population. MATERIALS AND METHODS: The subjective assessment of voice by VHI was performed in 105 teachers with dysphonia and 60 dysphonic subjects whose jobs did not involve vocal effort. The control group comprised 65 healthy individuals with normal voice. RESULTS: The results of total VHI score and each of its subscales, functional, emotional and physical, were significantly worse in the study groups (I and II) than in the control group (p < 0.001). The analysis of VHI-score distribution showed that the highest percentage of subjects in groups I and II self-assessed their own voice problems as moderate disability (67% and 57%), while 20% of teachers and 16% of nonteachers reported severe voice disability. All individuals in the control group assessed their voice problems as minor, their results fell within the range of the lowest level of VHI score. CONCLUSIONS: This study confirmed that VHI as a tool for self-assessment of voice can significantly contribute to the diagnosis of occupational and non-occupational dysphonia (40) Nerriere E, Vercambre MN, Gilbert F, Kovess-Masfety V. Voice disorders and mental health in teachers: a cross-sectional nationwide study. BMC Public Health 2009;9:370. Ref ID: 15 Abstract: BACKGROUND: Teachers, as professional voice users, are at particular risk of voice disorders. Among contributing factors, stress and psychological tension could play a role but epidemiological data on this problem are scarce. The aim of this study was to evaluate prevalence and cofactors of voice disorders among teachers in the French National Education system, with particular attention paid to the association between voice complaint and psychological status. METHODS: The source data come from an epidemiological postal survey on physical and mental health conducted in a sample of 20,099 adults (in activity or retired) selected at random from the health plan records of the national education system. Overall response rate was 53%. Of the 10,288 respondents, 3,940 were teachers in activity currently giving classes to students. In the sample of those with complete data (n = 3,646), variables associated with voice disorders were investigated using logistic regression models. Studied variables referred to demographic characteristics, socio-professional environment, psychological distress, mental health disorders (DSM-IV), and sick leave. RESULTS: One in two female teachers reported voice disorders (50.0%) compared to one in four males (26.0%). Those who reported voice disorders presented higher level of psychological distress. Sex- and age-adjusted odds ratios [95% confidence interval] were respectively 1.8 [1.5-2.2] for major depressive episode, 1.7 [1.3-2.2] for general anxiety disorder, and 1.6 [1.2-2.2] for phobia. A significant association between voice disorders and sick leave was also demonstrated (1.5 [1.3-1.7]). CONCLUSION: Voice disorders were frequent among French teachers. Associations with psychiatric disorders suggest that a situation may exist which is more complex than simple mechanical failure. Further longitudinal research is needed to clarify the comorbidity between voice and psychological disorders (41) Neumann K, Kob M. Folia Phoniatrica et Logopaedica: Editorial. Folia Phoniatrica et Logopaedica 2009;61:125. 17 Ref ID: 388 (42) Nguyen DD, Kenny DT. Effects of muscle tension dysphonia on tone phonation: acoustic and perceptual studies in Vietnamese female teachers. J Voice 2009;23:446-459. Ref ID: 35 Abstract: Muscle tension dysphonia (MTD) is a hyperfunctional voice disorder commonly seen in professional voice users. To date, published acoustic studies of this disorder have mainly focused on nontonal language speakers, and no publication has documented its impact on lexical tone characteristics. In this study, we examined whether and how this voice disorder affected acoustically and perceptually the characteristics of tones in Vietnamese teachers. Voice data were obtained from 42 Vietnamese female primary school teachers diagnosed with MTD and 30 vocally healthy teachers. Tonal data were analyzed using Computerized Speech Lab (CSL-4300B) and Speech Analyzer. Parameters analyzed included the two most important acoustic cues in Vietnamese tones, that is, tonal fundamental frequency (F(0)) and laryngealization. Tonal F(0) was assessed using a factorial analysis of variance with group and career durations as independent variables. Tonal samples were also perceptually assessed by a panel of native speakers of the same dialect. The results showed that MTD lowered tonal F(0) in high tones and tones with extensive fundamental frequency variation. There was also a significant main effect for career duration; in MTD group, tonal F(0) was lower in teachers with longer career duration. The teachers with MTD showed different patterns of laryngealization compared with the control group. Tone perception was poorer for tones with extensive fundamental frequency variation and without a typical phonation type. The results in this group of teachers supported our hypothesis that MTD impairs lexical tone phonation (43) Nguyen DD, Kenny DT, Tran ND, Livesey JR. Muscle tension dysphonia in Vietnamese female teachers. J Voice 2009;23:195-208. Ref ID: 44 Abstract: There has been no published research on muscle tension dysphonia (MTD) in speakers who use a tonal language. Using a sample of 47 Northern Vietnamese female primary school teachers with MTD, we aimed to discover whether professional voice users of tonal languages presented with the same symptoms of MTD as speakers of nontonal languages and whether they presented with additional symptoms as a result of speaking a tonal language. The vocal characteristics were assessed by use of a questionnaire and expert perceptual evaluation. Laryngeal features were assessed by photolaryngoscopy. The results showed that MTD was associated with a larger number of vocal symptoms than previously reported. However, the participants did not have the same vocal symptoms reported in English speakers, for example, hard glottal attack, pitch breaks, unusual speech rate, and glottal fry. Factor analysis of the vocal symptoms revealed three factors: "vocal fatigue/hyperfunction," "physical discomfort," and "voice quality," all of which demonstrated high reliability. The major laryngeal characteristic was a glottal gap. The glottal shapes observed included: 44.7% had an incomplete closure, 29.8% a posterior gap, 12.8% an hourglass-shaped gap, 8.5% a spindle-shaped gap, and 4.3% had complete glottal closure. The findings implied a potential contribution of linguistic-specific factors and teachingrelated factors to the presentation of this voice disorder in this group of teachers (44) Nguyen DD, Kenny DT. Randomized controlled trial of vocal function exercises on muscle tension dysphonia in Vietnamese female teachers. J Otolaryngol Head Neck Surg 2009;38:261-278. Ref ID: 19 Abstract: OBJECTIVE: This study evaluated the treatment effects of vocal function exercises on muscle tension dysphonia (MTD) in tonal language speakers. DESIGN: Single-blinded, randomized, controlled, clinical trial. METHODS: Forty female primary school teachers from Northern Vietnam, diagnosed with MTD, were randomly allocated into a treatment group (n = 22), which used a full vocal exercise protocol (FE) (modified for use with Vietnamese speakers), and a control group (n = 18) which was treated with a partial vocal exercise protocol (PE). The treatment duration was 4 weeks for both groups. MAIN OUTCOME MEASURES: Acoustic and perceptual data were used as primary outcome measures. Acoustic parameters included frequency and amplitude perturbation, harmonics-to-noise ratio (HNR), mean fundamental frequency of the broken and rising tones, and parameters representing pitch movement in the rising tone. Perceptual analyses were performed on pre- and posttreatment samples of the sustained /a/ sound using anchor vocal samples. Self-report data, collected via a posttreatment questionnaire, comprised the secondary outcome measure. RESULTS: Significant changes in perturbation, HNR, and perceptual data were observed in the FE group but not in the PE group. The FE group showed increased size and speed of pitch change. Participants from both groups showed positive changes in some tonal parameters after treatment. However, the magnitude of change and the number of participants with positive changes were larger in the FE group. CONCLUSION: The data showed that vocal function exercises may be a cost-effective treatment for MTD (45) Nguyen DD, Kenny DT. Impact of muscle tension dysphonia on tonal pitch target implementation in vietnamese female teachers. J Voice 2009;23:690698. Ref ID: 32 Abstract: Muscle tension dysphonia (MTD) is a voice disorder with deteriorated vocal quality, particularly pitch problems. Because pitch is mainly controlled by the laryngeal muscles, and because MTD is characterized by increased laryngeal muscle tension, we hypothesized that it may result in problems in pitch target implementation in tonal languages. We examined tonal samples of 42 Vietnamese female primary school teachers diagnosed with MTD and compared them with 30 vocally healthy female teachers who spoke the same dialect. Tonal data were analyzed using Computerized Speech Lab (CSL-4300B) for Windows. From tonal sampling bases, fundamental frequency (F0) was measured at target points specified by contour examination. Parameters representing pitch movement including time, size, and speed of movement were measured for the falling tone and rising tone. We found that F0 at target points in MTD group was lowered in most tones, especially tones with extensive F0 variation. In MTD group, target F0 of the broken tone in isolation was 37.5 Hz lower (P<0.01) and target F0 of rising tone in isolation was 46 Hz lower (P<0.01) than in control group. In MTD group, speed of pitch fall of the falling tone in isolation was faster than control group by 2.2 semitones/second (st/s) (P<0.05) and speed of pitch rise in the rising tone in isolation was slower than control group by 7.2 st/s (P<0.01). These results demonstrate that MTD is associated with problems in tonal pitch variation 19 (46) Niebudek-Bogusz E. [Occupational dysphonia management in different countries of the European Union and throughout the world]. Med Pr 2009;60:151-158. Ref ID: 17 Abstract: Teachers are significantly more likely to develop multiple voice problems than non-teachers. The article presents methods for the diagnoses and treatment of occupational dysphonia in different countries of the European Union and throughout the world. Conclusions comprise the implications concerning the model of dysphonic teachers management in Poland, putting strong emphasis on the necessity for multidimensional therapy in collaboration with otolaryngologist/phoniatrician, logopedist/speech therapist and also psychologist/physiotherapist. The importance of training professional voice users in vocal hygiene and healthy voice habits has also been emphasized (47) Oliveira AG, Behlau M, Gouveia N. Vocal symptoms in telemarketers: a random and controlled field trial. Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics 2009;61:76-82. Ref ID: 454 Abstract: The present study was carried out to evaluate the effectiveness of a specific program regarding the occurrence of vocal attrition symptoms in telemarketers. A total of 71 subjects participated in this study: 28 completed the Vocal Symptoms questionnaire to test its reliability, and 43 were randomly assigned to two groups: an 8-week vocal training group (n = 14) and a notraining control group (n = 29), to evaluate the effectiveness of the training program with this tool. The voice training group also filled in the posttraining questionnaire 'Benefits Obtained with Voice Training' (BVT). The vocal training program was not considered effective with regard to the occurrence of vocal symptoms. However, due to a probable increase in symptoms in untrained telemarketers, it can work as a protective factor. According to BVT answers, the vocal training contributed to an improvement in vocal use as a communication tool for telemarketers (48) Pennington L, Miller N, Robson S. Speech therapy for children with dysarthria acquired before three years of age. Pennington Lindsay , Miller Nick , Robson Sheila Speech therapy for children with dysarthria acquired before three years of age Cochrane Database of Systematic Reviews: Reviews 2009 Issue 4 John Wiley & Sons , Ltd Chichester, UK DOI : 10 1002 /14651858 2009. Ref ID: 458 Abstract: BACKGROUND: Children with motor impairments often have the motor speech disorder dysarthria, a condition which effects the tone, power and coordination of any or all of the muscles used for speech. Resulting speech difficulties can range from mild, with slightly slurred articulation and low-pitched voice, to profound, with an inability to produce any recognisable words. Children with dysarthria are often prescribed communication aids to supplement their natural forms of communication. However, there is variation in practice regarding the provision of therapy focusing on voice and speech production. Descriptive studies have suggested that therapy may improve speech, but its effectiveness has not been evaluated. OBJECTIVES: To assess whether direct intervention aimed at improving the speech of children with dysarthria is more effective than no intervention at all. To assess whether individual types of intervention are more effective than others in improving the speech intelligibility of children with dysarthria. SEARCH STRATEGY: We searched CENTRAL, MEDLINE, EMBASE, CINAHL , LLBA, ERIC, PsychInfo, Web of Science, Scopus, UK National Research Register and Dissertation Abstracts up to April 2009, handsearched relevant journals published between 1980 and April 2009, and searched proceedings of relevant conferences between 19962009. SELECTION CRITERIA: We considered randomised controlled trials and studies using quasi-experimental designs in which children were allocated to groups using non-random methods. DATA COLLECTION AND ANALYSIS: L Pennington conducted searches of all databases and conference reports. L Pennington, N Miller and S Robson handsearched journals. All searches included a reliability check in which a second review author independently checked a random sample comprising 15% of all identified reports. We planned that two review authors would independently assess the quality and extract data from eligible studies. MAIN RESULTS: No randomised controlled trials or group studies were identified. AUTHORS' CONCLUSIONS: We found no firm evidence of the effectiveness of speech and language therapy to improve the speech of children with early acquired dysarthria. No change in practice is warranted at the present time. Rigorous research is needed to investigate if the positive changes in children's speech observed in small descriptive studies are shown in randomised controlled trials. Research should examine change in children's speech production and intelligibility. It should also investigate the secondary education, health and social care outcomes of intervention, including children's interaction with family, friends and teachers, their participation in social and educational activities, and their quality of life. Cost and acceptability of interventions must also be investigated. SPEECH THERAPY FOR CHILDREN WITH EARLY ACQUIRED DYSARTHRIA: Dysarthria is a disorder which reduces the control of movements for speech. Children with dysarthria often have shallow, irregular breathing and speak on small, residual pockets of air. They have low pitched, harsh voices, nasalised speech and very poor articulation. Together, these difficulties make the children's speech difficult to understand. Dysarthria is caused by neurological impairment and can arise early in children's lives, from neurological damage sustained before, during or after birth, such as in cerebral palsy, or in early childhood through traumatic brain injury or neurological disease. Communication difficulties have a profound impact on children's development. They reduce the quality of life of children with cerebral palsy and place children at risk of social exclusion, educational failure and later unemployment. Speech and language therapy aims to help children to control the movements for breathing and speech and so become more intelligible. Small, observational studies have suggested that for some children therapy might have been associated with positive changes in intelligibility and clarity of children's voices. This review aimed to investigate if therapy is generally effective for children with dysarthria acquired early in life, and if certain types of therapy may be better than others. We found no randomised controlled trials or controlled group studies which investigate the effects of speech and language therapy to improve the speech of children with dysarthria acquired below three years of age. Rigorous research, using randomised controlled trials, is needed to evaluate if therapy can help children to increase the intelligibility of their speech and if enhanced intelligibility increases children's participation in social and educational activities and their quality of life (49) Roers F, Murbe D, Sundberg J. Voice classification and vocal tract of singers: a study of x-ray images and morphology. J Acoust Soc Am 2009;125:503-512. 21 Ref ID: 23 Abstract: This investigation compares vocal tract dimensions and the classification of singer voices by examining an x-ray material assembled between 1959 and 1991 of students admitted to the solo singing education at the University of Music, Dresden, Germany. A total of 132 images were available to analysis. Different classifications' values of the lengths of the total vocal tract, the pharynx, and mouth cavities as well as of the relative position of the larynx, the height of the palatal arch, and the estimated vocal fold length were analyzed statistically, and some significant differences were found. The length of the pharynx cavity seemed particularly influential on the total vocal tract length, which varied systematically with classification. Also studied were the relationships between voice classification and the body height and weight and the body mass index. The data support the hypothesis that there are consistent morphological vocal tract differences between singers of different voice classifications (50) Roers F, Murbe D, Sundberg J. Predicted singers' vocal fold lengths and voice classification-a study of x-ray morphological measures. J Voice 2009;23:408413. Ref ID: 39 Abstract: Students admitted to the solo singing education at the University of Music Dresden, Germany have been submitted to a detailed physical examination of a variety of factors with relevance to voice function since 1959. In the years 1959-1991, this scheme of examinations included X-ray profiles of the singers' vocal tracts. This material of 132 X-rays of voice professionals was used to investigate different laryngeal morphological measures and their relation to vocal fold length. Further, the study aimed to investigate if there are consistent anatomical differences between singers of different voice classifications. The study design used was a retrospective analysis. Vocal fold length could be measured in 29 of these singer subjects directly. These data showed a strong correlation with the anterior-posterior diameter of the subglottis and the trachea as well as with the distance from the anterior contour of the thyroid cartilage to the anterior contour of the spine. These relations were used in an attempt to predict the 132 singers' vocal fold lengths. The results revealed a clear covariation between predicted vocal fold length and voice classification. Anterior-posterior subglottic-tracheal diameter yielded mean vocal fold lengths of 14.9, 16.0, 16.6, 18.4, 19.5, and 20.9mm for sopranos, mezzo-sopranos, altos, tenors, baritones, and basses, respectively. The data support the assumption that there are consistent anatomical laryngeal differences between singers of different voice classifications, which are of relevance to pitch range and timbre of the voice (51) Rosenman K. Asthma, hypersensitivity pneumonitis and other respiratory diseases caused by metalworking fluids. Curr Opin Allergy Clin Immunol 2009;9:97-102. Ref ID: 400 Abstract: Both asthma and hypersensitivity pneumonitis occur among workers exposed to metalworking fluid. The incidence of these diseases among such workers is unknown. Outbreaks of these conditions continue to be identified among metal machinists. Whether these are true outbreaks associated with some breakdown in workplace controls or, rather the recognition of ongoing endemic disease that is typically misdiagnosed as pneumonia or common adult onset asthma, needs further evaluation. Further work to elucidate the specific causal agent(s) is necessary to affect effective workplace controls. Treating an identified individual case as an index case with a followup workplace investigation will only be possible if practicing physicians interact with public health authorities to report newly diagnosed cases (52) Tonini S, Dellabianca A, Costa C, Lanfranco A, Scafa F, Candura SM. Irritant vocal cord dysfunction and occupational bronchial asthma: differential diagnosis in a health care worker. Int J Occup Med Environ Health 2009;22:401-406. Ref ID: 13 Abstract: OBJECTIVES: Vocal cord dysfunction (VCD) is an uncommon respiratory disease characterized by the paradoxical adduction of vocal cords during inspiration, that may mimic bronchial asthma. The pathogenesis of VCD has not been clearly defined but it is possible to recognize nonpsychologic and psychologic causes. The majority of patients are female but, interestingly, a high incidence of VCD has been documented in health care workers. A misdiagnosis with asthma leads to hospitalisation, unnecessary use of systemic steroids with related adverse effects, and sometimes tracheostomy and intubation. In a subset of VCD patients, the disease can be attributed to occupational or environmental exposure to inhaled irritants. MATERIALS AND METHODS: We report the case of a 45-year-old woman, working as a nurse, who complained of wheezing, cough, dyspnoea related to inhalation of irritating agents (isopropylic alcohol, formaldehyde, peracetic acid). She underwent chest radiography, pulmonary function assessment both in the presence and in the absence of symptoms, bronchial provocation with methacholine and bronchodilation test with salbutamol to recognize asthma's features, allergy evaluation by skin prick tests and patch tests and videolaryngoscopy. RESULTS: VCD diagnosis was made on the basis of videolaryngoscopy, that visualized the paradoxical motion of the vocal cords during symptoms, in the absence of other pathologic processes. CONCLUSIONS: This case fulfils the proposed criteria for the diagnosis of irritant VCD (IVCD). This is the first report of VCD onset following exposure to several irritants: formaldehyde, glutaraldehyde, sopropylic alcohol, peracetic acid-hydrogen peroxide mixture. These substances are used as cleaning and antiseptic agents in healthcare settings and some ones can also be found in many indoor environments. A correct diagnosis is important both to give the appropriate treatment and for medical legal implications (53) Wiskirska W, Wojnowski W. [The smokers voice self assessment based on Voice Handicap Index (VHI)]. Przegla ̧ ;d lekarski 2009;66:565-566. Ref ID: 469 Abstract: Complex voice assessment due to European Laryngeal Society proposals (2000) contains voice self estimation based on the Polish version of the Voice Handicap Index (VHI). This study focuses on the relation between voice handicap and smoking in dysphonic patients, who are using voice professionally. Thirty outpatient (25 female and 5 male, aged 40 to 55 years) voice department attendees suffering from professional dysphonia took part in this study. All patients after phoniatric examination completed the Polish version of the Voice Handicap Index (VHI). The questions concern functional, emotional and physical complains due to dysphonia. Most of smokers did not complain of dysphonia related problems comparing to non smokers. Even the scores of functional and emotional scales of VHI in smokers shown better results (less handicap) than in nonsmokers. Smoking does not affect patients 23 handicap due to dysphonia measured in the Voice Handicap Index (54) Occupational skin diseases and dermal exposure in the European Union (EU25): policy and practice overview. 2008. European Risk Observatory Report No. 6. Ref Type: Report Ref ID: 478 Abstract: Skin diseases are the second most common work-related health problem in Europe. They represent more than 7% of all occupational illnesses and are one of the most important emerging risks related to the exposure to chemical, physical and biological risk factors. The fact that there is no scientific method to measure the level of the body's exposures to risks via dermal contact and their physiological consequences, increases the importance of recognising risk factors and developing methods of assessing the level of exposure and controlling it. This report presents an overview of dermal exposures and occupational skin diseases. It also presents the principal policies relating to the recognition and recording of skin diseases, as well as the recognition, assessment and control of dermal exposure to chemical, biological and physical risk factors in the Member States of the European Union (55) COUNCIL REGULATION (EC) No 440/2008 of 30 May 2008 laying down test methods pursuant to Regulation (EC) No 1907/2006 of the European Parliament and of the Council on the Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH). 2008. EU Legislation, (EC) No 440/2008. Ref Type: Statute Ref ID: 477 (56) TEACHERS LOST FOR WORDS. ROSPA OCCUPATIONAL SAFETY AND HEALTH JOURNAL 2008. Ref ID: 509 Abstract: Reports on statistics released by the Association of Teachers and Lecturers (ATL) trade union that highlights teachers working in primary schools are increasingly experiencing problems with their voices. Provides a brief summary of the statistics compiled and the situations that generated them. Highlights the support ATL has proved to Voice Care Network UK to have voice care made a compulsory part of teacher training and a health and safety consideration. Includes separate personal views of teachers who have experienced voice problems (57) Amicucci GL, Platania G, Ciancamerla E, Minichino M. Telemedicine systems: methods for safety and quality of service analysis of systems connected via a communication network. 2008. Ref ID: 480 Abstract: Although telemedicine was developed in the 1960s, it is only in recent years that its full application has become possible with the improvement of communication networks and the introduction of mobile terminals. The most successful applications have been developed in the fields of cardiology (with the trans-telephonic electrocardiograph), infectious disease assistance (for remote monitoring of individual patients as well as for the prompt notification of infectious and communicable diseases), and of teleconsultancy of experts. Telemedicine is especially required when it is difficult to provide local health services (e.g., on ships, aircrafts, in case of major regional crises). Currently, many telemedicine applications are based on public mobile networks (PMNs). In these cases, the dependability of services based on PMN connections (such as voice and data connections) is required to avoid that adverse events (such as failure of PMN main elements or PMN resource contention) may affect the delivery of health services. Objectives: Major regional crises (e.g., great floods and earthquakes) may require telemedical assistance based on PMNs. In telemedical and civil protection applications, telemedical assistance systems (TASs) based on PMNs are proposed as prototype systems for the diagnosis and medical treatment of victims of catastrophic events. This paper analyses the reliability of a PMN supporting Global System for Mobile communications (GSM) and General Packet Radio Service (GPRS) connections for exchanging voice and data communications between remote mobile nodes and a telemedical assistance centre (TMAC). Methods: The dependability measures of PMN connections were assessed by building, computing and analyzing stochastic models of the network. Results: In particular, a GPRS model based on the Stochastic Activity Network formalism was analysed. Two different modelling levels were adopted. At the first level, two separate submodels were built in order to calculate, respectively, the pure unavailability and the pure performance of the packet data connection. At the second level, the submodels were joined for computing the dependability measures of the GPRS connection. Information and communication technologies can be factors of progress even in the healthcare sector. Some experiences have shown that the additional costs required by telemedicine systems are widely offset by savings in terms of time and human resources. Thus, telemedicine can significantly contribute to rationalize medical health interventions, while simultaneously aiming for cost-effectiveness in public health (58) Araujo TM, Reis EJ, Carvalho FM, Porto LA, Reis IC, Andrade JM. [Factors associated with voice disorders among women teachers]. Cad Saude Publica 2008;24:1229-1238. Ref ID: 31 Abstract: This study aimed to identify risk factors for voice disorders (hoarseness in the previous six months as an initial manifestation, and vocal cord nodules as a more severe manifestation of overt disease) among teachers. The cross-sectional study included 747 women teachers from elementary and middle schools in the public school system in Vitoria da Conquista, Bahia State, Brazil. Data were collected using a self-applied, standardized questionnaire. Hoarseness in the previous six months was reported by 59.2% of teachers and vocal cord nodules by 12.9%. Logistic regression techniques showed that hoarseness was statistically associated with > 24 classroom hours per week, work in more than one school, and having to make an effort to speak. Vocal cord nodules were associated with working > 5 years as a teacher, work in more than one school, working at another job besides teaching, and having to make an effort to speak. In conclusion, voice disorders are frequent among schoolteachers and are associated with multiple occupational risk factors, besides purely biological ones (59) Beltrati CRMI, Behlau M. Perceptual, auditory and acoustic vocal analysis of speech and singing in choir conductors. Pro-Fono 2008;20:195-200. Ref ID: 345 25 Abstract: Background: The voice of choir conductors. Aim: To evaluate the vocal quality of choir conductors based onthe production of a sustained vowel during singing and when speaking in order to observe auditory and acoustic differences. Method: Participants of this study were 100 choir conductors, with an equal distribution between genders. Participants were asked to produce the sustained vowel "q" using a singing and speaking voice. Speech samples were analyzed based on auditory-perceptive and acoustic parameters. The auditory-perceptive analysis was carried out by two speechlanguage pathologist, specialists in this field of knowledge. The acoustic analysis was carried out with the support of the computer software Doctor Speech (Tiger Electronics, SRD, USA, version 4.0), using the Real Analysis module. Results: The auditory-perceptive analysis of the vocal quality indicated that most conductors have adapted voices, presenting more alterations in their speaking voice. The acoustic analysis indicated different values between genders and between the different production modalities. The fundamental frequency was higher in the singing voice, as well as the values for the first formant; the second formant presented lower values in the singing voice, with statistically significant results only for women. Conclusion: The voice of choir conductors is adapted, presenting fewer deviations in the singing voice when compared to the speaking voice. Productions differ based the voice modality, singing or speaking (60) Berghs G. Stage fright in singers: three reaction types. Folia Phoniatr Logop 2008;60:294-297. Ref ID: 26 Abstract: Drawing on both my own personal experience and that of many colleagues and pupils, I shall describe three kinds of reactions to stage fright. The first is the primarily mental reaction of derealization, which involves feeling cut off from fear and decreasing body awareness. The second and third reactions to stage fright involve (a) increased and (b) decreased muscle tonus and their associated breathing patterns. Furthermore, I shall indicate how singers manage to pull themselves together through the very act of producing their first tones (61) Cho J, Kang GH, Kim EC et al. Comparison of manikin versus porcine models in cricothyrotomy procedure training. Emergency medicine journal : EMJ 2008;25:732-734. Ref ID: 438 Abstract: OBJECTIVE: To compare the usefulness for training of a porcine model (larynx, trachea, and pig skin) and a manikin model using a Portex cricothyrotomy kit (PCK). METHODS: In a prospective randomised crossover trial, participants in the airway workshop performed crico-thyrotomy using a PCK on the porcine and manikin models (Tracheostomy Trainer and Case). The porcine model was made with larynxes and trachea from freshly slaughtered pigs and covered with a piece of thinned pigskin stapled to a wooden board. Participants were asked to assess the following: reality of skin turgor; difficulty with skin penetration, landmark recognition and procedure; reality of the model; and preference for each model using a visual analogue scale (VAS) of 0-10 cm. The VAS scores for each model were compared. RESULTS: 49 participants were included in the study. Mean (SD) VAS scores for the reality of skin turgor, degree of difficulty with skin penetration and landmark recognition were higher with the porcine model than with the manikin model (7.0 (2.1) vs 4.7 (2.0), 6.4 (2.4) vs 3.6 (2.2), 5.1 (2.2) vs 4.2 (2.5), respectively). There was no difference between the models in the difficulty of the procedure (5.0 (2.4) vs 4.7 (3.2)). The porcine model had a higher VAS score for overall reality and preference of the model (7.1 (2.0) vs 4.8 (2.3) and 7.1 (2.0) vs 4.8 (2.2), respectively). CONCLUSION: The porcine model is a more useful training tool than the manikin model for cricothyrotomy with PCK because of its reality and similarity to human anatomy (62) Cox A, O'Regan S, Denvir A, Broughton A, Pearmain D, Tyers C et al. What works in delivering improved health and safety outcomes: A review of the existing evidence. 2008. HSE Research Report RR654. Ref Type: Report Ref ID: 482 Abstract: This report consists of a literature review on 'what works' in delivering improved health and safety outcomes, using data published since 2002. It is supplemented by an analysis of how HSE uses and generates research-based evidence, drawing on data from interviews conducted with HSE staff. The report identifies knowledge gaps in relation to 'what works' where further research is required, discusses barriers to use and generation of evidence and makes recommendations for how HSE could improve its use of evidence and commissioning of both policy and programme interventions and their respective evaluations (63) de la Hoz RE, Shohet MR, Bienenfeld LA, Afilaka AA, Levin SM, Herbert R. Vocal cord dysfunction in former World Trade Center (WTC) rescue and recovery workers and volunteers. Am J Ind Med 2008;51:161-165. Ref ID: 43 Abstract: BACKGROUND: Vocal cord dysfunction (VCD) is a condition characterized by paradoxical partial adduction of the vocal cords on inspiration. It has been associated with exposures to irritants, as well as with psychological illnesses and conditions. Workers who participated in the recovery of the WTC disaster site were exposed to a large amount of irritants as well as considerable psychological stressors. We describe the clinical characteristics of 10 symptomatic former WTC workers diagnosed with this condition, as well as the frequency of spirometric findings suggestive of variable extrathoracic obstruction. METHODS: Workers who became symptomatic after their WTC work experience have been evaluated clinically by a multidisciplinary team at an academic medical center. The evaluation included history, physical examination, chest radiograph, blood tests, and preand post-bronchodilator spirometry in all patients. Additional evaluations and diagnostic tests included otolaryngological evaluation with flexible rhinolaryngoscopy and stroboscopy, gastroenterological and psychiatric evaluations. A randomly selected sample of 172 spirometry results were reviewed for evidence of inspiratory flow limitation. RESULTS: Variable extrathoracic obstruction was found in 18.6% of the spirometries. Ten patients were diagnosed with VCD. In addition to symptoms suggestive of comorbid conditions (particularly rhinitis and acid reflux disease), most of the 10 patients had (1) hoarseness, (2) dyspnea that was not associated with bronchial hyperreactivity, or (3) dyspnea associated with asthma, with either mild bronchial hyperreactivity and/or poor response to asthma treatment. CONCLUSIONS: VCD appears to be part of the spectrum of airway disorders caused by occupational exposures at the WTC disaster site. Further study of this association is warranted 27 (64) de Medeiros AM, Barreto SM, Assuncao AA. Voice disorders (dysphonia) in public school female teachers working in Belo Horizonte: prevalence and associated factors. J Voice 2008;22:676-687. Ref ID: 48 Abstract: The objective of this study is to establish the prevalence of dysphonia and associated factors in public school female teachers working in Belo Horizonte. This cross-sectional study was conducted on a random sample of schools between May 2004 and July 2005. There were 2103 elementary education daytime teachers from 83 schools included in the study. Selfapplied questionnaires were used for data collection. These included questions on social and demographic matters, general health and mental health (General Health Questionnaire-12 [GHQ-12]), the environment and organization of work, and voice-related aspects. The variable dysphonia was classified as absent, possible, or probable based on the association between frequency of fatigue when speaking and worsened voice quality during the past 15 days. Multinomial logistic regression was used to analyze factors independently associated with dysphonia in each response subgroup and in total. One third of the female teachers did not report voice symptoms during the past 15 days (33%). The prevalence of probable dysphonia was 15%, and the prevalence for possible dysphonia was 52%. Factors associated with probable dysphonia were presence of recent upper airway problems (odds ratio [OR]=5.95, 95% confidence interval [CI]=4.06-8.71), problems at work because of voice (OR=65.30, 95% CI=19.33-220.59), other activities with intense voice use (OR=1.71, 95% CI=1.08-2.71), high noise levels (OR=2.55, 95% CI=1.72-3.76), poor ventilation in the classroom (OR=2.00, 95% CI=1.24-3.22), current mental disorder (OR=3.20, 95% CI=2.18-4.70), sedentary life style (OR=1.94, 95% CI=1.21-3.09), and marriage (OR=1.70, 95% CI=1.16-2.47). Associations between probable dysphonia, poor working conditions, health-related aspects, and professional jeopardy indicate the complexity of dysphonia in female teachers and the need for collective intervention strategies (65) Donnell D, Hernandez P, Kaplan A et al. Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease 2008 update - Highlights for primary care. Can Respir J 2008;15:1A-8A. Ref ID: 364 Abstract: Chronic obstructive pulmonary disease (COPD) is a major respiratory illness in Canada that is preventable and treatable but unfortunately remains underdiagnosed. The purpose of the present article from the Canadian Thoracic Society is to provide up-to-date information so that patients with this condition receive optimal care that is firmly based on scientific evidence. Important summary messages for clinicians are derived from the more detailed Update publication and are highlighted throughout the document. Three key messages contained in the update are: use targeted screening spirometry to establish a diagnosis and initiate prompt management (including smoking cessation) of mild COPD; improve dyspnea and activity limitation in stable COPD using new evidence-based treatment algorithms; and understand the importance of preventing and managing acute exacerbations, particularly in moderate to severe disease. ® 2008 Pulsus Group Inc. All rights reserved (66) Echternach M, Sundberg J, Arndt S et al. Vocal tract and register changes analysed by real-time MRI in male professional singers-a pilot study. Logoped Phoniatr Vocol 2008;33:67-73. Ref ID: 30 Abstract: Changes of vocal tract shape accompanying changes of vocal register and pitch in singing have remained an unclear field. Dynamic realtime magnetic resonance imaging (MRI) was applied to two professional classical singers (a tenor and a baritone) in this pilot study. The singers sang ascending scales from B3 to G#4 on the vowel /a/, keeping the modal register throughout or shifting to falsetto register for the highest pitches. The results show that these singers made few and minor modifications of vocal tract shape when they changed from modal to falsetto and some clear modifications when they kept the register. In this case the baritone increased his tongue dorsum height, widened his jaw opening, and decreased his jaw protrusion, while the tenor merely lifted his uvula. The method used seems promising and should be applied to a greater number of singer subjects in the future (67) Franco G. Ramazzini and workers' voice disorders. Otolaryngol Head Neck Surg 2008;139:329. Ref ID: 28 (68) Hicks M, Brugman S, Katial R. Vocal Cord Dysfunction/Paradoxical Vocal Fold Motion. Prim Care Clin Off Pract 2008;35:81-103. Ref ID: 373 Abstract: Vocal cord dysfunction, also called paradoxical vocal cord motion, is a common mimicker of asthma, allergies, and severe upper airways obstruction with consequent misdiagnosis and mismanagement, and is frequently overlooked. Unfortunately, there is no unified understanding of this disorder, nor is there any consensus on its evaluation, etiology, or treatment. This article reviews the literature regarding the pathophysiology, causes, diagnosis, and treatment for this common disorder. ® 2008 Elsevier Inc. All rights reserved (69) Howard-Quijano KJ, Huang YM, Matevosian R, Kaplan MB, Steadman RH. Video-assisted instruction improves the success rate for tracheal intubation by novices. British journal of anaesthesia 2008;101:568-572. Ref ID: 447 Abstract: BACKGROUND: Tracheal intubation via laryngoscopy is a fundamental skill, particularly for anaesthesiologists. However, teaching this skill is difficult since direct laryngoscopy allows only one individual to view the larynx during the procedure. The purpose of this study was to determine if video-assisted laryngoscopy improves the effectiveness of tracheal intubation training. METHODS: In this prospective, randomized, crossover study, 37 novices with less than six prior intubation attempts were randomized into two groups, video-assisted followed by traditional instruction (Group V/T) and traditional instruction followed by video-assisted instruction (Group T/V). Novices performed intubations on three patients, switched groups, and performed three more intubations. All trainees received feedback during the procedure from an attending anaesthesiologist based on standard cues. Additionally, during the video-assisted part of the study, the supervising anaesthesiologist incorporated feedback based on the video images obtained from the fibreoptic camera located in the laryngoscope. RESULTS: During video-assisted instruction, novices were successful at 69% of their intubation attempts whereas those trained during the non-video-assisted portion were 29 successful in 55% of their attempts (P=0.04). Oesophageal intubations occurred in 3% of video-assisted intubation attempts and in 17% of traditional attempts (P<0.01). CONCLUSIONS: The improved rate of successful intubation and the decreased rate of oesophageal intubation support the use of video laryngoscopy for tracheal intubation training (70) Ilomaki I, Laukkanen AM, Leppanen K, Vilkman E. Effects of voice training and voice hygiene education on acoustic and perceptual speech parameters and self-reported vocal well-being in female teachers. Logoped Phoniatr Vocol 2008;33:83-92. Ref ID: 29 Abstract: Voice education programs may help in optimizing teachers' voice use. This study compared effects of voice training (VT) and voice hygiene lecture (VHL) in 60 randomly assigned female teachers. All 60 attended the lecture, and 30 completed a short training course in addition. Text reading was recorded in working environments and analyzed for fundamental frequency (F0), equivalent sound level (Leq), alpha ratio, jitter, shimmer, and perceptual quality. Self-reports of vocal well-being were registered. In the VHL group, increased F0 and difficulty of phonation and in the VT group decreased perturbation, increased alpha ratio, easier phonation, and improved perceptual and self-reported voice quality were found. Both groups equally self-reported increase of voice care knowledge. Results seem to indicate improved vocal well-being after training (71) Kosztyla-Hojna B, Citko D, Milewska A, Rogowski M. [Analysis of voice disorders among university teachers at Medical University of Bialystok]. Pol Merkur Lekarski 2008;25:236-239. Ref ID: 25 Abstract: Voice disorders constitute a serious health problem for teachers. More than 80% of them experience voice disorders and still among those 40% suffer from pathological phoniatric changes confirmed by phoniatric examination. Chronic disorders resulting from vocal abuse and misuse are the most frequent among occupational diseases diagnosed in Poland. THE AIM OF THE STUDY: To investigate the chronic voice disorders among the teaching community of Medical University of Bialystok and to examine its awareness of voice hygiene and proper vocal techniques. MATERIAL AND METHOD: The research was based on a survey of 434 university teachers from Medical University of Bialystok. Results. Increased voice fatigue and voice loss were most often the consequence of prolonged voice use (over 20 years). Occupational voice disorders were more frequent in females, even though they did not ignore initial symptoms and consulted specialists. Disregard for prevention, reluctance to undergo treatment, and negligence of the first symptoms of disease are the most common cause of occupational voice disorders. CONCLUSION: Working in a voice-friendly environment, organizing trainings devoted to voice hygiene and vocal techniques are in favor of enhancing the voice function of university teachers (72) Lam Tang JA, Boliek CA, Rieger JM. Laryngeal and respiratory behavior during pitch change in professional singers. J Voice 2008;22:622-633. Ref ID: 45 Abstract: The aim of this study was to examine the physiology of pitch change in terms of laryngeal and respiratory mechanisms in professional singers. Nine female professional singers were recruited to participate in the study. Videoendoscopic recordings of the participants producing one-octave ascending and descending scales were used as a basis to apply a ratio measurement of vocal fold length for each note produced on the scale. Simultaneous respiratory data using Respitrace were also collected. Questionnaires (Voice Handicap Index and Vocal Questionnaire) were used to obtain information about psychosocial aspects related to voice use. Two vocal fold lengthening patterns (static and dynamic) were observed with pitch change. Participants exhibiting a static pattern of vocal fold lengthening had fewer years of vocal training, exhibited a more variable use of vital capacity, and also began the singing task at a higher position in their vital capacity. The reverse was true for participants exhibiting a dynamic vocal fold pattern. These preliminary data indicate that the pattern of vocal fold lengthening exhibited by singers may be related to the number of years of training possessed. Furthermore, the data indicate that stability in one subsystem may result in variability in another, as shown by the interaction between the vocal fold and respiratory patterns (73) Larsson H, Hertegard S. Vocal fold dimensions in professional opera singers as measured by means of laser triangulation. J Voice 2008;22:734-739. Ref ID: 61 Abstract: A new laser triangulation technique was used to measure vocal fold length and width in 27 professional opera singers. The singers belonged to different voice register categories: soprano, mezzo, tenor, and bass/baritone. High-speed recordings were made during glissandos from each singer's speaking fundamental frequency (SFF) up to the highest frequency for which it was possible to place the laser spot on the vocal folds. Vocal fold length and width were measured at the singers' SFF and then at two or three times the SFF, and for some singers at four times the SFF. In addition, measurements were also made at C4 (260 Hz) for all singers. The results confirmed that the bass/baritone group had significantly longer vocal folds than the soprano group; also, males have significantly longer vocal folds than females. Measured values for vocal fold width were significantly larger for the bass/baritone group compared with all other groups. A measured strain parameter showed different patterns of vocal fold elasticity with increasing pitch. The results suggest that although vocal fold length and width contribute to a singer's voice register category, there seem to be also other parameters that are essential for this distinction (74) Laukkanen AM, Ilomaki I, Leppanen K, Vilkman E. Acoustic measures and self-reports of vocal fatigue by female teachers. J Voice 2008;22:283-289. Ref ID: 66 Abstract: This study investigated the relation of symptoms of vocal fatigue to acoustic variables reflecting type of voice production and the effects of vocal loading. Seventy-nine female primary school teachers volunteered as subjects. Before and after a working day, (1) a 1-minute text reading sample was recorded at habitual loudness and loudly (as in large classroom), (2) a prolonged phonation on [a:] was recorded at habitual speaking pitch and loudness, and (3) a questionnaire about voice quality, ease, or difficulty of phonation and tiredness of throat was completed. The samples were analyzed for average fundamental frequency (F0), sound pressure level (SPL), and phonation type reflecting alpha ratio (SPL [1-5 kHz]-SPL [50 Hz-1 kHz]). The vowel samples were additionally analyzed for perturbation (jitter and shimmer). After a working day, F0, SPL, and alpha ratio were higher, jitter 31 and shimmer values were lower, and more tiredness of throat was reported. The average levels of the acoustic parameters did not correlate with the symptoms. Increase in jitter and mean F0 in loud reading correlated with tiredness of throat. The results seem to suggest that, at least among experienced vocal professionals, voice production type had little relevance from the point of view of vocal fatigue reported. Differences in the acoustic parameters after a vocally loading working day mainly seem to reflect increased muscle activity as a consequence of vocal loading (75) Lowell SY, Barkmeier-Kraemer JM, Hoit JD, Story BH. Respiratory and laryngeal function during spontaneous speaking in teachers with voice disorders. J Speech Lang Hear Res 2008;51:333-349. Ref ID: 40 Abstract: PURPOSE: To determine if respiratory and laryngeal function during spontaneous speaking were different for teachers with voice disorders compared with teachers without voice problems. METHOD: Eighteen teachers, 9 with and 9 without voice disorders, were included in this study. Respiratory function was measured with magnetometry, and laryngeal function was measured with electroglottography during 3 spontaneous speaking tasks: a simulated teaching task at a typical loudness level, a simulated teaching task at an increased loudness level, and a conversational speaking task. Electroglottography measures were also obtained for 3 structured speaking tasks: a paragraph reading task, a sustained vowel, and a maximum phonation time vowel. RESULTS: Teachers with voice disorders started and ended their breath groups at significantly smaller lung volumes than teachers without voice problems during teaching-related speaking tasks; however, there were no between-group differences in laryngeal measures. Task-related differences were found on several respiratory measures and on one laryngeal measure. CONCLUSIONS: These findings suggest that teachers with voice disorders used different speech breathing strategies than teachers without voice problems. Implications for clinical management of teachers with voice disorders are discussed (76) McAleavy GJ, Adamson G, Hazlett DE, Donegan HA, Livesey GE. Modelling determinants of the vocal health of teachers in Northern Ireland: Implications for educational policy and practice. Public Health 2008;122:691-699. Ref ID: 385 Abstract: Objectives: To quantify the relative contributions of behavioural, environmental and psychological factors to the vocal health of teachers, and to describe the relationships using structural equation modelling, with a view to identifying preventive action. Method: A cross-sectional survey of teachers across 69 primary and secondary schools was conducted. In total, 217 responses were analysed. Teachers self-reported on: the quality of their voice; the frequency with which they perform a series of voice-related behaviours; the quality of the environment in which they work; the feelings they have about their vocal health; and an anxiety rating measured by the State-Trait Anxiety Inventory (STAI) questionnaire. A structural equation modelling approach was used to estimate the associated effects. Results: The hypothesized model described the data well. It emerged that voice-related behaviours, the teachers' work environment and the presence of trait anxiety had a significant influence on vocal health. Moreover, the model demonstrated that the quality of the voice is related strongly to how respondents feel about the condition of their voice, which, in turn, had an indirect reciprocal effect on the quality of teachers' vocal health. Conclusion: The model demonstrates the important contributions of psychological and behavioural variables to vocal health. Of the six independent variables that impact directly on 'vocal dysfunction', three were found to be statistically significant. These were the voice-related 'behaviours' that teachers perform, the environment in which teachers work, and 'trait anxiety present' as measured by the STAI. The implications of the results are considered in relation to rethinking policy and practice with the intention of identifying preventative actions to improve the vocal health of professional educators. ® 2007 The Royal Institute of Public Health (77) McGrath B. Programme for the assessment of NDT in industry. PANI 3. 2008. HSE Research Report RR617. Ref Type: Report Ref ID: 479 Abstract: This report describes the work undertaken and the results obtained during the 3rd project under Health and Safety Executive's Programme for the Assessment of NDT in Industry (PANI 3). The project was instigated with the objective of identifying solutions which will allow industry to optimise performance and minimise the magnitude of operator variation in the application of manual ultrasonic inspections. The PANI 3 project was managed on behalf of the Health and Safety Executive by Serco's Inspection Validation Centre (IVC). In order to keep the report easy to read and assimilate, the main text gives the key information and the reader is referred to the Appendices for the supporting detail. The project comprised of an investigation into the human factors aspects of the manual ultrasonic task and an assessment of the organisation of NDT and the NDT process (initially referred to as QA Assessment). Following a data gathering exercise which is reported in Appendix 2, experimental work was performed with the twin objectives of investigating the operators' decision making processes and the correlation of ultrasonic performance with the operators' scores on ability tests and a number of personality scales. The assessment of the organisation of NDT was conducted through eliciting information from operators and NDT vendor companies and reviews of previous reliability studies and other initiatives to improve NDT reliability (78) Munier C, Kinsella R. The prevalence and impact of voice problems in primary school teachers. Occup Med (Lond) 2008;58:74-76. Ref ID: 46 Abstract: BACKGROUND: Teachers have been identified as at increased risk of developing an occupational voice disorder. Primary school teachers are particularly at risk as they have little opportunity for voice rest during the working day. AIM: To analyse the prevalence and impact of voice problems in primary school teachers in the workplace. METHOD: An 85-item questionnaire was administered to 550 primary school teachers from 42 schools in the greater Dublin area. RESULTS: A response rate of 55% was obtained. Results suggest that 27% suffered from a voice problem, 53% an 'intermittent' voice problem, while only 20% had no voice problem. Teachers of the junior classes were more vulnerable to developing a voice problem than those of senior classes. The most common symptoms were 'dry throat' and 'vocal fatigue'. CONCLUSION: Voice disorders were very common in our study of primary school teachers. Those most frequently affected taught the younger classes. Further intervention is needed to identify and minimize risk factors and 33 reduce the negative impact of voice on the individual and on work (79) Murphy J. In defense of the stethoscope. Respir Care 2008;53:355-369. Ref ID: 387 Abstract: The stethoscope is widely considered to be an unreliable instrument. Many studies document the significant observer variability in its use. Numerous other diagnostic tools are available that are generally regarded to provide more reliable diagnostic information. Some even argue that teaching of the ancient art should be de-emphasized in medical schools. Yet auscultation with an acoustic stethoscope can provide important, even lifesaving, information. The purpose of this article is to present evidence that supports the use of the stethoscope in clinical medicine. The argument for the stethoscope will be made by presenting relevant investigations, including clinical studies acknowledged to meet the criteria of evidence-based medicine. It will focus on studies that have employed computerized acoustic technology to correlate lung sounds with disease states. This technology has advanced in recent years, which has stimulated a resurgence of interest in auscultation. Numerous studies have been done that utilized objective methods that circumvented the problem of observer variability. There is now a good deal of scientific evidence to support the hypothesis that lung sounds contain information that is clinically useful. This technology also allows this information to be collected more efficiently than previously possible. Advances in educational technology have made it possible to impart information on auscultation much more easily than was possible in the past. Contrary to predictions, the stethoscope is not likely to be relegated to the museum shelf in the near future. Computer technology is making it an even more useful clinical instrument. ® 2008 Daedalus Enterprises (80) Niebudek-Bogusz E, Kotylo P, Politanski P, Sliwinska-Kowalska M. Acoustic analysis with vocal loading test in occupational voice disorders: outcomes before and after voice therapy. Int J Occup Med Environ Health 2008;21:301308. Ref ID: 22 Abstract: OBJECTIVE: To assess the usefulness of acoustic analysis with vocal loading test for evaluating the treatment outcomes in occupational voice disorders. METHODS: Fifty-one female teachers with dysphonia were examined (Voice Handicap Index--VHI, laryngovideostroboscopy and acoustic analysis with vocal loading) before and after treatment. The outcomes of teachers receiving vocal training (group I) were referred to outcomes of group II receiving only voice hygiene instructions. RESULTS: The results of subjective assessment (VHI score) and objective evaluation (acoustic analysis) improved more significantly in group I than in group II. The posttreatment examination revealed a decreased percentage of subjects with deteriorated jitter parameters after vocal loading, particularly in group I. CONCLUSIONS: Acoustic analysis with vocal loading test can be a helpful tool in the diagnosis and evaluation of treatment efficacy in occupational dysphonia (81) Niebudek-Bogusz E, Sznurowska-Przygocka B, Fiszer M et al. The effectiveness of voice therapy for teachers with dysphonia. Folia Phoniatr Logop 2008;60:134-141. Ref ID: 41 Abstract: OBJECTIVE: An incorrect voice emission is a risk factor for developing occupational voice disorders. The study aimed at assessing the effectiveness of voice therapy in female teachers with dysphonia. METHODS: The study comprised 133 subjects with voice disorders, taking part in a vocal training programme. A reference group for the present study included 53 teachers with dysphonia. Questionnaire surveys, phoniatric examination and videostroboscopic evaluation were conducted at initial and control examination. RESULTS: In the study group, an improvement after the vocal training was noted in most of the reported symptoms and also in some quantitative parameters of phoniatric examinations compared to the findings for the reference group. The number of patients who assessed their voice as normal increased significantly after the vocal training (2.3 vs. 46.6%). A significant increase in the mean maximum phonation time, from 13.3 to 16.6 s, was observed. The same applied to voice frequency range (increase from 171 to 226.8 Hz). CONCLUSIONS: The outcomes of vocal training, such as a subjective improvement of voice quality and an increase in the quantitative parameters (prolonged maximum phonation time, extended voice range) seem to be important parameters for monitoring the effectiveness of training in correct voice emission (82) Pitt M. An update of the Foresight Future Flooding 2004 qualitative risk analysis - An independent review by Sir Michael Pitt. 2008. Ref ID: 481 (83) Preciado-Lopez J, Perez-Fernandez C, Calzada-Uriondo M, Preciado-Ruiz P. Epidemiological study of voice disorders among teaching professionals of La Rioja, Spain. J Voice 2008;22:489-508. Ref ID: 59 Abstract: The purpose of the present study was to calculate the prevalence and incidence of voice disorders among teaching staff and find out the associated occupational risk factors. A case-control study was performed with 905 teachers, 579 cases and 326 controls; 492 were randomly selected and 413 volunteered. All teachers were asked to fill out a standard questionnaire. Next, a complete laryngeal exam was performed including a general ear, nose, and throat evaluation and videolaryngostroboscopy. The prevalence of voice disorders among teaching staff was 57%. The most prevalent lesions were vocal overstrain (18%), nodular lesions (14%), and hyperfunctional dysphonia (8%). The incidence rate was 3.87 new cases per year per 1000 teachers. Women had organic lesions three times more than men (odds ratio [OR]: 3.52, confidence interval [CI]: 2.04-6.09). However, men had chronic laryngitis three times more than women (OR: 2.93, CI: 1.50-5.71) and functional dysphonia nearly twice more than women (OR: 1.81, CI: 1.212.69). We find a significant risk of suffering voice disorders in teachers who smoke daily (OR: 2.31, CI: 1.58-3.37) and who drink several cups of coffee or tea (OR: 1.87, CI: 1.36-2.56). It is advisable to carry out an annual evaluation of all teaching staff on account of the high prevalence of voice disorders among them (84) Reich SG, Meyer T. Teaching video NeuroImage: Spasmodic dysphonia: adductor and abductor. Neurology 2008;70:e78. Ref ID: 34 (85) Silverio KC, Goncalves CG, Penteado RZ, Vieira TP, Libardi A, Rossi D. Actions in vocal health: a proposal for improving the vocal profile of teachers. Pro 35 Fono 2008;20:177-182. Ref ID: 27 Abstract: BACKGROUND: several authors have pointed to the urgent need of researches and actions involving teachers, in the school environment, that have a preventive and vocal health promotion character with the purpose of improving work conditions. AIM: to analyze the vocal complaints, laryngeal symptoms, vocal habits and vocal profile of teachers of a public school before and after their participation in voice workshops. METHOD: the study was divided in different steps: 1st step - closed interview, larynx and perceptiveauditory assessment in which 42 teachers were evaluated; 2nd step - voice workshops; 3rd step - perceptive-auditory reassessment in which 13 teachers were evaluated. RESULTS: 73% of the subjects presented vocal complaints; 57.14% presented mild to moderate hoarseness, 78.57% presented breathiness and 52.38% vocal tension. Evaluation of the larynx indicated that 75.86% of the subjects presented glottal gaps and 34.48% mucous thickening. After the voice workshops a significant difference was observed in the level of vocal tension, both in the analysis of the /e/ vowel and in the analysis of Spontaneous Speech (p = 0.0277 for p > 0.05 for both). Improvement was observed in vocal care and in the understanding of intervening and determinant factors for vocal alterations, which are present in the teaching environment. CONCLUSION: health actions, such as voice workshops, are important to trigger changes in the work environment as well as in the health of teachers (86) Simões Z, Latorre MdRDdO. Changes in behavior associated to the use of voice after a speech therapy intervention with professionals of child day care centers. Pro Fono 2008;20:61-66. Ref ID: 411 Abstract: BACKGROUND: preventive programs have been used with teachers with the purpose of lowering the number of risk factors for voice disorders. However, few studies have focused on the effectiveness of these programs. AIM: to assess changes in behaviors that are considered, according to the specific literature, as having a negative impact on the voice, during a speech therapy intervention program offered to educators. METHOD: an experimental study where a theoretical-practical program involving the professional use of voice was developed with 26 educators from two day care centers of Spo Paulo. This program involved five monthly meetings, working up to a total of twelve hours. During the program, topics concerning negative behaviors that affect the voice were discussed. On four of the meetings the educators filled in a protocol, making it possible to analyze the frequency on which they presented those specific behaviors. Later on, scores were given to the answers on the protocol in order to compare the findings during the program. For this comparison the statistical test of Wilcoxon and the linear tendency chi-square test were used. RESULTS: the gradual decrease in the use of voice out of work was observed, as well as in speaking with a very low or high pitch voice and in eating excessively before sleeping. There was an increase in the occurrence of coughing in the third application of the protocol. As for the overall monthly averages, statistically significant differences were not found when comparing the four applications of the protocol. The overall average score was of 11.75, which was considered moderately abusive. CONCLUSION: the changes that were observed during the program were interesting, but very restrict which makes one wonder about the real effects of this kind of practice and how much broader changes rely on small individual changes. Actions that involve information about vocal well-being exclusively should be revised (87) Steiner M, Scaife A, Semple S, Hulks G, Ayres JG. Sodium metabisulphite induced airways disease in the fishing and fish- processing industry. Occup Med 2008;58:545-550. Ref ID: 414 Abstract: Background: Sodium metabisulphite (SMBS) is recognized as a potential cause of airway irritation and possibly occupational asthma, but awareness of its use in the fishing and fish-processing industry is low. Aims and methods: To describe three cases of occupational airways disease due to SMBS exposure and to review the literature. Results: Three patients, one trawlerman and two prawn processors, developed work-related airways disease due to exposure to SMBS, one with irritant-induced asthma with a positive-specific bronchial challenge associated with very high sulphur dioxide exposures, one with occupational asthma and one with vocal cord dysfunction and underlying asthma. Of the nine cases recorded in the literature, most were non- atopic and responses to specific bronchial challenge when undertaken showed an immediate response. Exposures to sulphur dioxide in these settings are very high, in excess of 30 ppm. Conclusion: SMBS should beregarded as a cause of occupational airways disease and its use in the fish and prawn-processing industry investigated further to better identify risks from exposure and handling of the agent in the workplace. ® The Author 2008. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved (88) Svec J, Sundberg J, Hertegard S. Three registers in an untrained female singer analyzed by videokymography, strobolaryngoscopy and sound spectrography. J Acoust Soc Am 2008;123:347-353. Ref ID: 416 Abstract: There has been a lack of objective data on the singing voice registers, particularly on the so called "whistle" register, occurring in the top part of the female pitch range, which is accessible only to some singers. This study offers unique strobolaryngoscopic and high- speed (7812.5 imagess) videokymographic data on the vocal fold behavior of an untrained female singer capable of producing three distinct voice qualities, i.e., the chest, head and whistle registers. The sound was documented spectrographically. The transition from chest to head register, accompanied by pitch jumps, occurred around tones B4-C#5 (500-550 Hz) and was found to be associated with a slight decrease in arytenoids adduction, resulting in decrease of the closed quotient. The register shifts from head to whistle, also accompanied by pitch jumps, occurred around tones E5-B5 (670-1000 Hz) without any noticeable changes in arytenoids adduction. Some evidence was found for the vocal tract influence on this transition. The mechanism of the vocal fold vibration in whistle register was found principally similar to that at lower registers: vibrations along the whole glottal length and vertical phase differences (indicated by sharp lateral peaks in videokymography) were seen on the vocal folds up to the highest tone G6 (1590 Hz). ® 2008 Acoustical Society of America (89) Tarlo S, Balmes J, Balkissoon R et al. Diagnosis and management of workrelated asthma: American College of Chest Physicians consensus statement. Chest 2008;134:1S-41S. 37 Ref ID: 418 Abstract: Background: A previous American College of Chest Physicians Consensus Statement on asthma in the workplace was published in 1995. The current Consensus Statement updates the previous one based on additional research that has been published since then, including findings relevant to preventive measures and work-exacerbated asthma (WEA). Methods: A panel of experts, including allergists, pulmonologists, and occupational medicine physicians, was convened to develop this Consensus Document on the diagnosis and management of work-related asthma (WRA), based in part on a systematic review, that was performed by the University of Alberta/Capital Health Evidence- Based Practice and was supplemented by additional published studies to 2007. Results: The Consensus Document defined WRA to include occupational asthma (ie, asthma induced by sensitizer or irritant work exposures) and WEA (ie, preexisting or concurrent asthma worsened by work factors). The Consensus Document focuses on the diagnosis and management of WRA (including diagnostic tests, and work and compensation issues), as well as preventive measures. WRA should be considered in all individuals with new-onset or worsening asthma, and a careful occupational history should be obtained. Diagnostic tests such as serial peak flow recordings, methacholine challenge tests, immunologic tests, and specific inhalation challenge tests (if available), can increase diagnostic certainty. Since the prognosis is better with early diagnosis and appropriate intervention, effective preventive measures for other workers with exposure should be addressed. Conclusions: The substantial prevalence of WRA supports consideration of the diagnosis in all who present with new-onset or worsening asthma, followed by appropriate investigations and intervention including consideration of other exposed workers. Copyright ® 2008 by American College of Chest Physicians (90) Bellia S, Serafino L, Luca N, Farruggia E, Bellia M. [Incidence of dysphonia in teaching staff of schools]. G Ital Med Lav Ergon 2007;29:613-614. Ref ID: 38 Abstract: Some categories of workers (actors, teachers, singers) use a particular working tool: their voice. In order to assess the spread of dysphonia and its possible causes across a specific class of workers--the teachers of some schools in the city of Catania--we have set up a ad hoc questionnaire. A special database has been subsequently arranged, aimed at the statistical analysis of the responses obtained. The analysis of the responses shows that the phenomenon is more present in female than male teachers, 48% versus 30%. The dysphonia occurs mainly at the end of the working day, lasts throughout the school year and improves in summer, demonstrating the importance of teaching activity in its pathogenesis. One aspect especially stands out: dysphonia occurs exclusively in those individuals suffering from diseases with possible alterations of the voice, such as allergopathies, tireopathies and gastropathies. Therefore, work activity alone does not seem able to cause a chronic dysphonia, whereas the presence of diseases causing disability of vocal cords appears to play an important role (91) Bovo R, Galceran M, Petruccelli J, Hatzopoulos S. Vocal problems among teachers: evaluation of a preventive voice program. J Voice 2007;21:705722. Ref ID: 435 Abstract: Summary: Vocal education programs for teachers may prevent the emergence of vocal disorders; however, only a few studies have tried to evaluate the effectiveness of these preventive programs, particularly in the long term. Two hundred and sixty-four subjects, mostly kindergarten and primary school female teachers, participated in a course on voice care, including a theoretical seminar (120 minutes) and a short voice group therapy (180 minutes, small groups of 20 subjects). For 3 months, they had to either attend the vocal ergonomics norms and, as psychological reinforcement, they had to make out a daily report of vocal abuse, or to follow the given exercises for a more efficient vocal technique, reporting on whether the time scheduled was respected or not. The effectiveness of the course was assessed in a group of 21 female teachers through a randomized controlled study. Evaluation comprehended stroboscopy, perceptual and electro-acoustical voice analysis, Voice Handicap Index, and a course benefit questionnaire. A group of 20 teachers matched for age, working years, hoarseness grade, and vocal demand served as a control group. At 3 months evaluation, participants demonstrated amelioration in the global dysphonia rates (P = 0.0003), jitter (P = 0.0001), shimmer (P = 0.0001), MPT (P = 0.0001), and VHI (P = 0.0001). Twelve months after the course, the positive effects remained, although they were slightly reduced. In conclusion, a course inclusive of two lectures, a short group voice therapy, home-controlled voice exercises, and hygiene, represents a feasible and cost-effective primary prevention of voice disorders in a homogeneous and well-motivated population of teachers. copyright 2007 The Voice Foundation. Copyright © 2010 Elsevier B. V., Amsterdam. All Rights Reserved (92) Carding P. Occupational voice disorders: Is there a firm case for industrial injuries disablement benefit? Logoped Phoniatr Vocol 2007;32:47-48. Ref ID: 63 (93) Carding P. Editorial. Logop Phoniatr Vocology 2007;32:98. Ref ID: 354 (94) Chen SH, Hsiao TY, Hsiao LC, Chung YM, Chiang SC. Outcome of resonant voice therapy for female teachers with voice disorders: perceptual, physiological, acoustic, aerodynamic, and functional measurements. J Voice 2007;21:415-425. Ref ID: 81 Abstract: Teachers have a high percentage of voice problems. For voice disordered teachers, resonant voice therapy is hypothesized to reduce voice problems. No research has been done on the physiological, acoustic, and aerodynamic effects of resonant voice therapy for school teachers. The purpose of this study is to investigate resonant voice therapy outcome from perceptual, physiological, acoustic, aerodynamic, and functional aspects for female teachers with voice disorders. A prospective study was designed for this research. The research subjects were 24 female teachers in Taipei. All subjects received resonant voice therapy in groups of 4 subjects, 90 minutes per session, and 1 session per week for 8 weeks. The outcome of resonant voice therapy was assessed from auditory perceptual judgment, videostroboscopic examination, acoustic measurements, aerodynamic measurements, and functional measurements before and after therapy. After therapy the severity of roughness, strain, monotone, resonance, hard attack, and glottal fry in auditory perceptual judgments, the severity of vocal fold pathology, mucosal wave, amplitude, and vocal fold closure in videostroboscopic examinations, phonation threshold pressure, and the score 39 of physical scale in the Voice Handicap Index were significantly reduced. The speaking Fo, maximum range of speaking Fo, and maximum range of speaking intensity were significantly increased after therapy. No significant change was found in perturbation and breathiness measurements after therapy. Resonant voice therapy is effective for school teachers and is suggested as one of the therapy approaches in clinics for this population (95) Chernobelsky SI. The treatment and results of voice therapy amongst professional classical singers with vocal fold nodules. Logoped Phoniatr Vocol 2007;32:178-184. Ref ID: 47 Abstract: In order to test the hypotheses that nonsurgical treatment and elimination of inappropriate use of the voice is sufficient for disappearance of vocal fold nodules (VN), 28 classical singers with these lesions were examined for a period of up to 24 years after establishing this diagnosis. Twenty vocally healthy female singers constituted the control group. Laryngoscopy, microlaryngoscopy, laryngostroboscopy and acoustic voice analyses were used to carry out this research. It was found that VN, having once occurred, tended to reoccur despite nonsurgical treatment and the elimination of incorrect singing. It was concluded that physiologically correct singing leads only to a temporary disappearance of soft nodules and does not promote the resolution of hard nodules (96) Cobzeanu MD, Rusu D, Ciochina P, Drug VL, Ciochina AD, Michels L. [Voice exploratory methods into professional vocal singers]. Rev Med Chir Soc Med Nat Iasi 2007;111:190-193. Ref ID: 58 Abstract: The aims of this study was to evaluated methods of voice explored to professional vocal singers. The modern methods microlaryngoscopy, stroboscopy, electroglottography are presented and comparatively evaluated with classic explorations, as direct and indirect laryngoscopy (97) Drummond A. A REVIEW OF THE OCCUPATIONAL DISEASES REPORTING SYSTEM IN THE REPUBLIC OF IRELAND. 2007. Ref ID: 483 Abstract: A Review of the Occupational Diseases Reporting System in the Republic of Ireland. Data on occupational disease are collected for a) preventive, and b) administrative, legal and/or compensatory purposes. The need for quality data and statistics to drive a national preventive policy combined with recent and pending changes in national and international legislation precipitated this review of national and international systems. There are many practical and political difficulties associated with estimating the true extent of the problem of occupational disease and a variety of issues that continue to cause uncertainty, lack of agreement and debate. The classification of 'occupational' relates to the cause and not the nature of the disease, and most countries have drawn up a list of 'prescribed diseases', for which compensation or benefits are payable. However there are also illnesses that arise that are related to, even if they cannot be wholly attributed to, work, and for prevention purposes, it is important that there is a source of information on these conditions, and that their incidence is monitored. Global and European agencies have an influence on legal collection requirements and on how the data are collected. The European legal instrument currently in place is a Recommendation and therefore not binding on member states. More recently, the European Commission has proposed a Regulation that will require member states to provide data on a wider range of conditions that are work-related. Recent changes to Irish legislation raise a question over what must be reported as the definition of personal injury has been widened, and accidents that result in personal injury (and absence) must be reported, which suggests that accidents resulting in disease or illness must be reported also. An examination of some of the systems used internationally indicates that there are many commonalities and some differences. The commonalities include the use of multiple data sources, and the elusiveness of the 'ideal' system. Systems in use abroad all have strengths and weaknesses but some important lesions can be learned from their experience, such as: use multiple sources, motivate reporters, mandatory reporting to an enforcement authority results in poor returns, and a pragmatic approach is needed. The occupational disease data collection capacity and data needs in Ireland were reviewed by assessing current and potential data sources, current and potential data collectors and taking into account the views of the end-users of the data. Primary data collection is carried out by the CSO and the physicians voluntary reporting scheme; secondary data are available from a variety of other sources, including the Department of Social and Family Affairs, agencies that collect health statistics and agencies that collect insurance and claims-based data. The main issues raised during this review were: 1. The difference between an occupational disease and a work-related illness and the implications of the difference. 2. Different occupational and work-related illness data reporting / collection systems. 3. The characteristics of a 'good' occupational disease surveillance system. 4. The optimum system of data collection for prevention purposes in Ireland. 5. The optimum system of data collection for Ireland to address national and international legislative requirements (98) Eller R, Heman-Ackah Y, Hawkshaw M, Sataloff RT. Vocal fold scar/sulcus vocalis. Ear Nose Throat J 2007;86:320. Ref ID: 57 (99) Franco RA, Andrus JG. Common diagnoses and treatments in professional voice users. Otolaryngol Clin North Am 2007;40:1025-61, vii. Ref ID: 55 Abstract: Common problems among all patients seen by the laryngologist are also common among professional voice users. These include laryngopharyngeal reflux, muscle tension dysphonia, fibrovascular vocal fold lesions (eg, nodules and polyps), cysts, vocal fold scarring, changes in vocal fold mobility, and age-related changes. Microvascular lesions and their associated sequelae of vocal fold hemorrhage and laryngitis due to voice overuse are more common among professional voice users. Much more common among professional voice users is the negative impact that voice problems have on their ability to work, on their overall sense of well-being, and sometimes on their very sense of self. This article reviews the diagnosis and treatment options for these and other problems among professional voice users, describing the relevant roles of medical treatment, voice therapy, and surgery. The common scenario of multiple concomitant entities contributing to a symptom complex is underscored. Emphasis is placed on gaining insight into the "whole" patient so that individualized management plans can be developed. Videos of select diagnoses accompany this content online 41 (100) Hamdan AL, Sibai AM, Srour ZM, Sabra OA, Deeb RA. Voice disorders in teachers. The role of family physicians. Saudi Med J 2007;28:422-428. Ref ID: 64 Abstract: OBJECTIVE: To look at the prevalence and impact of voice problems on teachers and assessing the teachers knowledge on vocal hygiene and habits, as well as which parameters mostly triggered the seeking of medical attention and how family doctors could intervene in this spectrum. METHODS: A survey that consists of 16 questions was used to look at the prevalence and impact of voice problems on teachers and to identify the associated risk factors at the American University of Beirut, Lebanon, during the year 2005. RESULTS: A considerable proportion (46%) perceived their voice as fair or worse, and 79% had never consulted a throat specialist. Voice disorders affected most of teachers particularly on their job. The mean number of vocal habits per person was estimated at 2.4 with smoking being the most common (38.7%). Two thirds of teachers were unaware of more than half the factors that can negatively affect their voice. Symptoms exceeding 6 months significantly increased the probability of consulting a physician by 2.5 folds. CONCLUSION: Family physicians can reduce the prevalence of vocal dysfunction in teachers through education and by pointing the various symptoms necessitating a specialist's early consultation especially when history of smoking is present (101) Jardim R, Barreto SM, Assuncao AA. [Work conditions, quality of life, and voice disorders in teachers]. Cad Saude Publica 2007;23:2439-2461. Ref ID: 52 Abstract: Voice disorders are common among teachers, with adverse consequences for their work and quality of life. This study focuses on factors associated with voice-related quality of life among female teachers in the municipal school system in Belo Horizonte, Southeast Brazil. A cross-sectional study with 2,133 female teachers was conducted, using the Voice-Related Quality of Life (VRQL) questionnaire, which has two domains: socio-emotional and physical. Teachers were grouped into quartiles based on the distribution of the final score in each domain. Those in the lowest quartile were then compared with all the others for a number of factors, using multiple logistic regression analysis. Less creativity at work and poor relationship with pupils were associated with worse voice-related quality of life in both domains. Mental disorders (GHQ12 > 4) were associated with worse voice-related quality of life in the socio-emotional domain, and intra-class noise with worse voice-related quality of life in the physical domain. Improvements in working conditions are key factors for achieving better voice-related quality of life among teachers (102) Kooijman PG, Thomas G, Graamans K, de Jong FI. Psychosocial impact of the teacher's voice throughout the career. J Voice 2007;21:316-324. Ref ID: 82 Abstract: It is generally accepted that vocal performance decreases with age. This decrease can be expected to be more pronounced in voice loading professions, which may lead to occupational dysphonia. The aim of this study was to investigate the course of voice complaints, experienced handicap, and absenteeism of work due to voice problems throughout the teaching years. Questionnaires were distributed among teachers of primary and secondary education, and 1875 were analyzed. The questionnaire was designed in such a way that personal aspects and questions about periods with symptoms and absence from work were included. The Voice Handicap Index (VHI) developed by Jacobson et al was sent along with the questionnaire. Surprisingly, a significant decrease of voice complaints during the career of the teachers was observed. The expectation that the percentage of teachers with a history of voice problems should experience more psychosocial impact, measured with the VHI, along their professional career could not be confirmed by this study. These results indicate that serious attention has to be paid to teachers with voice complaints. The fact that teachers in the beginning of their career complain more than in the end of their career emphasizes the importance of adequate aimed prevention programs for future teachers and for starting teachers with regard to their voice (103) Magnavita N, Bordignon P, Ciaffi G, Ferraro P, Vincenti F. [Dysphonia and cacosmia in a worker in sterilized rooms]. G Ital Med Lav Ergon 2007;29:804805. Ref ID: 37 Abstract: A 39 year male pharmaceutical worker employed in a clean-room developed in 2003 acute dysphonia after environmental disinfection with glutaric aldehyde and isopropyl alcohol. Laryngoscopic examination showed glottis edema; the syndrome healed after a cycle of cortisone. In subsequent years, withdrawal from exposure to irritating chemicals was observed. The worker, however, complained for recurrent episodes of dysphonia, in the absence of abnormalities of the larynx, and gradually developed intolerance for perfume, solvents, and other smelling substances. He came to our observation in 2007, showing strong conviction that occupational exposure had a causative effect in his complaints. He was working in an office open to public, and fragrance exposure appeared to be the main cause of dysphonic episodes. We rejected the hypothesis of association between complaint and job exposure, and advised him to work in a well defined working situation, such as in a clean room, where chemical contamination may be effectively controlled over time (104) Munoz X, Roger A, De la Rosa D, Morell F, Cruz MJ. Occupational vocal cord dysfunction due to exposure to wood dust and xerographic toner. Scand J Work Environ Health 2007;33:153-158. Ref ID: 62 Abstract: OBJECTIVES: Vocal cord dysfunction is a poorly understood entity that is often misdiagnosed as asthma. Both irritant and non-irritant vocal cord dysfunction have been described. This report presents two cases of irritant vocal cord dysfunction secondary to specific environmental exposure, the first to iroko and western red cedar wood (a carpenter) and the second to xerographic printing toner (a secretary). METHODS: Several tests were performed, including chest radiographs, measurements of total serum immunoglobulin E, skin prick tests with common pneumoallergens (as well as iroko and western red cedar in the first case), pulmonary function studies, methacholine challenge testing, specific inhalation challenge performed with suspected agents in a single-blinded fashion, and peak expiratory flow testing and fiberoptic rhinolaryngoscopy (in case 1). RESULTS: During the specific inhalation challenge, the patients showed dysphonia, chest tightness, inspiratory stridor, and flattening of the inspiratory limb of the maximum flowvolume loop in spirometry, with no significant decreases in the level of forced expiratory volume in 1 second; fiberoptic rhinolaryngoscopy confirmed the diagnosis of vocal cord dysfunction in case 1. CONCLUSIONS: It is important 43 to know that agents that can cause occupational asthma can also cause vocal cord dysfunction. The mechanisms by which these agents produce vocal cord dysfunction are unknown. The differences in the clinical presentation of the patients described relative to the reported cases suggest that more than one pathophysiological mechanism may be implicated in the genesis of this entity (105) Ney J, Joseph K. Neurologic uses of botulinum neurotoxin type A. Neuropsychiatr Dis Treat 2007;3:785-798. Ref ID: 389 Abstract: This article reviews the current and most neurologic uses of botulinum neurotoxin type A (BoNT-A), beginning with relevant historical data, neurochemical mechanism at the neuromuscular junction. Current commercial preparations of BoNT-A are reviewed, as are immunologic issues relating to secondary failure of BoNT-A therapy. Clinical uses are summarized with an emphasis on controlled clinical trials (as appropriate), including facial movement disorders, focal neck and limb dystonias, spasticity, hypersecretory syndromes, and pain. ® 2007 Dove Medical Press Limited. All rights reserved (106) Niebudek-Bogusz E, Kuzanska A, Woznicka E, Sliwinska-Kowalska M. [Voice disorders in female teachers assessed by Voice Handicap Index]. Med Pr 2007;58:393-402. Ref ID: 42 Abstract: BACKGROUND: The aim of this study was to assess the application of Voice Handicap Index (VHI) in the diagnosis of occupational voice disorders in female teachers. MATERIAL AND METHODS: The subjective assessment of voice by VHI was performed in fifty subjects with dysphonia diagnosed in laryngovideostroboscopic examination. The control group comprised 30 women whose jobs did not involve vocal effort. RESULTS: The results of the total VHI score and each of its subscales: functional, emotional and physical was significantly worse in the study group than in controls (p < 0.001). The analysis of VHI-score distribution showed that 68% of female teachers estimated their own voice problems as a moderate disability, while 12% of them reported severe voice disability. However, all non-teachers assessed their voice problems as slight, their results ranged at the lowest level of VHI score. CONCLUSIONS: This study confirmed that VHI as a tool for selfassessment of voice can be a significant contribution to the diagnosis of occupational dysphonia (107) Niebudek-Bogusz E, Kuzanska A, Bloch P et al. [Applicability of Voice Handicap Index to the evaluation of voice therapy effectiveness in teachers]. Med Pr 2007;58:501-509. Ref ID: 36 Abstract: BACKGROUND: The aim of this study was to assess the applicability of Voice Handicap Index (VHI) to the evaluation of effectiveness of functional voice disorders treatment in teachers. MATERIAL AND METHODS: The subjects were 45 female teachers with functional dysphonia who evaluated their voice problems according to the subjective VHI scale before and after phoniatric management. Group I (29 patients) were subjected to vocal training, whereas group II (16 patients) received only voice hygiene instructions. RESULTS: The results demonstrated that differences in the mean VHI score before and after phoniatric treatment were significantly higher in group 1 than in group II (p < 0.05). Moreover, the improvement observed in group I applied to each of VHI subscales: functional, emotional and physical, while in group II it applied only to physical subscale. CONCLUSIONS: This study confirmed that the VHI test can be a useful method for monitoring phoniatric management efficacy in teacher's dysphonia (108) Niebudek-Bogusz E, Kotylo P, Sliwinska-Kowalska M. Evaluation of voice acoustic parameters related to the vocal-loading test in professionally active teachers with dysphonia. Int J Occup Med Environ Health 2007;20:25-30. Ref ID: 56 Abstract: INTRODUCTION: Teachers are at risk of developing voice disorders. A clinical battery of vocal function tests should include non-invasive and accurate measurements. The quantitative methods (e.g., voice acoustic analysis) make it possible to objectively evaluate voice efficiency and outcomes of dysphonia treatment. MATERIALS AND METHODS: To identify possible signs of vocal fatigue, acoustic waveform perturbations during sustained phonation were measured before and after the vocal-loading test in 51 professionally active female teachers with functional voice disorders, using IRIS software. All the participants were also subjected to laryngological/phoniatric examination involving videostroboscopy combined with self-estimation by voice handicap index (VHI)-based scale. RESULTS: The phoniatric examination revealed glottal insufficiency with bowed vocal folds in 35.2%, soft vocal nodules in 31.4%, and hyperfunctional dysphonia with a tendency towards vestibular phonation in 19.6% of the patients. In the VHI scale, 66% of the female teachers estimated their own voice problems as moderate disability. An acoustic analysis performed after the vocal-loading test showed an increased rate of abnormal frequency perturbation parameters (pitch perturbation quotient (Jitter), relative average perturbation (RAP), and pitch period perturbation quotient (PPQ)) compared to the pre-test outcomes. The same was true of pitch-intensity contour of vowel /a:/, an indication of voice instability during sustained phonation. DISCUSSION AND CONCLUSIONS: The recorded impairments of voice acoustic parameters related to vocal loading provide further evidence of dysphonia. The voice acoustic analysis performed before and after the vocal-loading test can significantly contribute to objective voice examinations useful in diagnosis of dysphonia among teachers (109) Nix J, Svec JG, Laukkanen AM, Titze IR. Protocol challenges for on-the-job voice dosimetry of teachers in the United States and Finland. J Voice 2007;21:385-396. Ref ID: 78 Abstract: The occupational voice use of teachers has been an important research topic over the last 10 years. However, data collection on vocal loading in teachers at and away from the workplace poses significant challenges to the research protocol. The challenges include recruitment of subjects, voice data collection on the job, and subject compliance and retention. The present article offers recommendations for coping with these protocol difficulties. The recommendations are based on the authors' experiences with long-term, on-the-job voice dosimetry of large subject groups of teachers in the United States and Finland (110) Olthoff A, Woywod C, Kruse E. Stroboscopy versus high-speed glottography: a comparative study. The Laryngoscope 2007;117:1123-1126. Ref ID: 455 Abstract: OBJECTIVES: To evaluate and to compare the diagnostic value of 45 videostroboscopy (VS) and high-speed glottography (HGG) in dysphonic patients. STUDY DESIGN: Randomized, prospective study. METHODS: A total of 162 patients underwent indirect laryngoscopy using both methods (VS and HGG). The resulting 324 films were evaluated by two professionals (laryngologists, MDs) using a standardized protocol containing established criteria to classify vocal fold vibratory movement qualities. RESULTS: The rating "not assessable" was mentioned significantly more often in VS than in HGG (P < .001). In HGG, methodologic failures were less frequent, and the length of investigation was shorter. Even if the agreement between the two raters was higher in HGG (54%) compared with VS (42%), both percentage values show a low accordance in diagnostic findings. CONCLUSIONS: Regardless of the method used (VS or HGG), perceptive evaluations of vibratory movements of vocal folds revealed a higher variability than assumed. This result supports the need for objective methods to analyze vocal fold vibratory movements. Therefore, real-time imaging of vocal fold vibratory movements using HGG will be necessary (111) Pasa G, Oates J, Dacakis G. The relative effectiveness of vocal hygiene training and vocal function exercises in preventing voice disorders in primary school teachers. Logoped Phoniatr Vocol 2007;32:128-140. Ref ID: 53 Abstract: Voice disorders in teachers have a significant impact on their occupational functioning and well being. Teachers are believed to have a high prevalence of voice problems because of the unfavourable acoustic environments in which they work and the high vocal demands and stress levels associated with teaching. Although the types of voice problems teachers experience should be preventable because they are caused by factors that teachers can change, there is limited information available regarding the effectiveness of different preventative strategies. Therefore, the aim of this study was to investigate the effectiveness of vocal hygiene training (VH) and vocal function exercises (VFE) in reducing vocal symptoms and vocal misuse, and increasing knowledge of voice care, maximum phonation time, and maximum phonational frequency range in school teachers. Thirty-seven teachers from four schools in Melbourne, Australia, participated in the study. Schools were randomly allocated to one of three groups: VH, VFE, and notreatment control. The VH and VFE participants reported improved vocal characteristics and voice knowledge after training while the control group showed deterioration on most variables. The VH participants showed greater improvements than the VFE participants. These fundings indicate that preventative voice training for teachers is likely to be effective (112) Rietveld ABM. Genees & Kunst 3: Third Biannual Symposium on Medical Problems of Dancers and Musicians, Gouda, December 9, 2006. Med Probl Perform Artists 2007;22:30-35. Ref ID: 398 (113) Ruotsalainen JH, Sellman J, Lehto L, Jauhiainen M, Verbeek JH. Interventions for preventing voice disorders in adults. Cochrane Database Syst Rev 2007;CD006372. Ref ID: 49 Abstract: BACKGROUND: Poor voice quality due to a voice disorder can lead to a reduced quality of life. In occupations where voice use is substantial it can lead to periods of absence from work. OBJECTIVES: To evaluate the effectiveness of interventions to prevent voice disorders in adults. SEARCH STRATEGY: We searched MEDLINE (PubMed, 1950 to 2006), EMBASE (1974 to 2006), CENTRAL (The Cochrane Library, Issue 2 2006), CINAHL (1983 to 2006), PsychINFO (1967 to 2006), Science Citation Index (1986 to 2006) and the Occupational Health databases OSH-ROM (to 2006). The date of the last search was 05/04/06. SELECTION CRITERIA: Randomised controlled clinical trials (RCTs) of interventions evaluating the effectiveness of treatments to prevent voice disorders in adults. For work-directed interventions interrupted time series and prospective cohort studies were also eligible. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed trial quality. Meta-analysis was performed where appropriate. MAIN RESULTS: We identified two randomised controlled trials including a total of 53 participants in intervention groups and 43 controls. One study was conducted with teachers and the other with student teachers. Both trials were poor quality. Interventions were grouped into 1) direct voice training, 2) indirect voice training and 3) direct and indirect voice training combined.1) Direct voice training: One study did not find a significant decrease of the Voice Handicap Index for direct voice training compared to no intervention.2) Indirect voice training: One study did not find a significant decrease of the Voice Handicap Index for indirect voice training when compared to no intervention.3) Direct and indirect voice training combined: One study did not find a decrease of the Voice Handicap Index for direct and indirect voice training combined when compared to no intervention. The same study did however find an improvement in maximum phonation time (Mean Difference -3.18 sec; 95 % CI -4.43 to -1.93) for direct and indirect voice training combined when compared to no intervention. No work-directed studies were found. None of the studies found evaluated the effectiveness of prevention in terms of sick leave or number of diagnosed voice disorders. AUTHORS' CONCLUSIONS: We found no evidence that either direct or indirect voice training or the two combined are effective in improving self-reported vocal functioning when compared to no intervention. The current practice of giving training to at-risk populations for preventing the development of voice disorders is therefore not supported by definitive evidence of effectiveness. Larger and methodologically better trials are needed with outcome measures that better reflect the aims of interventions (114) Ruotsalainen JH, Sellman J, Lehto L, Jauhiainen M, Verbeek JH. Interventions for treating functional dysphonia in adults. Ruotsalainen Jani H , Sellman Jaana , Lehto Laura , Jauhiainen Merja , Verbeek Jos H Interventions for treating functional dysphonia in adults Cochrane Database of Systematic Reviews: Reviews 2007 Issue 3 John Wiley & Sons , Ltd Chichester, UK DOI : 10 2007. Ref ID: 461 Abstract: BACKGROUND: Poor voice quality due to functional dysphonia can lead to a reduced quality of life. In occupations where voice use is substantial it can lead to a loss of employment. OBJECTIVES: To evaluate the effectiveness of interventions to treat functional dysphonia in adults. SEARCH STRATEGY: We searched MEDLINE (PubMed, 1950 to 2006), EMBASE (1974 to 2006), CENTRAL (The Cochrane Library, Issue 2 2006), CINAHL (1983 to 2006), PsychINFO (1967 to 2006), Science Citation Index (1986 to 2006) and the Occupational Health databases OSH-ROM (to 2006). The date of the last search was 5th April 2006. SELECTION CRITERIA: Randomised controlled trials (RCTs) of interventions evaluating the effectiveness of treatments 47 targeted at adults with functional dysphonia. For work-directed interventions interrupted time series and prospective cohort studies were also eligible. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed trial quality. Meta-analysis was performed where appropriate. MAIN RESULTS: We identified six randomised controlled trials including a total of 163 participants in intervention groups and 141 controls. One trial was high quality. Interventions were grouped into 1) Direct voice therapy 2) Indirect voice therapy 3) Combination of direct and indirect voice therapy and 4) Other treatments: pharmacological treatment and vocal hygiene instructions given by phoniatrist.No studies were found evaluating direct voice therapy on its own. One study did not show indirect voice therapy on its own to be effective when compared to no intervention. There is evidence from three studies for the effectiveness of a combination of direct and indirect voice therapy on self-reported vocal functioning (SMD -1.07; 95% CI -1.94 to -0.19), on observer-rated vocal functioning (WMD -13.00; 95% CI -17.92 to -8.08) and on instrumental assessment of vocal functioning (WMD -1.20; 95% CI -2.37 to -0.03) when compared to no intervention. The results of one study also show that the remedial effect remains significant for at least 14 weeks on self-reported vocal functioning (SMD -0.51; 95% CI -0.87 to -0.14) and on observer-rated vocal functioning (Buffalo Voice Profile) (WMD -0.80; 95% CI -1.14 to -0.46). There is also limited evidence from one study that the number of symptoms may remain lower for a year. The combined therapy with biofeedback was not shown to be more effective than combined therapy alone in one study nor was pharmacological treatment found to be more effective than vocal hygiene instructions given by phoniatrist in one study. Publication bias may have influenced the results. AUTHORS' CONCLUSIONS: Evidence is available for the effectiveness of comprehensive voice therapy comprising both direct and indirect therapy elements. Effects are similar in patients and in teachers and student teachers screened for voice problems. Larger and methodologically better studies are needed with outcome measures that match treatment aims. INTERVENTIONS FOR TREATING FUNCTIONAL DYSPHONIA IN ADULTS: Functional dysphonia is characterised by an abnormal quality of voice in the absence of an identifiable lesion. People in occupations where voice use is central, like teachers, are more at risk of developing functional dysphonia. The causes of voice disorders are still being debated. There is also no consensus on the best method of evaluating voice, although many consider auditory voice quality assessment as a gold standard measure. Because functional dysphonia is a non-organic voice disorder there is no indication for surgical or medical interventions, and it is treated with behavioural (i.e. voice) therapy. Voice therapy usually consists of a combination of direct and indirect treatment techniques. Direct techniques focus on the underlying physiological changes needed to improve an individual's technique in using the vocal system whereas indirect techniques concentrate on contributory and maintenance aspects of the voice disorder (such as lack of knowledge).We conducted a systematic search of the literature on treating functional dysphonia in adults. We then appraised the quality of the studies found and combined their results.A combination of direct and indirect voice therapy is effective in improving vocal functioning when compared to no intervention. The achieved results may still be apparent after a year.Most of the studies are small and of low methodological quality and further research is warranted (115) Scheuermann K, Delank KW. [Ackerman's tumor of the larynx and occupational exposure to asbestos]. Laryngorhinootologie 2007;86:588-591. Ref ID: 54 Abstract: The so-called "Ackerman's tumor" is a neoplasm of uncertain dignity. Aim of this paper is to clarify, whether this is an asbestos-induced tumor of the larynx in accordance with German regulations for occupational diseases. A 43-year old male presented the clinical picture of a stenosing laryngeal tumor. A verrucous neoplasm without a proven malignity in the sense of an Ackerman's tumor was diagnosed through several sequential biopsies. Approximately 2 years later a total laryngectomy was performed, because of a squamous cell carcinoma of the larynx. An occupational disease in accordance with 4104 BKV was claimed in connection with an asbestos exposition of 28,3 fibre years (fibres/m3 x years). An Ackerman's tumor is--in accordance with its definition in the German-speaking area--not conclusively malignant, there is no indication of a relation between asbestos and such a tumor in literature, there is no specific benign disorder of the larynx caused by asbestos. This brings us to the conclusion that the Ackerman's tumor of the larynx is no asbestos-induced laryngeal tumor as per German occupational disease regulations (116) Sulkowski WJ. [Diagnosis of the occupational voice disorders.]. Med Pr 2007;58:185. Ref ID: 51 (117) Titze IR, Hunter EJ, Svec JG. Voicing and silence periods in daily and weekly vocalizations of teachers. J Acoust Soc Am 2007;121:469-478. Ref ID: 65 Abstract: The National Center for Voice and Speech (NCVS) data bank on voice dosimetry was used to study the distributions of continuous voicing periods and silence periods in 31 teachers over the duration of two weeks. Recordings were made during all awake hours of the day. Voicing periods were grouped into half decades, ranging from 0.0316 to 0.10 s for the shortest periods of phonation to 31.6-100 s for the longest periods of phonation. Silence periods were grouped into similar half decades, but ranged up to periods of several hours. On average, the teachers had 1800 occurrences of voicing (onset followed by offset) per hour at work and 1200 occurrences per hour while not at work. Voicing occurred 23% of the total time at work, dropping to 13% during off-work hours and 12% on weekends. The greatest accumulation of voicing occurred in the 0.316-1.0 s voicing periods, whereas the greatest accumulation of silence occurred in the 3-10 s silence periods. The study begins to lay the groundwork for understanding vocal fatigue in terms of repetitive motion and collision of tissue, as well as recovery from such mechanical stress (118) Toro-Soto JM, Rodrķguez-Fornells A, Sebastiįn-Gallés N. Stress placement and word segmentation by Spanish speakers. Psicologica (Valencia) 2007;28:167176. Ref ID: 528 Abstract: Varios estudios han mostrado que el patrón acentual de la lenguamaterna se aplica a estķmulos lingüķsticos novedosos. En el campo de lasegmentación del habla sintetizada, esta idea ha recibido apoyo deexperimentos con lenguajes en los cuales el patrón acentual coincide con loslķmites de las palabras (p.e. Inglés, Finlandés y Holandés). En este estudio,presentamos datos sobre la segmentación del habla en hablantes de 49 Espańol,cuyo patrón acentual tiende a marcar la penśltima sķlaba de las palabras.Los resultados muestran que acentuar la sķlaba del medio en las palabrastrisilįbicas de un flujo de habla artificial no facilita su segmentación, tal ycomo se podrķa predecir. Se exploran pues las posibles explicaciones deestos resultados, en la medida en que se relacionan con la interacción declaves estadķsticas y acentśales durante la segmentación del habla(AU)^ies Several studies have shown that the stress pattern of one's native languageis applied to new linguistic stimuli. Regarding the segmentation of artificialsynthesized speech, this idea has been supported by experiments withlanguages where the stress pattern coincides with word boundaries (i.e.English, Finnish and Dutch). In this study, we present data on speechsegmentation with native Spanish speakers whose stress pattern would markthe penultimate syllable of words. Results show that to stress the middlesyllable of trisyllabic words in an artificial speech stream does not facilitatesegmentation as would be predicted. Possible explanations of these resultsare explored as related to the interaction of statistical and stress cues inspeech segmentation(AU)^ien (119) Vogel U, Pfannenberg C, Renck T, M³ller W, B³ltmann B. Silicotic mediastinal lymphadenopathy can cause left vocal cord paralysis and dysphagia. Virchows Arch 2007;451:737-740. Ref ID: 422 (120) Allan PF, Abouchahine S, Harvis L, Morris MJ. Progressive vocal cord dysfunction subsequent to a chlorine gas exposure. J Voice 2006;20:291296. Ref ID: 89 Abstract: Chlorine gas inhalation, similar to other toxic gas exposures, can impart a variety of effects to the entire airway ranging from mucous membrane irritation to acute respiratory distress syndrome. The extent and location of damage is determined by numerous situational factors such as the duration of exposure, quantity of gas released, environmental factors, and instituted chemical defense measures. Reactive airways dysfunction and nonspecific bronchial hyperresponsiveness are commonly reported as sequelae to chlorine exposure. This article constitutes the first case of a single antecedent chlorine exposure inducing progressive vocal cord dysfunction (121) Baur X. Patient and occupation: Occupation and working world related obstructive airway diseases. Dtsch Med Wochenschr 2006;131:2705-2706. Ref ID: 343 (122) Bovo R, Galceran M, Petruccelli J, Hatzopoulos S. Vocal Problems Among Teachers: Evaluation of a Preventive Voice Program. J Voice 2006;21:705722. Ref ID: 434 Abstract: SUMMARY: Vocal education programs for teachers may prevent the emergence of vocal disorders; however, only a few studies have tried to evaluate the effectiveness of these preventive programs, particularly in the long term. Two hundred and sixty-four subjects, mostly kindergarten and primary school female teachers, participated in a course on voice care, including a theoretical seminar (120minutes) and a short voice group therapy (180 minutes, small groups of 20 subjects). For 3 months, they had to either attend the vocal ergonomics norms and, as psychological reinforcement, they had to make out a daily report of vocal abuse, or to follow the given exercises for a more efficient vocal technique, reporting on whether the time scheduled was respected or not. The effectiveness of the course was assessed in a group of 21 female teachers through a randomized controlled study. Evaluation comprehended stroboscopy, perceptual and electro-acoustical voice analysis, Voice Handicap Index, and a course benefit questionnaire. A group of 20 teachers matched for age, working years, hoarseness grade, and vocal demand served as a control group. At 3 months evaluation, participants demonstrated amelioration in the global dysphonia rates (P=0.0003), jitter (P=0.0001), shimmer (P=0.0001), MPT (P=0.0001), and VHI (P=0.0001). Twelve months after the course, the positive effects remained, although they were slightly reduced. In conclusion, a course inclusive of two lectures, a short group voice therapy, home-controlled voice exercises, and hygiene, represents a feasible and cost-effective primary prevention of voice disorders in a homogeneous and well-motivated population of teachers (123) Carroll T, Nix J, Hunter E, Emerich K, Titze I, Abaza M. Objective measurement of vocal fatigue in classical singers: a vocal dosimetry pilot study. Otolaryngol Head Neck Surg 2006;135:595-602. Ref ID: 69 Abstract: OBJECTIVES: To collect objective vibration dose data on singers and relate them to subjective measurements of vocal fatigue. STUDY DESIGN AND SETTING: Seven subjects completed a 2-week study period. The National Center for Voice and Speech (NCVS) dosimeter recorded vocal load, soft phonation tasks, and subjective soft voice ratings. Three vocal doses (time, distance, and cycle) were measured in classical singers' larynges during an intensive practice period. RESULTS: Spikes in vocal load are reflected as harsher subjective ratings on the same day as well as 24-72 hours later. When at least 48 hours of vocal rest occurred before a vocal load, improved subjective evaluations were seen after the load. CONCLUSIONS: The NCVS dosimeter appears to be an effective tool for data collection on prolonged use of the voice. SIGNIFICANCE: This is the first multi-day study comparing objective and subjective data on vocal fatigue in a group of professional singers (124) Chitkara A, Meyer T, Keidar A, Blitzer A. Singer's dystonia: first report of a variant of spasmodic dysphonia. Ann Otol Rhinol Laryngol 2006;115:89-92. Ref ID: 83 Abstract: OBJECTIVES: We discuss the phonatory characteristics of a previously undescribed focal laryngeal dystonia present in the singing voice. METHODS: We performed a retrospective chart review of 5 patients with singer's dystonia at a neurolaryngology referral center. RESULTS: Four patients reviewed demonstrated phonatory characteristics consistent with adductor spasmodic dysphonia present in their singing voice. One patient demonstrated abductor spasmodic dysphonia in the singing voice. Each patient initially exhibited normal connected speech in conversational voicing. The treatment protocol and outcome are discussed, including the use of botulinum toxin. CONCLUSIONS: Singer's dystonia is a previously undescribed neurologic disorder that should be understood by those who treat voice performers and voice disorders (125) Gallivan GJ, Eitnier CM. Vocal fold polyp in a professional brass/wind 51 instrumentalist and singer. J Voice 2006;20:157-164. Ref ID: 85 Abstract: Wind instrumentalists, especially brass players, and singers share common factors, including vocal tract shape, function and pressure, vocal fold opening and closure, breath vector of force and air flow rates. To understand the mechanism and function of the vocal folds with a pathological lesion, it is necessary to visualize the differing interactions of the vocal tract during wind and brass instrument playing and in singing. A school band director, singer, wind and brass instrumentalist, was referred by musician colleagues with intermittent dysphonia, aphonia, and inability to sing high notes. Simultaneous videolaryngoscopy, with and without stroboscopy, and external video examination were documented. An hourglass glottis with a sessile, cystic polyp of the left vocal fold were recorded and studied during phonation and the playing of 3 instruments. The techniques of glottic opening, closure, configuration and function varied with the type of instrument and phonatory function. Singing was adversely affected by the vocal fold polyp but no harmful interaction occurred during wind/brass instrument playing. Downstream loading in singers is at the laryngeal level and in wind/brass instrumentalists is at the embouchure. Preoperative voice therapy, phonomicrosurgery, and postoperative voice rest followed by voice therapy, succeeded in restoring her combined wind/brass instrumental and singing career (126) George RB, McKeen D, Law JA. Laryngoscopic evaluation with the Airway Cam. Canadian journal of anaesthesia = Journal canadien d'anesthésie 2006;53:512-515. Ref ID: 443 Abstract: PURPOSE: The Airway Cam is a head-mounted direct laryngoscopy video system which uses a prismatic sighting system that aligns with the operator's line of sight. This study evaluated intra- and inter-observer consistency in laryngoscopy grading comparing direct laryngoscopy to the laryngoscopy grade obtained with the Airway Cam. METHODS: Twenty-seven patients receiving a general anesthetic for elective surgery had laryngoscopy performed by an anesthesiologist wearing the Airway Cam. Each video was duplicated, then randomized and reviewed in a blinded fashion by the original laryngoscopist and a second anesthesiologist. Intra- and inter-observer correlations were identified. RESULTS: There was good intra-observer agreement of the Cormack-Lehane scale between direct laryngoscopy and laryngoscopy recorded with the Airway Cam (kappa = 0.63). The corresponding intra-observer correlation of the percentage of glottic opening score was strong at r = 0.83. There was good inter-observer agreement of the Cormack-Lehane scale between direct laryngoscopy and that observed by the second anesthesiologist during Airway Cam video review (kappa = 0.70). There was moderate correlation of the inter-observer percentage of glottic opening scores (r = 0.73). CONCLUSION: This study validates that the view recorded by the Airway Cam reflects the view of the laryngoscopist. The Airway Cam may introduce an additional level of objectivity into airway management research and teaching (127) Gillivan-Murphy P, Drinnan MJ, O'Dwyer TP, Ridha H, Carding P. The effectiveness of a voice treatment approach for teachers with self-reported voice problems. J Voice 2006;20:423-431. Ref ID: 90 Abstract: SUMMARY: Teachers are considered the professional group most at risk of developing voice-problems, but limited treatment effectiveness evidence exists. We studied prospectively the effectiveness of a 6-week combined treatment approach using vocal function exercises (VFEs) and vocal hygiene (VH) education with 20 teachers with self-reported voice problems. Twenty subjects were randomly assigned to a no-treatment control (n = 11) and a treatment group (n = 9). Fibreoptic endoscopic evaluation was carried out on all subjects before randomization. Two self-report voice outcome measures were used: the Voice-Related Quality of Life (VRQOL) and the Voice Symptom Severity Scale (VoiSS). A Voice Care Knowledge Visual Analogue Scale (VAS), developed specifically for the study, was also used to evaluate change in selected voice knowledge areas. A Student unpaired t test revealed a statistically significant (P < 0.05) improvement in the treatment group as measured by the VoiSS. There was not a significant improvement in the treatment group as measured by the V-RQOL. The difference in voice care knowledge areas was also significant for the treatment group (P < 0.05). This study suggests that a voice treatment approach of VFEs and VH education improved self-reported voice symptoms and voice care knowledge in a group of teachers (128) Hamdan AL, Sibai A, Youssef M, Deeb R, Zaitoun F. The use of a screening questionnaire to determine the incidence of allergic rhinitis in singers with dysphonia. Arch Otolaryngol Head Neck Surg 2006;132:547-549. Ref ID: 77 Abstract: OBJECTIVES: To report the incidence of allergic rhinitis in singers with nonspecific laryngeal examination findings and to correlate the incidence of allergic rhinitis with their vocal symptoms when present. DESIGN: A retrospective review of all the medical records of singers with nonspecific laryngeal findings who presented to a specialty voice center for either vocal training or therapy between June 2002 and September 2005. SETTING: Specialty voice center. PARTICIPANTS: Forty-five singers with nonspecific laryngeal findings who presented to a specialty voice center for either vocal training or therapy. MAIN OUTCOME MEASURES: A standardized validated questionnaire for evaluation of allergic rhinitis was filled out by all the subjects. A score above 0 was considered positive. RESULTS: The total prevalence of allergic rhinitis was 87% (39 of 45 subjects). The singers with vocal symptoms were approximately 15% more likely to have allergic rhinitis than those with no vocal symptoms (92% vs 84%). Singers with more than 2 vocal symptoms had a 25% higher likelihood of having allergic rhinitis. CONCLUSIONS: The incidence of allergic rhinitis in singers is extremely high. Hidden respiratory allergies may affect the professional voice. Proper awareness and a multidisciplinary approach are indispensable for proper diagnosis and treatment (129) Heaney L, Butler CA. Difficult asthma: An overview. Int J Respir Care 2006;2:10-14. Ref ID: 371 Abstract: The diagnosis of asthma is made easily in most cases and responds to standard doses of inhaled steroid therapy with or without add-on therapies. Recent data suggest that almost 80% of asthmatic subjects would have well controlled disease using combination inhaled steroid and long-acting betaagonists. However, a proportion of adult patients do not respond well, have poor symptomatic control and are often referred to as having 'difficult 53 asthma'. This poor response to conventional therapy may not always be due to underlying asthma severity: a number of studies have documented the frequency of co- morbid factors and how targeted intervention affects outcome in a population of poorly controlled asthmatics. We review these studies and outline an approach to the patient with difficult asthma (130) LaPine PR. Care of the vocalist: an uncommon perspective in rehabilitative medicine. Phys Med Rehabil Clin N Am 2006;17:755-7vi. Ref ID: 68 Abstract: Neurogenic communication disorders are a routine component of clinical practice in physiatry. The organicity of motor speech impairments and of forms of dysphagia is a basic, recurring element of clinical practice in physical and rehabilitative medicine. The purpose of this article is to provide an overview of some forms of and causes for predictable dysphonias associated with professional voice use. Intended as a synopsis of hyperfunctional voice disorders associated with professional voice use, only certain laryngeal pathologies with functional etiology and their effects on phonation are acknowledged (131) Laukkanen AM, Kankare E. Vocal loading-related changes in male teachers' voices investigated before and after a working day. Folia Phoniatr Logop 2006;58:229-239. Ref ID: 74 Abstract: Vocal loading-related changes have mainly been investigated in female voice users. The present study investigated male teachers' voices before and after a working day. A questionnaire was used to select 22 male teachers as subjects from a larger group. Ten reported suffering often from symptoms of vocal fatigue (MC = multiple complaints group), 12 reported few vocal complaints (FC group). The subjects recorded a text reading sample at habitual loudness and loudly, and sustained vowel [a:] before and after an approximately 6-hour working day. Text samples were analyzed for total sound pressure level (SPL) and SPL at three frequency regions (50-1,000 Hz, 1-2 kHz, 2-5 kHz), fundamental frequency (F0) and alpha ratio [(SPL 1-5 kHz) - SPL (50 Hz-1 kHz)]. Jitter and shimmer were calculated from the vowel. The subjects filled in a questionnaire about vocal sensations. The MC group reported more symptoms of vocal fatigue, and the symptoms increased during the working day. F0 and SPL increased in both groups. Alpha ratio increased in the MC group but remained the same in the FC group. The MC group had higher values of jitter and shimmer. Jitter diminished in the FC group but did not change significantly in the MC group. The differences between the groups reflect either different strategies for coping with vocal loading or different loading-induced changes in the vocal organ (132) Lehto L, Laaksonen L, Vilkman E, Alku P. Occupational voice complaints and objective acoustic measurements-do they correlate? Logoped Phoniatr Vocol 2006;31:147-152. Ref ID: 67 Abstract: To enable the development of appropriate diagnostics and treatment for occupational voice disorders, this study addresses connections between subjective voice complaints and objective observations. The subjects of this study were 24 female customer advisors, who mainly use the telephone during their working hours. During one working day, at four different times, speech samples covering 20 minutes of telephone conversation by the customer service advisors (CSAs) were recorded. In addition, the CSAs filled in a questionnaire (visual analogue scale) concerning their voice problems. To represent the vocal symptoms three variables were used: vocal fatigue, hoarseness and a general sum-variable. A 5-minute sample was taken from recordings for further analyses. This included fundamental frequency, sound pressure level, alpha ratio (the ratio between the spectral energy below and above 1000 Hz) and number of vocal fold vibrations. In the objective acoustic measurements, it was found that fundamental frequency (F0) rose significantly during the working day. Also the self-reported voice symptoms increased significantly during the working day. However, correlations between vocal symptoms and acoustic measures were not found (133) McKay S, Craw M, Chopra D. Migrant workers in England and Wales: An assessment of migrant worker health and safety risks. 2006. HSE Research Report RR502. Ref Type: Report Ref ID: 484 Abstract: This report, which draws on interviews with 200 migrant workers in five regions of England and Wales, considers whether the position that recent migrant workers occupy within the labour market puts their health and safety at increased risk, in comparison with other workers in similar positions. The research findings suggest that it is not the case that the risks inherent in a particular type of work of necessity only present themselves in relation to migrant workers. However, what it does reveal is that migrants are more likely to be working in sectors or occupations where there are existing health and safety concerns and that it is their status as new workers that may place them at added risk, due to their relatively short periods of work in the UK and limited knowledge of the UK's health and safety system. The report also notes that migrant motivations in coming to the UK, particularly where these are premised on earning as much as possible in the shortest possible time, add to their risk factors and that limited means of communication between migrant workers and indigenous supervisors also may place these workers at greater risk (134) Mendes A, Alves-Pereira M, Castelo Branco NA. Voice acoustic patterns of patients diagnosed with vibroacoustic disease. Rev Port Pneumol 2006;12:375-382. Ref ID: 71 Abstract: BACKGROUND: Long-term low frequency noise exposure (LFN) (< or = 500 Hz, including infrasound) may lead to the development of vibroacoustic disease (VAD), a systemic pathology characterized by the abnormal growth of extra-cellular matrices. The respiratory system is a target for LFN. Fibrosis of the respiratory tract epithelia was observed in VAD patients through biopsy, and confirmed in animal models exposed to LFN. Voice acoustic analysis can detect vocal fold variations of mass, tension, muscular and neural activity. Frequency perturbation (jitter), amplitude perturbation (shimmer) and harmonic-to-noise ratio (HNR) are used in the evaluation of the vocal function, and can be indicators of the presence and degree of severity of vocal pathology. Since the respiratory system is the energy source of the phonation process, this raises questions about the effects of VAD on voice production. The purpose of this study was to determine if voice acoustic parameters of VAD patients are different from normative data. METHODS: Nine individuals (5 males and 4 females) 55 diagnosed with VAD were recorded performing spoken and sung tasks. The spoken tasks included sustaining vowels and fricatives. The sung tasks consisted of maximum phonational frequency range (MPFR). Voice acoustic parameters ana- lysed were: fundamental frequency (F0), jitter, shimmer, HNR and temporal measures. RESULTS: Compared with normative data, both males and females diagnosed with VAD exhibited increased F0, shimmer and HNR. Jitter, MPFR and one temporal measure were reduced. CONCLUSIONS: VAD individuals presented voice acoustic parameter differences in spectral, temporal and perturbation measures, which may be indicative of small morphological changes in the phonatory system (135) Niebudek-Bogusz E, Fiszer M, Kotylo P, Sliwinska-Kowalska M. Diagnostic value of voice acoustic analysis in assessment of occupational voice pathologies in teachers. Logoped Phoniatr Vocol 2006;31:100-106. Ref ID: 72 Abstract: It has been shown that teachers are at risk of developing occupational dysphonia, which accounts for over 25% of all occupational diseases diagnosed in Poland. The most frequently used method of diagnosing voice diseases is videostroboscopy. However, to facilitate objective evaluation of voice efficiency as well as medical certification of occupational voice disorders, it is crucial to implement quantitative methods of voice assessment, particularly voice acoustic analysis. The aim of the study was to assess the results of acoustic analysis in 66 female teachers (aged 40-64 years), including 35 subjects with occupational voice pathologies (e.g., vocal nodules) and 31 subjects with functional dysphonia. The acoustic analysis was performed using the IRIS software, before and after a 30-minute vocal loading test. All participants were subjected also to laryngological and videostroboscopic examinations. After the vocal effort, the acoustic parameters displayed statistically significant abnormalities, mostly lowered fundamental frequency (Fo) and incorrect values of shimmer and noise to harmonic ratio. To conclude, quantitative voice acoustic analysis using the IRIS software seems to be an effective complement to voice examinations, which is particularly helpful in diagnosing occupational dysphonia (136) Niebudek-Bogusz E, Sliwinska-Kowalska M. [Applicability of voice acoustic analysis with vocal loading testto diagnostics of occupational voice diseases]. Med Pr 2006;57:497-506. Ref ID: 60 Abstract: BACKGROUND: An assessment of the vocal system, as a part of the medical certification of occupational diseases, should be objective and reliable. Therefore, interest in the method of acoustic voice analysis enabling objective assessment of voice parameters is still growing. The aim of the present study was to evaluate the applicability of acoustic analysis with vocal loading test to the diagnostics of occupational voice disorders. MATERIAL AND METHODS: The results of acoustic voice analysis were compared using IRIS software for phoniatrics, before and after a 30-min vocal loading test in 35 female teachers with diagnosed occupational voice disorders (group I) and in 31 female teachers with functional dysphonia (group II). RESULTS: In group I, vocal effort produced significant abnormalities in voice acoustic parameters, compared to group II. These included significantly increased mean fundamental frequency (Fo) value (by 11 Hz) and worsened jitter, shimmer and NHR parameters. Also, the percentage of subjects showing abnormalities in voice acoustic analysis was higher in this group. CONCLUSIONS: Conducting voice acoustic analysis before and after the vocal loading test makes it possible to objectively confirm irreversible voice impairments in persons with work-related pathologies of the larynx, which is essential for medical certification of occupational voice diseases (137) Obrebowski A, Tuszynski K, Wilmowska-Pietruszynska A, ObrebowskaKarsznia Z, Wojnowski W. [The teachers health damage and pension related to occupational voice disease]. Otolaryngol Pol 2006;60:55-60. Ref ID: 75 Abstract: The current regulations allow in special cases for the acknowledgement of the occupational disease among teachers who suffer from voice disorders. The physician who acts as the adjudicator in ZUS (National Insurance System) usually consults a phoniatrician and determines the percent of the permanent or long-term health damage, which can vary between 10-40%. The aim of the paper was to analyze the evidence which is taken into consideration while determining the percent of health damage and granting the occupational disease pension. The authors present proposition in detail the rules which govern the process of health damage calculation due to advancement of voice disorders, which can be very useful to adjudicating physicians in government and commercial insurance companies (138) Pocetta G, Terenzoni B, Quercia A, Borzacchi G, Garista P. Quality assessment of training courses for the qualification to purchase and use pesticides in agriculture. 2006. Ref ID: 485 Abstract: Training for authorization to use pesticides at the Workplace Prevention, Hygiene, and Safety Department (PISSL) of the Local Health Unit of Viterbo (ASL). To assess the perceived quality of the courses. To obtain information on the applicability of a qualitative survey method. The setting up of a multidisciplinary research group. Joint development of a research protocol. Participant selection by theoretical sampling. Data analysis by grounded theory approach: triangulation of more data obtained by the different readings of the recordings by the researchers. 95% attendance rate. Results show sensitivity to risks linked to these substances but also conflicting messages by teachers from different scientific areas. Although these courses improve skills, proved by farmers' statements of self-efficacy, a notable discrepancy between theory and professional practice was detected. Users' "participation" is also a key factor. The focus group proved to be a valuable and productive methodology (from the point of view of information) for assessing the quality of courses, as well as a useful tool for a service that attaches importance to participation (139) Przerwa E. [Voice emission and the tongue]. Ann Acad Med Stetin 2006;52 Suppl 3:31-35. Ref ID: 50 Abstract: Tongue function is seldom studied in relationship to voice emission. Normal tongue function supports to a varying extent subsequent phases of voice emission, including respiration, phonation, articulation, and resonance. Disorders of tongue motoric function lead to difficulties in voice emission at each of these phases. The disorders vary as to the degree, type, and extent but in consequence lead to pathologies of the organ of voice. When learning voice emission, more attention paid to tongue function and its role in voice formation could improve the training and rehabilitation processes 57 (140) Schneider B, Enne R, Cecon M et al. Effects of vocal constitution and autonomic stress-related reactivity on vocal endurance in female student teachers. J Voice 2006;20:242-250. Ref ID: 92 Abstract: Several studies revealed a high percentage of voice problems in future teachers. The influence of vocal constitution on the vocal endurance is, however, still unclear. The goal of this study was to evaluate whether the increase of voice fundamental frequency (F0) during teaching is caused by (1) autonomic regulation patterns under stress, (2) anxiety as an emotional factor, or (3) limitations in voice constitution. Thirty-three subjects with either normal voice constitution (n = 15, group 1) or constitutional hypofunction (n = 18, group 2) assessed by voice range profile measurements were enrolled in this study. Furthermore, they underwent a standardized baseline test to register selected autonomic test parameters and were classified into autonomic outlet types (AOT) as proposed by Johannes et al. Later the subjects were examined during 1 hour of teaching (field study). The parameters tested included heart rate, pulse transition time, finger temperature, and voice fundamental frequency. To measure situational anxiety and general anxiety proneness, a state-trait anxiety inventory was taken. Eleven subjects per group were identified as autonomic stable (AOT 1), two per group as responding cardiovascularly (AOT 2), and two of group 1 and four of group 2, respectively, as having higher heart rate and higher blood pressure responses to stress (AOT 4). One subject had to be excluded because of missing data. However, statistical analyses showed no differences between AOT groups regarding the voice constitution groups. Increased fundamental frequencies of speaking voice after 30 and 45 minutes of teaching were found in group 2 (constitutional hypofunction). No effect of state or trait anxiety on voice endurance could be detected. Thus, the increase of fundamental frequency of voice has to be regarded as a consequence of vocal fatigue. A constitutionally weak voice seems to be a risk factor for developing a professional voice disorder (141) Shah A, da Silva EJ. Crouching gasman; hidden larynx. Anaesthesia 2006;61:206. Ref ID: 87 (142) Simberg S, Sala E, Tuomainen J, Sellman J, Rönnemaa AM. The effectiveness of group therapy for students with mild voice disorders: a controlled clinical trial. Journal of voice : official journal of the Voice Foundation 2006;20:97109. Ref ID: 465 Abstract: Previous studies of students studying to be teachers have indicated that these students commonly have voice disorders. Ideally, voice disorders should be treated before students start their work as teachers, but the resources for this treatment are often limited. This study examines whether group voice therapy is effective for teacher students. Accordingly, 20 teacher students with mild voice disorders received group voice therapy (in three small groups), whereas 20 students with similar voice disorders served as a control group and consequently did not receive voice therapy. Two out of three outcome measures (perceptual evaluation of voice quality and a questionnaire on the occurrence of vocal symptoms) indicated significant changes in the treatment group compared with the control group. No differences between groups were noted in the laryngeal status. The results suggest that group voice therapy seems to be an effective method to treat students with mild voice disorders (143) Sinkiewicz A, Pruszewicz A, Obrebowski A, Wiskirska-Woznica B, Wojnowski W. [Subjective assessment of voice functions among teachers taking part in the rehabilitation program]. Otolaryngol Pol 2006;60:391-395. Ref ID: 70 Abstract: INTRODUCTION: In daily phoniatric practice, apart from laryngoscopy, another simple and useful method of examining the voice organ is perceptual voice assessment based on the GRBAS scale. An extension to this examination can be the Voice Handicap Index test (VHI). MATERIALS AND METHODS: 79 female teachers taking part in a 7-week-long rehabilitation course on voice emission techniques. Before and after the course the participants were subject to phoniatric examination including laryngovideostroboscopy, GRBAS scale assessment and determining the voice handicap index (VHI). RESULTS: After the course, a substantial improvement has been observed in voice emission, perceptual assessment and the VHI test. It has been observed that there is a statistically significant correlation between GRBAS and VHI results and mean phonation time (MPT) measured before and after the course. CONCLUSIONS: The VHI test should be included in complex analysis of the effects of intensive rehabilitation (144) Sliwinska-Kowalska M, Niebudek-Bogusz E, Fiszer M et al. The prevalence and risk factors for occupational voice disorders in teachers. Folia Phoniatr Logop 2006;58:85-101. Ref ID: 86 Abstract: OBJECTIVE: Occupational voice disorders in Poland account for over 25% of all occupational diseases. The aim of the study was to assess the prevalence of voice problems in the general population of Polish teachers, and identify risk factors for developing voice pathology. PATIENTS AND METHODS: The study group comprised 425 female full-time teachers (most of them primary and secondary school, age ranging from 23 to 61 years) and 83 nonteacher women (control) whose jobs did not involve vocal effort, matched for age to the study group. All participants were subjected to a survey using an extensive questionnaire, and to laryngological, phoniatric and videostroboscopic examinations. RESULTS: The overall lifetime vocal symptoms were more frequent in the teachers than in the non-teachers (69 vs. 36%), and in particular it related to permanent and recurrent hoarseness, and dryness in the throat. Mean number of the voice symptoms was 3.21 in teachers and 1.98 in controls (p < 0.001). Abnormal (non-euphonic) voice, neck muscle hypertension during phonation and incorrect resonator function were also significantly more frequent in the teachers. Mean maximum phonation time was shorter in teachers than in the controls (14.3 vs. 15.9 s, p < 0.01). Occupational voice disorders and hyperfunctional dysphonia (that is thought to predispose to such pathology) were found in 32.7% of teachers and 9.6% of control subjects. The probability of developing incomplete glottal closure (odds ratio 13.2x; 95% CI: 1.8-96.8) and hyperfunctional dysphonia (odds ratio 2.7; 95% CI: 1.14-6.44) were significantly higher in the teacher group versus non-teachers. A significant positive relationship was found in teachers between the prevalence of hyperfunctional dysphonia and strained phonation, neck muscle hypertension, instability of voice, self-assessed hyper-arousal, and lifetime vocal effort index (years of employment as a teacher x hours of professional activity/week). The 59 prevalence of vocal nodules and incomplete glottal closure were correlated with incorrect phonation technique parameters, but not with psychological factors. No correlation was found with environmental variables, such as classroom temperature, humidity, airborne dust. CONCLUSION: The prevalence of self-reported symptoms and clinical signs of voice disorders is around 2-3 times more frequent in Polish female teachers than in nonteachers. Lifetime vocal effort, incorrect technique of phonation and psychological predisposition seem to constitute major risk factors for developing occupational voice disorders (145) Smith LJ, Sataloff RT. Hemorrhage, varicosity, and cysts in a professional singer. Ear Nose Throat J 2006;85:302. Ref ID: 76 (146) Smith LJ, Sataloff RT. Vocal fold masses and a varicosity in a professional singer. Ear Nose Throat J 2006;85:15. Ref ID: 84 (147) Zeitels SM, Akst LM, Bums JA, Hillman RE, Broadhurst MS, Anderson RR. Pulsed angiolytic laser treatment of ectasias and varices in singers. Ann Otol Rhinol Laryngol 2006;115:571-580. Ref ID: 73 Abstract: OBJECTIVES: Varices and ectasias in singers are typically the result of phonotraumatic shearing stresses and/or collision forces on the microcirculation within the superficial lamina propria. These lesions can be debilitating in performing vocalists because of the effect of recurrent hemorrhage and/or as a contributing factor to the morbidity of other mass lesions such as polyps, nodules, and cysts. Phonomicrosurgical treatment of performers is understandably approached with great trepidation, as the vocal liability of surgically disturbing the superficial lamina propria and epithelium must be balanced with the inherent detrimental vocal effect(s) of the lesion(s). Pulsed angiolytic lasers that emit radiation at high absorbance peaks of oxyhemoglobin were examined to determine whether they were an efficacious treatment approach for ectasias and varices based on these lasers' mechanisms of action and prior experience in phonomicrosurgery. METHODS: A prospective trial was done in 39 patients (40 procedures in 54 vocal folds) without complication to evaluate the effectiveness of a 585-nm pulsed dye laser (PDL; 25 cases) and a 532-nm pulsed KTP laser (15 cases) in a noncontact mode to treat 65 varices and 43 ectasias. Twenty-nine of 39 patients had varices and ectasias associated with other phonotraumatic mass lesions that required resection. Results: All patients have resumed full vocal activities, and no patient has had a subsequent hemorrhage or vocal deterioration. CONCLUSIONS: Both the 585-nm PDL and the 532-nm pulsed KTP laser were found to be efficacious and relatively safe treatment modalities for vascular abnormalities of the vocal folds in singers. Noncontact selective photoangiolysis of the aberrant vessels prevented future bleeding without substantial photothermal trauma to the overlying epithelium and surrounding delicate superficial lamina propria, thereby allowing for optimal postoperative mucosal pliability and glottal sound production. However, the pulsed KTP laser was substantially easier to use because of its enhanced hemostasis due to its longer pulse width. Vessel wall rupture was commonplace during use of the 585-nm PDL, but rarely occurred during photoangiolysis with the 532-nm pulsed KTP laser (148) Begliarov ME. The method of voice recovery in functional dysphonias in voice professionals. Vestn Otorinolaringol 2005;50-51. Ref ID: 344 Abstract: The method of the treatment of psychogenic functional dysphonia in voice professional is described. This method (audiovocalotherapy) consists in listening professional singing or speech. The mechanism of a therapeutic action of audiovocalotherapy is analysed. It is emphasized that such therapy is not expensive and can be used by ENT doctors in outpatient clinics (149) Ceballos B. Is EMG-guidance of botulinum toxin injections useful? PsychoNeuro 2005;31:307-314. Ref ID: 356 Abstract: Guidelines regarding technique and dosage of botulinum toxin vary considerably. One issue remains the role of EMG to refine treatment outcome. Basically all studies in blepharospasm were conducted without EMG. More than 60% of patients with cervical dystonia consider Botulinumtoxin even after years of regular injection sessions every 3 to 4 months as a valuable treatment and ask for reinjections. The impact of EMG guidance has only been rarely assessed. The effectiveness of Botulinumtoxin with EMG control in writer's cramp and in spasmodic dysphonia has been demonstrated in a number of studies. Refinement of therapy remains a challenge in writer's cramp and other occupational dystonias, jaw opening dystonia and anterocollis. EMG guidance may be helpful, probably even a prerequisite in these indications. The role of EMG guidance in the major indications such as uncomplicated cervical dystonia and spasticity to improve outcome, minimize side effects and to save toxin remains unclear (150) Engen RL. The singer's breath: implications for treatment of persons with emphysema. J Music Ther 2005;42:20-48. Ref ID: 98 Abstract: This study investigated the effects of group singing instruction on the physical health and general wellness of senior citizens with emphysema. Subjects (n = 7) participated in 6 weeks of group vocal instruction, which emphasized breath management techniques. Dependent measures reflected physical health, functional outcomes, and quality of life. No significant differences were found on measures of physical health (FEV1, inspiratory threshold, distance walked, and The DUKE physical health subscale). Measures of functional outcomes each showed a significant change across time. Results of the ANOVAs for breath management (extent of counting) and breath support (intensity of speech) were significant (p < .038 & p < .000 respectively). Descriptive analyses showed a clear and dramatic shift in breathing mode from clavicular to diaphragmatic breathing that was maintained 2 weeks after the treatment period. Quality of life measures (subjective scales and The Duke Health Profile) yielded mixed results. Findings of this study suggest that vocal instruction, inclusive of breathing exercises, may help to improve the quality of life for senior citizens with emphysema. Subjects in this study responded positively to the instruction and further investigation of the treatment method is warranted (151) Galdi E, Perfetti L, Pagella F, Bertino G, Ferrari M, Moscato G. Irritant vocal cord dysfunction at first misdiagnosed as reactive airway dysfunction syndrome. Scand J Work Environ Health 2005;31:224-226. Ref ID: 93 61 Abstract: OBJECTIVES: This report describes a case of vocal cord dysfunction at first misdiagnosed as reactive airway dysfunction syndrome (RADS). METHODS: A woman developed recurrent episodes of cough, dyspnea, and wheezing unresponsive to asthma therapy after irritant exposure to glutaraldehyde. Direct laryngoscopy was performed immediately after the induction of symptoms. RESULTS: Laryngoscopy showed a paradoxical adduction of the vocal cord on inspiration. Vocal cord dysfunction was diagnosed. CONCLUSIONS: A case of vocal cord dysfunction occurred after exposure to glutaraldhyde in a person with a history highly suggestive of RADS. Vocal cord dysfunction should always be considered in the differential diagnosis of patients with acute respiratory symptoms after exposure to irritants and with asthma-like symptoms that fail to respond to conventional asthma therapy (152) Hartl DM, Crevier BL, Vaissičre J, Brasnu DF. Phonetic effects of paralytic dysphonia. The Annals of otology, rhinology, and laryngology 2005;114:792798. Ref ID: 444 Abstract: OBJECTIVES: This study was performed to determine whether and how unilateral vocal fold paralysis (UVFP) affects the production and perception of voiced stop consonants as compared with unvoiced stops, and to analyze the phonetic effects of UVFP on the voicing feature. METHODS: Phonetic constructs pronounced by 7 male patients with UVFP and 5 normal male subjects were recorded. The 432 speech tokens consisted of intervocalic, prevocalic, and postvocalic stop consonants (/p/, /t/, /k/, /b/, /d/, /g/) in the vowel contexts /a/ and /i/. Perceptual consonant identification testing was performed with 5 voice and speech professionals as listeners. The type and frequency of errors made in consonant identification were analyzed. Spectrographic analysis was used to analyze acoustic cues. RESULTS: The rate of correct consonant identification was significantly lower for tokens pronounced by patients with UVFP (77.3% versus 97.6%, p = .0001) because of incorrect identification of the voiced consonants, frequently perceived as their unvoiced homologues. Confusion between dental and alveolar place of articulation for unvoiced stops was also noted. CONCLUSIONS: Unilateral vocal fold paralysis alters the voiced-unvoiced stop consonant distinction and the dental-palatal stop consonant distinction in an experimental nonspeech context. This finding implies the existence of a phonetic handicap for patients with UVFP. Further studies should determine the effects of UVFP on global speech intelligibility (153) Kooijman PG, de Jong FI, Oudes MJ, Huinck W, van AH, Graamans K. Muscular tension and body posture in relation to voice handicap and voice quality in teachers with persistent voice complaints. Folia Phoniatr Logop 2005;57:134147. Ref ID: 95 Abstract: The aim of this study was to investigate the relationship between extrinsic laryngeal muscular hypertonicity and deviant body posture on the one hand and voice handicap and voice quality on the other hand in teachers with persistent voice complaints and a history of voice-related absenteeism. The study group consisted of 25 female teachers. A voice therapist assessed extrinsic laryngeal muscular tension and a physical therapist assessed body posture. The assessed parameters were clustered in categories. The parameters in the different categories represent the same function. Further a tension/posture index was created, which is the summation of the different parameters. The different parameters and the index were related to the Voice Handicap Index (VHI) and the Dysphonia Severity Index (DSI). The scores of the VHI and the individual parameters differ significantly except for the posterior weight bearing and tension of the sternocleidomastoid muscle. There was also a significant difference between the individual parameters and the DSI, except for tension of the cricothyroid muscle and posterior weight bearing. The score of the tension/posture index correlates significantly with both the VHI and the DSI. In a linear regression analysis, the combination of hypertonicity of the sternocleidomastoid, the geniohyoid muscles and posterior weight bearing is the most important predictor for a high voice handicap. The combination of hypertonicity of the geniohyoid muscle, posterior weight bearing, high position of the hyoid bone, hypertonicity of the cricothyroid muscle and anteroposition of the head is the most important predictor for a low DSI score. The results of this study show the higher the score of the index, the higher the score of the voice handicap and the worse the voice quality is. Moreover, the results are indicative for the importance of assessment of muscular tension and body posture in the diagnosis of voice disorders (154) Niebudek-Bogusz E, Fiszer M, Sliwinska-Kowalska M. [Assessment of voice acoustic parameters in female teachers with diagnosed occupational voice disorders]. Med Pr 2005;56:431-438. Ref ID: 80 Abstract: BACKGROUND: Laryngovideostroboscopy is the method most frequently used in the assessment of voice disorders. However, the employment of quantitative methods, such as voice acoustic analysis, is essential for evaluating the effectiveness of prophylactic and therapeutic activities as well as for objective medical certification of larynx pathologies. The aim of this study was to examine voice acoustic parameters in female teachers with occupational voice diseases. MATERIALS AND METHODS: Acoustic analysis (IRIS software) was performed in 66 female teachers, including 35 teachers with occupational voice diseases and 31 with functional dysphonia. RESULTS: The teachers with occupational voice diseases presented the lower average fundamental frequency (193 Hz) compared to the group with functional dysphonia (209 Hz) and to the normative value (236 Hz), whereas other acoustic parameters did not differ significantly in both groups. CONCLUSIONS: Voice acoustic analysis, when applied separately from vocal loading, cannot be used as a testing method to verify the diagnosis of occupational voice disorders (155) Preciado J, Perez C, Calzada M, Preciado P. [Prevalence and incidence studies of voice disorders among teaching staff of La Rioja, Spain. Clinical study: questionnaire, function vocal examination, acoustic analysis and videolaryngostroboscopy]. Acta Otorrinolaringol Esp 2005;56:202-210. Ref ID: 94 Abstract: OBJECTIVE: The aim of this study was calculate the prevalence and incidence of voice disorders among teaching staff of La Rioja, Spain. DESIGN: We carried out a transversal study of voice disorders in teaching staff of La Rioja (a random sample of 931 of 3113 teachers) and a longitudinal study (we collect the new cases during the 3 years which lasts the study). PATIENTS: 527 teachers of random sample took part of study: 332 female (63%) and 195 male (37%). METHODS: All of teachers fill in a standard 63 questionnaire, ENT and function vocal examination, videolaryngostroboscopy and acoustic analysis with MDVP. RESULTS: The prevalence of voice disorders among La Rioja Teachers was 57%: 20.3% for organic lesions [nodular lesions (14%), polyps (2%), submucous suffusions (1.4%), edema Reinke (1.2%) Sulcus (0.4%), scalp (0.6%), leucoplasia (0.2%) vocal cord paralysis (0.2%)] 8.1% for chronic laryngitis [not specific (2.8%), smoke (3.9%) gastroe-sofageal reflux (2.5%)] and 29% for functional lesions [hyperfunctional dysphonia (7.5%) hypofunctional dysphonia (0.4%) vocal overefforts (18%) hyperplasia false cords (2.8)]. The incidence rate was 4 new cases each 1000 teachers and year. CONCLUSIONS: Organic lesions were more prevalent in women (25.4%) than in men (9.5%), but functional lesions and chronic laryngitis were more prevalent in men (36.5% and 13.2%) than in women (24% and 5%) (156) Rogerson J, Dodd B. Is there an effect of dysphonic teachers' voices on children's processing of spoken language? J Voice 2005;19:47-60. Ref ID: 100 Abstract: There is a vast body of literature on the causes, prevalence, implications, and issues of vocal dysfunction in teachers. However, the educational effect of teacher vocal impairment is largely unknown. The purpose of this study was to investigate the effect of impaired voice quality on children's processing of spoken language. One hundred and seven children (age range, 9.2 to 10.6, mean 9.8, SD 3.76 months) listened to three video passages, one read in a control voice, one in a mild dysphonic voice, and one in a severe dysphonic voice. After each video passage, children were asked to answer six questions, with multiple-choice answers. The results indicated that children's perceptions of speech across the three voice qualities differed, regardless of gender, IQ, and school attended. Performance in the control voice passages was better than performance in the mild and severe dysphonic voice passages. No difference was found between performance in the mild and severe dysphonic voice passages, highlighting that any form of vocal impairment is detrimental to children's speech processing and is therefore likely to have a negative educational effect. These findings, in light of the high rate of vocal dysfunction in teachers, further support the implementation of specific voice care education for those in the teaching profession (157) Rydzynski K. International Journal of Occupational Medicine and Environmental Health: Editorial. Int J Occup Med Environ Health 2005;18:303-304. Ref ID: 403 (158) Rzewnicki I, Jackiewicz M, Biszewska J, Bulatewicz A, Wierzba U, Rzewnicka M. Quality of life of patients with larynx cancer. Pol Merkuriusz Lek 2005;19:353-355. Ref ID: 404 Abstract: The number of diagnosed instances of larynx cancer is systematically increasing, especially in men. Treatment, in the majority of cases, is undertaken at an advanced stage of the disease. This is the major factor determining the outcome of therapy and the patients' quality of life. The aim of this paper is to estimate the environmental and occupational risk factors as well as to evaluate the quality of life of patients before they were diagnosed with larynx cancer and after the treatment was completed. The analysis involved 82 patients after total laryngectomy due to squamous cell carcinoma. A vast majority of the patients (96%) abused alcohol and were heavy smokers (95%). 76% were exposed to harmful environmental conditions and 56% - to harmful conditions at workplace. After treatment, which was accepted by over 96% of the patients, many of them quit using alcohol (57%) and quit smoking (73%). Because of difficult economic situation only few of them decided to change their working or living conditions. 47% of patients judged that after the diagnosis and consequently after undergoing complete treatment, the quality of their life deteriorated. Their awareness of the health-threatening factors had however grown (159) Schneider B, Bigenzahn W. Vocal risk factors for occupational voice disorders in female teaching students. Eur Arch Otorhinolaryngol 2005;262:272-276. Ref ID: 109 Abstract: The objective of the study was to assess voice capabilities and laryngeal abnormalities in female teaching students in order to evaluate risk factors of future occupational voice disorders. One hundred forty-four women (aged 17 to 41 years) were examined using videostroboscopy and voice range profile measurements. Stroboscopically, the subjects were classified into three groups depending on the shape of the glottal closure. Thirty-five phonationassociated alterations and six organic alterations of the vocal folds were found. Subjects with an insufficient glottal closure showed a higher percentage of phonation-associated vocal fold alterations (i.e. vocal nodules) and reached lower maximum sound pressure levels. The results underline the necessity to execute vocal examinations and vocal assessment analyses for candidates of voice intensive professions in order to avoid profession-related dysphonias at a later stage (160) Schneider B, Bigenzahn W. How we do it: voice therapy to improve vocal constitution and endurance in female student teachers. Clin Otolaryngol 2005;30:66-71. Ref ID: 101 Abstract: Vocal hypofunction should be regarded as risk factor of occupational voice disorders. Voice therapy is effective to improve vocal endurance and voice constitution. Elucidation of constitutionally weak voices in teachers is recommended prior to their professional career (161) Seven H, Calis AB, Vural C, Turgut S. Microscopic thyroidectomy: a prospective controlled trial. European archives of oto rhino laryngology : official journal of the European Federation of Oto Rhino Laryngological Societies : affiliated with the German Society for Oto Rhino Laryngology Head and Neck Surgery 2005;262:41-44. Ref ID: 463 Abstract: The purpose of this prospective study was to evaluate microsurgical thyroidectomy by comparing it with traditional thyroidectomy. Before surgery, patients were assigned either to the microscopic thyroidectomy group (MT group), with the use of the surgical microscope, or the traditional thyroidectomy group (TT group), without the use of visual magnification. Outcome measures were operative time, intraoperative bleeding and complication rates including injury to the recurrent laryngeal nerve (RLN), the external branch of the superior laryngeal nerve (EBSLN) or the parathyroid glands. Ninety-eight patients underwent thyroid surgery (58 patients in the MT group, 40 patients in the TT group). The two groups were similar in age, sex, surgical procedures and histological findings. There was no difference 65 between the two techniques regarding the operative time and the amount of blood loss. Neither permanent nerve palsy nor persistent hypocalcemia occurred in either group. Transient nerve palsies (RLN and EBSLN) were lower in the MT group (1.7%) compared to the TT group (7.5%), but the difference did not reach statistical significance (P>0.05). Overall transient hypocalcemia was significantly lower in the MT group (1.7%) compared with the TT group (12.5%, P=0.032). If the population was restricted to total thyroidectomy, the rate of transient hypocalcemia was 4.1% in the MT group and 33.3% in the TT group, respectively (P=0.022). In conclusion, microsurgical thyroidectomy is a feasible and efficacious surgical procedure. It significantly reduces the complications without increasing the operating time in thyroid surgery procedures. A major advantage of this technique is the possibility of attaching a camera to the microscope, thereby greatly facilitating teaching (162) Shine NP, Lacy P, Conlon B, McShane D. Spontaneous retropharyngeal and cervical emphysema: a rare singer's injury. Ear Nose Throat J 2005;84:726727. Ref ID: 88 Abstract: Spontaneous retropharyngeal and cervical emphysema is rare. We describe a case that was unusual in its etiology: the result of singing. Although this condition is usually benign, hospital admission for close observation and supportive therapy is prudent (163) Simberg S, Sala E, Vehmas K, Laine A. Changes in the prevalence of vocal symptoms among teachers during a twelve-year period. J Voice 2005;19:95102. Ref ID: 99 Abstract: Vocal symptoms and voice disorders among teachers were studied in 1988 using a questionnaire designed to obtain information on six vocal symptoms that had appeared during the past 2 years. Twelve percent of the 478 respondents reported vocal symptoms occurring weekly or more often. The study was repeated using the same questionnaire in 2001. The results of this second study (n=241) indicate that vocal symptoms had increased considerably. Twenty-nine percent of the teachers reported symptoms occurring weekly or more often, and 20% reported two symptoms or more occurring at least once a week, which is significantly more than in 1988. Accordingly, voice disorders are probably a growing problem among teachers. Several factors may explain these increases. In 2001, the teachers complained more often about increases in the size of their classes. Factors that disturbed normal work routines, such as noisy or misbehaving pupils, had also increased significantly. A growing number of misbehaving pupils probably cause increased background noise and stress and, thus, increase the vocal symptoms in teachers (164) Smith LJ, Sataloff RT. Vocal fold polyp in a professional singer. Ear Nose Throat J 2005;84:552. Ref ID: 91 (165) Sulkowski WJ, Kowalska S. Occupational voice disorders: an analysis of diagnoses made and certificates issued in 1999-2004. Int J Occup Med Environ Health 2005;18:341-349. Ref ID: 79 Abstract: OBJECTIVES: It has been decided to identify the most frequent diseases of the larynx in people occupationally exposed to a considerable voice load and to assess the feasibility of using videostroboscopy to diagnose voice disorders and their organic effects in order to improve the reliability of certification of occupational vocal organ diseases as well as to evaluate the functioning of new regulations on diagnosing and certifying occupational vocal organ diseases and to assay the conformity of clinical diagnoses made at voivodeship (provincial) centers (level I) with those made at scientific research institutes (level II). MATERIALS AND METHODS: The study involved an analysis of 1261 cases (1042 women and 219 men) with the vocal organ disorders referred to the ENT Unit, Nofer Institute of Occupational Medicine, Lodz, by voivodeship centers during 1999-2004 for consultation or under the appeal procedure (if applicants were denied the right to be included in the category of patients with occupational disease of the vocal organ). The majority of the patients (65.7%) were primary school teachers, and those aged 51-60 years made 54.8%. Laryngological, phoniatric and videostroboscopic examinations, when necessary, supplemented with other testing procedures (paranasal sinus imaging, allergenic tests) were taken to assess the clinical state of the patients. RESULTS: As a result of these comprehensive examinations, organic changes in the larynx were detected in 161 (12.7%) cases, including 139 (11.0%) women and 22 (1.7%) men. According to current diagnostic/certifying criteria those pathologies could be classified into the category of occupational disease of the vocal organ. Paresis of vocal folds due to the insufficiency of vocal fold adductor and tensor muscles with permanent dysphonia was found in 97 (7.6%) patients, vocal nodules in 53 (4.2%) and secondary hypertrophy changes in vocal folds in 11 (0.87%) patients. The most frequent reasons for excluding the occupational etiology of the disease were functional disorders of the voice observed in 82.3% of patients in the form of hyperfunctional dysphonia (64.3%), hypofunctional dysphonia (17.0%) and dysfunctional dysphonia (about 1.0%). In 9.0% of patients, the functional disorders of the voice were accompanied by organic changes in the larynx caused by non-occupational factors. CONCLUSIONS: The analysis showed that due to new Polish regulations, the number of certified occupational disease of the vocal organ was reduced; videostroboscopic tests proved to be a very helpful tool for discriminating between the functional and organic disorders of the vocal organ; and good agreement between clinical diagnoses issued at both levels (I and II) was also revealed (166) Timmermans B, Vanderwegen J, De Bodt MS. Outcome of vocal hygiene in singers. Curr Opin Otolaryngol Head Neck Surg 2005;13:138-142. Ref ID: 96 Abstract: PURPOSE OF REVIEW: In this article, we illustrate the evolution of studies that contribute to a better understanding of vocal care for professional voice users and singers in particular. RECENT FINDINGS: Research on vocal hygiene is specific, focusing on concrete solutions. It has commonly been believed that hydration and vocal rest are beneficial; recent research proves this supposition. An exhaustive medical diagnosis and careful therapy is stressed to detect and treat any micro-organic lesions caused by reflux, infection, allergy and environmental circumstances, which can harm a singer's voice. The use of medication is reviewed and side effects are evaluated. SUMMARY: Vocal coaches, speech therapists and otolaryngologists need to focus more specifically on the management of vocal care. Accurate medical diagnosis and specific guidelines for singers must be provided as higher voice 67 demands imply more profound and structured voice care. In the past, vocal hygiene had a negative connotation; a more positive and supporting approach to voice care, with more attention to the singer, is recommended (167) International Journal of Occupational Medicine and Environmental Health: Editorial. Int J Occup Med Environ Health 2004;17:219-220. Ref ID: 337 (168) Bancone C, Bigoni F, Borleri D, Caironi M, Regonesi A, Mosconi G. Casereport: Occupational laryngeal cancer in shipwright-welder. G Ital Med Lav Ergon 2004;26:161-162. Ref ID: 340 Abstract: The present work reports the case of a 49 years old shipwrightwelder who developed a squamous carcinoma of the vocal chords, after prolonged exposure to welding-fumes and exavalent chromium. Analysis of the scientific literature and epidemiological studies confirms the association between occupational exposure to metal and welding fumes and laryngeal squamous-cell carcinoma. A diagnosis of occupational disease was thus formulated (169) Braz JR, Volney A, Navarro LH, Braz LG, Nakamura G. Does sealing endotracheal tube cuff pressure diminish the frequency of postoperative laryngotracheal complaints after nitrous oxide anesthesia? Journal of clinical anesthesia 2004;16:320-325. Ref ID: 436 Abstract: STUDY OBJECTIVES: To study endotracheal tube (ETT) cuff pressures during nitrous oxide (N2O) anesthesia when the cuffs are inflated with air to achieve sealing pressure, and to evaluate the frequency of postoperative laryngotracheal complaints. DESIGN: Prospective, randomized, blind study. SETTING: Metropolitan teaching hospital. PATIENTS: 50 ASA physical status I and II patients scheduled for elective abdominal surgery. INTERVENTIONS: Patients received standard general anesthesia with 66% N2O in oxygen. In 25 patients, the ETT cuff was inflated with air to achieve a sealing pressure (Pseal group). In 25 patients, the ETT cuff was inflated with air to achieve a pressure of 25 cm H2O (P25 group). MEASUREMENTS AND MAIN RESULTS: ETT intracuff pressures were recorded before (control) and at 30, 60, 90, 120, and 150 minutes during N2O administration. We investigated the frequency and intensity of sore throat, hoarseness, and dysphagia in patients in the Post-Anesthesia Care Unit (PACU) and 24 hours following tracheal extubation. The cuff pressures in the Pseal group were significantly lower than in the P25 group at all time points studied (p < 0.001), with a significant increase with time in both groups (p < 0.001). The cuff pressures exceeded the critical pressure of 30 cm H2O only after 90 minutes in the Pseal group and already by 30 minutes in the P25 group. The frequency and intensity of sore throat, hoarseness, and dysphagia were similar in both groups in the PACU and 24 hours after tracheal extubation (p > 0.05). CONCLUSIONS: Minimum ETT sealing cuff pressure during N2O anesthesia did not prevent, but instead attenuated, the increase in cuff pressure and did not decrease postoperative laryngotracheal complaints (170) Duffy O, Hazlett D. The impact of preventive voice care programs for training teachers: A longitudinal study. J Voice 2004;18:63-70. Ref ID: 365 Abstract: Summary The teaching profession puts vocal health at a higher risk than other professions, causing what is referred to as "occupational dysphonia." There is a need for primary prevention of "occupational dysphonia" among the teaching profession, where good vocal health is promoted before a problem occurs. To investigate the primary prevention of occupational dysphonia among teachers, this study uses a sample population of 55 training teachers, in the postgraduate certificate of education (PGCE) course at the University of Ulster, Northern Ireland, who were randomly assigned to three training groups: control, indirect, and direct. The vocal performance of the three groups was measured at two points over the year of the PGCE course: first before any teaching or training began, and again after the first teaching practice. The training for the indirect and direct groups was provided before the teaching practices. Acoustic and self-perceptual measurements were used to assess the multidimensional outcomes. The results demonstrate interesting trends, that although not found to be significant, are approaching significance. Their voices will be reevaluated at a third point of measurement. The acoustic measurement reflects deterioration from time 1 to time 2 for the control group, improvement for the direct group, and no change for the indirect group, indicating that the training has proved beneficial. The self- rating scores vary in agreement with the acoustic results, presenting interesting findings. The findings of this study will be of benefit to teachers, their educators, voice therapists, health promoters, and human resource personnel (171) Dworkin JP, Abkarian GG, Stachler RJ, Culatta RA, Meleca RJ. Is voice amplification for teachers with dysphonia really beneficial? J Speech Lang Hear Res 2004;47:353-357. Ref ID: 107 (172) Kosztyla-Hojna B, Rogowski M, Ruczaj J, Pepinski W, Lobaczuk-Sitnik A. An analysis of occupational dysphonia diagnosed in the North-East of Poland. Int J Occup Med Environ Health 2004;17:273-278. Ref ID: 103 Abstract: OBJECTIVE: The objective of the study was to evaluate factors predisposing to occupational dysphonia in a group of professional voice users. MATERIAL AND METHODS: The study involved 374 patients treated in the Clinic of Otolaryngology and the Phoniatric Outpatient Clinic, Department of Otolaryngology, Medical University of Bialystok in 1999--2001. Group I consisted of 309 patients qualified as professional voice users. The obtained results were compared with those yielded in a group of 65 persons of other occupations (group II). All the diagnosed patients neither smoked nor abused alcohol. Tobacco smokers, patients with chronic diseases of the respiratory system or individuals exposed to irritating vapors were excluded from the study. The clinical evaluation included phoniatric examinations with use of videoendoscopy (VIS) and videolaryngostroboscopy (VLSS) of the larynx. Based on the larynx endoscopic image the voice organ pathology was diagnosed in the patients as functional and/or organic dysphonia. The former comprised hyperfunctional or hypofunctional dysphonia and insufficiency of the glottis and the latter other laryngeal disturbances. In the statistical analysis chi2 parametric test of independence for two averages was used. RESULTS AND CONCLUSIONS: Female teachers of primary and lower secondary schools, mean age 43 years, prevailed in the group of professional voice users, in which functional dysphonia was more common. In this group, 69 the onset of organic changes was earlier than that of functional changes and was manifested by soft vocal nodules, edematous and inflammatory changes in the vocal fold mucosa. Functional dysphonia of 3 degrees, 4 degrees and even 5 degrees predominated in the group of professional voice users in the course of their employment (173) Kosztyla-Hojna B, Rogowski M, Ruczaj J, Pepinski W. [Professional dysphonia and its risk factors in the material of the outpatient clinic of the Department of Otolaryngology, Medical Academy of Bialystok]. Otolaryngol Pol 2004;58:569-575. Ref ID: 104 Abstract: Occurrence of professional dysphonia was analysed in a group of 309 patients treated in the Phoniatric Outpatient Clinic, Department of Otolaryngology, Medical Academy in Bialystok through the period of 19992001. In a group of professional voice users female teachers of primary schools and lower secondary schools predominated. Obtained results were compared with those from a group of 65 persons of other occupations. In the both groups other harmful factors affecting the voice organ were excluded. The clinical assessment included subjective and objective laryngological examination using videolaryngostroboscopy. The clinical material was evaluated in a view of functional and organic disorders of the voice organ. Early occurrence and aggravation of functional changes in the larynx was recorded in non professional voice users in the course of their seniority. In professional patients organic changes were more common and occurred earlier than functional disorders. Severity of dysphonia was related to the larynx pathology, especially of a functional character (174) Krecicki T, Zalesska K, Pastuszek P, Rak J, Morawska K, Zatonski M. Treatment of Reincke's edema among different professional groups: Presentation of results. Int J Occup Med Environ Health 2004;17:279-284. Ref ID: 380 Abstract: Objectives: Reincke's edema is one of the most common voice disorders in adults. The main purpose of our study, was to analyze factors that may influence the development of this disease. We also estimated the results of surgical treatment. Materials and Methods: The research was performed on a group of 261 patients with Reincke's edema treated in the ENT Department of the Medical University of Wroclaw in the years 1994-2000. In the study population, women were in a majority and teachers formed the largest occupational group (30%) followed by salespersons (15%). Most of the patients (86%) were tobacco smokers. All of the patients underwent detailed videostroboscopic examination of the larynx and perceptual analysis of the voice quality before and after treatment. Results: The symmetry of vocal cords before and after treatment was found in 75 patients. Lack of symmetry before treatment, and proper symmetry after surgery was observed in 71 subjects. Fifty patients showed less symmetry after treatment, and 65 patients were asymmetric before and after surgery. The difference between the symmetry of vocal folds before and after treatment was at the border of statistical significance (p = 0.069). The number of patients with full vocal cords closure increased after treatment. This difference was statistically significant (p = 0.032). The periodicity of vocal cord movements was significantly higher after treatment (p < 0.001). Conclusions: The perceptual assessment of voice, before and after treatment, revealed statistically significant post-treatment improvement in voice quality (175) McHenry MA, Carlson HK. The vocal health of auctioneers. Logoped Phoniatr Vocol 2004;29:41-47. Ref ID: 111 Abstract: A questionnaire designed to assess vocal demands and vocal health was completed by 438 randomly selected auctioneers. Over 96% reported using amplification to auction the majority of the time. A greater proportion of individuals who auctioned in environments with poor air quality visited a physician for a voice problem than individuals who auctioned in environments with clean air. Significant contributors to vocal quality changes and vocal fatigue were frequency of auctioning, as well as auctioning in noise. In addition, the duration of auctioning without a break significantly contributed to vocal fatigue. Vocal hygiene recommendations are provided based on these findings (176) Mojica M, Reidy J, Wilson K, Douglas W. Larynx squamous cell carcinoma: Concepts and future directions. Surg Oncol Clin North Am 2004;13:99-112. Ref ID: 386 (177) Ortiz E, De C, Spina A, Crespo A. Multidisciplinary protocol proposal for professional dysphonia: Preliminary study. Rev Bras Otorrinolaringol 2004;70:590-596. Ref ID: 390 Abstract: Dysphonia has an occupational view nowadays. A shift in the voiceoriented professional's clinical approach has been required. New voiceoriented job categories have emerged and, as a result, the voice disorder in the professional enviroment has increased. The economic and productivity harm due to voice disorders are a preocupation. Dysphonia has multiple causes and its evaluation, ethiological conclusion and occupational reports aren't defined yet. Aim: In order to obtain a more accurate and comprehensive evaluation, a multidisciplinary protocol was elaborated to ensure proper medical scientific support. It consists of anamnesis, physical exam, laryngeal endoscopy, perceptive voice analysis and Voice Handicap Index application (VHI). Study design: Transversal historic cohort. Material e mqtodo: In this preliminary study, the protocol was applied on 15 voice professionals with dysphonia. Results: 13,3% with normal voice performance; 33,3% with functional dysphonia; 46% with organic dysphonia. Dysphonia was related to the voice-oriented job in 40% cases and it was ruled out in 46,6%. Conclusion: We concluded that the protocol is complete enough to help otolaryngologists evaluate this workers' category (178) Roy N, Merrill RM, Thibeault S, Parsa RA, Gray SD, Smith EM. Prevalence of voice disorders in teachers and the general population. J Speech Lang Hear Res 2004;47:281-293. Ref ID: 108 Abstract: Over 3 million teachers in the United States use their voice as a primary tool of trade and are thought to be at higher risk for occupationrelated voice disorders than the general population. However, estimates regarding the prevalence of voice disorders in teachers and the general population vary considerably. To determine the extent that teachers are at greater risk for voice disorders, 2,531 randomly selected participants from Iowa and Utah (1,243 teachers and 1,288 nonteachers) were interviewed by telephone using a voice disorder questionnaire. Prevalence-the number of cases per population at risk at a specific time-was determined. The 71 prevalence of reporting a current voice problem was significantly greater in teachers compared with nonteachers (11.0% vs. 6.2%), chi(2)(1) = 18.2, p <.001, as was the prevalence of voice disorders during their lifetime (57.7% for teachers vs. 28.8% for nonteachers), chi(2)(1) = 215.2, p <.001. Teachers were also significantly more likely than nonteachers to have consulted a physician or speech-language pathologist regarding a voice disorder (14.3% vs. 5.5%), chi(2)(1) = 55.3, p <.001. Women, compared with men, not only had a higher lifetime prevalence of voice disorders (46.3% vs. 36.9%), chi(2)(1) = 20.9, p <.001, but also had a higher prevalence of chronic voice disorders (>4 weeks in duration), compared with acute voice disorders (20.9% vs. 13.3%), chi(2)(1) = 8.7, p =.003. To assess the association between past voice disorders and possible risks, adjusted odds ratios (ORs) were estimated using multiple logistic regression. The results identified that being a teacher, being a woman, being between 40 and 59 years of age, having 16 or more years of education, and having a family history of voice disorders were each positively associated with having experienced a voice disorder in the past. These results support the notion that teaching is a high-risk occupation for voice disorders. Important information is also provided regarding additional factors that might contribute to the development of voice disorders (179) Roy N, Merrill RM, Thibeault S, Gray SD, Smith EM. Voice disorders in teachers and the general population: effects on work performance, attendance, and future career choices. J Speech Lang Hear Res 2004;47:542551. Ref ID: 106 Abstract: To examine the frequency and adverse effects of voice disorders on job performance and attendance in teachers and the general population, 2,401 participants from Iowa and Utah (n1 = 1,243 teachers and n2 = 1,279 nonteachers) were randomly selected and were interviewed by telephone using a voice disorder questionnaire. Teachers were significantly more likely than nonteachers to have experienced multiple voice symptoms and signs including hoarseness, discomfort, and increased effort while using their voice, tiring or experiencing a change in voice quality after short use, difficulty projecting their voice, trouble speaking or singing softly, and a loss of their singing range (all odds ratios [ORs] p <.05). Furthermore, teachers consistently attributed these voice symptoms to their occupation and were significantly more likely to indicate that their voice limited their ability to perform certain tasks at work, and had reduced activities or interactions as a result. Teachers, as compared with nonteachers, had missed more workdays over the preceding year because of voice problems and were more likely to consider changing occupations because of their voice (all comparisons p <.05). These findings strongly suggest that occupationally related voice dysfunction in teachers can have significant adverse effects on job performance, attendance, and future career choices (180) Schneider B, Cecon M, Hanke G, Wehner S, Bigenzahn W. [Significance of voice constitution as a predisposition for occupational voice disorders]. HNO 2004;52:461-467. Ref ID: 110 Abstract: Occupational voice disorders have been increasing for years. The aim of this study was to examine whether a constitutionally weak voice should be regarded as a risk factor for developing such voice disorders. In a prospective study, 15 female teacher students with a normal vocal constitution were compared with 18 students with constitutionally weak voices during teaching practice. There was a significant difference in the mean fundamental frequency of both groups after teaching for 30 min. Students with constitutionally weak voices tended to have increased values. Taking into consideration the physiological aspects of an increasing fundamental frequency as a sign of vocal fatigue, a constitutionally weak voice has to be regarded as a potential risk factor for developing a voice disorder in vocally intensive occupations. To prevent future vocal problems by appropriate prophylactic intervention (i.e. voice therapy, introduction to vocal hygiene), a phoniatric examination of vocal constitution and endurance is recommended at the beginning of a voice dependent professional career (181) Schneider B, Cecon M, Hanke G, Wehner S, Bigenzahn W. Significance of vocal constitution for occupational voice disorders. HNO 2004;52:461-467. Ref ID: 408 Abstract: Occupational voice disorders have been increasing for years. The aim of this study was to examine whether a constitutionally weak voice should be regarded as a risk factor for developing such voice disorders. In a prospective study, 15 female teacher students with a normal vocal constitution were compared with 18 students with constitutionally weak voices during teaching practice. There was a significant difference in the mean fundamental frequency of both groups after teaching for 30 min. Students with constitutionally weak voices tended to have increased values. Taking into consideration the physiological aspects of an increasing fundamental frequency as a sign of vocal fatigue, a constitutional weak voice has to be regarded as a potential risk factor for developing a voice disorder in vocally intensive occupations. To prevent future vocal problems by appropriate prophylactic intervention (i.e. voice therapy, introduction to vocal hygiene), a phoniatric examination of vocal constitution and endurance is recommended at the beginning of a voice dependant professional career (182) Thibeault SL, Merrill RM, Roy N, Gray SD, Smith EM. Occupational risk factors associated with voice disorders among teachers. Ann Epidemiol 2004;14:786792. Ref ID: 102 Abstract: PURPOSE: This study was designed to determine the occupational risk factors associated with voice disorders among schoolteachers, a high-risk population for developing voice problems. METHODS: Telephone interviews were completed by 1243 teachers from Utah and Iowa. Response rates were 98% and 95%, respectively. Bivariate analyses were computed and assessed using chi-square test and Cochran-Mantel-Haenszel test, and logistic regression analyses were performed and resulting odds ratios assessed using 95% confidence intervals. RESULTS: Teachers of vocal music, drama, other performing arts and chemistry were at significantly greater risk of having a voice disorder (OR=2.2, 95% CI: 1.2-4.0; OR=2.1, 95% CI: 0.9-4.8; OR=1.6, 95% CI: 1.0-2.4; OR=2.0, 95% CI: 1.1-3.4), while teachers of special and vocational education had a significantly lower risk (OR=0.5, 95% CI: 0.3-0.7; OR=0.6, 95% CI: 0.4-0.9). When adjusted for the intensity of vocalization, only teachers of chemistry were significantly at risk (OR=2.0, 95% CI: 1.1-3.5) while teachers of special education continued to have less of a risk (OR=0.5, 95% CI: 0.4-0.8). Chronic voice disorders were more prevalent among teachers of vocal music (OR=4.1, 95% CI: 2.2-7.9) and less 73 prevalent among teachers of vocational education (OR=0.29, 95% CI: 0.090.95). CONCLUSIONS: These findings suggest that teachers of specific courses are at greater risk of developing a voice disorder (183) Vilkman E. Occupational safety and health aspects of voice and speech professions. Folia Phoniatr Logop 2004;56:220-253. Ref ID: 105 Abstract: A well-functioning voice is an essential tool for one third of the labour force. Vocal demands vary to a great extent between the different voice and speech professions. In professions with heavy vocal loading (e.g. school and kindergarten teachers), occupational voice disorders threatening working ability are common. Vocal loading is a combination of prolonged voice use and additional loading factors (e.g. background noise, acoustics, air quality) affecting the fundamental frequency, type and loudness of phonation or the vibratory characteristics of the vocal folds as well as the external frame of the larynx. The prevention and treatment of occupational voice disorders calls for improved occupational safety and health (OSH) arrangements for voice and speech professionals. On the basis of epidemiological and acousticphysiological research, the presence of risk to vocal health can be substantiated. From the point of view of the physical load on the vocal apparatus, loading-related physiological changes (adaptation) may play a role in the occupational risk. Environmental factors affect vocal loading changes. In teaching professions, the working environment is shared with children, who benefit from amendments of OSH legislation concerning their teachers (184) Ward C, Robertson D. Rehabilitation in Parkinson's disease. Rev Clin Gerontol 2004;13:223-239. Ref ID: 423 (185) COMMISSION RECOMMENDATION 2003/670/EC of 19 September 2003 concerning the European schedule of occupational diseases. 2003. EU Legislation, 2003/670/EC. Ref Type: Statute Ref ID: 486 (186) Report Issue 209: Gender issues in safety and health at work. 2003. OSH Reports: Research on Work and Health. Ref Type: Report Ref ID: 487 Abstract: Achieving gender equality in all aspects of employment is now a key European priority. It is a matter of rights, but it is also a matter of sound economic policy - especially considering the human and economic costs of injuries and ill health caused (187) -Yiu-EM-and-Chan-RMM. Effect of hydration and vocal rest on the vocal fatigue in amateur karaoke singers. J Voice 2003;17. Ref ID: 428 (188) Aichenbaum SR, Ring H. Rehabilitation of a patient with critical illness polyneuropathy (CIP) following acute respiratory failure: A case report and review of literature. Disabil Rehabil 2003;25:273-276. Ref ID: 339 Abstract: Critical illness polyneuropathy (CIP), a neurologic complication that may occur secondary to cardio-respiratory distress, surgery, trauma and coma, is associated with sepsis or multiple organ failure. CIP is characterized by an axonal distal degeneration of sensory and motor fibres. The patients will often become neurologically conspicuous when weaning from mechanical ventilation is unexpectedly difficult. There are just a few cases reported with description of the functional outcome and rehabilitation issues of this condition. An additional CIP case of a 62-year old man complicated with anoxic brain damage during the respiratory distress is reported here. He was referred for rehabilitation, made a remarkable recovery (FIM gain 45!) and returned home after 79 days of treatment in the ward. A review of the pertinent literature is provided. Rehabilitation specialists and other professionals working within ICU's should be aware of this condition and be able to recognize and treat CIP at early possible stage (189) Berrino F, Richiardi L, Boffetta P et al. Occupation and larynx and hypopharynx cancer: a job-exposure matrix approach in an international case-control study in France, Italy, Spain and Switzerland. Cancer Causes Control 2003;14:213-223. Ref ID: 119 Abstract: OBJECTIVE: To investigate the effect of exposure to occupational agents on the risk of hypopharyngeal/laryngeal cancer. METHODS: Casecontrol study conducted during 1979-1982 in six centres in South Europe. An occupational history and information on exposure to non-occupational factors were collected for 1010 male cases of hypopharyngeal/ laryngeal cancer as well as for 2176 population controls. The exposure to 10 occupational agents was assessed through a job-exposure matrix. As occupational histories had been collected since 1945 major analyses were restricted to subjects aged less than 55 years (315 cases and 819 controls). RESULTS: Significant elevated risks adjusted for non-occupational variables (smoking, alcohol consumption and diet) and other occupational exposures were consistently found for organic solvents (odds ratio (OR) for ever-exposure: 1.7, 95% confidence interval: 1.1-2.5) and asbestos (OR: 1.6, 1.0-2.5). A significant positive trend for both probability of exposure and duration was found for exposure to solvents. A positive association between exposure to formaldehyde and laryngeal cancer was also suggested. No association was found for exposure to arsenic and compounds, chromium and compounds, and polycyclic aromatic hydrocarbons. Analyses restricted to subjects aged 55 or more did not show elevated risks, with the exception of wood dust (OR: 1.8, 1.3-2.7). CONCLUSIONS: In our study occupational exposure to solvents was associated with an increased risk of hypopharyngeal/laryngeal cancer. Results also provide additional evidence of an excess of risk for exposure to asbestos (190) Boffetta P, Richiardi L, Berrino F et al. Occupation and larynx and hypopharynx cancer: an international case-control study in France, Italy, Spain, and Switzerland. Cancer Causes Control 2003;14:203-212. Ref ID: 120 Abstract: OBJECTIVE: To estimate risks for laryngeal/hypopharyngeal cancer associated with occupational titles and industrial activities. METHODS: A multicentre population-based case-control study was conducted in the early 1980s in six southern European areas. Analyses included 1010 male cases and 2176 controls. Odds ratios (ORs) (adjusted for age, study area, tobacco consumption, and alcohol consumption) were estimated for 156 occupations 75 and 70 industrial activities. RESULTS: An excess risk has been confirmed for categories of construction workers, potters (OR: 5.91, 95% confidence intervals 1.46-24.0), butchers (2.53, 1.22-5.22), barbers (2.33, 1.00-5.40), laborers not otherwise specified (1.52, 1.12-2.06), as well as for men who had been employed in railway transport (1.52, 0.97-2.39), shipbuilding (2.05, 0.89-4.94), and hotels (2.06, 0.89-4.75). An association was also found for shoe finishers (3.23, 0.75-13.9), loggers (2.07, 0.87-4.90), and some groups of metal workers. ORs for loggers, butchers, railway transport workers, laborers, and reinforced concreters increased with duration of employment. The suggestion of a risk for machine operators among woodworkers (3.10, 0.92-10.5) conflicts with previous findings. No significant excess of risk was found for categories previously reported to be associated with laryngeal and hypopharyngeal cancer, such as drivers, mechanics, welders, machinists, and painters. CONCLUSIONS: The present study provides additional evidence to the hypothesis of a risk of cancer of the larynx/ hypopharynx for workers engaged in jobs in the construction, metal, textile, ceramic, and food industries and in railway transport. Loggers were also found at risk; a previously unreported finding (191) Perez Fernandez CA, Preciado LJ. [Vocal fold nodules. Risk factors in teachers. A case control study design]. Acta Otorrinolaringol Esp 2003;54:253-260. Ref ID: 118 Abstract: Vocal nodules are structural lesions very common amongst professional voice users such as teachers. We have studied the risk factors that predispose the development of vocal nodules in teachers. Two hundred and forty-two teachers were selected: 120 with vocal nodules and 120 with normal vocal folds. Professional and personal factors as well as classroom environment were studied. A complete evaluation of the voice was performed, aerodynamic measures, tone and extension of the voice, acoustic analysis, perceptual evaluation of the voice as well as a videolaryngostroboscopy which was definitive in the diagnosis. Younger teachers with less years of teaching experience a greater have tendency to develop vocal nodules than the rest. Class-room's dryness, loudness and echo are correlated with the pathological group. The most relevant personal factors in the pathological group were previous vocal pathology, laryngeal surgery, nasal surgery and gastroesophageal reflux. Vocal intensity and vocal frequency ranks were shorter in the pathological group. We could also see that, fonatory flow was less effective in the pathological group (192) Roy N, Weinrich B, Gray SD, Tanner K, Stemple JC, Sapienza CM. Three treatments for teachers with voice disorders: a randomized clinical trial. J Speech Lang Hear Res 2003;46:670-688. Ref ID: 112 Abstract: Voice problems are a common occupational hazard of teaching school, yet few studies exist that have objectively evaluated treatment approaches aimed at rehabilitating these occupation-related voice disorders. This randomized clinical trial used patient-based treatment outcome measures to evaluate the effectiveness of three treatment programs. Sixty-four teachers with voice disorders were randomly assigned to 1 of 3 treatment groups: voice amplification using the ChatterVox portable amplifier (VA; n = 25), resonance therapy (RT; n = 19), and respiratory muscle training (RMT; n = 20). Before and after a 6-week treatment phase, all teachers completed (a) the Voice Handicap Index (VHI; B. H. Jacobson et al., 1997), an instrument designed to appraise the self-perceived psychosocial consequences of voice disorders, and (b) a voice severity self-rating scale. Both intention-to-treat and as-treated analyses revealed that only the VA and RT groups reported significant reductions in mean VHI scores and in voice severity self-ratings following treatment. Furthermore, results from a posttreatment questionnaire regarding the perceived benefits of treatment showed that compared to RT and RMT, teachers in the VA group reported significantly more overall voice improvement, greater vocal clarity, and greater ease of speaking and singing voice following treatment. These findings replicate previous results from an earlier clinical trial confirming the efficacy of VA and provide new evidence to support RT as an effective treatment alternative for voice problems in teachers. The results are discussed in the context of uneven levels of selfreported compliance and disparate dropout rates among the treatment groups (193) Sinkiewicz A, Pawlak A, Wojnowski W, Owczarzak H. [Assessment of rehabilitation of teachers' voice disorders]. Otolaryngol Pol 2003;57:417-420. Ref ID: 115 Abstract: Results of treatment of teacher's voice disorders were presented. Patients except pharmacological treatment and physiotherapy realised the course of voice emission exercises under speech therapist supervision. Ninety teachers were examined before and after treatment. Laryngological, phoniatric and laryngostroboscopic studies were carried out. In most patients phoniatric assessment revealed elongation of phonation time, changing of breathing route from cleidocostal to phrenocostal and voice creation without neck muscle tension after completing of treatment. 6 weeks lasting period of exercises was determined to be sufficient in most patients to learn correct breathing and phonation but to establish normal voice emission patient strong motivation, discipline and regularity during several months lasting exercises is needed (194) Skowronek J, Zemla B. Epidemiology of lung and larynx cancers in coal mines in Upper Silesia--preliminary results. Health Phys 2003;85:365-370. Ref ID: 117 Abstract: The results of the preliminary analysis of the risk of lung and larynx cancers among coal miners in Upper Silesia are presented. The risk increases substantially during the work under conditions of short-lived radon progeny hazard, especially when the concentration of alpha potential energy of shortlived radon progeny is higher than 2.5 (microJ m(-3)) that corresponds to the possibility of receiving the effective dose higher than 6 mSv y(-1). Significant differences of the risk are noticed between sub-populations of autochthonminers and immigrant-miners: it was found that the relative risk for immigrant-miners was up to 2 times higher than for autochthon-miners (195) Stone RE, Jr., Cleveland TF, Sundberg PJ, Prokop J. Aerodynamic and acoustical measures of speech, operatic, and Broadway vocal styles in a professional female singer. J Voice 2003;17:283-297. Ref ID: 116 Abstract: Understanding how the voice is used in different styles of singing is commonly based on intuitive descriptions offered by performers who are proficient in only one style. Such descriptions are debatable, lack reproducibility, and lack scientifically derived explanations of the characteristics. We undertook acoustic and aerodynamic analyses of a female subject with professional experience in both operatic and Broadway styles of 77 singing, who sang examples in these two styles. How representative the examples are of the respective styles was investigated by means of a listening test. Further, as a reference point, we compared the styles with her speech. Variation in styles associated with pitch and vocal loudness was investigated for various parameters: subglottal pressure, closed quotient, glottal leakage, H1-H2 difference (the level difference between the two lowest partials of the source spectrum), and glottal compliance (the ratio between the air volume displaced in a glottal pulse and the subglottal pressure). Formant frequencies, long-term-average spectrum, and vibrato characteristics were also studied. Characteristics of operatic style emerge as distinctly different from Broadway style, the latter being more similar to speaking (196) Szabo A, Hammarberg B, Granqvist S, S÷dersten M. Methods to study preschool teachers' voice at work: Simultaneous recordings with a voice accumulator and a DAT recorder. Logop Phoniatr Vocology 2003;28:29-39. Ref ID: 417 Abstract: Long-term recordings with reliable methods are desirable for objective documentation of voice use during natural conditions. The purpose of this study was to evaluate a voice accumulator (VAC) with a digital audiotape (DAT) recorder as a reference. The VAC is based on a microprocessor that accumulates information about fundamental frequency (F0) and phonation time. A contact microphone attached to the front of the neck registers vocal fold vibrations. The DAT recorder was connected to two microphones for airborne signals placed at equal distance from the mouth close to the subject's ears. The computer program Aura was used to separate the subject's voice from the background noise. The Soundswell program was used for F0 and phonation time analysis. Two tests were performed: 1) One female speech-language pathologist was recorded with the two devices simultaneously in a sound-proof booth. She read a standard text with different voice qualities and sustained vowels with increasing F0 and intensity separately. The results showed good agreement between the two methods with respect to F0 and phonation time. However, the VAC failed to register high frequencies above around 440 Hz as well as low intensities. 2) Three female pre-school teachers were recorded with the two devices simultaneously during a working day. Results showed high correlations between the two methods in terms of long-term measurements of F0 and phonation time for two subjects. For one subject with subcutaneous soft tissue on the neck, the registration with the contact microphone was not reliable. It was concluded that the VAC has potential for assessment of occupational voice disorders if certain limitations of the method are considered (197) Telec B, Piestrzynska H, Gajewski T. [Efficacy of the health promotion program "Prevention of Voice Disorder in Teachers and Students" implemented by the WOMP from Zielona Gora ]. Med Pr 2003;54:95-98. Ref ID: 122 (198) Tilles S, Jerath T. Differential diagnosis of occupational asthma. Immunol Allergy Clin North Am 2003;23:167-176. Ref ID: 419 Abstract: Confidently establishing the diagnosis of occupational asthma (OA) is a complicated undertaking, because it requires that the patient's asthma symptoms are caused exclusively (or at least in large part) by occupational exposures. Asthma is a common disease, and the differential diagnosis of asthma is a frequently discussed subject that includes common and uncommon disorders. This article presents a broad characterization of OA, including the elements necessary to establish a diagnosis. Differential diagnosis also is discussed (199) Welham NV, Maclagan MA. Vocal fatigue: current knowledge and future directions. J Voice 2003;17:21-30. Ref ID: 123 Abstract: Vocal fatigue is a complex multifaceted clinical phenomenon. Several hypotheses exist concerning its underlying mechanism, and a range of empirical studies have examined its manifestation. This article reviews the literature pertaining to the nature, underlying processes, and salient features of vocal fatigue. First, vocal fatigue is defined, its major symptoms are discussed, and hypotheses concerning its primary physiological and biomechanical mechanisms are considered. Second, studies of experimentally induced vocal fatigue in humans are evaluated. Third, research investigating the clinical and occupational manifestations of vocal fatigue is discussed. Fourth, directions for ongoing research in this area are offered (200) Williams NR. Voice recognition products-an occupational risk for users with ULDs? Occup Med (Lond) 2003;53:452-455. Ref ID: 114 Abstract: BACKGROUND: Voice recognition systems (VRS) allow speech to be converted both directly into text-which appears on the screen of a computerand to direct equipment to perform specific functions. Suggested applications are many and varied, including increasing efficiency in the reporting of radiographs, allowing directed surgery and enabling individuals with upper limb disorders (ULDs) who cannot use other input devices, such as keyboards and mice, to carry out word processing and other activities. Aim This paper describes four cases of vocal dysfunction related to the use of such software, which have been identified from the database of the Voice and Speech Laboratory of the Massachusetts Eye and Ear infirmary (MEEI). METHOD: The database was searched using key words 'voice recognition' and four cases were identified from a total of 4800. RESULTS: In all cases, the VRS was supplied to assist individuals with ULDs who could not use conventional input devices. Case reports illustrate time of onset and symptoms experienced. CONCLUSION: The cases illustrate the need for risk assessment and consideration of the ergonomic aspects of voice use prior to such adaptations being used, particularly in those who already experience work-related ULDs (201) Williams NR. Occupational groups at risk of voice disorders: a review of the literature. Occup Med (Lond) 2003;53:456-460. Ref ID: 113 Abstract: BACKGROUND: Occupational voice health is becoming more important as more people rely on their voices for their work. A number of studies have identified certain occupational groups at increased risk of developing occupational voice disorders, namely teachers, singers and aerobics instructors. Aim The paper aims to review the literature on occupational groups at risk of voice disorders and identify areas for future research. METHOD: A literature review of key databases using key words such as 'occupational', 'voice health', 'voice loss', 'dysphonia' and 'work related' was undertaken. RESULTS: The review identified case reports, studies of 79 attendees at hospital voice clinics and a few cross-sectional studies of occupational groups in the workplace. There were no longitudinal studies found or intervention studies looking at reduction of risk. CONCLUSION: Further research on occupational voice disorders needs to be based in the workplace, and to look at the risk factors for the development of voice problems and for the efficacy of controls (202) -McCabe-DJ-and-Titze-IR. Chant therapy for treating vocal fatigue among public school teachers: a preliminary study. American Journal of Speech Language Pathology 2002;11:356-369. Ref ID: 427 (203) Balkissoon R. Occupational upper airway disease. Clin Chest Med 2002;23:717-725. Ref ID: 126 Abstract: The upper airway plays a critical role in filtering and conditioning air for the lungs. It provides the first line of warning and defense against microbials, allergens, and toxic inhalants. Current evidence suggests that the upper airway is susceptible to many of the pathogenic processes that the agents cause in the lower respiratory tract. Work-related rhinosinusitis or vocal cord dysfunction should prompt physicians and employers to identify the injurious agent(s) and formulate strategies to eliminate or reduce such exposures. Improving the work environment will prevent the development of new cases and the worsening of symptoms in existing cases (204) Bodenes A, Andre M, Dewitte JD et al. An occupational vocal dysfunction syndrome? Arch Mal Prof Med Trav 2002;63:87-90. Ref ID: 347 Abstract: Our attention has recently been drawn by a case of persistent dysphonia in a grainstore worker suffering from occupational asthma. The fiberoptic visualization of a paradoxical movement of the vocal cords raised the diagnosis of an irritant-associated vocal cord dysfunction. This recently described entity is discussed here. The dysfunction of vocal cords not due to irritants can create a multitude of clinical signs during the crises such as cough, short breath and more rarely hoarseness, dysphonia, and difficulties in swallowing. As in our case, a chronic cough or hoarseness can be the only observed manifestations. Different activating factors were previoulsy studied. The strong clinical resemblance to asthma makes all the difficulty of this pathology. A delay diagnosis of 4.8 years on average when the dysfunction is isolated can be observed. This problem is frequent because 56 % out of the 95 cases of vocal cords dysfunction studied by Newman were associated with asthma. The diagnosis is authenticated thanks to direct or indirect laryngeal fiberscopy or better, to video - laryngoscopy which allows the observation of a paradoxical lock of the anterior two thirds of the vocal cords during the respiratory cycle with the persistant opening of a laryngeal posterior rhombus. In every case the therapeutic approach consists in reassuring the patient. In the long run, the coverage consists of sessions of speech therapy based on learning diaphragmatic breathing in order to stop focusing on the larynx and in psychological conversations when a favorable ground is suspected (205) Chernobel'skii SI. [Vocal nodules in professional singers of classical style]. Vestn Otorinolaringol 2002;21-22. Ref ID: 131 Abstract: Whether physiologically correct singing promotes disappearance of vocal nodules (VN) was studied in 27 professional classic style singers having VN for 20 years. VN arose primarily in women, tended to recur. As shown by examination with laryngostroboscope, electroglottograph and sound level meter, physiologically correct singing resulted in temporary disappearance of soft nodules but hard nodules did not resolve. It is inferred that professional singing is not recommended for subjects with hard vocal nodules (206) Chernobelsky SI. A study of menses-related changes to the larynx in singers with voice abuse. Folia Phoniatr Logop 2002;54:2-7. Ref ID: 142 Abstract: Fifteen vocally abusive and 15 healthy female classical singers were examined before and outside menses by means of laryngoscopy, laryngostroboscopy and electroglottography. Investigation before menses revealed more extensive alteration of the larynx in vocally abusive singers than in healthy ones. Subsequent investigation, after the inappropriate use of their voice had been eliminated, indicated decreased changes to the larynx. It was concluded that premenstrual hyperchanges were a result of combined abuse- and menses-related influence on the larynx, and that laryngeal examination before menstruation could be a useful test for the presence of physiologically correct singing (207) English M. Safety implications of industrial uses of internet technology. 2002. Ref ID: 488 (208) Errando CL. Anaesthesia for the professional singer. Eur J Anaesthesiol 2002;19:687. Ref ID: 136 (209) Faure MA. [Different therapeutic suggestions used in 4 types of laryngopathies presenting in professional singers]. Rev Laryngol Otol Rhinol (Bord ) 2002;123:321-324. Ref ID: 121 Abstract: Four clinical cases involving non-surgical approaches to disorders usually treated surgically are considered. The emphasis is placed on the collaboration of artists with laryngologists combining their musical and medical training in their daily work at their office and an alternative clinical management of disorders (210) Hanke W, Szeszenia-Dabrowska N, Szymczak W. [Occupational diseases-epidemiologic evaluation of the situation in Poland]. Med Pr 2002;53:23-28. Ref ID: 139 Abstract: The incidence of occupational diseases is one of the basic indices of the effectiveness of prevention in the area of occupational health. It allows for the identification of jobs, plants and branches of the national economy with potentially increased risks for pathologies induced by working conditions. However, we should be aware of the fact that many of the recently diagnosed diseases result from long-term exposures experienced at work sites which are no longer under operation. The analysis was based on data included in occupational disease certificates. All sanitary and epidemiological stations throughout the country are committed to notify cases of occupational diseases to the National Register of Occupational Diseases at the Nofer 81 Institute of Occupational Medicine in Lodz. After a significant increase in the number of occupational diseases (8305-12,017 cases per year) observed in 1980-1998, its decrease has been noted in Poland over the recent two years (9982 cases in 1999 and 7339 in 2000). In 1998-2000, a substantial decrease in the decreasing rate was also found (from 117.3 to 73.9 per 100,000 employed), which means that the decreasing trend does not result only from the increasing size of the working population in Poland. In 2000 like in previous years, among occupational diseases the following ones were most often diagnosed: diseases of vocal organ due to excessive voice effort most common in teachers, occupational hearing loss, pneumoconiosis, contagious and invasive diseases, dermatoses, chronic diseases of bronchi, vibration syndrome as well as acute and chronic poisonings. There were registered 6626 cases of the above listed diseases, that is 90.3% of all occupational diseases. In 1998-2000, a significant decrease in the incidence of this category of diseases was noted. The largest decrease applied to the vocal organ diseases, occupational hearing loss and contagious and invasive diseases (by 30%, 51% and 40%, respectively). Neither in the member states of the European Union, nor in the USA, vocal organ pathologies are listed among occupational diseases. The main reason for this is an inappropriate medical prevention in the group of teachers and somewhat limited opportunity to teach them how to use techniques of voice emission. A decreased incidence of occupational diseases observed in Poland in 19982000 results partly from improvements in working conditions and partly from more effective prevention (211) Heman-Ackah YD, Dean CM, Sataloff RT. Strobovideolaryngoscopic findings in singing teachers. J Voice 2002;16:81-86. Ref ID: 140 Abstract: Professional voice users often present to otolaryngologists and laryngologists with specific voice complaints. The contributions of pathologic lesions to the patients' vocal complaints are not always clear on examination, and often, premorbid examinations of the larynx are not available for review. This study examines the incidence of laryngeal pathology among singing teachers. At a national convention of singing teachers, volunteers were recruited for a "free strobovideolaryngoscopic examination." All volunteers completed a detailed questionnaire of their vocal and medical history and underwent strobovideolaryngoscopic examination. Strobovideolaryngoscopic examinations were completed in 20 volunteers, 7 of whom had voice complaints and 13 of whom perceived their voices to be normal. Vocal fold masses were common among the asymptomatic singing teachers. Evidence of reflux laryngitis was a common finding among both symptomatic and asymptomatic singing teachers. Asymmetries in vocal fold hypomobility were more common among those with voice complaints than was the presence of vocal fold masses in the population studied (212) Kaplan MB, Ward DS, Berci G. A new video laryngoscope-an aid to intubation and teaching. J Clin Anesth 2002;14:620-626. Ref ID: 124 Abstract: In recent decades, video techniques have been employed in the majority of endoscopic procedures because of several distinct advantages provided. These include the following: The displayed anatomy is magnified. Recognition of the anatomical structures and anomalies is easier, and manipulation of airway devices is facilitated. When assistance is required, the operator and assistant can coordinate their movements because each sees exactly the same image on the video monitor. As a result, video techniques have become the method of choice in teaching. The Video Macintosh Intubating Laryngoscope System (VMS) was designed employing a standard Macintosh blade and laryngoscope handle. A camera was incorporated into the handle with a short image and light bundle. The magnified anatomy is displayed on an 8-inch monitor, which is attached to a swivel arm on a small cart. Observation and manipulation can be performed in one axis.A total of 235 patients were studied and were divided into two groups: Group A (n = 217), in whom intubation was thought unlikely to be difficult, and Group B (n = 18), in whom difficulty with intubation was anticipated. External laryngeal manipulation (ELM) was required in 22 of the 217 Group A patients (10%). All intubations but one in this group were successful. In the second group (B) of 18 patients who had anatomical conditions that suggested that direct laryngoscopy might be challenging, all 18 cases required ELM but all were successfully intubated using the VMS. The improved coordination afforded by an image on a video monitor seen by both the assistant providing laryngeal manipulation and the anesthesiologist handling the laryngoscope results in a significant advantage over the conventional laryngoscope technique. As a consequence, the learning curve is short. In our view, video laryngoscopy will become the method of choice in teaching (213) Marcotullio D, Magliulo G, Pezone T. Reinke's edema and risk factors: Clinical and histopathologic aspects. Am J Otolaryngol Head Neck Med Surg 2002;23:81-84. Ref ID: 384 Abstract: Purpose: The purpose of this study was to evaluate retrospectively the distribution of histologic damage and its correlation with various risk factors in a group of patients affected by Reinke's edema. Materials and Methods: The study subjects comprised 125 patients with bilateral Reinke's edema consecutively presenting at the Department of Otorhinolaryngology, "La Spienza" University, Rome. The patients were divided into 4 groups according to Hellquist, Lundgren, and Olofsson's histologic classification and were then further categorized according to the number of cigarettes they smoked daily. Average exposure to cigarette smoke, occupation, habitual voice use, and gastroesophageal reflux were also considered. Results: Fiftytwo patients did not exhibit histologic lesions, 64 patients were histologically classified as Group 1 (epithelial hyperplasia and/or keratosis with or without mild dysplasia), and 6 patients exhibited moderate dysplasia (Group 2) . In 3 patients, histologic examination showed evidence of unilateral carcinoma in situ (Group 3). Forty-four patients suffered recurrences within the first 2.5 years. Both daily cigarette consumption and duration of exposure to cigarette smoke were found to influence the severity of the histologic lesion. An association with gastroesophageal reflux was observed in 4 patients (3.2%). Prolonged vocal abuse did not prove to be a noteworthy factor in our study. Conclusions: The main risk factor for Reinke's edema and for its recurrence is tobacco use. Our study results showed that the clinical manifestation of this disease is related to the number of cigarettes smoked daily and the duration of exposure to smoke. Longer durations of exposure to cigarette smoke result in higher degrees of histologic damage (214) Olthoff A, Kruse E. [Modern sociomedical views of dysphonia]. HNO 2002;50:1092-1095. 83 Ref ID: 130 (215) Orr R, de JF, Cranen B. Some objective measures indicative of perceived voice robustness in student teachers. Logoped Phoniatr Vocol 2002;27:106-117. Ref ID: 129 Abstract: One of the problems confronted in the teaching profession is the maintenance of a healthy voice. This basic pedagogical tool is subjected to extensive use, and frequently suffers from overload, with some teachers having to give up their profession altogether. In some teacher training schools, it is the current practice to examine the student's voice, and to refer any perceived susceptibility to strain to voice specialists. For this study, a group of vocally healthy students were examined first at the teacher training schools, and then at the ENT clinic at the University Hospital of Nijmegen. The aim was to predict whether the subject's voice might be at risk for occupational dysphonia as a result of the vocal load of the teaching profession. We tried to find objective measures of voice quality in student teachers, used in current clinical practice, which reflect the judgements of the therapists and phoniatricians. We tried to explain such measures physiologically in terms of robustness of, and control over voicing. Objective measures used included video-laryngostroboscopy, phonetography and spectrography. Maximum phonation time, melodic range in conjunction with maximum intensity range, and the production of soft voice are suggested as possible predictive parameters for the risk of occupational voice strain (216) Pavlikhin OG. [Treatment of vocal fold nodules in singers]. Vestn Otorinolaringol 2002;34-36. Ref ID: 127 Abstract: Vocal nodules (singer's nodules) are a typical professional disease of the vocal apparatus. This disease occurs more frequently in 20- to 50-yearold singers. The nodules form because of vascular disorders secondary to overstrain of the vocal apparatus in phonation and disorders of vegetative innervation. 43 opera singers were treated whose age and singing history ranged from 22 to 57 years and 3 to 26 years, respectively. The treatment combined psychotherapy, medicines with phlogenzym as a basic drug, physiotherapy and phonopedia. Phlogenzym allows to avoid "silence regimen", surgical intervention. This improves treatment efficacy, shortens the time of disability for singers (217) Peltomaa M, Vilkman E. [The song has disappeared--where's the help? A singer's health is a doctor's challenge]. Duodecim 2002;118:1587-1595. Ref ID: 135 (218) Peplonska B, Szeszenia D. Occupational diseases in Poland, 2001. Int J Occup Med Environ Health 2002;15:337-345. Ref ID: 394 Abstract: The Central Register of Occupational Diseases keeps the records of all reported and certified occupational diseases in Poland. In this paper the incidence of occupational diseases in Poland in 2001 is discussed on the basis of the data provided by the Register. The changes in the incidence pattern over the recent 30 years are also shown. In 2001, 6007 cases of occupational diseases were registered, with the incidence rate of 63.2 per 100 000 employees. The highest incidence rates were noted for seven categories of diseases: the vocal organ diseases, noise-induced hearing loss, pneumoconioses, contagious and invasive diseases, dermatoses, chronic diseases of bronchi, and vibration syndrome. Altogether these diseases covered 5239 cases (87.2% of all registered cases). Mining and quarrying, agriculture, hunting and forestry, education, health and social works were the economy activities with the highest incidence of occupational diseases. The majority of occupational diseases (93.9%) have developed after a long-term (over 10 years) exposure to particular harmful factors. As much as 58.5% of cases were recorded in males. The predominant occupational diseases in males were occupational hearing lesions, while in females chronic vocal organ diseases, most common in teachers, were most frequently recognized. In Poland, the diseases of the vocal organ poses a serious problem from the medical and socio- economic points of view. These pathologies show the highest dynamics of the incidence among all registered occupational diseases. Over the last five years the vocal organ diseases have moved upwards to the top in the ranking, both with respect to the number of cases and the incidence rate. Since 1998, the incidence of occupational diseases has been continuously showing a downward tendency. Four categories of occupational diseases have accounted mostly for this decline: noise- induced hearing loss, chronic diseases of vocal organ, contagious and invasive diseases, and dermatoses (a decrease by 64%, 54%, 40%, and 51%, respectively). The decreased incidence has been also noted for "classical pathologies": chronic poisonings, pneumoconioses and vibration syndrome. At least three most important explanatory factors have to be pointed out: a) the decrease in employment and liquidation of industrial plants with the highest health risk; b) the modernization of plants and improvement of working conditions; and c) effective prevention (219) Peslovb M, Brhel P. Occupational vocal disorders. Prac Lek 2002;54:21-23. Ref ID: 395 Abstract: In 1975 to 2000 in the Czech Republic 247 occupational vocal disorders were notified as occupational diseases. They included above all severe hyperkinetic dysphonia, nodes on the vocal cords, severe incompetence of the vocal cords or severe phonasthenia. Detailed analysis of occupational diseases notified by the Clinic of Occupational Diseases in Brno revealed that during the mentioned period 30 occupational vocal disorders were notified. In 26 instances women were involved. Teachers were affected most frequently - a total of 28. The disease was diagnosed and notified on average after 21.2 years of work in the occupation pretentious on the voice. The mean age of the subjects was 44.6 years. The authors describe the symptoms and development of occupational vocal disorders and their evaluation. They describe also principles of prevention. They submit a list of occupations where we can speak of vocal profesionals, incl. quantification of demands on vocal functions (220) Rantala L, Vilkman E, Bloigu R. Voice changes during work: subjective complaints and objective measurements for female primary and secondary schoolteachers. J Voice 2002;16:344-355. Ref ID: 132 Abstract: The purpose of this investigation was to study voice changes during a working day. The subjects consisted of 33 female primary and secondary schoolteachers who recorded their first and last lessons during one school day. The subjects were studied both as one group and two subgroups (those with many and those with few voice complaints). Estimates of fundamental 85 frequency (F0), sound pressure level (SPL), the standard deviations of these values (F0 SD; SPL SD) and F0 time (vibration time of vocal folds) were made. The most obvious change due to loading was the rise of F0 that was 9.7 Hz between the first and last lesson (P = 0.00). F0 increased more (12.8. Hz, P = 0.006) in the subgroup with few complaints (221) Rathor AM, Singh R, Ramji S, Tripathi R. Randomised trial of amnioinfusion during labour with meconium stained amniotic fluid. BJOG : an international journal of obstetrics and gynaecology 2002;109:17-20. Ref ID: 460 Abstract: OBJECTIVE: To assess the effect of amnioinfusion during labour with meconium stained amniotic fluid on caesarean section rate and perinatal outcome. DESIGN: Prospective randomised controlled study. SETTING: A tertiary care teaching hospital in India. POPULATION: Women in labour at term with meconium stained amniotic fluid. METHODS: Two hundred women in labour with > or = 37 weeks gestation, single cephalic presentation with moderate or thick meconium were randomised to control and amnioinfusion groups at a 1:1 ratio. Amnioinfusion was performed using 500 mL of normal saline over a period of 30 minutes in a study group. The control group received routine care. Both groups had intermittent auscultation of fetal heart rate during labour. MAIN OUTCOME MEASURES: The primary outcome measure was caesarean section rate. Secondary outcome measures were meconium aspiration syndrome, 1 minute and 5 minute apgar < 7, hypoxic ischaemic encephalopathy, neonatal intensive care unit admission, meconium at the level of vocal cords. RESULTS: The caesarean section rate in the amnioinfusion group was less than the control group (RR 0.47; 95% CI 0.240.93). Amnioinfusion was associated with a significant decrease in the incidence of meconium at the vocal cords (P = 0.001); improvement in 1 minute apgar scores (P < 0.05), respiratory distress (P = 0.002) and fewer admissions to nursery compared with the controls. This sample size was inadequate to study the impact on meconium aspiration syndrome. CONCLUSION: Amnioinfusion in an under resourced labour ward decreases caesarean section rates and fetal morbidity (222) Roy N, Weinrich B, Gray SD et al. Voice amplification versus vocal hygiene instruction for teachers with voice disorders: a treatment outcomes study. J Speech Lang Hear Res 2002;45:625-638. Ref ID: 137 Abstract: Voice problems are common among schoolteachers. This prospective, randomized clinical trial used patient-based treatment outcomes measures combined with acoustic analysis to evaluate the effectiveness of two treatment programs. Forty-four voice-disordered teachers were randomly assigned to one of three groups: voice amplification using the ChatterVox portable amplifier (VA, n = 15), vocal hygiene (VH, n = 15), and a nontreatment control group (n = 14). Before and after a 6-week treatment phase, all teachers completed: (a) the Voice Handicap Index (VHI), an instrument designed to appraise the self-perceived psychosocial consequences of voice disorders; (b) a voice severity self-rating scale; and (c) an audiorecording for later acoustic analysis. Based on pre- and posttreatment comparisons, only the amplification group experienced significant reductions on mean VHI scores (p = .045), voice severity self-ratings (p = .012), and the acoustic measures of percent jitter (p = .031) and shimmer (p = .008). The nontreatment control group reported a significant increase in level of vocal handicap as assessed by the VHI (p = .012). Although most pre- to posttreatment changes were in the desired direction, no significant improvements were observed within the VH group on any of the dependent measures. Between-group comparisons involving the three possible pairings of the groups revealed a pattern of results to suggest that: (a) compared to the control group, both treatment groups (i.e., VA and VH) experienced significantly more improvement on specific outcomes measures and (b) there were no significant differences between the VA and VH groups to indicate superiority of one treatment over another. Results, however, from a posttreatment questionnaire regarding the perceived benefits of treatment revealed that, compared to the VH group, the VA group reported more clarity of their speaking and singing voice (p = .061), greater ease of voice production (p = .001), and greater compliance with the treatment program (p = .045). These findings clearly support the clinical utility of voice amplification as an alternative for the treatment of voice problems in teachers (223) Rubin JS, Greenberg M. Psychogenic voice disorders in performers: a psychodynamic model. J Voice 2002;16:544-548. Ref ID: 125 Abstract: Psychogenic voice disorders are not infrequently encountered in the busy voice clinic. A clinician-friendly psychodynamic model and a multidisciplinary management approach are presented which have proven helpful for our voice team and our patients. In essence the formulation revolves around an "event" occurring, which may be either organic or psychological in nature. The ensuing dysphonia then leads to emotional consequences which in turn have physical consequences on the vocal tract. The situation can become reinforcing and illness behaviors develop. Elucidating this event/process to the patient improves the likelihood of a successful long-term outcome. The diagnostic and management roles of the various team members are discussed (224) Sala E, Airo E, Olkinuora P et al. Vocal loading among day care center teachers. Logoped Phoniatr Vocol 2002;27:21-28. Ref ID: 133 Abstract: Day care center teachers suffer from voice disorders more often than nurses do. Several risk factors may increase voice disorder prevalence of day care center teachers. The risk factors can be bound to their job content and manner of working i.e. having to raise their voice to attract the attention of the children and to offer them the possibility to perceive spoken information, or to the environment i.e. poor acoustics and excess background noise. The purpose of this study was to measure some of the risk factors for voice disorders of day care center teachers and of a control group (nurses); these were speaking times and speech levels. The background noise levels during activities and RASTI-values (Rapid Speech Transmission Index), i.e. measures of the acoustics of rooms, were also measured at the day care centers. It was found that day care center teachers use their voices more and with higher levels than nurses do. It was also found that the background noise levels are high, which is partly due to the poor acoustics (lack of sufficient attenuation) of the rooms. Control of excess background noise is of utmost importance both for speakers' speech production as well as children's speech recognition (225) Sivasankar M. Effects of vocal fatigue on voice parameters of Indian teachers. 87 Indian J Otolaryngol Head Neck Surg 2002;54:245-247. Ref ID: 412 Abstract: Vocal fatigue is a frequently reported voice symptom among professional voice users. Indian school of teachers continuously for many hours in adverse acoustical environments and are highly susceptible to vocal fatigue. The present study is the first to examine acoustic voice measures in teachers reporting naturally induced vocal fatigue. 40 female primary school of teachers (mean age = 36 years) with varying severity of vocal fatigue participated in this study. Voice measures of minimum and maximum fundamental frequency were obtained before and after one and a half hours of continuous teaching at the workplace. Maximum fundamental frequency was an important acoustic parameter in determining presence of vocal fatigue. Most common perceptual symptoms include throat dryness, discomfort and loss of voice. The role of vocal hygiene and warm-up in reducing vocal fagitue are considered (226) Sliwinska-Kowalska M, Fiszer M, Kotylo P, Ziatkowska E, Stepowska M, Niebudek-Bogusz E. [Effect of voice emission training on the improvement in voice organ function among students attending the college of teachers]. Med Pr 2002;53:229-232. Ref ID: 134 Abstract: One of the major causes of frequent voice disorders in teachers is incorrect vocal emission technique. The aim of the study was to assess the effect of logopedic training on voice emission parameters and vocal organ disorders in students attending the college for teachers. The study group comprised 45 female students who experienced vocal abnormalities after excessive vocal effort. Questionnaire surveys, phoniatric and videostroboscopic examinations were performed in all subjects before starting and after completing the logopedic training. The training was preceded by a theoretical seminar on voice organ anatomy, physiology, and hygiene. The logopedic training lasting two-three months contributed to the improvement in voice characteristics and the condition of voice organ in the majority of students, as well as in phoniatric parameters, including the increase in the maximum phonation time, the frequency range of voice, the reduction of the glottal insufficiency and the elimination of "soft" vocal nodules. The results of the study indicate that the implemented voice emission training improved significantly voice quality and allowed for providing an efficient therapy of already existing functional disorders of the larynx (227) Tepe ES, Deutsch ES, Sampson Q, Lawless S, Reilly JS, Sataloff RT. A pilot survey of vocal health in young singers. J Voice 2002;16:244-250. Ref ID: 138 Abstract: The objective of this study was to determine the incidence of vocal problems in young choir singers and to correlate vocal problems with demographic and behavioral information. A questionnaire addressing vocal habits and hygiene was offered to 571 young choir singers, up to 25 years of age, who sing at least weekly; 129 (22.6%) responded. More than one-half of the respondents had experienced vocal difficulty, particularly older adolescents. Detrimental behaviors and circumstances surveyed were not reflective of the incidence of vocal difficulty, except for morning hoarseness, chronic fatigue, insomnia, and female gender after puberty. Voice care professionals should be aware that self-reported voice difficulties are common among young choral singers, especially postpubescent girls, and children with symptoms consistent with reflux (morning hoarseness) and emotional stress (insomnia). Laryngologists should communicate with choral conductors and singing teachers to enhance early identification and treatment of children with voice complaints, and to develop choral educational strategies that help decrease their incidence (228) Williams NR. Occupational voice disorders due to workplace exposure to irritants--a review of the literature. Occup Med (Lond) 2002;52:99-101. Ref ID: 141 Abstract: The medical literature contains relatively few examples of reports of voice disorders that could be attributed to chemical exposure at work. General medical conditions such as gastro-oesophageal reflux and the use of medication such as inhaled steroids are well-recognized causes of laryngitis, but the occupational causes are less well documented. This paper describes the results of a literature review looking at the reporting of cases of occupationally acquired voice disorders due to exposure to irritants in the workplace (229) Yiu E, Ma E. Voice activity limitation and participation restriction in the teaching profession: The need for preventive voice care. J Med Speech Lang Pathol 2002;10:51-60. Ref ID: 425 Abstract: Teachers are prone to developing voice problems because of the specific occupational demand of teaching. Voice problems impose difficulties or limitations not only on their teaching activities but also on other daily voice activities. Activity limitation and participation restriction are two separate dimensions introduced in the International Classification of Impairments, Disabilities, and Handicaps by the World Health Organization (1997). Teachers with voice problems may face difficulties or limitations in their teaching activities. However, they may have little choice but to continue participating in these teaching activities. This study reports the extent of voice problems and their impact on 30 self-selected teachers enrolled for a workshop to improve their teaching voice. The findings show that job, daily communication, social communication, and emotion were all affected in the majority of the teachers. It also points to the need of implementing preventive voice care for the teaching profession (230) Zeitels SM, Hillman RE, Desloge R, Mauri M, Doyle PB. Phonomicrosurgery in singers and performing artists: treatment outcomes, management theories, and future directions. Ann Otol Rhinol Laryngol Suppl 2002;190:21-40. Ref ID: 128 Abstract: Phonomicrosurgery in performing artists has historically been approached with great trepidation, and vocal outcome data are sparse. The vocal liability of surgically disturbing the superficial lamina propria (SLP) and epithelium must be balanced with the inherent detrimental vocal effect of the lesion(s). A prospective investigation was performed on 185 performing artists who underwent phonomicrosurgical resection of 365 lesions: 201 nodules, 71 polyps, 66 varices and ectasias, 13 cysts, 8 keratotic lesions, 2 granulomas, 2 Reinke's edema, and 2 papillomas. Nearly all patients with SLP lesions reported improvement in their postsurgical vocal function. This subjective result was supported by objective acoustic and aerodynamic measures. All postsurgical objective vocal function measures fell within normal limits, including a few that displayed presurgical abnormalities. 89 However, given the relative insensitivity of standard objective measures to assess higher-level vocal performance-related factors, it is even more noteworthy that 8 of 24 objective measures displayed statistically significant postsurgical improvements in vocal function. Such changes in objective measures mostly reflect overall enhancement in the efficiency of voice production. Phonomicrosurgical resection of vocal fold lesions in performing artists is enjoying an expanding role because of a variety of improvements in diagnostic assessment, surgical instrumentation and techniques, and specialized rehabilitation. Most of these lesions are the result of phonotrauma and arise within the SLP. Successful management depends on prudent patient selection and counseling, ultraprecise technique, and vigorqus vocal rehabilitation. Furthermore, an understanding of the vocal function and dysfunction of this high-performance population provides all otolaryngologists who manage laryngeal problems with valuable information that they can extrapolate for use in their practices (231) Arnkil R. Issue 20010315: Evaluation of the European Agency for Safety and Health at Work - does information communicate. 2001. Issue 20010315. Ref Type: Report Ref ID: 489 Abstract: At a meeting held in March 2001, the European Agency's Board and Focal Point members discussed the findings of an independent evaluation of the Agency's performance during its first four years of existence. Overall, the report recognised in very positive terms the Agency's achievement in setting up its EU-wide information network and launching its range of events, publications and, especially, its websites. Their recommendations for future development included: improving communication and user-feedback mechanisms; ways of strengthening the network of national Focal Points; and further development of strategic management of the agency. The report, together with responses from the Agency's key stakeholders, has been sent to the European Commission, which is responsible for reviewing the Agency's founding regulation (232) Brandenburg JH. Laser cordotomy versus radiotherapy: an objective cost analysis. - 2001;110(4):312-318. Ref ID: 470 (233) Bullough A, Craig R. Anaesthesia for the professional singer (1). Eur J Anaesthesiol 2001;18:414-415. Ref ID: 351 (234) Domeracka-Kolodziej A. [Diseases of the larynx and voice disorders in teachers after many years of performing their profession, claiming the recognition of occupational disease]. Otolaryngol Pol 2001;55:671-672. Ref ID: 97 (235) Gardner C. Work hoarse? Occup Health 2001;53:24-26. Ref ID: 366 (236) Hoover CA, Sataloff RT, Lyons KM, Hawkshaw M. Vocal fold mucosal tears: maintaining a high clinical index of suspicion. J Voice 2001;15:451-455. Ref ID: 143 Abstract: Vocal fold mucosal tears have been discussed in the literature rarely, although they are not uncommon clinically. Disruptions in the epithelium usually follow trauma that may result from voice abuse and/or misuse, coughing, and other causes. A high index of suspicion is necessary to avoid missing vocal fold mucosal tears, and strobovideolaryngoscopy is indispensable in making the diagnosis. A brief period of complete voice rest is the standard of care and appears to be helpful in avoiding adverse sequelae and advancing the healing process, but there are no scientific studies to confirm its efficacy. Mucosal tears may heal completely or may be followed by the development of vocal fold masses, scar, and permanent dysphonia (237) King A, Ashby J, Nelson C. Effects of testosterone replacement on a male professional singer. J Voice 2001;15:553-557. Ref ID: 377 Abstract: Testosterone has been known to play an important role in the development of the postpubertal male voice for many centuries. In fact, the prevention of pubertal development of the voice by castrating young male singers was a well-known practice, especially in Italy beginning in the sixteenth century. The "castrati" were well known for their clear, high-pitched voices. Because of the resulting small larynx and vocal folds, castrati apparently produced a distinctive resonance as well as the high pitch, which cannot be matched even by the counter tenors of today. Busy voice labs occasionally see males with sex hormone deficiencies secondary to chromosomal or gonadal problems. This is a presentation of an unusual patient who was a trained tenor singer and was found to have hypogonadism on a premarital health examination. Administration of replacement testosterone resulted in significant vocal register and voice quality changes (238) Liu AY, Yousem DM, Chalian AA, Langlotz CP. Economic consequences of diagnostic imaging for vocal cord paralysis. - 2001;8(2):137-148. Ref ID: 471 (239) MacKenzie K, Millar A, Wilson JA, Sellars C, Deary IJ. Is voice therapy an effective treatment for dysphonia? A randomised controlled trial. BMJ 2001;323:658-661. Ref ID: 448 Abstract: OBJECTIVES: To assess the overall efficacy of voice therapy for dysphonia. DESIGN: Single blind randomised controlled trial. SETTING: Outpatient clinic in a teaching hospital. Participants: 204 outpatients aged 1787 with a primary symptom of persistent hoarseness for at least two months. INTERVENTIONS: After baseline assessments, patients were randomised to six weeks of either voice therapy or no treatment. Assessments were repeated at six weeks on the 145 (71%) patients who continued to this stage and at 12-14 weeks on the 133 (65%) patients who completed the study. The assessments at the three time points for the 70 patients who completed treatment and the 63 patients in the group given no treatment were compared. MAIN OUTCOME MEASURES: Ratings of laryngeal features, Buffalo voice profile, amplitude and pitch perturbation, voice profile questionnaire, hospital anxiety and depression scale, clinical interview schedule, SF-36. RESULTS: Voice therapy improved voice quality as assessed by rating by patients (P=0.001) and rating by observer (P<0.001). The treatment effects for these two outcomes were 4.1 (95% confidence interval 1.7 to 6.6) points and 0.82 (0.50 to 1.13) points. Amplitude perturbation showed improvement at six weeks (P=0.005) but not on completion of the study. Patients with 91 dysphonia had appreciable psychological distress and lower quality of life than controls, but voice therapy had no significant impact on either of these variables. CONCLUSION: Voice therapy is effective in improving voice quality as assessed by self rated and observer rated methods (240) Majdevac Z, Mitrovic S, Jovic R. Classification of dysphonias based on the primary etiologic factor (part II). Med Pregl 2001;54:135-139. Ref ID: 382 Abstract: INTRODUCTION: Phonation is a complex integral function of an organism. Regular phonation is characterized by: clearness and adequate pitch. Dysphonia is a disorder of phonation. It can have many acoustic forms, but hoarseness is the best known symptom of dysphonia. Acoustic phenomena in regard to voice are caused by: irregularities in vocal cord vibration, turbulent airflow in the glottis and obstruction of glottis. PREVIOUS CLASSIFICATIONS OF DYSPHONIAS: The best known classification of dysphonias was introduced by Perello. There are two groups: 1. organic dysphonias and 2. functional dysphonias. On the 8th Congress of the Union of European Phoniatrists, in K÷szeg (Hungary, 1979), Majdevac proposed a new classification. CLASSIFICATION OF DYSPHONIAS: We are proposing a new classification according to the primary etiologic factor of dysphonias. In this paper, we shall consider four gropus: from the fifth to eighth. V DYSPHONIAS CAUSED BY PRIMARY ENDOCRINE DISORDERS: This group includes: 1. Dysphonia caused by pituitary disorders 2. Dysphonia caused by thyroid gland disorders 3. Dysphonia caused by parathyroid glands disorders 4. Dysphonia caused by pancreatic function disorders 5. Dysphonia caused by suprarenal function disorders 6. Dysphonias caused by sexual glands function disorders 7. Intersexuality. VI DYSPHONIAS CAUSED BY COMPLEX PROFESSIONAL REASONS: This group includes: 1. Permanent hyperkinetic dysphonia 2. Permanent hyperkinetic dysphonia with vocal cord nodules 3. Dysphonia caused by myogenic imperfect closure of vocal cords 4. Phonastenia. VII DYSPHONIAS CAUSED BY PRIMARY DISPLASTIC DISORDERS: This group includes: 1. Dysphonia caused by laryngeal hypoplasia 2. Dysphonia caused by laryngeal asymmetry 3. Dysphonia caused by epiglottal anomalies 4. Dysphonia caused by laryngeal diaphragm. VIII DYSPHONIAS CAUSED BY LARYNGEAL TUMORS: This group includes: 1. Dysphonia caused by benign tumors 2. Dysphonia caused by malignant tumors. CONCLUSION: Dysphonia is a disorder of phonation which originates from glottal level. Disorders of phonation require observation of an organism as a whole and studying all mechanisms which take part in voice production. This provides examination of voice disorders, their establishment and adequate treatment (241) Merritt L, Richards A, Davis P. Performance anxiety: loss of the spoken edge. J Voice 2001;15:257-269. Ref ID: 449 Abstract: The study aimed to assess whether a specific training program in vocal and physical skills could reduce the level of perceived performance anxiety. Eighteen undergraduate performing arts students were divided into two even groups. The experimental group experienced 10 two-hour sessions in a specialized vocal and physical skills training program. The control group received the same number of sessions in text analysis by the same teacher. Ten weeks after the training period, both groups were videotaped delivering a short speech of general interest. The videotaped material was assessed by four judges, using a visual analog scale (VAS). Perceptual variables considered were eight vocal and physical features: physical ease, physical presence, effective gesture use, effective eye contact, correct breath use, suitable pace, vocal variety, speech clarity, and one performance feature: perceived performance anxiety. Results indicated that the particular vocal and physical skills training program used showed positive results in effectively reducing the level of perceived performance anxiety. The experimental group scored significantly higher on each of the eight vocal and physical features and significantly lower on the perceived anxiety feature than the control group. This research has implications for those affected by performance anxiety in vocal presentation (242) Obrebowski A, Pruszewicz A, Sulkowski W, Wojnowski W, Sinkiewicz A. [Proposals of rational procedures for certifying occupational voice disorders]. Med Pr 2001;52:35-38. Ref ID: 148 Abstract: Following a long period of experience acquired in assessing occupation-related voice disorders, the proposals of objective measures, facilitating the certification of occupational disease of the voice organ in accordance with the binding legal regulations, are presented. The importance of documentary evidence of at least two years of treatment and phoniatric rehabilitation is stressed. A need to prevent occupation-related voice disorders through phoniatric diagnostic procedures is highlighted (243) Pedersen M, McGlashan J. Surgical versus non-surgical interventions for vocal cord nodules. Pedersen Mette , McGlashan Julian Surgical versus non surgical interventions for vocal cord nodules Cochrane Database of Systematic Reviews: Reviews 2001 Issue 2 John Wiley & Sons , Ltd Chichester, UK DOI : 10 1002 /14651858 CD001934 2001. Ref ID: 457 Abstract: BACKGROUND: This is an update of a Cochrane Review first published in The Cochrane Library in Issue 2, 2001 and previously updated in 2007.Vocal cord nodules are bilateral, benign, callous-like growths of the midportion of the membranous vocal folds. They are of variable size and are characterised histologically by thickening of the epithelium with a variable degree of inflammation in the underlying superficial lamina propria. They characteristically produce hoarseness, discomfort and an unstable voice when speaking or singing. OBJECTIVES: To assess the effectiveness of surgery versus non-surgical interventions for vocal cord nodules. SEARCH STRATEGY: We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; mRCT and additional sources for published and unpublished trials. The date of the most recent search was 25 November 2009, following a previous update search in January 2007. SELECTION CRITERIA: Randomised and quasi-randomised trials comparing any surgical intervention for vocal cord nodules with non-surgical treatment or no treatment. DATA COLLECTION AND ANALYSIS: No suitable trials were identified. MAIN RESULTS: No studies fulfilled the inclusion criteria. AUTHORS' CONCLUSIONS: There is a need for high quality randomised controlled trials to evaluate the effectiveness of surgical and non-surgical treatment of vocal cord nodules. SURGERY VERSUS NON-SURGICAL INTERVENTIONS (VOICE THERAPY, MEDICAL TREATMENT) FOR THE RESOLUTION OF VOCAL CORD NODULES: Vocal cord nodules are benign, callous-like growths on the vocal 93 cords. Symptoms include hoarseness, throat discomfort, pain and an unstable voice when speaking or singing. They can be caused by 'voice abuse' (prolonged shouting or singing above the individual's own range) but may also be caused by infection, allergy or acid reflux.Vocal cord nodules can be surgically removed but may also be treated with non-surgical voice therapy interventions (e.g. voice re-training, rest or hygiene advice) or medical/pharmacological treatment of underlying infections, allergy or gastroesophageal reflux.The authors of this review sought to identify trials which compared surgical with non-surgical treatment. They found that there was not enough evidence to compare surgery to other treatment options. More research is needed (244) Pelclovb D, Ameille J, Urban P, Fenclovb Z, Lebedovb J. Occupational diseases in the Czech Republic. Arch Mal Prof Med Trav 2001;62:629-633. Ref ID: 393 Abstract: Purpose of the study. To describe the system of recognition and compensation of occupational diseases in the Czech Republic including its advantages and weak points. Method. Statistical data concerning occupational diseases in the Czech Republic are presented here. Czech criteria for acknowledgement of occupational diseases and some advantages and disadvantages of the Czech system are discussed. Results. In the Czech Republic, 1 751 occupational diseases were acknowledged in the year 2000. The Czech List of occupational diseases is divided into six chapters. Diseases due to physical factors come first among statistical data with 39.9% in the year 2000. Diseases of the respiratory system and skin diseases represent 20.7% each; infectious diseases, 16.4% of all occupational diseases. Poisonings were acknowledged only in 2.1% and other diseases (i.e. disorders of vocal cords) in 0.2% cases. Discussion The Czech system is simple. Occupational medicine specialists play a crucial role. Working conditions and exposures to noxious agents are controlled by the regional occupational hygienists. If the conditions at work do not meet appropriate criteria, occupational disease cannot be acknowledged. All diseases are compensated according to the general system of the Social insurance. The compensation of occupational diseases in the Czech Republic is relatively generous; therefore the phenomenon of under-reporting is not very important. Rather frequently the patients try to be acknowledged for an occupational disease in order to solve their social, psychological and non-occupational problems. A disadvantage of the Czech system is the insufficient promotion of the need for prevention of these diseases. The taxes of the employers are not increased with the increasing number of occupational diseases. Conclusion The statistical data concerning occupational diseases strictly depend on the criteria accepted in different countries. It is necessary to promote at the European level the harmonization of the recognition and compensation of occupational diseases in accordance with the demands of justice and equity. Different criteria of recognition and acknowledgement of occupational diseases in European countries make the comparison very difficult (245) Roy N, Gray SD, Simon M, Dove H, Corbin-Lewis K, Stemple JC. An evaluation of the effects of two treatment approaches for teachers with voice disorders: a prospective randomized clinical trial. J Speech Lang Hear Res 2001;44:286296. Ref ID: 149 Abstract: Teachers commonly report voice problems and often seek medical assistance for voice-related complaints. Despite the prevalence of voice disorders within this occupation, there are no studies evaluating the effectiveness of treatment programs designed to remedy the voice problems of teachers. To assess the functional effects of two voice therapy approaches, 58 voice-disordered teachers were randomly assigned to 1 of 3 groups: vocal hygiene (VH, n = 20), vocal function exercises (VFE, n = 19), and a nontreatment control group (CON, n = 19). Subjects completed the Voice Handicap Index (VHI)-an instrument designed to appraise the self-perceived psychosocial consequences of voice disorders-before and following a 6-week treatment phase. The VFE and VH subjects also completed a posttreatment questionnaire regarding the perceived benefits of treatment. Only the group who adhered to the VFE regimen reported a significant reduction in mean VHI scores (p <.0002). Furthermore, when compared to the VH group, the exercise group reported more overall voice improvement (p < .05) and greater ease (p < .02) and clarity (p < .01) in their speaking and singing voice after treatment. These findings suggest that the VFE should be considered as a useful alternative or adjunct to vocal hygiene programs in the treatment of voice problems in teachers (246) Sala E, Laine A, Simberg S, Pentti J, Suonpaa J. The prevalence of voice disorders among day care center teachers compared with nurses: a questionnaire and clinical study. J Voice 2001;15:413-423. Ref ID: 144 Abstract: The acceptance of voice disorders by day care center teachers as an occupational disease is not an invariably established practice. This is due to the lack of reliable evidence of a higher risk for voice disorders in this profession. To find out the risk of voice disorders, an epidemiological study was conducted among day care center teachers (n = 262), using hospital nurses (n = 108) as a control group. Symptoms were charted by a questionnaire. In a clinical examination made by a laryngologist, the voice quality was assessed and the laryngeal status noted. Teachers at day care centers had significantly more voice disorders than did nurses. Vocal nodules and laryngitis findings appeared significantly more frequently among day care center teachers than among those in the control group. The results prove voice disorders to be more frequent among day care center teachers than among control group subjects, and also that the main cause for this may be a higher vocal loading among day care center teachers than among control group subjects (247) Sataloff RT. Professional voice users: the evaluation of voice disorders. Occup Med 2001;16:633-47, v. Ref ID: 145 Abstract: Substantial advances in understanding the anatomy and physiology of phonation, and the new technology that has improved voice measurement and voice surgery, have led to marked improvement in the standard-of-care for patients with voice disorders. Expert voice care is essential for all patients, but especially crucial for voice professionals. Professional voice users include not only singers and actors, but also clergy, teachers, receptionists, sales personnel, physicians, and anyone else whose ability to earn a living is impacted negatively by loss of vocal quality and endurance. Physicians should be familiar with the latest concepts in voice diagnosis and treatment, and with the management of common voice disorders 95 (248) Sataloff RT, Shaw A, Markiewicz A. Acute laryngitis in a professional singer. Ear Nose Throat J 2001;80:436. Ref ID: 146 (249) Simberg S, Sala E, Laine A, Ronnemaa AM. A fast and easy screening method for voice disorders among teacher students. Logoped Phoniatr Vocol 2001;26:10-16. Ref ID: 147 Abstract: A recent study concerning voice disorders among future teachers showed that about 20% of the students had a voice disorder. Most of the disorders were organic. In the current study, we describe a voice-screening method that can be administered by the health care personnel in order to select students for further examination by the speech language therapist and/or phoniatrician. The screening method consists of a perceptual assessment of voice quality and a questionnaire concerning vocal symptoms. As criterion for further medical investigation and voice therapy, we selected a score of 35 mm or above on a visual analogue scale assessing Grade, i.e. overall grade of hoarseness and/or two or more weekly or more often occurring vocal symptoms. The results showed that health care personnel with some training in assessing voices using the questionnaire are competent to perform a rough voice screening on students (250) Carding P, Wade A. Managing dysphonia caused by misuse and overuse. BMJ 2000;321:1544-1545. Ref ID: 151 (251) Kohout J, Noskova J. Occupational diseases of workers in education in the west Bohemian region. Prakt Lek 2000;80:496-497. Ref ID: 379 Abstract: The authors analyzed the documentation of 36 patients working in educational services where in 1980-1999 an occupational disease was notified. Most frequently university teachers were affected (7 patients), cooks (6 patients) and educators (5 patients). Most frequently viral patients), rhinitis. hepatitis was diagnosed (13 patients), contact eczema (6 - and allergic Hyperkinetie dysphonia was reported in two patients (252) Neely JL, Rosen C. Vocal fold hemorrhage associated with coumadin therapy in an opera singer. J Voice 2000;14:272-277. Ref ID: 154 Abstract: Vocal fold hemorrhage can represent a disastrous and potentially career ending injury to a singer or professional voice user. The risk factors of vocal fold hemorrhage, including laryngeal trauma, phonotrauma, aspirin and nonsteroidal antiinflammatories, and hormonal imbalances are well known. We present a case of an opera singer who developed recurrent vocal fold hemorrhage associated with coumadin anticoagulation therapy. This case highlights the importance of the risk of vocal fold hemorrhage to professional singers and professional voice users and offers an alternative to long-term coumadin therapy in this select population (253) Sataloff RT, Abaza MM. Impairment, disability, and other medical-legal aspects of dysphonia. Otolaryngol Clin North Am 2000;33:1143-1152. Ref ID: 153 Abstract: As awareness of the importance of the human voice has grown, so too have legal issues surrounding voice dysfunction. Otolaryngologists must be familiar with principles of impairment and disability and with appropriate medical-legal management for voice patients (254) Sataloff RT, Hawkshaw MJ. Vocal fold cyst, hemorrhage, and scar in a professional singer. Ear Nose Throat J 2000;79:140. Ref ID: 156 (255) Simberg S, Laine A, Sala E, Ronnemaa AM. Prevalence of voice disorders among future teachers. J Voice 2000;14:231-235. Ref ID: 155 Abstract: An epidemiological study was conducted in order to find out the prevalence of voice disorders among students studying to be teachers. Vocal symptoms were inquired of 226 students. Their voices were assessed perceptually by a speech therapist and those who had abnormal voice quality or reported several vocal symptoms were referred to a clinical examination by a laryngologist. The results showed that 20% of this population reported two or more vocal symptoms during the previous year and that 19% had an organic voice disorder. This reinforces the need for clinical evaluation of students with vocal symptoms and more vocal training in the teacher education programs (256) Sliwinska-Kowalska M, Fiszer M, Niebudek-Bogusz E, Kotylo P, Rzadzinska A. [Evaluation of voice quality in students from teaching colleges]. Med Pr 2000;51:573-580. Ref ID: 150 Abstract: Vocal disorders are very common occupation-related disease in teachers. Their remarkable incidence might be associated with inappropriate techniques of speech and poor vocal hygiene. The aim of this study was to assess the function of vocal organ including voice emission technique in persons starting their teaching occupation. The study group included 66 female students at Teaching College. Their were thoroughly interviewed and subjected to laryngological, phoniatric and videostroboscopic examinations. All subjects reported subjective symptoms after vocal effort. Hoarseness and throat dryness were the most common. In the majority of students functional vocal disorders were observed. In 30% of them insufficiency of glottis and in four (6.1%) students soft vocal nodules were found. Signs and symptoms of vocal diseases were more frequent in a subgroup of students exposed to increased vocal effort during their professional education. The results indicate that young teachers are not sufficiently prepared for increased vocal strain, apparently associated with their profession. It is indeed necessary to introduce preventive programs including special training of appropriate speech technique, into the curricula of schools for teachers (257) Vasilenko I, Pavlikhin OG, Izgarysheva ZA. [Analysis of the causes of vocal tract diseases in singers]. Vestn Otorinolaringol 2000;13-17. Ref ID: 152 Abstract: The etiology of vocal apparatus diseases in opera singers is due to both specific features of their theatrical activity and conventions of opera genre in particular. A hundred and twenty seven vocalists (soloists and choristers) aged 23 to 70 years with service length of 3 to 40 years were examined. Both the status of the vocal apparatus itself and comorbidity were found to affect the occurrence of occupational diseases of the larynx. Of great 97 importance are the quality of vocal background of a singer, his/her age, length of service, the even distribution of vocal load during a month and a season, the volume of additional work (concert and pedagogical activities), the correspondence of parts to his/her techniques and actor's capacities, and living and social conditions. The pattern of vocal apparatus diseases also depends on the type of a singer's voice and on the status of his/her nervous system. This study-based recommendations for singers and theater managers administrators reduced the incidence rates of laryngeal diseases in the followed-up professional opera singers by 15-20% (258) Hogikyan ND, Appel S, Guinn LW, Haxer MJ. Vocal fold nodules in adult singers: regional opinions about etiologic factors, career impact, and treatment. A survey of otolaryngologists, speech pathologists, and teachers of singing. J Voice 1999;13:128-142. Ref ID: 161 Abstract: This study was undertaken to better understand current regional opinions regarding vocal fold nodules in adult singers. A questionnaire was sent to 298 persons representing the 3 professional groups most involved with the care of singers with vocal nodules: otolaryngologists, speech pathologists, and teachers of singing. The questionnaire queried respondents about their level of experience with this problem, and their beliefs about causative factors, career impact, and optimum treatment. Responses within and between groups were similar, with differences between groups primarily in the magnitude of positive or negative responses, rather than in the polarity of the responses. Prevailing opinions included: recognition of causative factors in both singing and speaking voice practices, optimism about responsiveness to appropriate treatment, enthusiasm for coordinated voice therapy and voice training as first-line treatment, and acceptance of microsurgical management as appropriate treatment if behavioral management fails (259) Lundy DS, Casiano RR, Sullivan PA, Roy S, Xue JW, Evans J. Incidence of abnormal laryngeal findings in asymptomatic singing students. Otolaryngol Head Neck Surg 1999;121:69-77. Ref ID: 159 Abstract: OBJECTIVE: Abnormalities in the mucosal lining of the vocal folds may interfere with the normal vibratory patterns and result in vocal limitations, especially for singers whose demands are great. A prospective, longitudinal study was undertaken to investigate the incidence of laryngeal abnormalities in asymptomatic singing students. METHODS: Sixty-five singing students at the school of music underwent videostroboscopic evaluation and completed a comprehensive questionnaire. Videos were rated by 3 experienced clinicians, and interrater reliability was calculated. Results were correlated with demographic factors, background medical history, and singing history. RESULTS: Five students (8.3%) exhibited early signs of benign vocal fold lesions (2 with nodules and 3 with cysts). A high incidence of posterior erythema (n = 44; 73.4%), suggesting possible reflux, was found. CONCLUSIONS: A surprisingly high number of otherwise asymptomatic singing students demonstrated abnormal laryngeal findings. Their relationship with vocal performance will be addressed as well as implications for preventative measures (260) Obrebowski A, Pruszewicz A. [Phoniatric interpretation of evaluation principles in professional voice disorders]. Otolaryngol Pol 1999;53:579-583. Ref ID: 157 Abstract: The critical assessment of the existing regulations of professional voice evaluation are presented. The necessity of the use of essential phoniatric principles is stressed in order to make respective legal decision more realistic and responsible (261) Phyland DJ, Oates J, Greenwood KM. Self-reported voice problems among three groups of professional singers. J Voice 1999;13:602-611. Ref ID: 158 Abstract: A vocal health questionnaire was administered to three groups of professional singers and a "friendship-matched" group of nonsingers in Melbourne, Australia. The responses of 79 opera, 57 musical theatre and 31 contemporary (excluding rock) singers and 86 nonsingers were analysed. The questionnaire solicited information regarding biographical data speaking and singing voice-use behaviours, and vocal health over the previous 12 months in terms of experiences of vocal impairment, vocal disability, and handicap. Significant differences between singers and nonsingers in the prevalence and nature of voice problems were reported. Of the singers, 44% reported one or more occurrences of a diagnosed vocal condition compared to 21% of nonsingers and 69% of singers experienced vocal disability compared to only 41% of nonsingers, over the previous 12 months. In contrast, no significant differences were found between the three different styles of singers in their experience of vocal impairment, disability or handicap (262) Sonninen A, Hurme P, Laukkanen A. The external frame function in the control of pitch, register, and singing mode: Radiographic observations of a female singer. J Voice 1999;13:319-340. Ref ID: 413 Abstract: This study investigates pitch control, register, and singing mode related movements of the laryngo-pharyngeal structures by radiographic methods. One trained female singer served as the subject. The results show that singing voice production involves complex movements in the laryngeal structures. Pitch related increase in the thyro-arytenoid distance (vocal fold length) is nonlinear, slowing down as pitch rises. Similar observations have been made earlier. At the highest pitches, a shortening of the distance can be seen, suggesting the use of alternative pitch control mechanisms. The various observations made support the existence of three registers in this trained female singing voice. Open and covered modes of singing seemed to be distinguishable on the basis of different amounts of tuner and outer forces acting on the larynx. Therefore, caution must be exercised when generalizing from the results (263) Zalesska-Krecicka M, Krecicki T, Cyganek P, Walulin J, Rozmiarek D. [Analysis of voice disorders in teachers treated in the Phoniatric Laboratory of the Otolaryngology Department AM in Wroclaw]. Przegl Lek 1999;56:139-143. Ref ID: 160 Abstract: Analysis of voice disorders in 898 teachers was performed. In all cases otolaryngologic, videostroboscopic and phoniatric examinations were completed. There was prevalence of women at the age ranged from 46 to 56 years. Majority of morphologic changes included Reinkes oedema (120 cases), chronic simple laryngitis (109 cases), vocal nodules (95 cases), chronic hypertrophic laryngitis (70 cases) and laryngeal polyps (35 cases). In 175 cases vocal insufficiency of glottis and in 57 cases functional disorders were 99 diagnosed. In 131 cases no morphologic and functional changes were found. In the group of teachers the incidence of vocal insufficiency was higher than in control group. The analysis of the examined teachers revealed that professional disease was confirmed in 33% of cases. Majority of them included vocal nodules and chronic hypertrophic laryngitis (264) Barnes PJ, Woolcock AJ. Difficult asthma. Eur Respir J 1998;12:1209-1218. Ref ID: 341 Abstract: Asthma is usually easy to manage, but ~5% of patients are not controlled even on high doses of inhaled corticosteroids. It is important to assess these patients carefully in order to identify whether there are any correctable factors that may contribute to their poor control. It is critical to make a diagnosis of asthma and to exclude other airway diseases, particularly chronic obstructive pulmonary disease (COPD), and vocal cord dysfunction ('pseudo-asthma') . Poor adherence to therapy, particularly inhaled corticosteroids, is a common reason for a poor response. There may be unidentified exacerbating factors, including unrecognized allergens, occupational sensitizers, dietary additives, drugs, gastro-oesophageal reflux, upper airway disease, or other systemic diseases, that need to be identified and avoided or treated. Psychological factors may be important in some patients, but it is difficult to know whether these are causal or secondary to troublesome disease. Some patients have instability of their asthma, with resistant nocturnal asthma, premenstrual exacerbations or chaotic and unpredictable instability (brittle asthma). A few patients are completely resistant to corticosteroids, but more patients are relatively resistant and require relatively high doses of corticosteroids to control their symptoms (steroid-dependent). Some patients develop progressive loss of lung function, as in patients with COPD. Management of patients with difficult asthma should be supervised by a respiratory specialist and should involve careful assessment to confirm a diagnosis of asthma, identification and treatment of exacerbating factors, particularly allergens, and recording of peak expiratory flow patterns. A period of hospital admission may be the best way to assess and manage these patients. Treatment involves optimizing corticosteroids therapy, assessing additional controllers such as long- acting inhaled or subcutaneous beta /sub 2/ -agonists or subcutaneous, theophylline and antileukotrienes. In some patients, the use of immunosuppressive treatments may reduce steroid requirements, although these treatments are rarely effective and have side-effects. In the future, the nonsteroid antiinflammatory treatments now in development may be useful in these patients (265) Bassiouny S. Efficacy of the accent method of voice therapy. Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics 1998;50:146-164. Ref ID: 430 Abstract: There is an increasing need for studies of efficacy of behavior readjustment therapy procedures in human communicative disorders. Legal, social, scientific and professional considerations point up the need for more careful documentation of the effects of treatment techniques used by phoniatricians and speech-language pathologists. This study is conducted in order to evaluate the efficacy of the accent method of voice therapy (AM). The AM is one of the holistic approaches for behavior readjustment voice therapy. It tackles collectively and simultaneously the various parameters of voice such as pitch, loudness and timbre. The results of intervention utilizing the AM in this clinical trial are assessed in a relatively controlled setup. Patients with voice problems resulting from various etiologic vocal pathologies are distributed randomly into two groups. Group 1 (G1) is given the full aspect of the AM, that is, voice hygiene advice plus the accent exercises to correct the faulty vocal technique (habit). Group 2 (G2) receives only voice hygiene advice. The AM is administered in individual sessions 20 min each, twice a week, while the voice hygiene advice counseling is given once a week. The assessment of the vocal pathology is done following a diagnostic protocol utilizing subjective as well as quasi-objective measures of evaluation. The initial assessment presents the baseline (pretest) data for both groups. The follow-up evaluations are done at mid intervention (mid-test), that is, 10 sessions for G1 and 5 sessions for G2, and at the termination of intervention/therapy (post-test). The difference in improvement between G1 and G2 at the end of the observation was generally significant in favor of G1. There were significant improvements in G1 in certain items specific for the various etiologic categories. The improvement from pretest to mid-test to post-test values followed a linear tendency. The significance of the results is discussed and the conclusions are outlined and criticized (266) Boucek CD, Landreneau R, Freeman JA, Strollo D, Bircher NG. A comparison of techniques for placement of double-lumen endobronchial tubes. Journal of clinical anesthesia 1998;10:557-560. Ref ID: 433 Abstract: STUDY OBJECTIVE: To compare two methods of double-lumen endobronchial tube placement for thoracic surgery and to identify factors that provide a rational basis for placement method selection. DESIGN: Prospective, randomized study. SETTING: Teaching hospital. PATIENTS: 58 ASA physical status II, III, and IV patients scheduled for surgical procedures requiring elective left-sided endobronchial intubation. INTERVENTIONS: Patients were assigned randomly to either a group in which the initial placement method was the traditional approach of placing the endobronchial tube through the larynx and then advanced blindly into the left mainstem bronchus, or to a second group in which the left mainstem bronchus was intubated under direct vision using the fiberoptic bronchoscope. MEASUREMENTS AND MAIN RESULTS: Of the 32 patients who underwent the traditional approach, primary success occurred in 27 patients and eventual success in 30. In 27 patients undergoing the directed approach, primary success occurred in 21 patients and eventual success in 25. Two patients in each group required the alternative method. The blind approach took 88 (+/91) seconds and the directed approach took 181 (+/- 193) seconds (p = 0.029). Timing data were analyzed using analysis of variance with respect to method and secretions and then t-tests as appropriate. Categorical data were analyzed using the Kruskal-Wallis and Fisher's exact tests as appropriate. All values are reported as means +/- SD. CONCLUSION: Both the blind and directed approaches resulted in successful left mainstem placement of the endobronchial tube in the majority of patients but either method may fail when used alone. More time was required using the directed approach. Operator experience with both methods will increase the likelihood of success. The choice of the initial approach may be influenced by patient factors as well as available equipment and personnel (267) Da S, Rabuske PA, Bernz MCN, Haas LJ, Nemetz MA. Minor structural alterations multiples and synchronics of the larynx in patient spoken voice 101 professional: Case report. Rev Bras Otorrinolaringol 1998;64:636-638. Ref ID: 360 Abstract: Minor structural alteration on larynx represent minor congenital alterations which do not provoke great impact in voice quality, but may cause dysphonia when associated with an increase in the vocal demand. Initially, the authors briefly introduce a discussion of the main disorders and their treatment, and then narrate the case of a 28 years old patient who presents four minor structural alterations but remain assymptomatic until he starts using his spoken voice professionally. From this moment on, he starts developing compensatory functional disorders which lead him to look for medical help, but do not make him stop using the voice-professionally for approximately 12 hours a day. The voice quality shows improvement with phonotherapy. Surgical treatment will be done in case there is no stability in this improvement (268) Delsupehe K, Zink I, Lejaegere M, Delaere P. Prospective randomized comparative study of tracheoesophageal voice prosthesis: Blom-Singer versus Provox. The Laryngoscope 1998;108:1561-1565. Ref ID: 439 Abstract: OBJECTIVES: Compare the most commonly used types of tracheoesophageal voice prostheses, Blom Singer and Provox. STUDY DESIGN: Prospective study of 113 prostheses placed in 52 patients randomly selected to receive Blom-Singer and Provox. METHODS: Postoperative voice was recorded at 1 and 4 months after valve placement. Survival time of the prosthesis and four objective voice parameters were analyzed. Eight judges rated all recordings in a random order for six subjective voice parameters. Subgroup analysis for primary versus secondary placements and type of procedure was performed. In addition, patients were asked for their subjective assessment. RESULTS: Overall, Blom-Singer and Provox prostheses give very similar voice quality, lifetime, and patient satisfaction. Cleaning management is somewhat better for Provox, but there is a trend toward better overall voice quality for the Blom-Singer prosthesis. In subgroup analysis secondarily placed prostheses score somewhat better than primary placements, and patients with total laryngectomy have better voices than patients with extended laryngectomy combined with partial pharyngectomy. CONCLUSIONS: Given the equal and good results in terms of voice quality, other factors (e.g., costs, surgery-related factors, maintenance, patient preference) should be taken into account when deciding which type of tracheoesophageal voice prosthesis to use (269) Doskov D. A system for the objective screening of dysphonia and the possibilities for its application in exposed workers. Int Arch Occup Environ Health 1998;71 Suppl:S79-S80. Ref ID: 164 Abstract: Modern computers and their implementation have enabled the development of software based on mathematical computations, which analyse the parameters of voice signals in real time, as well as in the spectral and capstral domains. A software system written on the basis of specific methods and algorithms for pathological voice analysis allows the evaluation of: to D; PPQ, APQ, D S, D DISS, HNR, DH and GQ. The system was tested (using the vowel "a") on 900 workers at the Neftochim and Devnya chemical refineries in Bulgaria, exposed to irritating gases (NOx, SOx, etc.). The analysis of the studied parameters of the voice signal "a" showed significant changes in 137 workers, diagnosed after routine otolaryngological examination as the following laryngeal pathology: 101 workers suffered from chronic laryngitis, 31 from inflammatory-reactive formations on the vocal folds and five from laryngeal carcinoma. The non-invasive microcomputer system for the quantitative analysis of hoarseness enabled the scanning of laryngeal pathology in large populations of workers exposed to irritating gases in the chemical industry (270) Gustavsson P, Jakobsson R, Johansson H, Lewin F, Norell S, Rutkvist LE. Occupational exposures and squamous cell carcinoma of the oral cavity, pharynx, larynx, and oesophagus: a case-control study in Sweden. Occup Environ Med 1998;55:393-400. Ref ID: 165 Abstract: OBJECTIVES: This community based case-referent study was initiated to investigate aetiological factors for squamous cell carcinoma of the upper gastrointestinal tract. METHODS: The study was based on all Swedish men aged 40-79 living in two regions of Sweden during 1988-90. Within that base, efforts were made to identify all incident cases of squamous cell carcinoma of the oral cavity, oropharynx and hypopharynx, larynx, and oesophagus. Referents were selected as a stratified (age, region) random sample of the base. The response was 90% among cases and 85% among referents. There were 545 cases and 641 referents in the final study group. The study subjects were interviewed about several lifestyle factors and a life history of occupations and work tasks. The exposure to 17 specific agents were coded by an occupational hygienist. The relative risk (RR) of cancer was calculated by logistic regression, standardising for age, geographical region, and alcohol and tobacco consumption. RESULTS: Exposure to asbestos was associated with an increased risk of laryngeal cancer, and a dose-response relation was present. The RR was 1.8 (95% confidence interval (95% CI) 1.1 to 3.0) in the highest exposure group. More than eight years of exposure to welding fumes was associated with an increased risk of pharyngeal cancer (RR 2.3 (1.1 to 4.7)), and laryngeal cancer (RR 2.0 (1.0 to 3.7)). There were indications of a dose-response for duration of exposure. Associations were also found for high exposure to polycyclic aromatic hydrocarbons (PAHs) and oesophageal cancer, RR 1.9 (1.1 to 3.2). Exposure to wood dust was associated with a decreased risk of cancer at the studied sites. CONCLUSIONS: Some of the present findings confirm known or suspected associations--such as asbestos and laryngeal cancer. The study indicates that welding may cause an increased risk of pharyngeal as well as laryngeal cancer. The findings corroborate an association between exposure to PAHs and oesophageal cancer (271) Hassan I, Shah PA, Nafae A. Botulinum toxin - Clinical applications. JK Pract 1998;5:265-267. Ref ID: 369 (272) Kostyk BE, Putnam RA. Laryngeal airway resistance in teachers with vocal fatigue: a preliminary study. J Voice 1998;12:287-299. Ref ID: 167 Abstract: A noninvasive pressure-flow technique was used to compare laryngeal airway resistances in nine female classroom teachers with symptoms of vocal fatigue and seven teachers without symptoms of vocal fatigue. Data were collected two times per day on the Monday, Wednesday, 103 and Friday of a typical work-week. No significant between-group differences were found, but two within-group differences were notable. Airflow in the fatigued subjects decreased across the sampling period (p = .0009). In the controls, air pressure increased across the sampling period (p = .021). These findings suggest that both groups may have reacted to vocal demands during the week by employing two different strategies to maintain habitual laryngeal airway resistance: laryngeal adjustments alone or laryngeal adjustments plus increased respiratory drive. The first strategy, employed by the fatigued subjects, may have been less efficient, thereby provoking conditions associated with their vocal fatigue (273) Nordlander NB. [Only a few of the castrated singers became famous-surgeons of questionable ethics performed the illegal interventions]. Lakartidningen 1998;95:5920-5922. Ref ID: 163 (274) Perkner JJ, Fennelly KP, Balkissoon R et al. Irritant-associated vocal cord dysfunction. J Occup Environ Med 1998;40:136-143. Ref ID: 170 Abstract: Vocal cord dysfunction (VCD) is a poorly understood entity that is often misdiagnosed as asthma. We report eleven cases of VCD in which there was a temporal association between VCD onset and occupational or environmental exposure. We conducted a case-control study to determine if the characteristics of irritant-exposed VCD (IVCD) cases differed from nonexposed VCD controls. Chart review of VCD patients at the authors' institution produced 11 cases that met IVCD case criteria. Thirty-three control VCD subjects were selected by age matching. There were statistical differences between the groups in ethnicity and chest discomfort. There were no statistical differences between the groups for gender, tobacco, smoking habits, symptoms, or pulmonary function parameters. Varied irritant exposures were associated with IVCD. IVCD should be considered in patients presenting with respiratory symptoms occurring after irritant exposures (275) Sataloff RT, McCarter AA, Hawkshaw M. Vocal fold mass and scar. Ear Nose Throat J 1998;77:250. Ref ID: 169 (276) Schmidt CP, Andrews ML, McCutcheon JW. An acoustical and perceptual analysis of the vocal behavior of classroom teachers. J Voice 1998;12:434443. Ref ID: 162 Abstract: This study examined perceptual evaluations of classroom teachers, acoustic measures of their voices ( fundamental frequency [F0], frequency range [F0SD], % jitter, and % shimmer), and behavioral measures (rate, dysfluencies, and episodes of vocal fry). This preliminary study attempted to identify perceptual and acoustic measures that discriminate between effective and less effective classroom teachers. Seven teachers were recorded on audiotape while presenting a 10-12 minute lecture. Voice samples (N > 200) for each teacher were subjected to acoustic analysis. Audiotapes were evaluated by listeners (N = 180), who scale-rated and used an adjective checklist to determine teachers' overall effectiveness. A three-member team evaluated global aspects of voice (e.g., use of pauses, inflections, contours, and phrasing). Results indicated that frequency range, frequency variability, rate, and number of dysfluencies appeared to correlate with perceptual judgments of teaching effectiveness and specific adjective descriptors. F0, % jitter, and % shimmer did not appear to be linked to perceptual judgments. Individual case profiles were established and recommendations were made for future empirical research involving larger samples of teachers (277) Smith E, Kirchner HL, Taylor M, Hoffman H, Lemke JH. Voice problems among teachers: differences by gender and teaching characteristics. J Voice 1998;12:328-334. Ref ID: 166 Abstract: This study describes the effects of teaching activities on voice problems in male (n = 274) and female teachers (n = 280). Over 38% of the teachers studied complained that teaching had an adverse impact on their voice and 39% of those had cut back teaching activities as a result. Compared to males, female teachers more frequently reported a voice problem (38% vs. 26%, p<.05), acute (p<.05), and chronic (p<.05) voice problems, six specific voice symptoms, and five symptoms of physical discomfort. However, there were no gender differences in the perception that a voice problem adversely affected their current or future teaching career. For every type of course taught, women had a higher probability of reporting voice problems compared to men: odds ratio (OR) = 1.7-2.1. Compared with other courses, the teaching of physical education also was associated with an increased risk of developing a voice problem (OR = 3.7, 95% CI: 1.4-9.4) independent of gender, age, hours/day, or years taught. This is the first study to show that in the same occupation, females report a higher frequency of vocal symptoms than males even when teaching characteristics and years employment are similar (278) Smith E, Lemke J, Taylor M, Kirchner HL, Hoffman H. Frequency of voice problems among teachers and other occupations. J Voice 1998;12:480-488. Ref ID: 467 Abstract: This study describes the frequency of reporting vocal problems among a random sample of elementary and high school teachers (n = 554) compared to individuals working in other occupations (n = 220). Teachers were more likely to define themselves as ever having a voice problem (32% versus. 1%, p < .05); having a tired, weak, or effortful voice (p < .05 each); and having a higher frequency of symptoms of physical discomfort with speaking (p < .05). They also were more likely to perceive that their voice problem negatively affected current job performance (p < .05) and limited options regarding change in work (p < .05). About 20% of teachers but only 4% of nonteachers had missed work due to their voice. These findings suggest that teachers are at high-risk for disability from voice disorders and that this health problem may have significant work-related and economic effects (279) Sonninen A, Hurme P. Vocal fold strain and vocal pitch in singing: radiographic observations of singers and nonsingers. J Voice 1998;12:274-286. Ref ID: 168 Abstract: The relationship between vocal fold strain and vocal pitch in singers and nonsingers singing a rising pitch series has been indirectly investigated by means of lateral radiographs. Nonsingers tend to exhibit more strain than singers. To standardize the degree of strain, an index of strain per semitone is proposed. The semitone strain indicates the average amount of strain per 1 105 semitone of pitch increase or decrease. The index has been shown to be affected by several factors: gender, singing training, singing technique, voice class, age, and status of muscle function. Observations suggest that similar groups of individuals occupy different positions on the stress-strain curve, indicated by their semitone strain values (280) Elias ME, Sataloff RT, Rosen DC, Heuer RJ, Spiegel JR. Normal strobovideolaryngoscopy: variability in healthy singers. J Voice 1997;11:104107. Ref ID: 172 Abstract: Strobovideolaryngoscopy has proven essential to accurate diagnosis of voice disorders. Clinical interpretation of stroboscopic images usually follows a standard assessment protocol. Features analyzed typically include symmetry of amplitude, symmetry of phase, regularity of periodicity, amplitudes and wave forms of individual vocal folds, presence or absence of adynamic segments, and other features. Speed and smoothness of abduction and adduction are also assessed. In order for stroboscopic data to be used meaningfully in a clinical setting, it is essential for the laryngologist to recognize the range of normal variability of these parameters. This may be particularly important when trying to establish diagnoses for subtle voice disorders in professional voice users. This study investigates strobovideolaryngoscopic findings in a population of normal professional singers without voice complaints. "Abnormal" strobovideolaryngoscopic findings occur in this asymptomatic population of "volunteers." These abnormalities might have been misinterpreted as causing voice complaints if seen for the first time when the singer sought medical care for a voice problem. Physicians must be aware of the range of laryngeal behavior that may be found among normal subjects and must be cautious when interpreting strobovideolaryngoscopic findings. This study also highlights the importance of obtaining "normal" baseline strobovideolaryngoscopic evaluations on professional voice users. The review of strobovideolaryngoscopy performed upon 65 healthy, asymptomatic professional singers revealed an incidence of 58% "abnormal" findings as six clinical entities (281) Los-Spychalska T. [Evaluation of the usefulness of laryngeal vocal efficiency tests during noise load for diagnosing occupational diseases of the larynx in teachers]. Med Pr 1997;48:279-284. Ref ID: 175 Abstract: A growing incidence of the voice organ occupational diseases has recently become one of major health problems. There is a need to objective diagnostic examinations performed in teachers who apply for occupational disease certification. The aim of our study was to assess the feasibility of larynx vocal efficiency test during noise load in diagnosis of the voice organ occupational diseases in teachers (282) Morales Suarez-Varela MM, Llopis GA, Moreno GE, Martinez Selva MI, Vitoria M, I, Gisbert V. [Toxic habits in relation to cancer of the larynx]. Acta Otorrinolaringol Esp 1997;48:45-50. Ref ID: 177 Abstract: Various modifiable toxic risk factors for cancer of the larynx were evaluated in our geographic area in a retrospective epidemiological study of a sample of 373 patients diagnosed as cancer of the larynx chosen randomly at the La Fe Hospital of Valencia Spain over a 5-year period. A "z" test of the contrast of proportions of the laryngeal cancer series studied and the results of a National Health Survey showed significant differences between the two study populations (p < 0.05). Compared with the National Health Survey, smoking had an odds ratio (OR) of 72.21 (33.10 < OR < 166.31) (p < 0.05, Mantel-Haenszel test). The association between smoking and cancer of the larynx increased with the dose. Alcohol consumption had an OR: 1.52 (1.09 < OR < 2.11) (p < 0.05, Mantel-Haenszel test). Smoking carried a risk of 71.21 and had an etiological fraction of 98.61% (IC 95%: 65.17100%), thus representing 98.61% of all etiological factors. Control of smoking could have prevented 65.17-100% of cases of cancer of the larynx (243 cases in our series). Alcohol consumption had a risk of 0.52 and etiological fraction of 34.21% (IC 95%: 2.38-100%). Control of alcohol use could have prevented cancer of the larynx in 2.38-100% of cases (9 cases in our series) (283) Paczona R. A cadaver larynx holder for teaching laryngomicrosurgery. J Laryngol Otol 1997;111:56-57. Ref ID: 176 Abstract: Although many reports can be found in the literature about temporal bone holders for postgraduate temporal bone surgery courses, the author did not find any kind of suitable description of a larynx holder for laryngomicrosurgery courses. A cadaver larynx holder is presented, made by the author himself for individual and postgraduate teaching courses. This simple model has been proved already to be a unique and a very useful tool for a practising course on laryngomicrosurgery during two training courses and the instructional session of the IIIrd EUFOS Congress in Hungary in 1996 (284) Shchibchik LP. Psychoneurologic aspects of occupational disturbances of vocal apparatus in singers. ZH USHN NOS GORL BOLEZN 1997;26-29. Ref ID: 409 Abstract: Incidence rate of occupational diseases of vocal apparatus due to neuropsychologic disturbances calls for particular attention. In the persons with various types of nervous system the individual method of their vocal makings development should be applied (285) Shydlovs'ka TA. [The electrophysiological indices of the state of the different sections of the auditory analyzer in persons with a normal voice and with functional voice disorders]. Fiziol Zh 1997;43:118-125. Ref ID: 174 Abstract: Individuals with normal voice and patients with voice functional impairments undergone electrophysiological investigation of various parts of the hearing system, using tone audiometry, including the extended frequency band (10, 12, 14 and 16 kHz), as well as short- and long-latency acoustic evoked potentials (SLAEP and LLAEP). It was found out, that individuals with voice functional impairments had all of their hearing system's parts impaired to various extent, with more marked impairments in the central, rather than in the peripheral part of the hearing system. It was shown, that hearing at 48 kHz, as well as with the extended frequency band, especially at 14-16 kHz, time patterns of acoustic evoked potentials (latencies of waves III and V of SLAEP, the interpeak interval I-V, as well as the latency periods of the LLAEP components P2 and N2) could be useful in professional selection of individuals of voice and speech professions and for solving labor expertise matters. Of those individuals with normal voice but systematic vocal stress, 17.5% had impaired hearing at 14 and 16 kHz, as well as significant latency prolongation 107 of the LLAEP wave N2 with tone stimulation at 1 and 4 kHz. Apparently, individuals of voice and speech professions should be referred to as the "risk" group. It may well be, that extended band audiometry and acoustic evoked potentials time patterns could be useful in determining the thresholds between the normality and pathology in voice dysfunctions (286) Smith E, Gray SD, Dove H, Kirchner L, Heras H. Frequency and effects of teachers' voice problems. J Voice 1997;11:81-87. Ref ID: 173 Abstract: This study compared the frequency and effects of voice symptoms in teachers to a group of individuals employed in other occupations. Teachers were more likely to report having a voice problem (15 vs. 6%), having 10 specific voice symptoms, and having 5 symptoms of physical discomfort. They averaged almost 2 symptoms compared with none for nonteachers. Likewise, teachers were more likely to perceive that a voice problem would adversely affect their future career options, had done so in the past, and was limiting their current job performance. Over 20% of teachers but none of the nonteachers had missed any days of work due to a voice problem. These findings suggest that teaching is a high-risk occupation for voice disorders and that this health problem may have significant work-related and economic effects (287) Vaughan TL, Stewart PA, Davis S, Thomas DB. Work in dry cleaning and the incidence of cancer of the oral cavity, larynx, and oesophagus. Occup Environ Med 1997;54:692-695. Ref ID: 171 Abstract: OBJECTIVES: To investigate whether employment in dry cleaning, and potential exposure to perchloroethylene (PCE), were associated with increased risk of carcinoma of the oral cavity and pharynx, larynx, oesophagus, and gastric cardia. METHODS: Two population based casecontrol studies were carried out. There were 491 cases of carcinoma of the oral cavity and pharynx, 235 of the larynx, and 404 of the oesophagus and gastric cardia. 724 controls were selected by random digit dialing. Personal interviews ascertained information on lifetime job histories, cigarette use, alcohol consumption, and other potential risk factors. The probability and level of exposure to PCE were estimated from the scientific literature. RESULTS: People who worked in dry cleaning tended to consume less alcohol and cigarettes than the general population. The adjusted odds ratio (OR) associated with ever having worked in dry cleaning was 1.6 (95% confidence interval (95% CI) = 0.6 to 4.4) for all cancer types together. The strongest associations were with laryngeal (OR 2.7; 95% CI 0.6 to 10.9) and oesophageal squamous cell carcinomas (OR 3.6; 95% CI 0.5 to 27.0). For laryngeal cancer, the relative risk increased with number of years employed in the dry cleaning industry (P = 0.14. The two cases of oesophageal squamous cell carcinomas had worked in dry cleaning for only a short time. Analyses of subsites showed higher risks for supraglottic laryngeal cancer (OR 5.7; 95% CI 1.0 to 32.1) and cancer of the tongue (OR 2.3; 95% CI 0.4 to 12.6). Analyses of exposure to PCE yielded similar results. CONCLUSIONS: These findings could easily be explained by chance; nevertheless, they are consistent with previous reports of excess risk of oesophageal, laryngeal, and tongue cancer, and suggest that previous studies of dry cleaners that could not control for alcohol and cigarette use may have underestimated the relative risks of such cancers (288) Bastian RW. Vocal fold microsurgery in singers. J Voice 1996;10:389-404. Ref ID: 178 Abstract: Some singers with benign vocal fold mucosal lesions remain unacceptably impaired vocally in spite of compliance with a regimen of medical treatment and voice therapy lasting several months-or even years. I present here my experience with 62 singers who, because of this predicament, chose to undergo vocal fold microsurgery. This series is the second largest reported to date in English literature. Procedures are presented which were used for patient selection, education, and vocal retraining, as well as for surgery itself and postoperative care. Results reported here include (a) comparison of my auditory-perceptual ratings of singing voice impairment before and after surgery, (b) preoperative versus postoperative videostroboscopic findings, (c) postoperative rate of return to public singing, and (d) postoperative patient questionaires which sought to uncover patient/singer perceptions of the results of vocal fold surgery. Excellent results were achieved overall with a very low incidence of untoward results, and no complications were encountered (289) Butler R. Effects of industrial pollutants on the larynx. Curr Opin Otolaryngol Head Neck Surg 1996;4:52-53. Ref ID: 353 Abstract: The larynx, as the passageway for air from the upper to the lower respiratory tract, is exposed to all of the pollutants that reach the lungs. However, the larynx seems much less susceptible to damage from these contaminants. The major result is the development of carcinoma of the larynx. A cause and effect relationship has been difficult to demonstrate. Retrospective population studies are used to determine pollutant influences. Most reports are from countries other than the United States, perhaps because of industry concerns about litigation in that nation. One basic science research report exposed guinea pig tracheas to varied concentrations of sulfur dioxide and studied mucociliary activity using a modified light beam reflex method. This may be a method to evaluate the effects of other pollutants on the larynx (290) Hastings RH, Hon ED, Nghiem C, Wahrenbrock EA. Force and torque vary between laryngoscopists and laryngoscope blades. Anesthesia and analgesia 1996;82:462-468. Ref ID: 445 Abstract: Several studies have examined the effects of patient characteristics on force of laryngoscopy, but little attention has been paid to the importance of technique and equipment. This study investigated whether force, torque, head extension, and view varied significantly between laryngoscopists and compared force and torque using Macintosh 3 and Miller 2 blades. The study population consisted of ASA grade I and II patients requiring general anesthesia and endotracheal intubation for elective surgery. Force, torque, head extension, and laryngeal view were highly reproducible when laryngoscopy was repeated by the same individual, Force and torque showed great variation between laryngoscopies performed by different anesthetists, For example, peak force varied over a range of 56 newtons among patients, but could also vary as much as 30 newtons between different anesthetists repeating laryngoscopy in the same patient. Force and head extension were 30% less with Miller laryngoscope compared to the Macintosh. Thus, laryngoscopic force and torque depend on technique and equipment. Further 109 studies of force and torque may lead to improved techniques. The forcemeasuring laryngoscope could be a useful tool in teaching laryngoscopy (291) Matveeva NV. [Voice disorders in benign nodose formations of the vocal cords in vocalists. Their treatment and rehabilitation]. Vestn Otorinolaringol 1996;30-32. Ref ID: 179 Abstract: The paper presents data on 5-year follow-up of 105 patients with neoplasms of the vocal cords. All the examinees belonged to vocal profession (actors, singers, musical students). Among the new growths of the vocal cords true or false vocal nodules occurred most frequently (84%). The second in frequency were fibromas and polyps (15%). Contact granuloma occurred only in 2 males with long smoking history. The diagnosis and treatment efficacy assessment were performed using measurement of maximal phonation time, electron laryngostroboscopy, electron glottography (292) Nguyen C, Naghibzadeh B, Black MJ, Rochon L, Shenouda G. Carcinoma in situ of the glottic larynx: excision or irradiation? Head & neck 1996;18:225228. Ref ID: 452 Abstract: BACKGROUND: The management of glottic carcinoma in situ (CIS) is controversial, with vocal cord stripping (S) generally accepted as the standard treatment, and radiotherapy (RT) as an alternative. We present our experience with 34 patients treated by either stripping or RT. METHODS: + +Between 1974 and 1990, 34 patients with CIS of the glottic larynx larynx were treated at McGill University teaching hospitals. The median age at diagnosis was 67 years, with a male:female ratio of 6:1. All patients had CIS involving the glottis and the pathology was reviewed on all patients. Twentyone patients were treated by S and 13 patients by RT as the primary treatment. RESULTS: With a median follow-up of 96 months (25-209 months), the 15-year actuarial survival rate is 95% for all patients, with 100% and 87% survival rates for S and RT groups, respectively (p = 0.25). One patient in the RT group developed a subglottic invasive squamous cell carcinoma. On the other hand, 11 patients in the S group developed recurrence and were treated by repeat S (6 patients) or RT (5 patients), with a salvage rate of 100%. CONCLUSION: Although most patients with CIS of the glottis are traditionally treated with vocal cord S, RT is effective in terms of freedom from recurrence; it is an attractive option and should be considered in patients with lesions recurring after stripping as well as in those whose follow-up presents a problem (293) Parnes S. Effects of asbestos on the larynx. Curr Opin Otolaryngol Head Neck Surg 1996;4:54-58. Ref ID: 392 Abstract: Asbestos, a naturally occurring hydrated silicate, may have a detrimental influence on the larynx. Since this potential effect was first recognized more than 20 years ago, multiple studies have sought to evaluate it further. In a review of 33 cohort studies, the majority did not demonstrate any increase in standard mortality rates and those that did often failed to take into account the compounding effects of cigarette smoking and alcohol consumption. Twenty-six case-control studies were also examined, and again very few demonstrated that those patients who presented with laryngeal cancer had had an increased exposure to asbestos. There also have been three cross- sectional studies performing on-site head and neck examinations where no specific laryngeal cancer had been seen in high-risk patients. The on- site studies, however, did demonstrate a higher incidence of harmful effects on the larynx, noting edema, inflammation, or specific lesions. Thus, there is some support that asbestos may act as an irritant, although a causal relationship between asbestos and laryngeal cancer cannot be definitively established (294) piech L, niar J, Rostkowska NB, Mróz E. [Influence of vapours of paint and toxic dusts on mucous membranes of the upper airways in paint and varnish factory workers]. Med Pr 1996;47:445-453. Ref ID: 459 Abstract: Macroscopic, cytologic and bacteriologic conditions of mucous membranes of the upper airways in workers (n = 146) of the Polifarb Factory, Wrocław, exposed to dusts and solvent vapours used in the paint and varnish production was estimated. In 89% of the workers, pathologic changes in throat mucous membranes were observed. Three types of macroscopic changes were distinguished. In workers with the shortest period of employment, laryngeal oedema congestion alteration was diagnosed, and atrophic changes with medium intensity were observed in workers employed for a long period. It was found that cytologic changes in the nose mucous membrane depended on the duration of exposure. Inflammation cytograms appeared during the first period of exposure to the substances discussed. The longer period of exposure, the more clear features of metaplasia squamous epithelium. The composition of the nose and throat bacterial flora changed according to the length of employment. An increased growth of G(-) genera Enterobacter, Klebsiella, Proteus, Escherichia and Candida fungi was found in workers with long period of employment (295) Sala E, Hytonen M, Tupasela O, Estlander T. Occupational laryngitis with immediate allergic or immediate type specific chemical hypersensitivity. Clin Otolaryngol Allied Sci 1996;21:42-48. Ref ID: 180 Abstract: Reports of allergic laryngitis are sparse. In some reports allergy has been mentioned as an aetiological factor, but the diagnosis has not been confirmed with provocation tests. This paper reports on 20 patients in order to show that laryngitis can be caused by organic substances and chemicals with mechanisms of immediate allergy or immediate type specific hypersensitivity. The agents in the former group consisted of flours, obeche, plants and acid anhydrides, whereas these in the latter group included chemicals like formaldehyde, acrylate compounds, and chemicals used in hairdressing. All the cases were confirmed with provocation tests in which the patients displayed a change in vocal cord status. Thirteen patients had positive skin-prick test results with suspected causative agents. Eleven of these 13 patients had an elevated level of specific IgE-antibodies to the same agents (296) Woskowiak G. [Occupational disorders of the larynx in Poland and in the Poznan province in the years 1985-1994]. Med Pr 1996;47:331-338. Ref ID: 181 Abstract: The epidemiology of all occupational diseases was compared with occupational diseases of the voice organ in Poland according to age, sex and duration of employment. Then the incidence of occupational diseases of the 111 voice organ in Poland was compared with the incidence in the Pozna++n region. The author postulates that the causes of the present situation be identified and the principles of certification be improved and she also recommends close cooperation between laryngologists and phoniatrists (297) Blom ED, Pauloski BR, Hamaker RC. Functional outcome after surgery for prevention of pharyngospasms in tracheoesophageal speakers. Part I: Speech characteristics. The Laryngoscope 1995;105:1093-1103. Ref ID: 432 Abstract: The speech characteristics of 29 patients with primary tracheoesophageal puncture who received either a pharyngeal constrictor myotomy, a unilateral pharyngeal plexus neurectomy, or a unilateral pharyngeal plexus neurectomy with drainage myotomy limited to the cricopharyngeus were studied. All patients used a Blom-Singer low-pressure voice prosthesis. Audio recordings of each patient speaking with both the Blom-Singer tracheostoma valve and manual occlusion of the tracheostoma were recorded at 3 weeks, 6 months, and 12 months after surgery. The three surgical variations were equally effective at preventing pharyngospasms; only 1 patient (10%) in each group had some loss of fluency during the 12-month study period. Neurectomized patients produced significantly higher fundamental frequencies during reading than did patients in the other groups. Residual resting tone in the neurectomized pharyngoesophageal segment may contribute to more favorable speaking frequencies in this group (298) Gadow KD, Sverd J, Sprafkin J, Nolan EE, Ezor SN. Efficacy of methylphenidate for attention-deficit hyperactivity disorder in children with tic disorder. Archives of general psychiatry 1995;52:444-455. Ref ID: 441 Abstract: BACKGROUND: The findings from case reports and patient questionnaire surveys have been interpreted as indicating that administration of stimulants is ill-advised for the treatment of attention-deficit hyperactivity disorder in children with tic disorder. METHODS: Thirty-four prepubertal children with attention-deficit hyperactivity disorder and tic disorder received placebo and three dosages of methylphenidate hydrochloride (0.1, 0.3, and 0.5 mg/kg) twice daily for 2 weeks each, under double-blind conditions. Treatment effects were assessed using direct observations of child behavior in a simulated (clinic-based) classroom and using rating scales completed by the parents, teachers, and physician. RESULTS: Methylphenidate effectively suppressed hyperactive, disruptive, and aggressive behavior. There was no evidence that methylphenidate altered the severity of tic disorder, but it may have a weak effect on the frequency of motor (increase) and vocal (decrease) tics. CONCLUSION: Methylphenidate appears to be a safe and effective treatment for attention-deficit hyperactivity disorder in the majority of children with comorbid tic disorder (299) Miller MK, Verdolini K. Frequency and risk factors for voice problems in teachers of singing and control subjects. Journal of voice : official journal of the Voice Foundation 1995;9:348-362. Ref ID: 450 Abstract: Using a questionnaire format, 125 teachers of singing and 49 control subjects indicated whether they had a current or past voice problem, and provided information about their demographic characteristics, voice use patterns, and medication use. The results revealed similar rates of current voice problems reported by the two subject groups. However, teachers of singing were considerably more likely to report ever having had a voice problem than controls (64 vs. 33%). Risk factors were similar for the two groups. Dehydrating medications and a report of a past voice problem both increased the likelihood of perceiving a current problem, by a factor of three and five, respectively. Females were twice as likely to report a past voice problem as males, and younger subjects were slightly more likely to report a past problem as compared with older subjects. The implications of the findings are discussed from a theoretical as well as pragmatic perspective (300) Sataloff RT, Hawkshaw M, Rosen DC, Spiegel JR. Bilateral vocal fold polyps. Ear Nose Throat J 1995;74:742. Ref ID: 182 (301) Shorten GD, Ali HH, Roberts JT. Assessment of patient position for fiberoptic intubation using videolaryngoscopy. Journal of clinical anesthesia 1995;7:3134. Ref ID: 464 Abstract: STUDY OBJECTIVE: To compare laryngoscopic appearance obtained during flexible fiberoptic laryngoscopy with the patient's atlanto-occipital joint in the neutral and extended positions. DESIGN: Controlled clinical trial with each patient (in the neutral position) acting as his or her own control. SETTING: University teaching hospital. PATIENTS: 20 adult ASA physical status I and II patients, without anatomical airway abnormalities, undergoing elective surgical procedures. INTERVENTIONS: Fiberoptic laryngoscopy was performed on each patient with his or her atlanto-occipital joint in the neutral and extended positions. MEASUREMENTS AND MAIN RESULTS: Photographs of the laryngoscopic appearances were graded on a scale of 1 to 4 by a blinded observer according to the proportion of the laryngeal inlet visible. Atlanto-occipital extension improved laryngoscopic appearance in 14 cases and produced no change in the remaining 6. CONCLUSION: Atlanto-occipital extension is a useful maneuver during attempted fiberoptic intubation (302) Singer HS, Brown J, Quaskey S, Rosenberg LA, Mellits ED, Denckla MB. The treatment of attention-deficit hyperactivity disorder in Tourette's syndrome: a double-blind placebo-controlled study with clonidine and desipramine. Pediatrics 1995;95:74-81. Ref ID: 466 Abstract: OBJECTIVES: Because psychostimulants can exacerbate preexisting motor/phonic tics in individuals with Tourette's syndrome (TS), a clinical trial was performed to examine the ability of clonidine and desipramine to modify attention-deficit hyperactivity disorder (ADHD) behaviors in children with TS + ADHD. METHODS: A double-blind, placebo-controlled protocol was used in which each subject served as his or her own control and received, in a randomly assigned fashion, 6-week medication cycles with clonidine (0.05 mg four times daily), desipramine (25 mg four times daily), and placebo. RESULTS: Thirty-seven children with TS+ADHD between the ages 7 to 13 years and of normal intellect were recruited, and 34 (31 males, 3 females) completed the entire protocol. Outcome measures for ADHD included Parent and Teacher Child Behavior Checklists (CBCL), continuous performance tests, and neuropsychologic tests of executive function. Several markers for ADHD were shown to improve significantly (P < .05) after treatment with desipramine (parent linear analogue rating, parent CBCL "hyperactivity" 113 subscale, and teacher CBCL subscales "nervous/overactive," "anxious," and "unpopular"). Improvement with desipramine was always superior to that noted with clonidine. Clinical improvement did not correlate with drug blood levels. On measures of tic severity, neither drug made tics worse. Desipramine showed a statistically significant improvement on a global linear analogue scale, but not on the Hopkins Motor/Vocal Tic Severity Scale, the Tourette Syndrome Severity Scale, or the Yale Global Tic Severity Scale. Clonidine did not significantly alter tic severity on any measure. CONCLUSION: The results of this study suggest that desipramine may be a useful alternative for the treatment of symptoms of ADHD in children with TS (303) Sundberg J, Iwarsson J, Billstrom AH. Significance of mechanoreceptors in the subglottal mucosa for subglottal pressure control in singers. J Voice 1995;9:20-26. Ref ID: 183 Abstract: According to Wyke and Kirchner (Wyke B, Kirchner J. Neurology of the larynx. In: Hinchcliffe R, Harrison D, eds. Scientific foundation of otolaryngology. London: William Heinemann Medical Books, 1976:546-66) mechanoreceptors in the subglottal mucosa play a significant role in the control of laryngeal muscle activity in response to changes of subglottal pressure during phonation. In singers this pressure is adapted not only to phonatory loudness but also to fundamental frequency. By spraying Xylocaine solution with a needle inserted into the trachea through the anterior gap between the cricoid and thyroid cartilages, the subglottal mucosa was anesthetized in three singers. The effects on subglottal pressure and fundamental frequency of this anesthesia were examined. The pressure effects varied between the subjects, whereas the fundamental frequency accuracy was adversely affected in all three subjects. The implications of these findings are discussed (304) Urrutikoetxea A, Ispizua A, Matellanes F. [Vocal pathology in teachers: a videolaryngostroboscopic study in 1046 teachers]. Rev Laryngol Otol Rhinol (Bord ) 1995;116:255-262. Ref ID: 184 Abstract: It is well known the vocal pathology occurs more frequently in professionals using their voice than in the general population. Teachers form a particular group. We performed a study on 1.046 teachers in 1993 to quantify the percentage presenting a visible organic lesion of the vocal cords. We sent out a questionnaire on dysphonia and the professional vocal activity practised, and we performed a laryngeal examination with video-laryngo-stroboscopy. The results obtained evidence 218 cases of pathological exploration, i.e. 20.84% with a predominance of vocal nodules (43%) and Reinke oedema (18%). The analytical method and the results obtained are presented (305) Borodic GE, Pearce LB. New concepts in botulinum toxin therapy. DRUG SAF 1994;11:145-152. Ref ID: 350 (306) Chan RW. Does the voice improve with vocal hygiene education? A study of some instrumental voice measures in a group of kindergarten teachers. Journal of voice : official journal of the Voice Foundation 1994;8:279-291. Ref ID: 437 Abstract: This study investigated the efficacy of a program of vocal hygiene education designed for an occupational group at risk for dysphonia, namely, kindergarten teachers. Twelve female teachers explored concepts and knowledge of vocal abuse and vocal hygiene in a workshop session and attempted to practice vocal hygiene for 2 months. They showed significant voice improvement as assessed instrumentally in terms of three acoustic and electroglottographic parameters. There was no significant change of voice in a control group of 13 teachers. The results suggest that teachers were able to improve their voices if they significantly reduced vocal abuses in daily life and practiced specific strategies to maintain classroom order and reduce the use of voice in teaching (307) Detweiler RF. An investigation of the laryngeal system as the resonance source of the singer's formant. J Voice 1994;8:303-313. Ref ID: 186 Abstract: Since its introduction, the Sundberg model of the laryngeal system as the resonance source of the singer's formant has gained wide acceptance. However, no studies directly testing this hypothesis in vivo have previously been reported. Thus, the present study was undertaken to test this hypothesis on three classically trained professional male singers. The vocal behaviors of the singer-subjects were evaluated during model and pulse register phonation via magnetic resonance imaging, strobolaryngoscopy, and acoustic analysis. Results indicated the subjects did not achieve the laryngopharyngeal/laryngeal outlet cross-sectional area ratio requisite to the model and that the formant remained robust in pulse register phonation. It was concluded that these subjects' behaviors were not consistent with Sundberg's model and that the model was inadequate to account for the generation of the singer's formant in these three subjects (308) Eisen EA, Tolbert PE, Hallock MF, Monson RR, Smith TJ, Woskie SR. Mortality studies of machining fluid exposure in the automobile industry. III: A casecontrol study of larynx cancer. Am J Ind Med 1994;26:185-202. Ref ID: 190 Abstract: A case-control study of larynx cancer was conducted within a cohort of automobile workers exposed to metal working fluids, commonly referred to as machining fluids (MF). Results are based on 108 cases of larynx cancer and 5:1 matched controls. Risks associated with specific types of MF, as well as specific components of the fluids were evaluated. Based on a retrospective exposure assessment, lifetime exposures to straight and soluble fluids, grinding particulate, biocides, selected metals, sulfur, and chlorine were examined. Exposure to asbestos and acid mists at two of the three study sites was also characterized. Results suggest that straight mineral oils are associated with almost a two-fold excess in larynx cancer risk. There was also evidence of an association with elemental sulfur, commonly added to straight MF to improve the integrity of the materials under extreme pressure and heat. It is not clear whether sulfur is causally related to an excess relative risk of larynx cancer or whether the observed association is the result of unmeasured confounding by another contaminant or process feature. For example, the high stress operations that require MF enriched with sulfur are also more likely to produce polycyclic aromatic hydrocarbons (PAHs) during the process. Thus, the observed association with sulfur may be due to an association with PAH. The finding of excess risk of laryngeal cancer associated with MF is consistent with several previous reports in the literature. This is the first study, however, to distinguish straight mineral oils from other types of 115 MF. Based on these findings, a general reduction in concentrations of straight mineral oil particulate in occupational environments would be prudent (309) Franke ED, Llanos CA, Echevarria J et al. Efficacy of 28-day and 40-day regimens of sodium stibogluconate (Pentostam) in the treatment of mucosal leishmaniasis. The American journal of tropical medicine and hygiene 1994;51:77-82. Ref ID: 440 Abstract: The efficacy and toxicity of two regimens of antimony, 28 and 40 days of 20 mg of antimony/kg/day, were compared in the treatment of culture-positive mucosal leishmaniasis involving more than one anatomic site. Forty consecutive eligible Peruvians with infiltrative or ulcerative mucosal disease of the lips, nose, palate-uvula-pharynx, or larynx-epiglottis were randomized to receive either 28 days (P28) or 40 days (P40) of sodium stibogluconate (Pentostam). Treatment was prematurely terminated due to thrombocytopenia in three patients and two patients did not complete six months of follow-up. At one month post-treatment, 13% (2 of 16) of the P28 patients and 16% (3 of 19) of the P40 patients no longer had infiltrates or ulcers and were initially considered cured. During a further 11 months of follow-up, infiltrated lesions healed in eight more P28 patients and in 10 more P40 patients. The cure rate after 12 months of follow-up was therefore 63% for both groups (10 of 16 in the P28 group and 12 of 19 in the P40 group). The total of 13 patients who had infiltrates or ulcers at the 9-12-month follow-up were considered failures. All seven patients (three in the P28 group and four in the P40 group) whose lesions were culture-positive for Leishmania at some point in the 12 months after treatment, and who were thereby parasitologic failures, were also clinical failures.(ABSTRACT TRUNCATED AT 250 WORDS) (310) Kitch JA, Oates J. The perceptual features of vocal fatigue as self-reported by a group of actors and singers. J Voice 1994;8:207-214. Ref ID: 189 Abstract: Performers (10 actors/10 singers) rated via a self-report questionnaire the severity of their voice-related changes when vocally fatigued. Similar frequency patterns and perceptual features of vocal fatigue were found across subjects. Actors rated "power" aspects (e.g., voice projection) and singers rated vocal dynamic aspects (e.g., pitch range) of their voices as most affected when vocally fatigued. Vocal fatigue was evidenced by changes in kinesthetic/proprioceptive sensations and vocal dynamics. The causes and context of vocal fatigue were vocal misuse, being "run down," high performance demands, and using high pitch/volume levels. Further research is needed to delineate the perceptual features of "normal" levels of vocal fatigue and its possible causes (311) O'Sullivan B, Mackillop W, Gilbert R et al. Controversies in the management of laryngeal cancer: results of an international survey of patterns of care. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology 1994;31:23-32. Ref ID: 453 Abstract: Cancer of the larynx is the most prevalent non-cutaneous malignancy of the head neck region and its treatment presents a threat to both natural speech and survival. This study examines the manner in which two separate specialties in the same and different geographic regions vary in their opinions about the treatment of glottic laryngeal cancer. The goal was to define options available to patients and to classify controversies about optimal treatment which might be resolved in clinical trials. Questionnaires depicting different presentations of glottic larynx cancer were mailed to 1649 otolaryngologists and radiation oncologists in North America, Europe and Australasia. Half the doctors were asked to describe their preferred treatment for a patient while the others were asked to imagine that they themselves were the patient. In all the disease situations opinions varied significantly with respect to the treatment modality advised (whether to employ surgical or radiotherapy approaches) and in more extensive disease situations the intention of treatment also varied depending on whether a curative approach should involve conservation or loss of the larynx. Doctors also recommended similar treatment for their patients as they would for themselves. Apart from disease extent the most significant variables influencing recommendations were the physicians' specialty (P = 0.0001) and where they practice (P = 0.0001). These findings demonstrate diversity of opinion which is influenced more profoundly by the traditions of the specialties and geographic location of practice than by the reported results of treatments for laryngeal cancer. Convictions about optimal management have become barriers to the assessment of the relative value of different treatments and to ensuring that patients are fully informed about management options. The profession should regard as a high priority efforts to resolve these therapeutic conflicts which are associated with major differences in quality of life (312) Scotto Di CN. Internal voice sensitivities in opera singers. Folia Phoniatr Logop 1994;46:79-85. Ref ID: 191 Abstract: To control their voices, singers rely not only on auditory feedback but also on proprioceptive feedback supplied by internal voice sensitivities (IVS). IVS, which are essentially pallesthetic (vibratory) and kinesthetic (muscular), provide singers with precise landmarks for controlling their emission. This means of control is more reliable than auditory feedback in which the voice is substantially modified by the acoustics of the environment (313) Verdolini K, Hoffman HT, McCoy S. Nonspecific laryngeal granuloma: a case study of a professional singer. J Voice 1994;8:352-358. Ref ID: 185 Abstract: A professional singer with laryngeal granuloma underwent surgery following failed response to conservative treatments. Two primary findings emerged. First, although a sizable lesion was present initially, presurgical voice measures were largely normal or superior. The exception was elevated phonatory effort during singing. Second, postsurgical voice functions were entirely normal or superior (including phonatory effort), despite demanding singing performances a few weeks following surgery. The results add to the limited corpus of quantitative, normative-referenced data on voice in patients with granulomas and are inconsistent with previous reports of voice abnormalities in such patients and poor functional response to surgery (314) Woo P, Casper J, Colton R, Brewer D. Diagnosis and treatment of persistent dysphonia after laryngeal surgery: a retrospective analysis of 62 patients. Laryngoscope 1994;104:1084-1091. Ref ID: 188 Abstract: Sixty-two patients with persistent or recurrent dysphonia after 117 laryngeal surgery underwent interdisciplinary voice evaluation, laryngostroboscopy, and objective measurements of vocal function. The causes of persistent dysphonia were attributed to vocal fold scarring (n = 22), residual mass lesion (n = 8), residual inflammation (n = 13), recurrent mass (n = 4), and hyperfunctional voice disorder (n = 7). Laryngoscopy often showed excessive ventricular compression and anterior-to-posterior laryngeal compression. Ventricular dysphonia was often a compensatory gesture in response to poorly mobile vocal fold membranes. Stroboscopy was able to document a number of abnormalities which included abnormalities of laryngeal configuration, vibratory asymmetry, reduction of amplitude, and mucosal wave. Using a diversified approach consisting of medical therapy, voice therapy, and repeat surgery, better vocal function was able to be restored in the majority of patients. An interdisciplinary approach to the dysphonic patient after laryngeal surgery was most useful in defining the pathology and refining a treatment rehabilitation program (315) Yanagisawa E. The use of video in ENT endoscopy: its value in teaching. Ear Nose Throat J 1994;73:754-763. Ref ID: 187 Abstract: Videography is the most practical and effective method of documenting and teaching ENT endoscopy. Videography allows: (1) documentation of anatomy, physiology and pathology of deep structures of the ear, nose and throat; (2) teaching of delicate surgical procedures such as functional endoscopic sinus surgery (FESS), laryngeal surgery, and other endoscopic procedures; (3) instantaneous production of high quality hard copies of video images for teaching and patient records; (4) instant replay and repeated viewing by a slow motion or frame-by-frame analysis; (5) simultaneous viewing by a small or large audience; and (6) image digitalization for storage in the computer for later analysis. The author describes the value of videography in ENT endoscopy, namely video-otoscopy, video rhinoscopy and videolaryngoscopy. The use of video in endoscopy will continue to play a vital role in Continuing Medical Education (CME) (316) The role of the speech-language pathologist and teacher of singing in remediation of singers with voice disorders. ASHA 1993;35:63. Ref ID: 192 (317) de VM, Gallo A, Boccia MM, Diletti G, Simonelli M, Della RC. [Environmental and occupational risk factors in keratosis of the larynx]. Acta Otorhinolaryngol Ital 1993;13:43-52. Ref ID: 196 Abstract: Laryngeal keratosis may frequently precede the appearance of carcinoma of the larynx which might well indicate that these diseases have a common denominator. A retrospective study of 120 subjects with laryngeal keratosis was examined. The intention of the Authors was to verify whether the principle risk factors involved in the appearance of laryngeal carcinoma were the same as those implicated in laryngeal keratosis formation. Sex age, work activity, cigarette smoke, alcohol consumption and vocal chord abuse were considered. Laryngeal keratosis takes keratosis with dysplasia as well as keratosis without. A link between these two types of keratosis and cancer was sought. In particular, the possibility that a persistent action of the mentioned risk factors could cause laryngeal dysplasia-free keratosis to change into dysplastic lesions and subsequently into cancer was investigated. A case- control study was performed in order to analyze the importance of work activity. Results were statistically significant (P < 0.001). The Cramer V2 calculation demonstrated a clear correlation between the number of cigarettes smoked and the appearance of dysplasia (V2 = 0.117; P < 0.005). Results showed a clearly different behaviour between sexes. The number of males was much higher than females as was the age at which keratosis appeared greater in males. The fact that the average age in which keratosis appeared preceded the appearance of laryngeal cancer by ten years indicates that this interrum is sufficient for keratosis with dysplasia to be transformed into cancer (due to the continued action of the mentioned etiologic factors, mainly referred to cigarette smoke). In our data analysis, no correlation was demonstrated between keratosis without dysplasia and cancer (318) Gotaas C, Starr CD. Vocal fatigue among teachers. Folia Phoniatr (Basel) 1993;45:120-129. Ref ID: 194 Abstract: Recordings were made at the beginning and end of workdays of teachers who experience vocal fatigue (n = 22) and those who do not experience fatigue (n = 17). Those who experienced fatigue were recorded on days in which they did and did not fatigue. Both groups evaluated their vocal characteristics, each time they made a recording. Subsequently, a listener panel evaluated the same characteristics from the recordings. Both groups estimated the amount and characteristics of their talking time, completed a psychological evaluation and provided medical histories. The authors interpret the data obtained as indicating that the vocal characteristics of teachers who fatigue and those who do not fatigue are similar on days the former group does not fatigue and that the two groups are similar in the amount and loudness of their talking time, at work and at home. However, teachers who fatigue tend to spend more time in activities that appear to be vocally demanding and are more likely to perceive situations as being anxiety producing. Teachers who fatigue tend to be in good health, but have had more hearing problems and allergies than their colleagues and more of their family members have had voice problems (319) Lamprecht J, Jansing PJ. Cancer of the larynx: Predisposition or exposure? OTO RHINO LARYNGOL NOVA 1993;3:308-311. Ref ID: 381 Abstract: Extensive investigations on the aerodynamics of inhalation show that the laryngeal mucosa is an important target area for contact with aerosols. These results, together with daily experience, point to the important role of exogenous factors in laryngeal carcinogenesis. We have to examine the probability of an occupational or nonoccupational cause or contributory cause of the larynx carcinoma in the individual case. This paper presents assessment criteria which, if applied consistently, permit a systematic evaluation of this question. We warn against schematic use of yes-no decisions and recommend weighting of various parameters (e.g., intensity and duration of exposure, carcinogen combinations, cigarette smoking, and occupational exposure) (320) Masuda T, Ikeda Y, Manako H, Komiyama S. Analysis of Vocal Abuse: Fluctuations in Phonation Time and Intensity in 4 Groups of Speakers. 1993. Ref ID: 490 Abstract: Speech intensity and phonation time were measured in 11 office 119 workers, six kindergarten teachers, seven elementary school teachers, and five patients with vocal fold nodules. Of the five patients, two were elementary school teachers, two were office workers, and one was a housewife. A speech intensity/speech time accumulator was used. A contact microphone was attached to the neck of the subject to eliminate the influence of environmental noise. Data were obtained by accumulating the phonation time at four degrees of vocal intensity, ranging from weak to strong. By using this instrument, the speaking habits of the 29 subjects were measured for up to 12 days. Data were collected which were relevant for developing criteria for vocal abuse. The findings indicated that workers in an office exhibited a phonation time three times shorter than that of teachers and patients with vocal fold nodules. For the teachers and patients with a long phonation time, half of the total phonation time was at high intensity. In comparing two typical cases, a kindergarten teacher and a patient with vocal fold nodules, it was determined that the kindergarten teacher used extremely loud voice in the range of 80 decibels and above only during her school time. The patient used a loud voice by habit all the time. The authors suggest that it is important to determine when and for how long the patient speaks loudly so that the voice therapist can more adequately treat the patient (321) Pabst W. Sick students of the teaching profession? Sprache Stimme Gehor 1993;17:59-64. Ref ID: 391 Abstract: In the winter semester 1991/92 and the summer semester 1992 60,6% of the students who are studying for teacher's profession at the university of Essen have defects of speech. The study of the seminar for speech education shows that logopedical therapies are necessary. The defects most frequently observed were the different kinds of lisping and of dysphonias. The observed differences of the german articulation standards and the habituel abuse of voice must be treated, because teacher's profession is a speaking profession and the teachers have to teach the german language correctly concerning the orthographics and the orthoepics. The dysphonias must be regarded as an occupation disease of teacher. Deficits in the offered trainings at the university are the method of speaking and the formation of the voice which must be trained prophylacticly. There is no departement of speech at the university of Essen, only some invitations to lecture on the subjects of speech. That's not sufficient as the study proved. We have to think about the situation studying for teacher's profession and also about the standards of articulation. There are a lot of problems concerning the speech education that have to be discussed (322) Sapir S, Keidar A, Mathers-Schmidt B. Vocal attrition in teachers: survey findings. Eur J Disord Commun 1993;28:177-185. Ref ID: 193 Abstract: A survey questionnaire, designed in part to assess prevalence and impact of vocal attrition, was administered to school teachers in different locations across the USA. Analysis of 237 questionnaires obtained from female teachers suggests that vocal attrition may be prevalent among teachers. The mean number of symptoms of vocal attrition reported by the teachers was 3.8. Over one half of the teachers reported multiple (3+) symptoms. A significant number of teachers, especially those with multiple symptoms, reported that their symptoms adversely affected their ability to teach effectively and that their voice was a chronic source of stress or frustration. The implications of these and other findings are discussed (323) Schalén L, Eliasson I, Kamme C, Schalén C. Erythromycin in acute laryngitis in adults. The Annals of otology, rhinology, and laryngology 1993;102:209214. Ref ID: 462 Abstract: Moraxella catarrhalis and Hemophilus influenzae are isolated from the nasopharynx in 50% to 55% and 8% to 15%, respectively, of cases of acute laryngitis in adults. This finding indicates that these organisms, M catarrhalis in particular, are in some way involved in the pathogenesis of the disorder. In the present double-blind, placebo-controlled trial, the effect of erythromycin ethylsuccinate (0.5 g twice a day for 5 days) on the elimination of nasopharyngeal pathogens and reduction of clinical signs of upper respiratory tract infection, as well as on subjective complaints, was evaluated in 106 adults with acute laryngitis. The bacterial isolation rates at presentation were M catarrhalis 50%, H influenzae 18%, and Streptococcus pneumoniae 4%. In the 99 patients who completed the study, the elimination of M catarrhalis after 1 week was better in the erythromycin group (25 of 30 cases) than in the placebo group (6 of 19 cases; p < or = .00038). The elimination of H influenzae was unaffected by erythromycin. Otolaryngologic examination did not reveal any significant group differences regarding laryngitis, pharyngitis, or rhinitis. Voice quality was improved after 1 week, irrespective of treatment. However, as compared to the placebo group, the erythromycin group reported fewer voice complaints after 1 week and fewer coughing complaints after 2 weeks. As acute laryngitis in adults is selflimiting, and subjective symptoms are spontaneously reduced after 1 week in most cases, antibiotic treatment does not seem warranted as a general policy. However, erythromycin may be justified in patients who are professionally dependent on voice function (324) Zemla B, Swiatnicka J, Kolosza Z, Banasik R. [Epidemiological risk factors of larynx cancer among natives and immigrants in the Upper Silesian region]. Otolaryngol Pol 1993;47:330-337. Ref ID: 195 Abstract: A case-control study has been used to analyse risk factors such as tobacco smoking, pollution exposure in the microenvironment of the place of work, ambient air pollution in the living place among natives and immigrants for larynx cancer in Upper Silesia Region. There were tested 399 cases (269 natives and 130 immigrants) and 942 controls (557 and 385 respectively). Tobacco smoking and exposure to air pollution in the place of work is connected with increased incidence of larynx cancer risk among natives and immigrants. It was shown that there is no connection between larynx cancer and the degree of air pollution in the living place among natives (325) Berrino F, Crosignani P. [Epidemiology of malignant tumors of the larynx and lung]. Ann Ist Super Sanita 1992;28:107-120. Ref ID: 200 Abstract: Respiratory tract cancers, unlike most other cancers, have known causes and are susceptible to primary prevention. According to a large population-based case-control study in Southern Europe, over 90% of the present incidence of laryngeal cancer could be prevented by avoiding smoking and alcohol consumption. Most of the risk is attributable to tobacco, but reducing alcohol alone could still prevent a quarter of the cases. Tobacco 121 smoking, on the other hand, explains 80 to 90% of lung cancer incidence in Italy. Other known causal factors include: occupational exposures, which, according to several studies, may account for one third of the cases in the highly industrialized areas of Northern Italy; environmental pollution; passive smoking; radon; and dietary factors. Factors associated to a diet rich in fruit and vegetables have been found to be protective for both larynx and lung cancer in several studies carried out in Italy and elsewhere. The factors associated to this diet may be a major determinant in the North/South gradient in incidence and mortality consistently observed in geographical and migrant studies on respiratory cancers in Italy. Cigarette smoking, however, remains by far the most important cause of respiratory cancer, and geographical and temporal trends in incidence can easily be interpreted in terms of market trends, both in Italy and worldwide. According to several population surveys in Italy, the prevalence of smokers in successive male cohort generations reached a maximum (almost 80%) in the 1920-1930 birth cohorts and decreased to about 60% among males born in the forties and fifties. In the same period, the mean number of cigarettes per day for smokers increased, and the age of starting smoking decreased; however, the market changed from unfiltered black tobacco to filtered low-tar cigarettes. This market trend is consistent with the observation of decreasing incidence and mortality of both larynx and lung cancer in young male cohorts and the persistent increase of both cancers in older males. As for women, the prevalence of smokers increased from less than 10% in the 1920's birth cohorts to over 30% among women born in the late forties. This is reflected by a steady increase of respiratory cancers mortality which, however, is still lower than the mortality for males (326) Dietz A, Maier H. [Squamous cell cancer of the larynx after exposure to tar vapor--a case report]. HNO 1992;40:360-363. Ref ID: 198 Abstract: The following case report describes the development of laryngeal cancer of a non-smoker exposed to tar-emissions due to working with asphalt. Additionally, a basal cell carcinoma in the face caused by taremission underlines the role of this risk factor in the development of cancer in the head and neck (327) Dietz A, Maier H. Squamous cell carcinoma of the larynx following exposure to tar emissions. A case report. HNO 1992;40:360-363. Ref ID: 363 (328) Flach M. [Indisposition and acute dysphonia in the professional singer]. Laryngorhinootologie 1992;71:233-235. Ref ID: 199 Abstract: In the event of vocal failure in professional singers, functional causes are at least as important as inflammatory mucosal lesions. Treatment should take both possibilities into account, together with the personality of the singer (329) Gejrot T. The men behind the speculum. A singer's vocal cord played a part in the development. Lakartidningen 1992;89:1806-1807. Ref ID: 368 (330) Maier H, Gewelke U, Dietz A, Heller WD. Risk factors of cancer of the larynx: results of the Heidelberg case-control study. Otolaryngol Head Neck Surg 1992;107:577-582. Ref ID: 197 Abstract: Squamous cell carcinoma of the larynx is a multifactorial disease. It is firmly linked to several environmental risk factors. In the meanwhile, a considerable amount of epidemiologic evidence has been built up to implicate chronic consumption of alcohol and tobacco, occupation, diet, and social status in the etiology of the laryngeal cancer. Herein is a report from the first case-control study on the role of these risk factors conducted in a German population of patients with laryngeal cancer (331) Rothman W. Laryngoplasty for the treatment of vocal cord paralysis in an amateur singer. ARCH OTOLARYNGOL HEAD NECK SURG 1992;118:209-210. Ref ID: 401 Abstract: We have performed a medialization laryngoplasty on a schoolteacher who was also an amateur singer. Medialization laryngoplasty has been slow to gain acceptance but offers many advantages over Teflon injection because it is a reversible procedure and can be utilized early in vocal cord paralysis instead of waiting 9 months. Postoperatively, the patient can vocalize more than two octaves with good volume. Objective measurement of results is needed in judging the success of these procedures (332) Sataloff RT. The impact of pollution on the voice. Otolaryngol Head Neck Surg 1992;106:701-705. Ref ID: 407 Abstract: Pollution is responsible for the presence of toxic substances and conditions throughout our environment. Inhalation of toxic pollutants may affect the voice adversely by direct laryngeal injury, by causing pulmonary dysfunction that results in voice maladies, or through impairments elsewhere in the vocal tract. Ingested substances- especially those that have neurolaryngologic effects-may also adversely affect the voice. Non-chemical environmental pollutants such as noise may also be responsible for voice abnormalities. Most of the information about the effects of pollution on the voice is anecdotal. Equipment and techniques that permit valid, reliable voice research have recently become available; and studies on the impact of pollution on communication, and specifically on voice, should be encouraged (333) Succo G, Giordano C, Sorrentino R, Riva F, Boggero R, Sartoris A. Pre-invasive laryngeal cancer detection: Screening and identification of high risk groups. MED SCI RES 1992;20:11-12. Ref ID: 415 (334) Vacanti CA, Roberts JT. Blind oral intubation: the development and efficacy of a new approach. Journal of clinical anesthesia 1992;4:399-401. Ref ID: 468 Abstract: STUDY OBJECTIVE: To develop an approach to blind oral intubation. With the aid of a fiberoptic laryngoscope and stylet within an endotracheal tube, a video camera, a monitor, and a recorder to correlate the effects of various manipulations of the airway on access to the trachea, a suitable approach was devised. We then evaluated its efficacy. DESIGN: Randomized, prospective comparison of regimens. SETTING: Inpatient surgery at a university-affiliated teaching hospital. PATIENTS: One hundred adult patients with no known abnormalities of the upper airway by history or on physical 123 examination, scheduled to undergo elective surgery, and without evidence of major cardiac disease or need for a rapid-sequence induction of anesthesia. INTERVENTIONS: Fifty patients in each of two groups were given fentanyl 5 micrograms/kg intravenously (IV), followed 2 minutes later by thiopental sodium 5 mg/kg and succinylcholine 2 mg/kg. Patients in Group 1 (the controls) were orally intubated via direct laryngoscopy using a Macintosh #3 blade. Patients in Group 2 (the experimentals) were intubated orally with the approach developed without the use of a laryngoscope. Intubations were deemed successful if they were performed within 1 minute after the mouth was opened. MEASUREMENTS AND MAIN RESULTS: All the patients in Group 1 were successfully intubated within 1 minute, while 49 of the 50 patients in Group 2 were successfully intubated within 1 minute. CONCLUSIONS: Blind oral tracheal intubation can be successfully performed in a safe and effective manner after appropriate teaching of the technique (335) Ahrens W, Jockel KH, Patzak W, Elsner G. Alcohol, smoking, and occupational factors in cancer of the larynx: a case-control study. Am J Ind Med 1991;20:477-493. Ref ID: 203 Abstract: A hospital-based case-control study of laryngeal cancer was conducted in Bremen in 1986 and 1987 with 100 prevalent male laryngeal cancer patients and 100 male hospital controls with diseases not considered to be related to smoking, alcohol, or occupational exposures, who were frequency matched by age. The odds ratio for heavy smoking (more than 30 pack-years) reached a value of 3.5 (95% confidence limits (CL) 1.1, 7.9). Exsmokers showed a significant decrease in risk; this reached the level of those who had never smoked about 15 years after smoking cessation. For daily consumers of alcohol an odds ratio of 3.2 (95% CL 1.4, 7.5) was observed. Among the 17 occupations in which at least ten subjects had worked, excess risks were observed for stock keeping and transportation workers, and for leather and textile workers. The odds ratio was significantly increased for the latter (p less than 0.05). Among all those persons ever employed in a priori defined-risk occupations, an odds ratio of 2.74 (95% CL 1.23, 6.06) was observed. Considering responses to an exposure check-list, no increased risks could be shown for exposure to asbestos, coal tar, or welding fumes. On the other hand, excess risks were observed for exposures to diesel oil, gasoline, and mineral oil, controlling for smoking and alcohol. The findings in occupational and exposure subgroups were based on small numbers of cases and controls and, consequently, were subject to large sampling errors. Many of the results are consistent, however, with occupational risk factors reported from other studies (336) Airainer R, Klingholz F. [Computer-assisted phonetography as a diagnostic aid in functional dysphonia]. Laryngorhinootologie 1991;70:362-366. Ref ID: 201 Abstract: A total of 160 voice-trained and untrained subjects with functional dysphonia were given a "clinical rating" according to their clinical findings. This was a certain value on a scale that recorded the degree of functional voice disorder ranging from a marked hypofunction to an extreme hyperfunction. The phonetograms of these patients were approximated by ellipses, whereby the definition and quantitative recording of several phonetogram parameters were rendered possible. By means of a linear combination of phonetogram parameters, a "calculated assessment" was obtained for each patient that was expected to tally with the "clinical rating". This paper demonstrates that a graduation of the dysphonic clinical picture with regard to the presence of hypofunctional or hyperfunctional components is possible via computerised phonetogram evaluation. In this case, the "calculated assessments" for both male and female singers and non-singers must be computed using different linear combinations. The method can be introduced as a supplementary diagnostic procedure in the diagnosis of functional dysphonia (337) Novak A, Dlouha O, Capkova B, Vohradnik M. Voice fatigue after theater performance in actors. Folia Phoniatr (Basel) 1991;43:74-78. Ref ID: 202 (338) Rudolph H, Eggemann G, Bruchmuller W. Malignant tumours of the larynx on male patients and profession - A comparison of patients with malignant tumours of stomach. Laryngo Rhino Otol 1991;70:681-682. Ref ID: 402 Abstract: A statistically comparison of the professions on 1119 male patients with malignant laryngeal tumours and the profession on 708 male patients with malignant tumours of stomach, shows the influence of occupational exposures. The quantity of malignant laryngeal tumours is high in the group of steelworks -and foundry workers, workers in the glass-, porcelain-, quartzand chemical industry and motorists. The inhalation of exogenous cancerpoisons are the cause probable (339) Sataloff RT. Care of the Professional Voice. 1991. Ref ID: 491 Abstract: The medical needs of professional voice users particularly singers were evaluated. The anatomy of structures involved in voice production (the larynx, supraglottic vocal tract, tracheobronchial tree, lungs and thorax) was described. Contribution of the abdominal musculoskeletal system and psychoneurological system was also considered. Aspects of medical history taking from patients with voice problems and the effects of age on the voice were examined. Common voice symptoms were discussed as were factors to be considered when choosing a treatment plan. The latter included the date of the next performance, the singing status and goals of the patient, the amount and nature of the vocal training, and the type of singing environment. A discussion of the effects of endocrine dysfunctions, mucosal irritants, diet and previous laryngeal surgery on the voice was presented. Methods for physical examination and objective analyses of voice patients were described. Common diagnoses included: reflux laryngitis, anxiety, muscle problems, voice abuse, vocal nodules, cysts and polyps, upper respiratory tract infection, tonsillitis, and laryngitis. The treatment of such problems with drugs, therapy, or surgery was discussed (340) Bravo MP, Espinosa J, Calero JR. Occupational risk factors for cancer of the larynx in Spain. Neoplasma 1990;37:477-481. Ref ID: 209 Abstract: Spain is one of the countries with the highest incidence of laryngeal cancer and, together with France, is the country with the lowest percentage of women with this disease. In order to identify the occupational risk factors associated with laryngeal cancer in this country a case-control study was performed. Cases included 85 patients with epidermoid carcinoma of the 125 larynx diagnosed in "La Paz" Hospital, Madrid, between 1985 and 1987. A sample of 170 patients from the same hospital was used as control. The results of the study revealed that 56.5% of larynx cancer patients had a sedentary occupation working in the service sector. Exposure to insecticides or silica were strongest risk factors for laryngeal cancer. An association between laryngeal cancer and exposure to fumes, chemical products, mineral dust, or wood dust was not found (341) Eremenko VN, Shkoba I, Manzhura NP, Makukha AL. [Singer's nodes]. Vrach Delo 1990;104-105. Ref ID: 206 (342) Grasl MC, Neuwirth-Riedl K, Vutuc C, Horak F, Vorbeck F, Banyai M. Risk of vocal chord dysplasia in relation to smoking, alcohol intake and occupation. Eur J Epidemiol 1990;6:45-48. Ref ID: 207 Abstract: The significance of tobacco smoking, alcohol consumption and occupation as risk factors for the development of vocal chord dysplasia was evaluated in a case-control study. Twenty-seven male patients with dysplasia of the vocal chords were chosen from the I. ENT-University Clinic in Vienna (1985-1988) and compared with 54 controls. The main results are: The relative risk (RR) of a smoker compared to that of a non-smoker for vocal chord dysplasia is 7.27 (6.81-7.73); the RR adjusted for occupation is 3.58 (2.31-4.84). The most important risk factor, however, is occupational exposure. The relative risk of a blue collar worker compared to that of a white collar worker is 11.04 (10.61-11.46), which is reduced only to 10.02 (10.6111.46) after stratification according to smoking habits (343) Maier H, de VN, Weidauer H. [Occupation and cancer of the oral cavity, pharynx and larynx]. HNO 1990;38:271-278. Ref ID: 204 Abstract: There is increasing evidence of an association between occupational factors and head and neck cancer. The present paper reviews the most relevant epidemiological studies published within the last 30 years. Generally these studies indicate an increased cancer risk for "blue collar workers" exposed to dust or inhaled organic and inorganic agents. Moreover, the increased risk of head and neck cancer in most studies persists after adjustment for alcohol and tobacco consumption. More detailed, clinically orientated studies are necessary to provide a better understanding of the role of occupational factors in head and neck cancer (344) Ocker C, Pascher W, Rohrs M, Katny W. Voice disorders among players of wind instruments? Folia Phoniatr (Basel) 1990;42:24-30. Ref ID: 208 (345) Parnes SM. Asbestos and cancer of the larynx: is there a relationship? Laryngoscope 1990;100:254-261. Ref ID: 205 Abstract: A head and neck examination was conducted on 322 personnel in a plant that manufactures brake linings and disks where asbestos is a major component. The personnel were categorized according to occupational risk, duration of employment, and smoking and alcohol habits. Thirty-nine percent had abnormalities, the most common being laryngitis (15%), deviated nasal septum (13%), and neck mass (5.3%). Six members required a biopsy, but no cancer was discovered. Of 47 personnel with laryngitis, 46 were smokers (P less than .01). In regard to asbestos exposure, 20% of the high-risk group had laryngitis, compared to 11% in the low-risk group (P less than .05). The data were compared to a previously prepared longitudinal study of plant personnel (2057 individuals and 37,361.5 person years), where three cases of laryngeal cancer had been observed (0.77 expected). As these cases involved smokers with limited asbestos exposure, neither the longitudinal or crosssectional data could support asbestos as an etiologic factor for laryngeal cancer, but it may act as an irritant (346) Charkhalashvili GE. [Significance of reflexogenic areas of the larynx in the treatment of professional singers]. Vestn Otorinolaringol 1989;59. Ref ID: 214 (347) Heuillet-Martin G. [Functional future of laryngopathies in singers]. Rev Laryngol Otol Rhinol (Bord ) 1989;110:391-392. Ref ID: 216 Abstract: As regards to 24 singers under observation traited for dysody (14 lyric singers, 3 amateur chorus singers and 7 pop singers), one deduces the following points: almost all the singers traited are professional. The lyric professional singers seek medical advice for minor lesions or simple dysfunctions, as early as needed. In the classical amateurism, patients are not adequately inform about the risk of vocal strain. They seek medical advice for secondary lesions. The first two groups are treated with good results. The majority of pop singers consult medical practitians, for surgical lesions. The results of such treatments are frail (348) Heuillet M. The functional future of benign laryngopathy in singers. REV LARYNGOL OTOL RHINOL 1989;110:391-392. Ref ID: 372 (349) Misterek M, Knothe M, Johannes E, Heidelbach JG, Scheuch K. [Studies of voice stress in teachers with functional voice disorders caused by teaching activity]. Z Gesamte Hyg 1989;35:415-416. Ref ID: 210 Abstract: 30 female teachers of ten-years technical schools-15 with functional voice-disturbance an 15 with healthy voice-have been examined while teaching in respect of their strain. Duration of speech, intensity of their teachers voice an background noise, the frequency of heart rate and the arterial blood pressure were measured on the teaching day. Between both research groups no statistically significant differences were shown. There were no correlations between the durations of speech, intensity and vegetative parameters (350) Moulin JJ, Wild P, Mur JM et al. Risk of lung, larynx, pharynx and buccal cavity cancers among carbon electrode manufacturing workers. Scand J Work Environ Health 1989;15:30-37. Ref ID: 212 Abstract: Among workers employed in factories producing carbon graphite products the risk of cancer due to exposure to polycyclic aromatic hydrocarbons was estimated. In one cohort (plant A), a cancer incidence study was carried out; the number of cases were not significantly increased 127 for lung cancers [7 cases, standardized incidence ratio (SIR) 79] or for cancers of the upper respiratory and alimentary tract (10 cases, SIR 103). In another cohort (plant B), a mortality study was carried out; neither the mortality from lung cancer [13 deaths, standardized mortality ratio (SMR) 118] nor that from upper respiratory and alimentary tract cancers (10 deaths, SMR 125) was significantly higher than expected. Within each cohort, a casereferent study was carried out. In plant A the odds ratios were high but nonsignificant for lung cancers (odds ratio 3.42) and upper respiratory and alimentary tract cancers (odds ratio 2.19) and they showed a nonsignificant relationship with duration of exposure. In plant B, the odds ratios were low for every cancer site (351) Oreggia F, de SE, Correa P et al. [Occupational exposure in cancer of the mouth, pharynx and larynx]. An Otorrinolaringol Ibero Am 1989;16:365-376. Ref ID: 213 Abstract: The AA. have scheduled a case-control study in order to assess the ambient hazards factors in these cancers, through the evaluation of its occupational risk. The program cover 242 cases of the epidermoid type of carcinoma (positive biopsy), and the group was parallelled with another group of 322 (after the age) admitted at the same Hospital, but affected with several processes. Were excluded the cancer of the lung, bladder, pancreas and kidney because of the causal link with tobacco smokers. In oral and pharyngeal cancer the AA. found out that the workers of high risk were butchers, blacksmiths, masons, drivers, electricians and railwaymen. Regarding the cancer of the larynx mechanics, plumbers, farmers, textile workers and drivers showed the greatest linkage. These findings are in accordance with those published in previous papers (352) Pascher W. [The Hamburg concept for the treatment of functional dysphonia in patients with speech occupations (pedagogy) from the holistic viewpoint]. Auris Nasus Larynx 1989;16 Suppl 1:S71-S83. Ref ID: 215 Abstract: Literature on functional voice disorders, on their etiopathogenetic criteria linked in a complex way, on the multifaceted aspects of the symptoms, and on the varieties, which arise out of influences during the longterm course of the disease has reached a considerable volume. In relation to this fact, the description of therapeutic methods is thin and there is only sparse attention given to quantitative facts, such as intensity and duration of therapy and the possible influences of patients' professional field on the therapeutic course. However, there is general agreement that qualitative features and quantitative volume of therapy should be enlarged under the holistic aspect of an adequate therapy of voice function, depending on individual necessities. Under such a holistic aspect, two fundamental ways of therapy are possible and both ways have advantages and disadvantages, which originate from principal differences: out-patient therapy and in-patient therapy. The Hamburg-Concepts of out-patient therapy of professional voice disorders which were created, tested, corrected and in a long-lasting process finally structured in terms of operational diagrams are discussed in this paper under different points of view: the precondition is a complete evaluation of all influencing factors in an interdisciplinary process. In closing, a new program of cooperation between the institution for in-patient voice therapy in Werscherberg/Osnabruck and the Hamburg Team is mentioned, a program which, though very complex and risky, is intended to close the gap between in-patient and out-patient therapy (353) Podol'skaia EV. [Precancerous conditions of the larynx in workers exposed to dust and their prevention]. Vestn Otorinolaringol 1989;67-69. Ref ID: 211 Abstract: This paper presents the results of examinations of 522 workers exposed to various industrial dusts and 361 workers exposed to different concentrations of carcinogenic asbestos dust. The examinations showed a significantly higher incidence of total processes in the upper respiratory tract which manifested as chronic subatrophic nasopharingitis and hyperplastic laryngitis. Also, they demonstrated a significantly higher incidence of local processes that manifested as hyperplasia of the laryngeal mucosa and contact fibromas. These laryngeal lesions can be viewed as etiologically associated with the effect of industrial dusts having traumatic (abrasive and glass dust) and carcinogenic (asbestos) properties. Patients with the above laryngeal pathologies should be removed from the dust environment and sent to physical examinations with emphasis on occupational diseases (354) Sarfati J. Vocal re-education of teachers. REV LARYNGOL OTOL RHINOL 1989;110:393-395. Ref ID: 405 (355) Vocal Cord Hemorrhages in Voice Professionals. Por buscar 1988. Ref ID: 510 Abstract: Fourteen cases of vocal cord hemorrhage in professional voice users were discussed. Two females had cases of bilateral hemorrhage and ten females and two males had cases of unilateral hemorrhage. The patients with bilateral hemorrhage complained of aphonia. The major complaints of the patients with unilateral hemorrhage were hoarseness, loss of power, and decreased vocal range. Three patients smoked 10 to 20 cigarettes daily. The hemorrhages were induced by vocal trauma such as yelling, coughing, and voice abuse and resulted from blood accumulating under the epithelium of the vocal cords and edema in Reinke's space. The patients were examined by indirect laryngoscopy, videostrobofiberoscopy, electrolaryngography, or computed tomography. The bilateral hemorrhage patients recovered their voices completely 3 months after treatment (not specified) and voice rest were initiated. The patients with unilateral hemorrhage were treated with cortisone for 3 days, antibiotics for 8 days, antiinflammatory agents for 12 days, and vocal rest for 2 weeks. Three patients recovered full voice function within 1 month. Nine required surgery to remove the hematomas and their sequelae 5 weeks to 6 months after diagnosis. The surgery was done by a carbon-dioxide laser in conjunction with endoscopy under general anesthesia. All surgery patients recovered their voices and were able to continue their careers. The author suggests that surgery should be a component of therapy for vocal fold hemorrhages (356) Castelli C. [The vocal body of the lyric singer]. Rev Laryngol Otol Rhinol (Bord ) 1988;109:383-386. Ref ID: 221 (357) Herrington-Hall BL, Lee L, Stemple JC, Niemi KR, Miller McHone M. Description of Laryngeal Pathologies by Age, Sex, and Occupation in a Treatment-Seeking Sample. 1988. 129 Ref ID: 493 Abstract: The occurrence of laryngeal pathologies and their distribution across the variables of sex, age, and occupation were described. A total of 1,262 patients seen in six separate otolaryngologic practices was studied retrospectively, using the medical charts of all patients with laryngeal pathology seen over a 3 year period. Twenty two different laryngeal pathologies were identified, with nodules, edema, polyps, cancer, vocal fold paralysis, and dysphonia being the most common, in that order. Pathologies were significantly more common in females than in males. Of the cases of psychogenic disorders, 29/34 occurred in females. Cancer, leukoplakia, and hyperkeratosis occurred significantly more often in males. The pathologies occurred primarily in the older age brackets. Fifty seven percent of patients were over 45 years old. Nodules and edema were most common in early adulthood, polyps and dysphonia with a normal larynx in middle adulthood, and vocal fold paralysis in late adulthood. The ten most frequently occurring occupations were retired persons, homemakers, factory workers, unemployed persons, executives and managers, teachers, students, secretaries, singers, and nurses (358) Koufman JA, Blalock PD. Vocal fatigue and dysphonia in the professional voice user: Bogart-Bacall syndrome. Laryngoscope 1988;98:493-498. Ref ID: 218 Abstract: Over the past 5 years, the authors have treated 67 adult professional voice users with a musculoskeletal tension disorder involving the larynx and supporting structures and leading to vocal dysfunction. Common clinical features in both sexes were muscle tension in the neck, poor control of the breath stream, and an abnormally low-pitched speaking voice. Most of the men sounded like Humphrey Bogart and the women like Lauren Bacall. These cases represent a discrete clinical vocal fatigue syndrome, the treatment of which is patient education and voice therapy (359) Krajcovic I. [Voice disorders in workers in a noisy work environment at the Sverma Ironworks in Podbrezova]. Cesk Otolaryngol 1988;37:33-37. Ref ID: 220 (360) LaMarte FP, Merchant JA, Casale TB. Acute systemic reactions to carbonless copy paper associated with histamine release. JAMA 1988;260:242-243. Ref ID: 217 Abstract: We report two cases of recurrent episodes of hoarseness, cough, flushing, pruritus, and rash occurring within 30 minutes of topical exposure to carbonless copy paper. Provocative challenges revealed that alkylphenol novolac resin was the ingredient responsible. Video endoscopy of the larynx was performed and plasma histamine levels were obtained prior to and 30 minutes after cutaneous challenge of a patient with alkylphenol novolac resin. We documented marked laryngeal edema and a sixfold increase in plasma histamine levels after challenge. We conclude that topical exposure to carbonless copy paper may cause mast cell/basophil-mediated acute systemic and potentially life-threatening reactions in susceptible patients (361) Leonard RJ, Ringel R, Horii Y, Daniloff R. Vocal shadowing in singers and nonsingers. J Speech Hear Res 1988;31:54-61. Ref ID: 219 Abstract: Five nonsingers and five singers vocally matched the pitches of frequency modulated tones. Subject responses to the shadowing task were analyzed in terms of accuracy, and in terms of duration and speed characteristics of pitch changes. In addition, each frequency change was categorized according to hit, overshoot, undershoot, or oscillate patterns. Singers were found to effect pitch changes in significantly less time than the nonsingers. This finding was attributed to more direct patterns (hits) and faster maximum speeds obtained by the singers. Both groups demonstrated a direct relationship between the size of the pitch change and each of the duration and speed parameters examined. Similarly, for both groups, pitch lowering was faster than pitch raising. Faster speeds and more direct paths in effecting pitch changes were viewed as evidence of greater vocal proficiency in singers as compared to nonsingers. Implications of the data for mechanical and physiological aspects of voice frequency control are discussed (362) Ovassapian A, Yelich SJ, Dykes MH, Golman ME. Learning fibreoptic intubation: use of simulators v. traditional teaching. British journal of anaesthesia 1988;61:217-220. Ref ID: 456 Abstract: This study compared a graduated training programme with that of a traditional teaching method to facilitate the learning of the technique of fibreoptic nasotracheal intubation. Thirty-two anaesthesia trainees were randomly assigned to two groups. The graduated programme involved: practice on a bronchoscopy teaching model; exposure of the epiglottis and vocal cords in patients recovering from general anaesthesia; performance of fibreoptic nasotracheal intubation in awake sedated patients. The traditional programme involved: demonstration (on a patient) of one fibreoptic nasotracheal intubation by the instructor; performance of fibreoptic nasotracheal intubation (by the trainee) in awake sedated patients. Nasotracheal intubation was accomplished significantly more often by the trainees in the graduated programme (86 out of 96 (89.6%) v. 64 out of 96 (66.5%) (P less than 0.01). The results demonstrate that trainees who undergo a graduated training programme using simulators are initially more successful at awake fibreoptic nasotracheal intubation than those who have learned in the traditional manner, and that the conditions of the investigation were acceptable to the trainees and patients (363) Peppard RC, Bless DM, Milenkovic P. Comparison of Young Adult Singers and Nonsingers with Vocal Nodules. 1988. Ref ID: 492 Abstract: This study was made to determine if young singers with vocal nodules perform similarly to nonsingers on a wide range of measures of vocal function. A group of 20 young adult females (ten singers and ten nonsingers) with a diagnosis of bilateral vocal nodules were selected for the study. Twenty women in the same age range, ten of whom were singers and ten nonsingers, without a diagnosis of vocal disorders served as comparisons. The singers were all sopranos with at least 2 years of formal voice training. Differences were noted in a wide range of acoustic, aerodynamic, laryngeal imaging and psychoacoustic measures between singers and nonsingers with nodules and between the two groups of normals (singers and nonsingers). Singers with nodules had smaller nodules, less impairment of vibratory function, and less severe vocal symptoms than their nonsinging counterparts. Superior ratings were obtained from the singers without nodules (compared to nonsingers without nodules) as regards acoustic measures including jitter, shimmer, and 131 signal to noise ratio. Even in the presence of nodules, singers had superior maximum performance skills than their nonsinging comparisons. The authors suggest that one reason singers detect problems with their vocal cords earlier than nonsingers would be a decrease in maximum performance levels. Also singers have not only themselves as a judge of their voice, but the presence of a trained listener in the person of their teacher. They are also more highly motivated to seek immediate aid as singing is their livelihood. These findings strongly suggest that studies attempting to establish normative data bases for voice production must differentiate those speakers with singing training from those without (364) Gould WJ. Surgery in professional singers. Ear Nose Throat J 1987;66:327332. Ref ID: 223 (365) Sataloff RT, Spiegel JR, Carroll LM, Schiebel BR, Darby KS, Rulnick R. Strobovideolaryngoscopy in Professional Voice Users: Results and Clinical Value. 1987. Ref ID: 498 Abstract: Results were presented of the initial experience of an otolaryngological practice with stroboscopic laryngoscopy supplemented with video recording. Over a 2 year period, 486 strobovideolaryngoscopic procedures, selected because of the presence or suspicion of a structural abnormality, were performed. Of 343 patients, 311 were professional voice users, and the others sought medical attention specifically for voice complaints. After a brief initial examination using visible light, the flexible laryngoscope was connected to a video camera and the examination continued using stroboscopic light. Thirty nine different entities were diagnosed. The most frequent diagnoses in which stroboscopy established or altered diagnosis or management were scar, nerve paralysis, hemorrhage, technique, dysphonia, laryngitis, and nodules. The authors conclude that strobovideolaryngoscopy is useful in establishing the presence or absence of structural lesions, and that it provides a rapid assessment of vibratory function of the leading edge of the vocal fold. In selected cases, the information obtained may establish a diagnosis that otherwise would be presumptive or missed altogether, and the findings may also result in changes in surgical judgment (366) Sataloff RT. The Professional Voice: Part III. Common Diagnoses and Treatments. 1987. Ref ID: 497 Abstract: Common diagnoses of voice disorders and their treatments were reviewed. Epidemiologic data on voice disorders were summarized. Anxiety induced vocal dysfunction was considered. Reassuring the patient was regarded as the most effective therapy for countering the effects of anxiety on singers. Vocal dysfunction due to muscle problems, vocal nodules, voice abuse, upper respiratory tract infection, and tonsillitis was reviewed. Laryngitis with or without serious vocal injury was discussed. Drugs used for treating vocal dysfunction were considered. Using speech pathologists and singing teachers to treat voice dysfunction was discussed. Speech pathologists were generally regarded as being valuable assets for treating vocal problems in singers. The helpfulness of singing teachers, under some conditions, in the treatment of nonsingers with voice problems was described, since techniques used to develop abdominothoracic strength, breath control, laryngeal and neck muscle strength, and relaxation are very similar to those used in speech therapy. Surgery and vocal dysfunction were discussed. Voice maintenance was considered. The author concludes that excellent regular training and practice as well as avoiding irritants such as smoke are essential in preventing vocal dysfunction in professional singers (367) Sataloff RT. Clinical Evaluation of the Professional Singer. 1987. Ref ID: 494 Abstract: The medical care and clinical evaluation of voice problems in professional singers was discussed. It was initially pointed out that most physicians lack the expertise and experience required to evaluate and treat subtle voice problems. In order to obtain more accurate diagnostic information than that provided by the vague terms hoarseness and fatigue, it was recommended that the patients fill out detailed questionnaires. Following this, the physician should perform an extensive examination of the larynx. The indirect laryngoscopy should establish the presence or absence of nodules, mass lesions, contact ulcers, hemorrhage, erythema, cord paralysis, arytenoid erythema (reflux), and other possible anatomic abnormalities. It was considered especially useful to perform the laryngoscopy with the combination of a fiberoptic laryngoscope and a stroboscopic light source which might reveal small vibratory irregularities and allow a closer examination of the vocal cords. The physician also should listen to and evaluate the singing voice, but without exceeding the limits of his expertise and without entering the territory of the voice teacher. Finally, it was emphasized that voice abnormalities may be manifestations of several types of systemic or neurologic disorders (368) Sataloff RT. Common Diagnoses and Treatments in Professional Voice Users. 1987. Ref ID: 496 Abstract: Laryngological problems relevant to the voice professional's ability to work were reviewed. The author emphasized that careful attention to individual history and frequent physical examination employed with professional singers allows detection of subtle organic changes. Gastric reflux laryngitis was said to be endemic among singers. This may result from fasting preceding a performance, done to prevent a full stomach from interfering with necessary abdominal support. Typical symptoms of gastric reflux laryngitis include hoarseness in the morning, prolonged warmup time, halitosis and a bitter taste in the morning, frequent throat clearing, chronic irritative cough, and frequent tracheitis and tracheobronchitis. Voice abuse in singing was said to be a real hazard for the professional singer. The most common technical errors in singing were said to involve excessive muscle tension in the neck and laryngeal muscles, inadequate abdominal support, and excessive volume. A good voice teacher can be helpful in managing problems and assuring a nonabusive technique. Voice abuse in speaking frequently occurs, even among well trained technical singers. Vocal nodules are caused by voice abuse and usually result in hoarseness, breathiness, loss of range, and vocal fatigue. Voice therapy is the preferred first therapy, although surgical excision is sometimes necessary. Vocal polyps, vocal fold cysts, Reinke's edema, upper respiratory infection without laryngitis, laryngitis with serious vocal fold injury, laryngitis without serious damage, allergy, hypothyroidism, laryngopathia premenstrualis, laryngopathia gravidarum, poor general health, aging, 133 substance abuse, and anxiety occurring in professional singers were also discussed (369) Sataloff RT. Common Diagnoses and Treatments in Professional Singers. 1987. Ref ID: 495 Abstract: The diagnoses and treatments of common ailments in professional singers were discussed. One of the most common afflictions is gastric reflux laryngitis which occurs because of the singers' habit of eating very late at night and then going directly to bed. Excessive tension in the muscles of the neck and larynx while singing and a wrong speaking technique may both cause voice abuse. To remedy either of these situations, a competent teacher was recommended. Among anatomical abnormalities of the larynx listed were vocal nodules, vocal polyps, vocal cord cysts, and Reinke's edema. The causes and treatments of these inflictions were discussed. Hemorrhage in the vocal cord area requires strict voice rest. This also may be required in the case of laryngitis, depending on the cause and seriousness of the inflammation. During relative voice rest the voice should be used only when necessary, but during absolute voice rest the voice must not be used at all. In addition to these ailments, the singing voice may suffer or change as a result of hormonal changes (thyroid hormones, sex hormones), poor general health, substance abuse, and anxiety. In all cases, cooperation between a voice teacher and the physician was recommended (370) Urbanova O, Uhrova M. [Development of hyperfunctional voice disorders in teachers studied 1972-1985 at the phoniatric department of the Medical School Hospital in Bratislava]. Cesk Otolaryngol 1987;36:295-299. Ref ID: 222 (371) Zemla B, Day N, Swiatnicka J, Banasik R. Larynx cancer risk factors. Neoplasma 1987;34:223-233. Ref ID: 224 Abstract: The larynx cancer relative risk has been evaluated (328 cases) in the stationary-native Upper Silesians (63.7%) and migrating (36.3%) male population. The particular control groups (656 men) included 418 and 238 men respectively not suffering from malignant neoplasms. The essentially higher larynx cancer incidence risk has been shown for men manual labor and exposed to the influence of various dusts, gases and vapors and other pollutants in their place of work. The increased substantial incidence risk is also true for men who smoke tobacco and are professionally exposed to the pollution. The results in regard to the consumption of raw and boiled vegetables suggest that these may be inhibitors of the neoplasmatic process in the area of larynx (although not only). The frequency of the consumption of alcohol--vodka or beer--increases the larynx cancer incidence risk both among autochthons and immigrants. Nevertheless, the data concerning the amount of alcohol consumed are less valuable here; they do not allow to establish fully reliable quantitative levels of the beer or vodka consumed. In comparison with the literature of the subject, divergent data have been obtained as far as the joint influence of drinking alcohol with simultaneous smoking of tobacco and professional exposure are concerned (372) Dejonckere PH. SPECTRAL CHARACTERISTICS OF VOICE IMPAIRMENT ASSOCIATED WITH VOCAL NODULES. INTERNATIONAL JOURNAL OF REHABILITATION 1986. Ref ID: 499 Abstract: Vocal nodules commonly appear in users of professional voice, eg. singers, in whom strenuous vocal activity is concomitant with emotional stress. Their appearance is associated with excessive or unusual mechanical stress at a well-defined localisation of the edge of the vocal folds. The voice impairment they cause is an occupational illness. This study measures acoustical characteristics of voice in nodule-carriers by means of Long-TimeAverage Spectra. Dysphonia associated with nodules leads to huskiness and a tendency towards low pitch (373) Eivazov AA, Kazhlaev OM. [Complex clinical and functional studies of the vocal apparatus]. Vestn Otorinolaringol 1986;52-55. Ref ID: 227 (374) Lastovka M. [Evaluation of short-term work disability in acute respiratory tract inflammations in voice professionals]. Cesk Otolaryngol 1986;35:337-343. Ref ID: 225 (375) Makukha AL, Abyzov RA, Svirid LM. [Acute inflammatory diseases of the vocal system in professionals using their voices]. Vrach Delo 1986;101-103. Ref ID: 228 (376) Wilson FB, Kudryk WH, Sych JA. The development of flexible fiberoptic video nasendoscopy (FFVN). Clinical-teaching-research applications. ASHA 1986;28:25-30. Ref ID: 226 (377) Agger WA, Seager GM. Granulomas of the vocal cords caused by Sporothrix schenckii. Laryngoscope 1985;95:595-596. Ref ID: 232 Abstract: A 42-year-old female acquired an acute respiratory infection one week after working in a sphagnum moss packing plant. Three and one half months later direct laryngoscopic examination, done because of persistent hoarseness, revealed granulomas of the left true cord. Initial biopsy showed noncaseating granulomas, and a repeat biopsy with fungal cultures grew Sporothrix schenckii. The patient was treated with an oral solution of saturated potassium iodide and gradually improved although mild hoarseness has persisted (378) Chernobel'skii SI. [Hormonal contraceptives and singers' voice]. Vestn Otorinolaringol 1985;62-63. Ref ID: 230 (379) Gates GA, Saegert J, Wilson N, Johnson L, Shepherd A, Hearne EM. Effect of beta blockade on singing performance. The Annals of otology, rhinology, and laryngology 1985;94:570-574. Ref ID: 442 Abstract: The symptoms associated with performance anxiety, or the socalled stage fright syndrome, are similar to those of alpha and beta adrenergic stimulation. Suppression of symptoms and improvement in instrumentalist's performance after beta blockade suggest that this modality would be of benefit for singers as well. To evaluate the dose-effect 135 relationship of beta blockade upon singing performance and the possible effect of these agents upon performance maturation, we studied 34 singing students during end of semester juries, using a double-blind crossover paradigm. Students performed once with either placebo, 20, 40, or 80 mg of nadolol, and again 48 hours later, with placebo. There was a significant doserelated, limiting effect upon intraperformance cardiac rate. A small, but statistically significant, dichotomous effect upon performance rating was noted: low-dose nadolol tended to enhance performance, whereas larger doses impaired performance. We conclude that the effects of low dose beta blockade upon singing are minimally helpful and high doses may detract from performance ability (380) Malavolta N. Occupational and environmental otorhinolaryngologic diseases. G CLIN MED 1985;66:253-265. Ref ID: 383 (381) Sulkowski W, Kowalska S. [Our experiences with the evaluation of occupational diseases of the organ of voice]. Otolaryngol Pol 1985;39:153159. Ref ID: 233 (382) Tagirova FG, Podol'skaia DV. [Treatment of vocal cord hemorrhages with sinusoidal modulated currents]. Vestn Otorinolaringol 1985;49-50. Ref ID: 231 (383) Zivazov AA, Kazhlaev OM. [Clinical course, complex diagnosis and treatment of various forms of organic occupational diseases of the larynx]. Vestn Otorinolaringol 1985;59-63. Ref ID: 229 (384) Elwood JM, Pearson JC, Skippen DH, Jackson SM. Alcohol, smoking, social and occupational factors in the aetiology of cancer of the oral cavity, pharynx and larynx. Int J Cancer 1984;34:603-612. Ref ID: 234 Abstract: A case-control study of 374 patients with primary epithelial cancers of the oral cavity, oro- and hypopharynx, and larynx is reported, the controls being patients with selected other cancers, matched for age and sex. Of all eligible patients, 93% were interviewed. Increased risks were seen with alcohol consumption and, less strongly, with smoking, which for all sites could be adequately fitted by either a multiplicative or an additive model. However, the site-specific relationships were different, alcohol consumption being significantly associated only with oral cavity, pharyngeal and extrinsic laryngeal tumours, and smoking only with intrinsic laryngeal tumours. Increased risks were associated with low socio-economic status, the unmarried state, and poor dental care. No significant associations were seen with specific occupational exposures (385) Frank F. [Functional voice disorder in singers and its sonographic analysis]. Folia Phoniatr (Basel) 1984;36:250-256. Ref ID: 237 (386) Henley-Cohn JL, Hausfeld JN, Jakubczak G. Artificial larynx prosthesis: comparative clinical evaluation. The Laryngoscope 1984;94:43-45. Ref ID: 446 Abstract: The work pioneered by Drs. Singer and Blom established the clinical feasibility of controlled tracheoesophageal fistula for generation of fluent esophageal speech. There have been numerous practical difficulties that have been encountered with the use of voice prosthesis. Problems encountered are: extrusion, speech initiation delay, leakage around the prosthesis, stoma obstruction, and low volume output. A second generation laryngeal prosthesis is introduced for comparison. Its design incorporates features that will significantly improve the clinical problems encountered; extrusion is minimized; and the new prosthesis allows for one size to fit all patients. A clinical trial was established to directly compare the artificial speech generated by the currently existing laryngeal prosthesis. Each laryngectomy patient was fitted with three different devices and the resulting speech was evaluated. Video recordings of patients are presented to illustrate the type of speech produced by each device. Comparisons of intelligibility, fluency, volume, and patient preference are made. Results indicate that a significant variation in the speech obtained is critically dependent on the choice of prosthesis (387) Lavrova EV, Taptapova SL, Ermakova II. [Importance of phoniatrics in rehabilitating patients with functional voice disorders]. Vestn Otorinolaringol 1984;55-59. Ref ID: 235 (388) Olsen J, Sabroe S, Lajer M. Welding and cancer of the larynx: a case-control study. Eur J Cancer Clin Oncol 1984;20:639-643. Ref ID: 236 Abstract: The purpose of the study was to examine the occupational history of laryngeal cancer patients, and especially their exposure to welding. The investigation was conducted as a case-control study where all newly diagnosed patients less than 75 yr of age with cancer of the larynx in Denmark during March 1980 to March 1982 were selected as cases. For each case, four age- and sex-matched controls were identified from the municipal person register in which the case was listed. Data were collected partly by means of questionnaires and partly by abstracting information from the medical records of cases. Workers exposed to welding fumes had a slightly increased risk of cancer of the larynx, most predominantly of cancer of the subglottic area (389) Cowles SR. Cancer of the larynx: occupational and environmental associations. South Med J 1983;76:894-898. Ref ID: 241 Abstract: This paper briefly reviews the available evidence for the influence of environmental and occupational factors in the development of cancer of the larynx. Although several occupational exposures have been suggested to play a role in the etiology of this disease, few have been convincingly confirmed. The strong association between smoking and cancer of the larynx, the weaker but still important association between alcohol consumption and cancer of the larynx, and the strong synergism between the two is emphasized. Other accepted or suspected environmental and occupational factors are also discussed (390) Dejonckere P. Voice, Occupational Diseases Of The. 1983. 137 Ref ID: 500 Abstract: Occupational diseases affecting the voice are reviewed. Some occupational diseases of the voice pertain to conditions of the sound producing organs. Apart from traumas, these are most often impairments of the larynx. Other occupational diseases involve the vocal function. These cover occupations where the use of the voice is preponderant, from teachers to opera singers. The voice most likely to contract diseases of the vocal function is the projected voice. In most cases these diseases occur without a primary permanent lesion, but with a disorder of muscle tone or coordination of the vocal apparatus. Such functional disorders may result from adoption of a faulty vocal habit or emotional perturbation frequently related to the occupation. In some instances a psychosomatic vocal disorder allows an individual to unconsciously avoid the responsibilities a normal voice would bring. Particular conditions resulting in voice disorders may include hyperemia of the free edges of the vocal cords, vasomotor chorditis, and nodules and polyps of the vocal cords. In addition to the common types of nodules and polyps, laryngeal contact ulcers and hyperplasia of the vestibular folds are seen. A common denominator of subjective symptoms is fatigability of the voice and aggravation of symptoms after vocal effort. Pharmacological treatment is secondary to vocal rest. Reeducation of vocal habits is generally required. For some conditions, surgery is indicated. Knowledge of vocal physiology and of laryngeal hygiene should be included in training for occupations using the voice extensively. The author concludes that, at early signs of vocal strain, the subject should reduce vocal output and moderate it (391) Feder RJ. Noise pollution as factor in voice disorders. Otolaryngol Head Neck Surg 1983;91:469. Ref ID: 239 (392) Feder RJ. Varix of the vocal cord in the professional voice user. Otolaryngol Head Neck Surg 1983;91:435-436. Ref ID: 240 Abstract: Singers and actors who abuse their voices may develop either polyps, nodules, contact ulcers, and/or contact granuloma. Rarely a vascular lesion consisting of a hypertrophic vessel projecting above the medial or superior mucosal surface of the vocal cord is encountered that may contain a small knucklelike deformity. Clinically this is not dissimilar in appearance to a vessel found on the anterior nasal septum that is responsible for epistaxis. When the voice is strained, these vessels can rupture, causing recurrent submucosal hemorrhages in the professional voice user. The case described is that of a well-known actress in whom vocal abuse did not produce a submucosal hemorrhage from the varix but rather an edematous change and symptoms identical to those of a soft, early vocal cord nodule (393) Ibragimova SI, Teleliaeva LM. [Vocal nodules: diagnosis, clinical manifestations and treatment]. Vestn Otorinolaringol 1983;44-47. Ref ID: 238 (394) Kazhlaev OM, Butusov AD. [Determination of the vocal field in singers with laryngeal diseases]. Vestn Otorinolaringol 1983;55-59. Ref ID: 242 (395) Neng RW, Siao CY. Roentgenological measurement of physiological vocal cord length. An analysis of 59 opera singers. Folia Phoniatr (Basel) 1983;35:289293. Ref ID: 243 (396) Punt NA. Laryngology applied to singers and actors. J Laryngol Otol Suppl 1983;6:1-24. Ref ID: 244 (397) Sataloff RT. Physical examination of the professional singer. J OTOLARYNGOL 1983;12:277-281. Ref ID: 406 Abstract: Examination of the professional singer must include an assessment of his general health and a thorough ear, nose, and throat evaluation. However, the physical examination can reveal much more than simply the appearance of the singer's vocal cords. The physician must be attuned to the singer's use of his speaking voice. Examination of actual singing allows specific observations that may substantiate a diagnosis of voice abuse or may guide the physician in his selection of therapy (398) Sidenius K, Sorensen HH, Svane O. Cancer of the larynx among metal workers. Accumulation of cases of cancer of the larynx in a machine factory in Copenhagen. UGESKR LAEG 1983;145:1623-1628. Ref ID: 410 Abstract: During the years 1971-76, five metal workers in an average-sized machine factory in Copenhagen developed cancer of the larynx. This represents an increased incidence of 114 times the anticipated figure. The suspicion therefore arose whether an increased risk of cancer of the larynx is present among metal workers in general and whether a particularly great risk is present among workers in a machine factory. Although only two out of the five workers with cancer of the larynx had worked in the present machine factory over ten years and all five had worked with different working procedures, the suspicion of a particularly great risk of developing cancer of the larynx must be maintained because all five worked in the same room with a great mixture and circulation of atmospheric pollution. Measurements revealed that known cancer-provoking substances such as chromium and nickel were present everywhere. These originated mainly from welding of stainless steel. Only a minority of Danish metal industries work with this. The occurrence of several cancer-provoking substances in the factory cannot be excluded as the methods of measurement and the present knowledge of cancer-provoking substances is limited. The consequences of the above findings are primarily that the Factory Supervision Authorities issue instructions that the atmospheric pollution be reduced to values far under the upper limits both in the factory and in all other metal industries. The present hygienic limits do not protect the workers from the risk of cancer. The ideal solution, however, would be to eliminate cancer-provoking substances entirely from the materials involved. Secondly, the necessity for further research is emphasized. The newly-developed mutagenic tests on microorganisms must be emphasized particularly as screening methods for advance assessment of cancer-provoking properties in substances and combinations of substances. Animal experiments are necessary for further testing of suspect substances. Epidemiologial investigations in man may reveal cancer risks under the influence of certain substances, working processes or types of jobs, although several decades of exposure must elapse before these are evident. As 139 'experiments' such as these occur in practically every occupation, epidemiological investigations will still be necessary. The occurrence of cancer of the larynx forms the basis for an epidemiological investigation of the risk of developing cancer of the larynx among metal workers in the processing of stainless steel (399) Jackson MC. [The voice of the young singer]. Folia Phoniatr (Basel) 1982;34:276-280. Ref ID: 245 (400) Vasilenko I, Kazhlaev OM. [Occupational diseases of the larynx in vocalists]. Vestn Otorinolaringol 1982;60-64. Ref ID: 246 (401) Apol AG. Health Hazard Evaluation Report No. HETA-81-090-997, Publishers Paper Company, Newberg, Oregon. 1981. Ref ID: 501 Abstract: Environmental air was analyzed for sulfuric-acid (7664939), sulfurdioxide (7446095) and phosphates, and noise level measurements taken, at the Publishers Paper Company (SIC-2621) in Newburg, Oregon, on April 14 to 16, 1981. A representative of the Association of Western Pulp and Paper Workers requested the evaluation to determine if vocal cord nodules experienced by two of four paper machine tenders were caused by their exposure to a combination of chemicals and high noise. Sulfur-dioxide concentrations ranged from about 0.01 to 0.95 parts per million (ppm) compared with the NIOSH standard of 0.5ppm. Sulfuric-acid concentrations ranged from about 0.01 to 0.06 milligrams per cubic meter (mg/Cum), compared with the NIOSH standard of 1mg/Cum. Concentrations of phosphates ranged from less than 0.01 to 0.16mg/Cum. All workers on the paper machine had 8 hour equivalent potential noise exposure that ranged from 94 to 101 decibels on the A-weighted scale (dBA), compared with the NIOSH recommended criteria of 85dBA. The author concludes that there may be a relationship between the occurrence of vocal cord nodules and exposure to high noise levels and respiratory irritants. He recommends raising the pH level of the pulp liquor, use of air supplied respirators, use of an electric communication system, and medical examination of workers experiencing persistent hoarseness (402) Apol AG. HHE Report No. HETA-81-090-997, Publishers Paper Company, Newberg, Oregon. 1981. HETA-81-090-997. Ref Type: Generic Ref ID: 502 Abstract: Environmental air was analyzed for sulfuric-acid (7664939), sulfurdioxide (7446095) and phosphates, and noise level measurements taken, at the Publishers Paper Company (SIC-2621) in Newburg, Oregon, on April 14 to 16, 1981. A representative of the Association of Western Pulp and Paper Workers requested the evaluation to determine if vocal cord nodules experienced by two of four paper machine tenders were caused by their exposure to a combination of chemicals and high noise. Sulfur-dioxide concentrations ranged from about 0.01 to 0.95 parts per million (ppm) compared with the NIOSH standard of 0.5ppm. Sulfuric-acid concentrations ranged from about 0.01 to 0.06 milligrams per cubic meter (mg/Cum), compared with the NIOSH standard of 1mg/Cum. Concentrations of phosphates ranged from less than 0.01 to potential noise exposure that ranged from 94 to 101 decibels on the A-weighted scale (dBA), compared with the NIOSH recommended criteria of 85dBA. The author concludes that there may be a relationship between the occurrence of vocal cord nodules and exposure to high noise levels and respiratory irritants. He recommends raising the pH level of the pulp liquor, use of air supplied respirators, use of an electric communication system, and medical examination of workers experiencing persistent hoarseness (403) Burch JD, Howe GR, Miller AB, Semenciw R. Tobacco, alcohol, asbestos, and nickel in the etiology of cancer of the larynx: A case-control study. J NATL CANCER INST 1981;67:1219-1224. Ref ID: 352 Abstract: A case control study of laryngeal cancer was conducted in southern Ontario between 1977 and 1979 with 204 subjects with newly diagnosed cancer and 204 controls, individually matched by sex, age, and residence. Tobacco products and alcohol showed strong associations with cancer of the larynx for males, with relative risks (RR) for users of cigarettes, cigars or cigarillos, pipes, and alcohol of 6.1, 2.9, 1.6, and 5.2, respectively. the population attributable risk percent for males using tobacco products and alcohol together was estimated to be 94%. Cigarette smoking was also an important risk factor for females, although the small number of female pairs (20) precluded any meaningful detailed analysis of other possible risk factors. The RR for males for exposure to asbestos after the effects of cigarette smoking were controlled was 2.3, and the effects seemed restricted to cigarette smokers. The findings on asbestos were based on small numbers of cases and controls exposed and consequently were subject to large sampling errors. The estimate was consistent, however, with that from other studies and supported a causal role for asbestos exposure and cancer of the larynx. The RR for males for exposure to nickel was 0.9 (404) Manning KP, Skegg DC, Stell PM, Doll R. Cancer of the larynx and other occupational hazards of mustard gas workers. Clin Otolaryngol Allied Sci 1981;6:165-170. Ref ID: 247 Abstract: An attempt was made to tract 511 men and women who manufactured mustard gas during the 1939--1945 war. Despite limitations in the identifying data available, 428 (84%) were traced to the end of 1974. The numbers of deaths from all neoplasms combined (45) and from all other causes (136) were slightly greater than those expected from national death rates, but not significantly so. Two deaths were attributed to carcinoma of the larynx and one to carcinoma of the trachea, compared with an expected number of 0.40 (P less than 0.02). Carcinoma of the larynx was also mentioned on the death certificate of another man. Seven subjects are known to have developed cancer of the larynx, compared with 0.75 expected (P less than 0.001). Excess mortality was also observed from cancer of the lung, pneumonia and accidents, but the excesses were small and difficult to interpret (405) Sataloff RT. Professional Singers: The Science and Art of Clinical Care. 1981. Ref ID: 503 Abstract: Clinical care for professional singers was reviewed. The parts of the body, including the larynx, supraglottic vocal tract, tracheobronchial tree, 141 lungs, thorax, abdomen, musculoskeletal system, and psychoneurological system, involved in singing were discussed. The effects of age on the voice producing mechanisms were considered. The treatment of voice problems was reviewed. The need to consider the importance that the singer places on upcoming concerts and the consequences of cancelling engagements, as well as on his voice in his long term career plans, when choosing a treatment program for voice disorders was discussed. The effect of factors such as amount and nature of vocal training, type of singing environment, rehearsal techniques, vocal abuse, general health, endocrine dysfunction, exposure to irritants and tobacco smoke, alcohol and drug abuse, and certain foods on tone production were discussed. Diagnosis and treatment for reflux laryngitis, anxiety, muscle problems, voice abuse, vocal nodules, upper respiratory tract infection, and laryngitis with and without serious vocal cord injury were reviewed. Drugs used for treating vocal dysfunction were described. Voice maintenance was considered. The author concludes that excellent regular training and practice and avoiding irritants such as smoke are essential in preventing vocal dysfunction in professional singers (406) Duclos JC, Dubreuil C, Faure MA. [Noise and the larynx]. J Fr Otorhinolaryngol Audiophonol Chir Maxillofac 1980;29:605-607. Ref ID: 248 (407) Krahulec I. [The voice after microsurgical procedures on the vocal cords in voice professionals]. Cesk Otolaryngol 1980;29:220-222. Ref ID: 249 (408) Newhouse ML, Gregory MM, Shannon H. Etiology of carcinoma of the larynx. IARC Sci Publ 1980;687-695. Ref ID: 253 Abstract: Since 1973, evidence based on case-control and mortality studies has suggested that carcinoma of the larynx was an asbestos-related tumour. In this study, 305 male and 206 female patients were interviewed on admission to the Royal National Throat Nose and Ear Hospitals in London. Following endoscopy, biopsy material was reviewed and classified as either neoplastic, cysts and polyps or inflammatory; a fourth group consisted of patients for whom the surgeon recorded that the larynx appeared normal on inspection and from whom no biopsy was taken. Only 15 neoplastic conditions were detected among the women, and only two had asbestos exposure; thus, no further analysis was made. Among the males, the neoplastic group was significantly older than the other groups, and cigarette smoking was significantly more common. Alcohol consumption did not differ significantly; and asbestos exposure was not more common in the neoplastic group than in the three other groups (409) Otto B, Klajman S, Koldej E, Otto-Sternal W. An analysis of the relation between dysphonia in shipyard workers and working in noise. Bull Inst Marit Trop Med Gdynia 1980;31:185-192. Ref ID: 252 (410) Roggli VL, Greenberg SD, McLarty JL. Asbestos body content of the larynx in asbestos workers. A study of five cases. ARCH OTOLARYNGOL 1980;106:533535. Ref ID: 399 Abstract: Occupational exposure to asbestos has been epidemiologically associated with carcinoma of the larynx; however, no search for or quantitation of laryngeal asbestos bodies has been performed. This report concerns an autopsy study of 5 patients with occupational asbestos exposure and proven asbestos-associated pulmonary disease in whom histologic sections of the larynx were examined and a digestion- concentration technique was used to isolate and quantitate the asbestos bodies in the remaining laryngeal tissues. No dysplastic epithelial changes were present in the mucosa. Asbestos bodies were recovered from 2 of the 5 larynges but from none of 10 larynges obtained from autopsy controls (411) van Deinse JB. [The instrument of singers and actors]. Ned Tijdschr Geneeskd 1980;124:1159-1162. Ref ID: 250 (412) Vineis P, Pastore G, Aimone G, Costa G, Masiero C. [Incidence and age of onset of larynx, bladder and infantile tumours in the Province of Turin in relation to industrial development(author's transl)]. Med Lav 1980;71:119131. Ref ID: 251 (413) Noisy work situations may impair vocal cords. JAMA 1979;241:2133. Ref ID: 256 (414) Berci G, Katz R. Optical stylet: an aid to intubation and teaching. Ann Otol Rhinol Laryngol 1979;88:828-831. Ref ID: 254 Abstract: An optical stylet was developed which can be inserted into an endotracheal tube, and the passage through the vocal cords and position of the cuff in the trachea could be controlled visually. It is of great help in difficult intubations in adults and children. It became an invaluable tool in teaching endotracheal intubation by coupling a teaching attachment (beam splitter) to theoptical system. The operator and the second observer (student) can see the actual manipulations simultaneously (415) Bernfeld P, Homburger F, Russfield AB. Cigarette smoke-induced cancer of the larynx in hamsters (CINCH): a method to assay the carcinogenicity of cigarette smoke. Prog Exp Tumor Res 1979;24:315-319. Ref ID: 258 (416) Bogdan C, Hociota D, Ciobotaru G. Functional dysphonias in the framework of occupational diseases. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Otorinolaringol 1979;24:125-130. Ref ID: 349 (417) Rontal E, Rontal M, Jacob HJ, Rolnick MI. Vocal cord dysfunction - an industrial health hazard. Ann Otol Rhinol Laryngol 1979;88:818-821. Ref ID: 255 Abstract: Vocal cord dysfunction has a definite incidence of association with high environmental noise levels. Our study has shown roughly an 8% incidence of vocal cord dysfunction (vocal cord nodules, vocal cord polyps and chronic laryngitis) in individuals working in high noise environments. In addition, those individuals who have surgery for vocal cord nodules and who 143 work in high noise environments will have over a 30% incidence of recurrent vocal cord dysfunction following surgery. Our study indicates that females tend to be more at risk in high noise environments than males (418) Siegert C. [Results of clinical and experimental studies on the strain of the organ of voice in noise]. Otolaryngol Pol 1979;33:623-634. Ref ID: 257 (419) Anikeeva ZI. [Treatment of pathological processes of the larynx in persons with vocal and speech occupations]. Zh Ushn Nos Gorl Bolezn 1978;27-29. Ref ID: 263 (420) Bianchi C, Di BL, Castelli M, Brollo A. [Exposure to asbestos in cancer of the larynx]. Pathologica 1978;70:403-408. Ref ID: 262 (421) Coleman RF, Mott JB. Fundamental frequency and sound pressure level profiles of young female singers. Folia Phoniatr (Basel) 1978;30:94-102. Ref ID: 264 (422) Nebes RD. Vocal Versus Manual Response as a Determinant of Age Difference in Simple Reaction Time. Por buscar 1978. Ref ID: 511 Abstract: The determination of how much of the discriminative reaction time (RT) difference between young and old persons could be accounted for by an age difference in psychomotor latency is discussed. The cumulative percentage of young and old subjects achieving a given RT is shown. It was found that 50% of the older subjects and 45% of the younger subjects had a mean total vocal latency of 333msec or less. The distributions of the young and old subjects' latencies were quite similar with the old tending to have shorter vocal reaction times than the young. There was no evidence that the young and old subjects differed in the speed with which they could initiate a vocal response to a visual stimulus. A preliminary analysis showed no interaction between the effect on reaction time produced by the length of the preparatory interval and that of any other variable, including age. The existence of a significant age difference in simple psychomotor latency depended upon the nature of the subjects' response. Results suggest that slowing psychomotor latency with age is not a general phenomenon, but may be limited to certain neural systems. It was also shown that respiratory muscles show little of the age related trophic changes which are seen in other muscles, including those of the limb (423) Paetzel P. VOCAL CHORD DISEASE FOLLOWING HEAVY EXPOSURE TO BAGASSE (SUGAR CANE RESIDUE) DUST. ZENTRALBLATT FUER ARBEITSMEDIZIN ARBEITSCHUTZ UND PROPHYLAXE 1978. Ref ID: 512 (424) Paetzel P. [Vocal cord disease following heavy exposure to bagasse dust]. Zentralbl Arbeitsmed Arbeitsschutz Prophyl 1978;28:349-351. Ref ID: 259 (425) Perekrest AI, Kudrin VA, Kopirovskij KM, Tysler EJu, Kirpicnikov AB. The laryngeal disease hazard in telephone operators. Por buscar 1978. Ref ID: 513 Abstract: Results of medical examinations of 169 telephonists and, as controls, 253 telegraph operators working under the same microclimatic conditions, to study the incidence of chronic laryngitis and absenteeism. Occupational overloading of the vocal apparatus gives rise to a much higher incidence of chronic laryngitis in telephonists, and abseenteeism due to acute laryngitis or chronic laryngotracheitis was several times that found in the control group. Telephone operators with a predisposition to laryngeal disease should be transferred to a different job (426) Prokhorov AA, Perekrest AI, Kudrin VA. Some problems concerned with the risk of the larynx affections in telephone operators. GIG TR PROF ZABOL 1978;22:16-19. Ref ID: 396 Abstract: A clinico-hygienic investigation was carried out which showed the major adverse factor (as to the condition of the upper respiratory tract) in telephone operators to be an intensive vocal effort in the course of their work. Because of this, they more often suffer from chronic laryngitis and the incidence of acute and chronic layryngitis (laryngotracheitis) among them is many times as high as among telegraphists working in identical microclimatic conditions. For this reason, intensive vocal efforts are considered to be one of the major factors in the etiology of laryngitis among telephone operators. A number of measures aimed at preventing chronic laryngitis in telephone operators are proposed (427) Rodin VI, Boenko SK. [Occupational diseases of the larynx]. Zh Ushn Nos Gorl Bolezn 1978;72-74. Ref ID: 260 (428) Wolf O. [Cancer of the larynx in naphthalene cleaners]. Z Gesamte Hyg 1978;24:737-739. Ref ID: 261 (429) Wolf O. Carcinoma of the larynx among naphthalene cleaners. Z GESAMTE HYG IHRE GRENZGEB 1978;24:737-739. Ref ID: 424 Abstract: Cancer of the larynx has primarily exogenous causes. The number of notices expressing a suspicion on an occupational disease is small. Report of 4 laryngeal carcinomas in a group totalling only 15 naphthalene cleaners. This represents a significantly high incidence. In the sense of a syncarcinogenesis chronic irritation of the mucous membrane, the effects of heat, coal-teer fumes and cigarette smoke are to blame. Where corresponding symptoms arise retraining should always be borne in mind of an occupational malignom disease (430) Barth V. Magnifying laryngostroboscopy. HNO 1977;25:35. Ref ID: 342 Abstract: A procedure for stroboscopic observation of vocal cord vibrations by means of a magnifying laryngoscope is reported. In addition, the clinical problems which can be managed successfully by this procedure are discussed (431) Bittersohl G. On the problem of asbestos induced carcinoma of the larynx. Z GESAMTE HYG IHRE GRENZGEB 1977;23:27-30. 145 Ref ID: 346 Abstract: The author analyses the cases of carcinoma of the larynx occurring in the district of Merseburg in the period from 1966 to 1975 in connection with asbestos exposure. It is shown that neither the total number nor the separate age groups deviate from the overall statistics of the GDR. No significant accumulation of cases can be confirmed in separate branches of the economy or factories. For this reason recognition of carcinoma of the larynx as an occupational disease will have to continue being given on the merits of each individual case, taking into account also other factors pointing to asbestos exposure. The presence of other signs, such as hyalinoses or fibroses, are regarded as evidence in support of asbestos exposure. But further epidemiological studies will have to be conducted in order to arrive at a definitive conclusion establishing the coincidence between carcinoma of the larynx and asbestos exposure (432) Freifeld S. Asbestos exposure and laryngeal carcinoma. JAMA 1977;238:1280. Ref ID: 266 (433) Price JH, Thoburn TW. HHE Determination, Report No. HHE-76-60-398 HayesAlbion Corporation, Wolverine Plastics Division, Milan, Michigan. 1977. HHE76-60-398. Ref Type: Generic Ref ID: 505 Abstract: A Health Hazard Evaluation investigation was conducted by NIOSH at the Hayes-Albion Corporation, Wolvering Plastics Division , Milan, Michigan, on May 5-7 and August 29 to September 2, 1976, acting on a request from an authorized employee representative regarding exposure of workers to organic solvents, isocyanates, and thermal degradation products from injection molding of thermoplastics(SIC- 3079). The request stated that some of the about 200 affected employees were developing nodes on their vocal cords, that there were a number of unexplained blood clots, and suggestion of tumors. Results of environmental sampling indicate that employees were not exposed to airborne contaminants at toxic concentrations during the survey. Medical evaluation showed no basis for relating the cases of thrombophlebitis and vocal cord nodules to chemical exposures. The evaluation did reveal possible problems with contact dermatitis from organic solvents, plastics, and jewelry. Other problems mentioned during employee interviews include breathing difficulties from isocyanate paints used in the past, and an obscure labyrinthine disorder possible associated to ultrasonic welding exposures. Recommendations are made for improved work practices (434) Price JH, Thoburn TW. Health Hazard Evaluation Determination, Report No. HHE-76-60-398 Hayes-Albion Corporation, Wolverine Plastics Division, Milan, Michigan. 1977. Ref ID: 504 Abstract: A Health Hazard Evaluation investigation was conducted by NIOSH at the Hayes-Albion Corporation, Wolvering Plastics Division , Milan, Michigan, on May 5-7 and August 29 to September 2, 1976, acting on a request from an authorized employee representative regarding exposure of workers to organic solvents, isocyanates, and thermal degradation products from injection molding of thermoplastics(SIC-3079). The request stated that some of the about 200 affected employees were developing nodes on their vocal cords, that there were a number of unexplained blood clots, and suggestion of tumors. Results of environmental sampling indicate that employees were not exposed to airborne contaminants at toxic concentrations during the survey. Medical evaluation showed no basis for relating the cases of thrombophlebitis and vocal cord nodules to chemical exposures. The evaluation did reveal possible problems with contact dermatitis from organic solvents, plastics, and jewelry. Other problems mentioned during employee interviews include breathing difficulties from isocyanate paints used in the past, and an obscure labyrinthine disorder possible associated to ultrasonic welding exposures. Recommendations are made for improved work practices (435) Vasilenko I. [Development of phoniatrics in the USSR over the last 60 years]. Vestn Otorinolaringol 1977;82-90. Ref ID: 265 (436) Ezerskii R. [Cancer of the larynx in miners]. Zh Ushn Nos Gorl Bolezn 1976;83-84. Ref ID: 267 (437) Komiakov SE. [Treatment of non-approximation of vocal folds in singers by means of a method causing narrowing of the larynx entrance]. Zh Ushn Nos Gorl Bolezn 1976;51-55. Ref ID: 268 (438) Guidotti TL, Abraham JL, DeNee PB. Letter: Asbestos exposure and cancer of the larynx. West J Med 1975;122:75. Ref ID: 273 (439) Lacina O. [Hypothesis for one cause of vocal cord nodules in alto singers]. Folia Phoniatr (Basel) 1975;27:321-324. Ref ID: 271 (440) Shipp T, Izdebski K. Letter: Vocal frequency and vertical larynx positioning by singers and nonsingers. J Acoust Soc Am 1975;58:1104-1106. Ref ID: 269 (441) Smulevich VB, Livshits GS. [Chronic diseases of the larynx in municipal transport drivers]. Vestn Otorinolaringol 1975;75-76. Ref ID: 270 (442) Spalajkovic M, Mitrovic K. [Participation of occupational factors on the incidence of carcinoma of the larynx]. Med Pregl 1975;28:245-247. Ref ID: 272 (443) Walsh FM, Castelli JB. Polytef Granuloma Clinically Simulating Carcinoma of the Thyroid. 1975. Ref ID: 506 Abstract: A case occurred in which polymerized tetrafluoroethylene (116143) (polytef), injected into the larynx, induced a mass near the thyroid that was clinically judged malignant. Polytef was injected into the larynx of a 42 year old male patient with a 3 month history of hoarseness resulting from idiopathic left vocal cord paralysis. After the injection the patient's voice improved, but about 10 days later he developed abdominal pain and vomiting, and the hoarseness recurred. Thyroid scan revealed a cold nodule suggesting 147 localization in the superior pole of the left lobe. Before the neck mass could be biopsied, it was found that the patient had adenocarcinoma of the ileum with intraabdominal lymph node metastases. He died 6 months later. Autopsy revealed that some of the polytef had been injected into an extracordal site with penetration into adjacent soft tissue of the neck via the cricothyroid membrane. The foreign body reaction was marked and created a mass 2.3 by 1.5 centimeters, which produced a pressure atrophy of the superior portion of the left lateral thyroid lobe. The radioisotope findings of the cold nodule corresponded to the area of the mass, thus suggesting a malignant neoplasm of the thyroid (444) Boehme G. Occupational vocal disorders. MUNCH MED WOCHENSCHR 1974;116:1721-1726. Ref ID: 348 Abstract: Numerous occupations demand an optimal speaking capacity. If occupational vocal disorders (occupational dysphonias) occur, these impair interpersonal communication and professional performance. Vocal disorders in and as a result of vocal professions must be differentiated. In general, an increased frequency of professional dysphonia is to be observed because numerous new occupational groups demand intensive speech performances. The findings are largely polysymptomatic and may include psychogenic disturbances. Questions of treatment, professional ability and prognosis are discussed (445) Carroll C. Longevity of vocal careers. Folia Phoniatr Basel 1974;26:293-294. Ref ID: 355 (446) Libshitz HI, Wershba MS, Atkinson GW, Southard ME. Asbestosis and carcinoma of the larynx. A possible association. JAMA 1974;228:1571-1572. Ref ID: 275 (447) Morris RJ, Suckerman KR. Therapist warmth as a factor in automated systematic desensitization. Journal of consulting and clinical psychology 1974;42:244-250. Ref ID: 451 (448) Tronczynska J, Sulkowski W. Diagnostic and certification criteria in professional voice diseases in the light of personal studies (Polish). Med Pr 1974;25:437-444. Ref ID: 420 Abstract: An account is given of the most frequently encountered functional disturbances and morphologic changes resulting from professional use of the vocal organ and their etiology. To depict the variability of the clinical picture 106 cases of voice disorders connected with the exercising of professions are analyzed, the individuals being placed in groups depending upon profession, age, sex, duration of complaints and diseases diagnosed. The medicolegal regulations for certifying the professional character of diseases of the vocal organ reducing the working ability and prophylactic action to be taken are cited (449) Zenk H. Occupational effects on the larynx. Z ARZTL FORTBILD 1974;68:1215-1220. Ref ID: 426 Abstract: An expose of the accidental and occupational damage of the larynx, with emphasis on the causes and indications for prophylactic measures, is given. The possibility of the recognition of certain diseases of the larynx as occupational disease is discussed. In addition to traumas, which increase in frequency primarily due to traffic accidents, the mechanical, chemical and physical effects on the larynx are dealt with. Attention is given to the importance of allergic processes in the larynx with their diagnostic problems in the occupational disease procedures. The most important infectious diseases caused by occupational activities are discussed, and the professional disturbances of the voice are explained, the diagnosis of which was made perfect by the development of phoniatrics. In the social prognosis of the prophylaxis and diagnosis of occupational laryngeal diseases, importance is to be attributed to the tactful collection of data on the occupational history of the insured patient, the working milieu, and the functional diagnosis; this requires a close cooperation between occupational medicine and E.N.T. specialists (450) Zenk H. [Effects of occupations on the larynx]. Z Arztl Fortbild (Jena) 1974;68:1215-1220. Ref ID: 274 (451) Chumakov FI. [Some symmetrical benign tumors and pseudotumors of the vocal cords]. Zh Ushn Nos Gorl Bolezn 1973;33:76-78. Ref ID: 281 (452) Lacina O. [Singer's unilateral hyperemic vocal lip]. Folia Phoniatr (Basel) 1973;25:325-330. Ref ID: 282 (453) Punt NA. Management of ENT disabilities of singers. Proc R Soc Med 1973;66:1073-1075. Ref ID: 277 (454) Shapiro SL. On the management of professional voice disorders. Eye Ear Nose Throat Mon 1973;52:328-331. Ref ID: 280 (455) Urbanova O. [Bleeding into vocal cords in hyperkinetic dysphonia and its consequences]. Cesk Otolaryngol 1973;22:346-348. Ref ID: 276 (456) van D, Berg JP. Remarks on the treatment of singer's nodes. LOGOPEDIE FONIAT 1973;45:109-116. Ref ID: 421 Abstract: Singer's nodes are small thickenings localized at the junction of the anterior and middle thirds of the vocal cords. They are frequent conditions which are not due to inflammation but to excessive use of the voice. This mechanical factor in straining the voice has a traumatic effect on the larynx. The prognosis of singer's nodes has been considerably improved by associating microsurgery with postoperative speech training. Quicker and better results are attained, with complete recovery of the voice. The intervention is harmless and can be advised for all forms of nodules of the vocal cords 149 (457) Vasilenko I, Tokman AS. [Occupational orientation and occupational choice of persons who intend to work in voice-speech professions]. Vestn Otorinolaringol 1973;35:47-50. Ref ID: 278 (458) Vasilenko I. [Vasomotor monochorditis in persons whose occupation requires the use of voice]. Vestn Otorinolaringol 1973;35:77-80. Ref ID: 279 (459) Frenkil J. Maryland's Occupational Disease Board. Md State Med J 1972;21:16-18. Ref ID: 284 (460) Lacina O. [Occurrence of vocal cord nodules in singers]. Folia Phoniatr (Basel) 1972;24:345-354. Ref ID: 286 (461) Symanski H. Current Thoughts on the Occupational Diseases Register. 1972. Ref ID: 507 Abstract: In the Federal Republic of Germany a register of occupational diseases is maintained on the basis of which workers qualify for indemnification. A number of diseases are considered for inclusion on the list based on experience in Germany and other countries. These include, byssinosis, farmer's lung, malignomas of the respiratory organs, vibration diseases, chronic bronchitis, vocal cord nodule, noise effects other than hearing disorders, degenerative meniscus damage of soccer players, laser ray damage, and damage done by isocyanate and dimethylformamide. The question of whether accident insurance should be replaced by a uniform insurance of all diseases and health damage, regardless of cause, is a multifactorial problem. (German; English translation available) (462) Vasilenko I. [Occupational voice disorders in tour guides]. Zh Ushn Nos Gorl Bolezn 1972;32:13-18. Ref ID: 285 (463) Vasilenko I. [Diseases of the vocal apparatus in teachers of kindergartens and nurseries]. Zh Ushn Nos Gorl Bolezn 1972;32:21-25. Ref ID: 283 (464) Batza EM. Vocal abuse in rock-and-roll singers. Report of five representative cases. Cleve Clin Q 1971;38:35-38. Ref ID: 294 (465) Habermann G. [Vocal diseases of singers]. HNO 1971;19:129-137. Ref ID: 290 (466) Hirano M, Miyahara T, Miyagi T, Kunitake H, Nagashima T. [Vocal regulation in singing--an experimental study on a vocalist]. Nippon Jibiinkoka Gakkai Kaiho 1971;74:1189-1201. Ref ID: 289 (467) Kleinsasser O. [Granulomatous pseudoblastomatous laryngitis]. Arch Klin Exp Ohren Nasen Kehlkopfheilkd 1971;199:724-726. Ref ID: 293 (468) Lebedeva NF, Kriukova NA. [Detection of allergic reactivity in professional singers]. Vestn Otorinolaringol 1971;33:51-55. Ref ID: 288 (469) van Deinse JB. [Voice disorders in singers]. Pract Otorhinolaryngol (Basel) 1971;33:352-354. Ref ID: 292 (470) Vasilenko I. [Laryngeal diseases in teachers (according to patient and screening data)]. Vestn Otorinolaringol 1971;33:5-10. Ref ID: 287 (471) Zboril M, Nozicka Z. [Histological and clinical diagnosis of the singers' nodes and of the polyps of the vocal cords]. Cesk Otolaryngol 1971;20:56-59. Ref ID: 291 (472) Gerasimova SS, Konovalov PF. [Electromyographic analysis of the functional status of the vocal muscles in persons in vocal professions]. Vestn Otorinolaringol 1970;32:27-30. Ref ID: 295 (473) Lacina O. [Adduction asymmetry of the larynx in singers (Asymmetria arytaenoidea cruciata cantatorum)]. Folia Phoniatr (Basel) 1970;22:100-106. Ref ID: 297 (474) Zenk H. [Occupational laryngeal carcinoma from the viewpoint of expert testimony]. Z Laryngol Rhinol Otol 1970;49:100-108. Ref ID: 296 (475) Giulev A, Cholakov I. [Our method of medical prophylactic observation of precancerous conditions of the larynx and the early detection of their malignant degeneration]. Folia Med (Plovdiv ) 1969;11:222-226. Ref ID: 301 (476) Imre V. [Medical problems of voice evaluation and treatment in actors and singers]. Monatsschr Ohrenheilkd Laryngorhinol 1969;103:468-471. Ref ID: 300 (477) Profazio A, Di FS. [Acoustic trauma in singers]. Otorinolaringol Ital 1969;37:337-346. Ref ID: 298 (478) Sedlackova E, Suntych F. [Evaluation of occupational voice disorders]. Cesk Otolaryngol 1969;18:161-168. Ref ID: 299 (479) Holinger PH, Schild JA, Maurizi DG. Internal and external trauma to the larynx. Laryngoscope 1968;78:944-954. Ref ID: 305 (480) Punt NA. Vocal disabilities of singers. Applied laryngology--singers and actors. 151 Proc R Soc Med 1968;61:1152-1155. Ref ID: 302 (481) Trinos LA. [Effect of vocal loads on the function of the vocal apparatus in professional singers of various ages]. Zh Ushn Nos Gorl Bolezn 1968;28:5562. Ref ID: 304 (482) Zilstorff K. Vocal disabilities of singers. Proc R Soc Med 1968;61:1147-1152. Ref ID: 303 (483) Kovcs A. Roentgenologic study of the laryngeal function in singers. Acta Radiol Diagn (Stockh) 1967;6:548-560. Ref ID: 306 (484) Lejska V. [Occupational voice disorders in teachers]. Prac Lek 1967;19:119121. Ref ID: 309 (485) Sato T, Utsumi S, Kajikawa K, Ikeda H. [A case of cancer of the larynx found in mustard gas poisoning]. Nippon Jibiinkoka Gakkai Kaiho 1967;70:17731778. Ref ID: 307 (486) Siroky J, Tesarik J. [Bleeding into the vocal cords]. Cesk Otolaryngol 1967;16:229-231. Ref ID: 308 (487) Hanslian L, Kadlec K. The Biological Effects of Wood Dust. 1966. Ref ID: 508 Abstract: The health effects of occupational exposure to wood dust were studied. Dermatological examination was done on 78 individuals from a furniture factory and an otorhinolaryngological (ORL) examination was done on 14 workers from another factory. All of these subjects were given an olfactometric examination at the beginning and end of the work shift for 1 week. Additionally, pulmonary examinations were done on 53 machine and manual sanding operators with an average exposure duration of 6.5 years. The dust concentrations in individual work shops varied from 40 to 80 milligrams per cubic meter (mg/cu m); in the machine sanding shops, this value was as high as 190mg/cu m. All subjects examined had been exposed to many woods including oak, beech, walnut, poplar, maple, pine, and spruce and the tropical woods dibetou, abachi, avodire, mahogany. Some employees had been exposed to Mansonia and African pear. Atrophic mucosa was evident in 47.8 percent of the subjects, blood vessel dilation in Kiesselbach's area in 39.1 percent, mucosal lamellar irritation in 20.6 percent and active lesions and petechiae in 18.4 percent. Short term exposure caused irritation of respiratory tract mucosa manifested by sneezing, coughing and then bronchial and pulmonary symptoms. A thickening of vocal cords and a reddening of vocal cords were seen in 56.6, and 38.0 percent of the workers respectively. Evidence of unilateral or complete anosmia was noted in 17 percent of the subjects. Workers exposed to Mansonia reported scratchiness of the throat and hoarseness. Isolated cases of local toxic effects of Mansonia splinters were observed, including redness, edema and increased size of lymph nodes. Skin damage due to Monsonia and African pear occurred in 34.6 and 25.0 percent of the exposed workers, respectively. Pulmonary reticulation was found in 2 wood sanders. The author concludes that the adverse health effects of wood dust are due mostly to the chemical properties of the wood. (Czechoslovakian) (488) Schiffmann H. [Occupational vocal cord carcinoma caused by inhalation of carcinogenic substances]. HNO 1966;14:82-87. Ref ID: 311 (489) Shamsheva TE, Morozov VP. [Peculiarities of the vocal spectrum of singers with phonasthenia]. Vestn Otorinolaringol 1966;28:32-38. Ref ID: 310 (490) Wendler J. [Results of treatment for functional dysphonia]. Folia Phoniatr (Basel) 1966;18:401-416. Ref ID: 312 (491) Minnigerode B. [Chorditis vocalis inferior hypertrophica (seu hyperplastica). New views on the pathologic and anatomical classification of the clinical features of the disease]. Pract Otorhinolaryngol (Basel) 1965;27:290-297. Ref ID: 317 (492) Morozov VP, Shamsheva TE. [SPECIAL ASPECTS OF VOICE INTENSITY IN SINGERS WITH PHONASTHENIA.]. Vestn Otorinolaringol 1965;27:68-73. Ref ID: 313 (493) NESSEL E. [OCCUPATIONAL INJURIES TO THE LARYNX.]. Arch Ohren Nasen Kehlkopfheilkd 1965;185:379-464. Ref ID: 315 (494) NESSEL E. [Occupational damages of the larynx]. Arch Ohren Nasen Kehlkopfheilkd 1965;185:474-477. Ref ID: 316 (495) Siegert C. [Problems of functional voice disorders in teachers]. Dtsch Gesundheitsw 1965;20:969-975. Ref ID: 314 (496) KAREN A. [PATHOLOGICAL CHANGES IN THE MUCOSA OF THE UPPER RESPIRATORY TRACT AND LARYNX IN GRAY CAST IRON FOUNDRY WORKERS, THEIR PREVENTION AND THERAPY.]. Cesk Otolaryngol 1964;13:214-216. Ref ID: 319 (497) SEDLACEK K, Sedlackova E. [ASSESSMENT OF OCCUPATIONAL VOICE DISORDERS (FROM THE VIEWPOINT OF MORE ACCURATE CLASSIFICATION).]. Prac Lek 1964;16:250-254. Ref ID: 318 (498) BLAHA K, HOUSTKOVA E, HLAVAC J. [CLINICAL PATHOLOGY OF THE UPPER RESPIRATORY TRACT AND LARYNX IN WELDERS.]. Cesk Otolaryngol 1963;12:161-167. Ref ID: 322 153 (499) DESANTIS M. [PHONIATRIC EXAMINATION OF THE ACTOR AND SINGER.]. Valsalva 1963;39:403-409. Ref ID: 320 (500) KHAMRAEVA RA. [ON THE EFFECT OF TONSILLECTOMY ON CHANGES IN THE SINGER'S VOICE.]. Med Zh Uzb 1963;11:17-19. Ref ID: 321 (501) Holinger PH, JOHNSTON KC. Contact ulcer of the larynx. J Am Med Assoc 1960;172:511-515. Ref ID: 324 (502) HUSSON R. [Restoration of impedance on the larynx by the pharyngobucconasal pavillon in the singer.]. J Physiol (Paris) 1960;52:125126. Ref ID: 325 (503) HUSSON R. [Phonatory behavior of the vocal cords at different intensities and genesis of singer's nodule.]. Rev Laryngol Otol Rhinol (Bord ) 1960;81:403411. Ref ID: 323 (504) FALEG G, LENZI R. [Changes of the larynx in chronic occupational mercury poisoning.]. Rass Med Ind Ig Lav 1959;28:299-305. Ref ID: 326 (505) GARDNER WH. Executive's dysphonia; a study of 49 patients. Cleve Clin Q 1958;25:177-186. Ref ID: 327 (506) SOKCIC A, MITIC A. [Polyps of the vocal cords.]. Vojnosanit Pregl 1958;15:113-116. Ref ID: 328 (507) BLUMLEIN H. [Cancer of the larynx and occupational inhalation agents.]. Munch Med Wochenschr 1957;99:133-135. Ref ID: 329 (508) LEROUX-ROBERT J. [Histopathology and histogenesis of polyps and nodules of singers compared with other tumors and pseudotumors of the larynx.]. Rev Laryngol Otol Rhinol (Bord ) 1955;76:737-748. Ref ID: 330 (509) BOERS G. [Education of teachers for patients with speech and voice disorders.]. Arch Ohren Nasen Kehlkopfheilkd 1954;165:632-633. Ref ID: 331 (510) KREJCI F. [Pathogenesis of carcinoma of the larynx.]. Wien Klin Wochenschr 1952;64:53-54. Ref ID: 332 (511) MANCIOLI G. [Tuberculosis of the larynx in workers.]. Rass Med Ind Ig Lav 1951;20:211-213. Ref ID: 333 (512) MANCIOLI G. [Ulcerations of the larynx and vocal cords in a chromate plant.]. Rass Med Ind Ig Lav 1950;19:170-172. Ref ID: 334 (513) Rees M. Care of Vocal Cords in Singers and Speakers. Br Med J 1937;2:208210. Ref ID: 335 (514) Dundas-Grant J. APHONIA, DYSPHONIA, AND THE "SINGER'S ATTITUDE.". Br Med J 1930;1:539. Ref ID: 336 (515) Adriįn JA, Casado JC, Rodrķguez-Parra MJ, Gonzįlez M. Evaluación funcional y tratamiento logopédico de pacientes con disfonķa: resultados de una intervención interdisciplinar de la voz en el įmbito hospitalario. Rev logop foniatr audiol (Ed impr ) [sin fecha];23:9. Ref ID: 514 Abstract: Este trabajo presenta los primeros resultados empķricos obtenidos al utilizar un protocolo interdisciplinar ("Teatinos") en la evaluación funcional de pacientes con trastornos de la voz. El objetivo es propiciar una mejor detección de las variables de pronóstico, recuperación y prevención de las disfonķas. Los resultados del estudio, llevado a cabo en 8 pacientes con nódulos bilaterales y disfonķa, muestran los efectos de los distintos parįmetros e ķndices multidimensionales valorados en la fase pre-tratamiento. Todos los pacientes manifestaron tras la rehabilitación funcional (fase posttratamiento) una mejorķa subjetiva en el bienestar vocal, en el grado de satisfacción con su voz, ademįs de una disminución de la ronquera y un aumento de la extensión vocal. Asimismo, se observa una desaparición o reducción de los nódulos vocales, un menor grado perceptual de la disfonķa, una mejora de los parįmetros acśsticos y una recuperación significativa de los ķndices aerodinįmicos. Por ejemplo, los resultados muestran una mejora de un 22,5 por ciento en el Tiempo Mįximo de Fonación (TMF) al comparar la fase pre vs. resultados en la evaluación de la efectividad del tratamiento logopédico son tratados en la discusión (AU)^iEs (516) Alonso Riofrķo R. Disfunción de las cuerdas vocales: una enfermedad a tener en cuenta. Acta Pediatr Esp [sin fecha];60:378-380. Ref ID: 515 (517) Įlvarez Garcķa MV, Jané Parera RM, Turón Įlvarez E. Protocolo de observación de la respiración para detectar alteraciones que pueden desencadenar o favorecer trastornos orofaciales o de la voz. Rev logop foniatr audiol (Ed impr ) [sin fecha];23:66-73. Ref ID: 516 Abstract: Es manifiesta la importancia de los factores respiratorios para el correcto desarrollo de las estructuras y funciones orofaciales implicadas en el acto de hablar, asķ como para la emisión vocal. En el presente artķculo, se presenta un protocolo de observación de la respiración elaborado para detectar alteraciones de sus mecanismos que pueden ser causa o consecuencia de trastornos orofaciales o de la voz. Se describen, también, las disfunciones mįs frecuentes observadas por las autoras entre la población 155 escolar, después de utilizar dicho protocolo en su intervención prįctica. Paralelamente, se intenta transmitir a los lectores algunas reflexiones sobre la utilidad de los datos obtenidos con este instrumento, para abordar la reeducación (AU)^iEs (518) Casado Morente JC, Conde Jiménez M, Piédrola Maroto D et al. Estudio objetivo de la voz en población normal y en la disfonķa por nódulos y pólipos vocales. Acta Otorrinolaringol Esp [sin fecha];52:476-482. Ref ID: 517 Abstract: Presentamos un estudio sobre la evaluación objetiva de la voz en 100 adultos sanos y en 60 sujetos con disfonķa por nódulos o pólipos vocales. A todos se les realizó una laringoestroboscopia y un anįlisis acśstico vocal. Se registró y digitalizó la vocal "a" con el programa Dr. Speech Science. Se estimaron los parįmetros: frecuencia fundamental (Fo, expresada en función del sexo), jitter, shimmer y Ruido Glótico (NNE, HNR y SNR). La Fo en el grupo normal fue de 139.72 en varones y 267.33 en mujeres, jitter 0.24 y shimmer 2.10. En pacientes disfónicos por nódulos Fo fue 126.96 en varones y 240.72 en mujeres, jitter 0.35 y shimmer 3.25. En pacientes disfónicos por pólipos Fo fue 119.75 en varones y 218.26 en mujeres, jitter 0.50 y shimmer 4.34. Todas estas diferencias fueron estadķsticamente significativas. El Ruido Glótico en población normal fue de: NNE -13.62, HNR 24.07 y SNR 24.49; en pacientes con nódulos: NNE -10.65, HNR 25.21 y SNR 25.55; en pacientes con pólipo vocal: NNE -8.24, HNR 29.63 y SNR 28.22. Sólo existió diferencia estadķsticamente significativa en el parįmetro NNE. Destacamos la importancia de la valoración objetiva de los trastornos de la voz (AU)^iEs (519) Castejón Fernįndez L, Gorjón Hernįndez A. La adaptación al paciente con disfonķa: una perspectiva interactiva, funcional y personalizada de intervención logopédica. Rev logop foniatr audiol (Ed impr ) [sin fecha];23:28. Ref ID: 518 Abstract: Este artķculo revisa la intervención logopédica en alteraciones de la voz considerando cuatro dimensione -la orgįnica, la funcional, la social y la personal - que permiten una comprensión global del problema que plantean al logopeda las personas con disfonķa. Atendiendo globalmente al problema se plantea un modelo de intervención interactivo, funcional y personalizado en el que la adaptación individual a las cuatro dimensiones mencionadas resulta esencial en el proceso terapéutico. Se constituyen como componentes bįsicos de la intervención: la información dada al paciente, la elaboración de un mapa de funcionamiento vocal que ponga de manifiesto la interconexión de los componentes de la técnica vocal en cada caso, el aprovechamiento de los contextos naturales en los que se utiliza la voz y la atención a la perspectiva del paciente, a su queja, a su vivencia del problema y de la intervención. Estos aspectos sirven de marco y dan sentido a los ejercicios propuestos y a las indicaciones para el cuidado de la voz, cuando se quiere hacer un planteamiento funcional en la intervención logopédica en alteraciones de la voz (AU)^iEs (520) Dorado Sįnchez MC, Cobo Martķnez P. Incidencias de las patologķas vocales en maestros de educación primaria en la ciudad autónoma de Ceuta. Rev logop foniatr audiol (Ed impr ) [sin fecha];23:30-41. Ref ID: 519 Abstract: El presente trabajo es un estudio descriptivo y retrospectivo de las bajas por patologķa vocal de los maestros de Educación Primaria en la Ciudad Autónoma de Cueta, territorio MEC, durante los cursos 98/99 y 99/00. En él se abordan diversos aspectos sobre trastornos de voz en el colectivo docente, tales como: comprensión general de la patologķa vocal en el profesorado, incidencia de la misma sobre el colectivo, anįlisis de la distribución de bajas por género, edad, tipo de patologķa y duración de las mismas, asķ como comparación de estos resultados con otros estudios anįlogos. Finalmente, realizamos un anįlisis de la incidencia que este tipo de patologķas tienen en los aspectos organizativos y algunas sugerencias o recomendaciones para mejorar este tipo de trastorno en el colectivo docente. Los resultados del estudio arrojan las siguientes conclusiones. La patologķa vocal es significativamente superior en la mujer. En relación a la edad la franja comprendida entre 30-39 ańos es la mįs afectada y la media recogida es de 47 ańos, coincidente con estudios anįlogos. Se constata la alta tasa de la patologķa de la voz de los maestros que causan baja laboral por gripe y laringitis que habitualmente derivan en disfonķas. Se pone de manifiesto la necesidad de establecer nuevos criterios de clasificación de las distintas patologķas respiratorias y alteraciones de la voz que permitan un mejor seguimiento de las mismas en su anįlisis y evaluación, asķ como potenciar programas preventivos de higiene de la voz a este colectivo (AU)^iEs (521) Elhendi W, Santos S, Rodrķguez Matul C, Rossi M, Dios C, Labella T. Nódulos vocales: puesta al dķa. O R L -Dips [sin fecha];32:142-149. Ref ID: 520 Abstract: Presentamos una revisión exhaustiva y actualizada de laliteratura referente a los nódulos vocales, su etiopatogenia,clķnica, diagnóstico y tratamiento, aportando nuestra experienciaen el manejo de esta patologķa^iEs We present an exhaustive and updated revision ofthe literature referring to the vocal nodules, itsetiopathogeny, clinic, diagnosis and treatment,displaying our experience in the management of thispathology^iEn (522) Gańet Benavente RE, Serrano Estrada C, Gallego Pulgarķn MI. Patologķa vocal en trabajadores docentes: influencia de factores laborales y extralaborales. Arch prev riegos labor [sin fecha];10:12-17. Ref ID: 521 Abstract: Objetivos. Valorar la importancia de la carga de trabajo en la patologķa vocal de los docentes considerando el tiempo de exposición y la dosis horaria, asķ como los efectos de otros factores potencialmente asociados a dichas alteraciones.Métodos. Se realiza un estudio transversal con muestreo bietįpico a partir del registro del Servicio de Prevención de ASEPEYO en Madrid. Se estudian 245 docentes procedentes de centros de enseńanza primaria, secundaria y universitaria a través de un cuestionario de autoaplicación, con posterior anįlisis estadķstico de los datos.Resultados. Se identifican 85 profesores con sķntomas de patologķa vocal (prevalencia 34,7%). El sķntoma principal es la alteración del timbre de la voz (95,3%). Un 31,8% pierde la voz por completo. Son mįs frecuentes los trastornos de la voz en quienes han trabajado mįs ańos (tiempo de exposición), en las mujeres y en los que padecen trastornos del sueńo, ansiedad y reflujo gastroesofįgico, con diferencias estadķsticamente significativas. Ademįs, hay mįs consultas al logopeda y aumenta el nśmero de bajas laborales en los que padecen alteraciones de la voz. No existen diferencias entre sintomįticos y asintomįticoscon respecto a la dosis horaria de uso de la voz, consumo de 157 tabaco o alcohol, ni consumo de medicamentos.Conclusiones. Se ha encontrado una proporción alta de docentes con sintomatologķa relacionada con la voz, principalmentetrastornos de carįcter funcional. Se pone de manifiesto la necesidad de detectar precozmente estas alteraciones y establecer medidas preventivas. El cuestionario puede ser un buen método de detección inicial^iEs Objectives. To assess the importance of work-related factors (work load) on voice pathologies suffered by teachers.�.To ToTo study the characteristics of exposure time and hourly dosage in voice use..Toidentifyeffect-modifyingfactors. To identify effect-modifying factors.. Methods. A cross-sectional study was conducted with a two-tiered sample. The study involved 245 teachers from the primary, secondary and university levels, using a self-administered questionnaire with subsequent statistical analysis of the data. Results. Eighty-five subjects exhibited symptoms (34.7% prevalence rate). The main symptom was alteration of voice tone (95.3%). Of those studied, 31.8% indicated complete voice loss. Voice disorders were more frequent among the most veteran teachers (exposure time), women, those suffering from sleep disorders, anxiety and gastroesophageal reflux, exhibiting statistically significant differences. Those affected turn more frequently to speech therapists for help when symptoms have already manifested themselves, and the number of teachers with voice disorders on sick-leave increases. No differences were found between symptomatic and asymptomatic subjects with regard to exposure time, tobacco use and consumption of alcohol or pharmaceuticals. Conclusions. A high percentage of teachers exhibiting voice-related symptoms, especially functional disorders, was found. This draws attention to the need for early detection of these disorders and for preventive measures. The questionnaire could be a good tool for initial detection of the problem^iEn (523) Hernįndez Sandemetrio R, Nieto Curiel P, Dalmau Galofre J, Forcada Barona M. æQué nos aporta la estroboscopia en el diagnóstico de los trastornos de la voz. Acta Otorrinolaringol Esp [sin fecha];61:145-148. Ref ID: 522 Abstract: En el tratamiento de los trastornos persistentes de la voz es aconsejable la actuación conjunta del otorrinolaringólogo/fonocirujano, foniatra y logopeda. El diagnóstico de las lesiones vocales es esencial para un enfoque terapéutico adecuado. La estroboscopia aporta datos funcionales śtiles para decidir un tratamiento quirśrgico, logopédico o combinado. Hemos revisado nuestros casos intervenidos de fonocirugķa de los śltimos 5 ańos y analizado la correlación que existe entre el diagnóstico preoperatorio con estroboscopia y los hallazgos intraoperatorios. En el 90% de los casos, existe una concordancia entre ambos diagnósticos. Consideramos que la estroboscopia es un medio de exploración imprescindible para establecer la indicación terapéutica adecuada y orientar al cirujano para el tratamiento quirśrgico(AU)^ies The management of voice disorders requires a close collaboration between the throat surgeon and the speech therapy team. The diagnosis of cordal lesions is essential to an accurate therapy. Stroboscopy contributes functional information which is useful to decide between microsurgery, vocal reeducation or a combined treatment. We have reviewed our phonomicrosurgery cases for the past five years and analyzed the correlation between preoperative diagnosis obtained by stroboscopy and intraoperative findings. In 90% of cases there exists a relation between both diagnoses. We consider stroboscopy as an essential means of evaluation to establish an adequate management and guidance for surgical treatment(AU)^ien (524) Pérez Fernįndez CA, Preciado López J. Nódulos de cuerdas vocales. Factores de riesgoen los docentes. Estudio de casos y controles. Acta Otorrinolaringol Esp [sin fecha];54:253-260. Ref ID: 523 Abstract: Los nódulos de cuerdas vocales son lesiones frecuentes entre los profesionales de la voz, como son los docentes. Hemos realizado un estudio de los factores de riesgo que favorecen el desarrollo de la patologķa nodular en 240 docentes: 120 normales y 120 con nódulos. Se evaluaron los antecedentes profesionales y los personales, el ambiente del aula y se realizó una exploración completa de la voz: pruebas aerodinįmicas, tono y extensión de voz, anįlisis acśstico de la voz, evaluación perceptual de la voz y videolaringo-estroboscopia para realizar el diagnóstico. Los docentes mįs jóvenes y con menos ańos de ejercicio profesional presentaban una mayor tendencia a padecer nódulos que los docentes normales. El ambiente seco y la existencia de ruido y de eco en la clase eran mįs frecuentes en los docentes con nódulos. Los antecedentes con mayor influencia en el desarrollo de los nódulos fueron: la patologķa vocal previa, la microcirugķa larķngea, la cirugķa nasal y el reflujo gastro-esofįgico. Los docentes con nódulos tenķan el rango de intensidades y el rango de frecuencias acortado. Existķa, ademįs, un aumento de los parįmetros de la perturbación de la frecuencia, de la amplitud y del ruido.Asimismo, existķa una mayor ineficacia del soplo fonatorio en los docentes patológicos. (AU)^iEs (525) Preciado J, Pérez C, Calzada M, Preciado P. Incidencia y prevalencia de los trastornos de la voz en el personal docente de La Rioja. Estudio clķnico: cuestionario, examen de la función vocal, anįlisis acśstico y vķdeolaringoestroboscopia. Acta Otorrinolaringol Esp [sin fecha];56:202-210. Ref ID: 524 Abstract: Objetivo: Calcular la incidencia y la prevalencia de los trastornos de la voz en el personal docente de La Rioja. Diseńo: Estudio transversal: 931 docentes elegidos de forma aleatoria entre los 3.113 docentes de La Rioja. Estudio longitudinal: durante 3 ańos recogemos los nuevos casos. Pacientes: 527 docentes de la muestra aleatoria tomaron parte en el estudio: 312 mujeres (63%) y 195 hombres (37%). Método: Todos rellenaron un cuestionario estandarizado y posteriormente se les realizó una exploración ORL, examen de la función vocal, vķdeolaringoestroboscopia y anįlisis acśstico de la voz con MDVP. Resultados: La prevalencia de los trastornos de la voz en el personal docente de La Rioja fue de un 57%: 20% de lesiones orgįnicas [nódulos (13,8%), pólipos (2%), sufusiones submucosas (1,4%), edema de Reinke (1,2%), quistes (0,4%), sulcus (0,4%), cicatrices (0,6%), leucoplasias (0,2%) y parįlisis de cuerda vocal (0,2%)], 8% de laringitis crónica [no especķfica (2,8%), tabįquica (3,9%) o por reflujo gastroesofįgico (2,5%)], y el 29% de lesiones funcionales [sobrecarga vocal (18%) disfonķa hiperfuncional (7,5%), disfonķa hipofuncional (0,4%) e hiperplasia de bandas (2,8%)]. La incidencia de la patologķa vocal fue de 4 nuevos casos por 1.000 docentes y ańo. Conclusiones: Las lesiones orgįnicas son mįs prevalentes en las mujeres (25,4%) que en los hombres (9,5%). Las lesiones funcionales y las laringitis crónicas son mįs prevalentes en los hombres (36,5% y 13,3%) que en las mujeres (24% y 5%)^iEs Objective: The aim of this study was calculate the prevalence and incidence of 159 voice disorders among teaching staff of La Rioja, Spain. Design: we carried out a transversal study of voice disorders in teaching staff of La Rioja (a random sample of 931 of 3113 teachers) and a longitudinal study (we collect the new cases during the 3 years which lasts the study). Patients: 527 teachers of random sample took part of study: 332 female (63%) and 195 male (37%). Methods: All of teachers fill in a standard questionnaire, ENT and function vocal ex-amination, videolaryngostroboscopy and acoustic analysis with MDVP. Results: The prevalence of voice disorders among La Rioja Teachers was 57%: 20.3% for organic lesions [nodular lesions (14%), polyps (2%), submucous suffusions (1.4%), edema Reinke (1.2%) Sulcus (0.4%), scalp (0,6%), leucoplasia (0.2%) vocal cord pa-ralysis (0.2%)] 8,1% for chronic laryngitis [not specific (2.8%), smoke (3.9%) gastroe-sofageal reflux (2.5%)] and 29% for functional lesions [hyperfunctional dysphonia (7.5%) hypofunctional dysphonia (0.4%) vocal overefforts (18%) hyperplasia false cords (2.8)]. The incidence rate was 4 new cases each 1000 teachers and year. Conclusions: Organic lesions were more prevalent in women (25.4%) than in men (9.5%), but functional lesions and chronic laryngitis were more prevalent in men (36.5% and 13.2%) than in women (24% and 5%)^iEn (526) Preciado J, Pérez C, Calzada M, Preciado P. Frecuencia y factores de riesgo de los trastornos de la voz en el personal docente de La Rioja. Estudio transversal de 527 docentes: cuestionario, examen de la función vocal, anįlisis acśstico y vķdeolaringoestroscopia. Acta Otorrinolaringol Esp [sin fecha];56:161-170. Ref ID: 525 Abstract: Objetivo: Analizar los factores de riesgo que influyen en la aparición de los trastornos de la voz en el personal docente de La Rioja. Diseńo: Estudio transversal: muestra aleatoria de 931 docentes de La Rioja. Pacientes: 527 docentes de los 931 elegidos aleatoriamente participaron en el estudio: 332 mujeres (63%) y 189 hombres (37%). Método: Todos rellenaron un cuestionario estandarizado y posteriormente se les realizó una exploración ORL, examen de la función vocal, vķdeolaringoestroboscopia y anįlisis acśstico de la voz. Resultados: La prevalencia de los trastornos de la voz en el personal docente de La Rioja fue de un 57% (20% de lesiones orgįnicas, 8% de laringitis crónicas y 29% de lesiones funcionales). La prevalencia de esta patologķa no es mayor en las mujeres que en los hombres (p > 0,05) (OR: 1,138). Entre los datos personales, datos profesionales, hįbitos vocales, antecedentes personales y hįbitos tóxicos sólo las disfonķas y patologķas larķngeas previas, sķntomas de reflujo gastro-esofįgico y el habito tabįquico eran mayores entre los docentes con trastornos de la voz. Conclusiones: El esfuerzo vocal que requiere la labor docente es la principal causa de los trastornos de la voz en los profesionales de la enseńanza. Es conveniente realizar un reconocimiento de todos los futuros docentes al comienzo de sus estudios^iEs Objective: To the analyse the risk factors of voice disorders among teaching staff of La Rioja, Spain. Design: We carried out a transversal study of voice disorders in teaching staff of La Rioja (a random sample of 931 of 3.113 teachers). Patients: 527 teachers of random sample took part of study: 332 female (63%) and 195 male (37%). Methods: All teachers filled in a standard questionnaire and posteriorly they underwentan, ENT and functional vocal cord examination, videolaryngostroboscopy and acoustic analysis with MDVP. Results: The prevalence of voice disorders among La Rioja Teachers was 57%: 20% for organic lesions, 8% for chronic laryngitis and 29% for functional disorders. Women compared with men did not have a higher prevalence of voice disorders (p > 0,05) (OR: 1,138). Professional and personal factors as well as classroom atmosphere were studied. The most relevant factors in the pathological group were previous vocal pathology, laryngeal surgery, gastroesophageal reflux and, classroom dryness and smoking habits. Conclusions: The most relevant factor of voice disorders in teaching professional is the vocal overwork during their job. It is advisable to carry out a clinical evaluation of all the future teachers in their educational programs^iEn (527) Rabadą I, Artazcoz L. Identificación de los factores de riesgo laboral en docentes: un estudio Delphi. Arch prev riegos labor [sin fecha];5:53-61. Ref ID: 526 Abstract: Objetivo: Identificar y priorizar los factores de riesgo laboral que afectan a la salud y el bienestar del profesorado de educación infantil, primaria y secundaria de centros pśblicos de la Generalitat de Catalunya de la ciudad de Barcelona.Métodos: Se ha utilizado la técnica Delphi con tres rondas consecutivas. Han participado 43 profesores de 180 seleccionados (24 por ciento), aleatoriamente, entre los afiliados y afiliadas a la Federación de Enseńanza del Sindicato Comisiones Obreras (CC.OO.) en Cataluńa que trabajaban en centros pśblicos de Barcelona.Resultados: Los factores identificados, con diferente grado de importancia, por el profesorado de enseńanza primaria y secundaria, ponen de manifiesto que las principales causas por las que se puede enfermar a consecuencia del trabajo profesional son de carįcter psicosocial. La complejidad de atención al alumnado con problemas de aprendizaje y la desmotivación de éste son, respectivamente, los factores mįs puntuados en enseńanza primaria y secundaria. La demanda y delegación de problemas y conflictos, los problemas de disciplina, la falta de colaboración entre compańeros y de reconocimiento social, el exceso de horario lectivo y la incertidumbre sobre los resultados de los alumnos completan los factores mįs votados. Los problemas musculosqueléticos y de esfuerzo vocal aparecen con una menor significación y solamente en enseńanza primaria. Conclusiones: Los resultados obtenidos en el presente estudio ponen de manifiesto que los factores psicosociales constituyen los principales riesgos laborales que afectan a la salud y el bienestar del profesorado. Considerando las caracterķsticas de los factores manifestados, es necesario promover entre el profesorado acciones destinadas a mejorar la satisfacción laboral entre el colectivo docente, asķ como otras de apoyo para resolver los problemas de complejidad de atención al alumnado con problemas de aprendizaje en la enseńanza primaria y de motivación y disciplina en enseńanza secundaria, como por ejemplo la solución de conflictos en el aula y metodologķas didįcticas que faciliten la adopción de nuevas estrategias (AU)^iEs (528) Suįrez Nieto C. Evaluación perceptual de la disfonķa: correlación con los parįmetros acśsticos y fiabilidad. Acta Otorrinolaringol Esp [sin fecha];55:282-287. Ref ID: 527 Abstract: El anįlisis de la calidad vocal mediante la escala perceptual GRBAS tiene importancia clķnica para las voces que no pueden ser estudiadas mediante la determinación de sus parįmetros acśsticos tales como las vocalizaciones con fuertes subarmónicos y modulaciones y las voces caóticas o aperiódicas. En el presente estudio se realizaron dos experimentos: 161 Primero, se investigó la correlación entre los parįmetros acśsticos y la escala GRBAS en 107 voces patológicas. Segundo, la coincidencia intra e interobservador del GRBAS. La severidad de la disfonķa se correlacionó con parįmetros relacionados con la voz aérea y con frecuencias fundamentales bajas. La presencia de subarmónicos en el espectrograma no mostró una relación significativa con el grado de aspereza. La fiabilidad intra e interobservador del sistema GRBAS es alta (AU)^iEs (529) Torres Gonzįlez JA, Hernįndez Fernįndez A. Detección de disfonķas en la escuela: la función del maestro de audición y lenguaje en educación. Rev logop foniatr audiol (Ed impr ) [sin fecha];27:39-44. Ref ID: 529 Abstract: Nuestro interés por las disfonķas ha sido una constante en nuestro dķa a dķa como maestros de audición y lenguaje. Esta cuestión se torna difķcil cuando trabajamos con nińos de edad inferior a 7 ańos, ya que el diagnóstico se complica notablemente, pero esto lo dejamos para los médicos especialistas. Nuestro įmbito de trabajo nos recomienda una detección precoz, que con estos alumnos se hace muy difķcil debido a su temprana edad. Este estudio aborda la problemįtica de la detección de disfonķas en edades de 4 a 7 ańos principalmente, con la ayuda del procesamiento de la voz y el anįlisis de los formantes de determinados sonidos. Se tratarķa de una tecnologķa imprecisa, pero suficiente y poco costosa para realizar barridos de clases completas de alumnos de educación infantil y primeros ciclos de primaria, permitiéndonos realizar derivaciones a los servicios de otorrinolaringologķa (ORL) con cierta garantķa^iEs Our interest for the dysphonia has been day by day a constant in our as audition teachers and language. This question is more difficult when we work with children of inferior age to 7 years, since the diagnosis gets complicated notably, but this leaves it for the specialist doctors. Our work environment recommends us a precocious detection that becomes very difficult with these students due to its early age. This study approaches the problem of the dysphonia detection in ages from 4 to 7 years mainly, with the help of the prosecution of the voice and the analysis of the formants of certain sounds. It would be an imprecise, but enough and not very expensive technology to carry out sweepings of students of infantile education complete classes and first cycles of primary, allowing us to carry out derivations to the services of ORL with certain guarantee^iEn (530) Tsikunov SG, Belokoskova SG. Psychophysiological analysis of the influence of vasopressin on speech in patients with post-stroke aphasias. Span j psychol [sin fecha];10:178-188. Ref ID: 530 Abstract: El habla es un atributo de la especie humana. Los trastornos centrales del habla después de una trombosiscerebral son modelos śnicos para la investigación de la organización del habla. Los logros en laneurobiologķa sugieren que posiblemente haya mecanismos neuroendocrinos implicados en la organizacióndel habla. Se sabe que el neuropéptido vasotocina, anįlogo de la vasopresina en los mamķferos, modulavarios componentes de la vocalización en los animales. Ademįs, se ha descrito la influencia positiva dela vasopresina en la memoria, que juega un papel importante en la formación del habla. En este estudio,se investigaron los procesos de la organización del habla y su recuperación con la administración de lavasopresina (1-desamino-8-D-arginin-vasopressin) a 26 pacientes con afasias crónicas después de unatrombosis cerebral. Los resultados mostraron que las dosis sub-endocrinas del neuropéptido conadministración intranasal tuvo influencia positiva primariamente en las formas simples del habla y, demanera secundaria, en las formas compuestas. No hubo diferencias estadķsticamente significativas entrelos componentes sensoriales e integrativos de la organización de los procesos del habla con vasopresina.En todos los casos, se demostró el efecto positivo del neuropéptido. Como resultado de los efectos,mejoró el habla regulado por ambos hemisferios. Se sugiere que el neuropéptido optimiza la actividadtanto en el hemisferio izquierdo como en el derecho, con influencia primaria sobre el hemisferio derecho.La persistencia de los efectos adquiridos se explica por la inducción de procesos compensatorios comoresultado de la reorganización de las conexiones intra-centrales por la vasopresina(AU9^ies Speech is an attribute of the human species. Central speech disorders following stroke are unique modelsfor the investigation of the organization of speech. Achievements in neurobiology suggest that there arepossible neuroendocrine mechanisms involved in the organization of speech. It is known that theneuropeptide vasotocin, analogous of vasopressin in mammals, modulates various components ofvocalization in animals. Furthermore, the positive influence of vasopressin on memory, which plays animportant role in the formation of speech, has been described. In this study, speech organization processesand their recovery with the administration of vasopressin (1-desamino-8-D-arginin-vasopressin) to 26patients with chronic aphasias after stroke were investigated. Results showed that sub-endocrine dosesof the neuropeptide with intranasal administration had positive influence primarily on simple forms ofspeech and secondarily on composite forms. There were no statistically significant differences betweenthe sensory and integrative components of the organization of speech processes with vasopressin. In allcases, the positive effect of the neuropeptide was demonstrated. As a result of the effects, speech regulatedby both brain hemispheres improved. It is suggested that the neuropeptide optimizes the activity both inthe left and right hemispheres, with primary influence on the right hemisphere. The persistence of theacquired effects is explained by an induction of compensatory processes resulting in the reorganizationof the intra-central connections by vasopressin(AU)^ien (531) Villegas Lirola F. Intervención en un caso de dificultades fonológicas. Rev logop foniatr audiol (Ed impr ) [sin fecha];25:128-139. Ref ID: 531 Abstract: En este artķculo se han pretendido concretar secuencias de evaluación e intervención de las dificultades fonológicas infantiles propuestas en anteriores trabajos y fundamentadas en el enfoque fonológico de anįlisis de las dificultades fonológicas, utilizando como referencia la presentación de un caso, para el que se explicitan los materiales y procedimientos utilizados en la valoración y actuación logopédica, tanto referida a entrenamiento fonoarticulatorio como metafonológico. Se describen las situaciones de intervención y los recursos didįcticos utilizados, organizados mediante actividades encadenadas, siguiendo rutinas tipológicas sobre las que se ha estructurado la estrategia de intervención. Comenzamos con la presentación de un inventario fonético en imįgenes teniendo en cuenta, para su elaboración, tanto la variedad de situaciones fonético-contextuales como su frecuencia e implicación en los procesos de simplificación infantil, asķ como la familiaridad de los vocablos implicados y la facilidad de reconocimiento de las 163 imįgenes. Continuamos con la presentación de los materiales usados en el proceso de intervención, categorizados, atendiendo a la tipologķa de las dificultades fonológicas observadas. Finalmente, pasamos a concretar su utilización para un caso concreto, analizando la situación de partida, describiendo detenida y exhaustivamente el procedimiento de intervención llevado a cabo y valorando los resultados observados tras su implementación^iEs This article is aimed at specifying some evaluation and intervention sequences for child phonological difficulties addressed in former works. These sequences are based upon the phonological approach in the analysis of phonological difficulties. A case report is used as a reference in order to explicit those materials and procedures utilised in the logopedic assessment and intervention, in relation to both phono-articulatory and meta-phonological training. Io this end, situations of intervention are described, as well as instructional resources organized through chained activities that were assembled by tipological routines on which the intervention strategy has been built. We begin by presenting a phonetic inventory with images. In ellaborating this inventory, we have taken into account the variety of phonetic-contextual situations, their frequency and involvement in child simplification processes, as well as the familiarity of involved words and ability for image recognition. We proceed by presenting the materials used in the intervention process, which are categorized according to the tipology of observed phonological difficulties. Finally, we specify its usage for a given case, which implies an analysis of the initial situation, a detailed description of the intervention process developed, and an assessment of observed results after its implementation^iEn (532) Young P, Finn BC, Fox ML, Emery N, Bruetman JE. Disfunción de cuerdas vocales secundaria a reflujo gastroesofįgico. An med interna (Madr ) [sin fecha];25:349-352. Ref ID: 532 Abstract: RESUMEN La disfunción de cuerdas vocales se caracteriza por la aducción paradójica de las mismas durante la inspiración, y ocurre con mayor frecuencia en mujeres jóvenes. Es un sķndrome caracterizado por crisis habitualmente autolimitadas de tos, sibilancias, disnea y estridor inspiratorio, presentados en forma brusca. Su incidencia e historia natural son desconocidas. Puede coexistir o asemejar a un asma refractario. Originalmente los trastornos psicológicos eran la śnica causa conocida, aunque luego se describieron mśltiples factores desencadenantes orgįnicos como el reflujo gastroesofįgico, ejercicio, sinusitis, distonķa, tiroidectomķa, irritantes respiratorios e infecciones de vķas aéreas superiores. Para el diagnóstico se requiere una alta sospecha, y la realización de una laringoscopia directa objetivando la aducción de las cuerdas vocales durante la inspiración en el paciente sintomįtico. La terapia fonoudiológica y la psicoterapia han sido extensamente utilizadas, sin una evaluación prospectiva. Uno de los ejes centrales del manejo, es el tratamiento de la causa subyacente si esta se identifica. Reportamos dos casos de disfunción de las cuerdas vocales secundaria a reflujo gastroesofįgico que evolucionaron en forma favorable con tratamiento especķfico ANEXO 4: Resultado busqueda en Dialog ANEXO IV Referencias bibliográficas búsqueda en Dialog ™ 3/9/1 (Item 1 from file: 5) 17299098 Biosis No.: 200300257742 Treatment of vocal nodules. Author: Pavlikhin O G Journal: Vestnik Otorinolaringologii ( 6 ): p 34-36 2002 2002 Medium: print ISSN: 0042-4668 _(ISSN print) Document Type: Article Record Type: Abstract Language: Russian Abstract: Vocal nodules (singer's nodules) are a typical professional disease of the vocal apparatus. This disease occurs more frequently in 20- to 50-year-old singers. The nodules form because of vascular disorders secondary to overstrain of the vocal apparatus in phonation and disorders of vegetative innervation. 43 opera singers were treated whose age and singing history ranged from 22 to 57 years and 3 to 26 years, respectively. The treatment combined psychotherapy, medicines with phlogenzym as a basic drug, physiotherapy and phonopedia. Phlogenzym allows to avoid "silence regimen", sur gical intervention. This improves treatment efficacy, shortens the time of disability for singers. DESCRIPTORS: Major Concepts: Methods and Techniques; Occupational Health--Allied Medical Sciences ; Otolaryngology--Human Medicine, Medical Sciences Biosystematic Names: Hominidae--Primates, Mammalia, Vertebrata, Chordata, Animalia Organisms: human (Hominidae)--patient, singer Organisms: Parts Etc: vocal apparatus--respiratory system Common Taxonomic Terms: Animals; Chordates; Humans; Mammals; Primates; Vertebrates Diseases: vocal nodules {singer's nodules}--respiratory system disease, therapy, pathology, surgery Chemicals & Biochemicals: phlogenzyme--enzyme-drug Methods & Equipment: psychotherapy--clinical techniques, therapeutic and prophylact ic techniques; physiotherapy--clinical techniques, therapeutic and prophylactic tech niques; phonopedia--clinical techniques; surgical intervention--clinical techniques, thera peutic and prophylactic techniques Miscellaneous Terms: Concept Codes: phonation; vegetative innervation; singing history Concept Codes: 11105 Anatomy and Histology - Surgery 12512 Pathology - Therapy 12502 Pathology - General 16004 Respiratory system - Physiology and biochemistry 16006 Respiratory system - Pathology 37013 Public health - Occupational health Biosystematic Codes: 86215 Hominidae Biosis Previews(R) (Dialog® File 5): (c) 2010 The Thomson Corporation. All rights ANEXO 4: Resultado busqueda en Dialog reserved. 3/9/2 (Item 2 from file: 5) 17130086 Biosis No.: 200300088805 Vocal nodules in professional singers of classic style. Author: Chernobelsky S I Journal: Vestnik Otorinolaringologii ( 4 ): p 21-22 2002 2002 Medium: print ISSN: 0042-4668 _(ISSN print) Document Type: Article Record Type: Abstract Language: Russian Abstract: Whether physiologically correct singing promotes disappearance of vocal nodules (VN) was studied in 27 professional classic style singers having VN for 20 years. VN arose primarily in women, tended to recur. As shown by examination with laryngostroboscope, electroglottograph and sound level meter, physiologically correct singing resulted in temporary disappearance of soft nodules but hard nodules did not resolve. It is inferred that professional singing is not recommended for subjects with hard vocal nodules. DESCRIPTORS: Major Concepts: Otolaryngology--Human Medicine, Medical Sciences; Speech Pathology--Allied Medical Sciences Biosystematic Names: Hominidae--Primates, Mammalia, Vertebrata, Chordata, Animalia Organisms: human (Hominidae)--female, patient Common Taxonomic Terms: Animals; Chordates; Humans; Mammals; Primates; Vertebrates Diseases: vocal nodules--respiratory system disease, therapy, diagnosis, pathology Methods & Equipment: laryngostroboscopy--clinical techniques, diagnostic techniques; laryngostroboscope--medical equipment; electroglottography--clinical techniques, dia gnostic techniques; sound level meter--medical equipment Miscellaneous Terms: Concept Codes: classic style professional singers; physiologically correct singing; soft nodules; hard nodules; menstrual cycle Concept Codes: 12502 Pathology - General 12504 Pathology - Diagnostic 12512 Pathology - Therapy 16006 Respiratory system - Pathology 20006 Sense organs - Pathology 20008 Sense organs - Deafness, speech and hearing Biosystematic Codes: 86215 Hominidae Biosis Previews(R) (Dialog® File 5): (c) 2010 The Thomson Corporation. All rights reserved. 4/9/3 (Item 3 from file: 5) 17112833 Biosis No.: 200300071552 Phonomicrosurgery is singers and performing artists: Treatment outcomes, management theories, and future directions. Author: Zeitels Steven M (Reprint); Hillman Robert E; Desloge Rosemary; Mauri Mar cello; Doyle Patricia B Author Address: Division of Laryngology, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA, 02114, USA**USA ANEXO 4: Resultado busqueda en Dialog Journal: Annals of Otology Rhinology and Laryngology 40 December 2002 2002 Medium: print ISSN: 0003-4894 _(ISSN print) Document Type: Article Record Type: Abstract Language: English 111 ( 12 Part 2 ): p 21- Abstract: Phonomicrosurgery in performing artists has historically been approached with great trepidation, and vocal outcome data are sparse. The vocal liability of surgically dis turbing the superficial lamina propria (SLP) and epithelium must be balanced with the in herent detrimental vocal effect of the lesion(s). A prospective investigation was per formed on 185 performing artists who underwent phonomicrosurgical resection of 365 lesions: 201 nodules, 71 polyps, 66 varices and ectasias, 13 cysts, 8 keratotic lesions, 2 granulomas, 2 Reinke's edema, and 2 papillomas. Nearly all patients with SLP lesions re ported improvement in their postsurgical vocal function. This subjective result was sup ported by objective acoustic and aerodynamic measures. All postsurgical objective vocal function measures fell within normal limits, including a few that displayed presurgical ab normalities. However, given the relative insensitivity of standard objective measures to assess higher-level vocal performance-related factors, it is even more noteworthy that 8 of 24 objective measures displayed statistically significant postsurgical improvements in vocal function. Such changes in objective measures mostly reflect overall enhancement in the efficiency of voice production. Phonomicrosurgical resection of vocal fold lesions in performing artists is enjoying an expanding role because of a variety of improvements in diagnostic assessment, surgical instrumentation and techniques, and specialized rehabil itation. Most of these lesions are the result of phonotrauma and arise within the SLP. Successful management depends on prudent patient selection and counseling, ultrapre cise technique, and vigorous vocal rehabilitation. Furthermore, an understanding of the vocal function and dysfunction of this high-performance population provides all otolaryngologists who manage laryngeal problems with valuable information that they can extrapolate for use in their practices. DESCRIPTORS: Major Concepts: Methods and Techniques; Occupational Health--Allied Medical Sciences ; Otolaryngology--Human Medicine, Medical Sciences; Surgery--Medical Sciences Biosystematic Names: Hominidae--Primates, Mammalia, Vertebrata, Chordata, Animalia Organisms: human (Hominidae)--female, male, patient Organisms: Parts Etc: vocal cord--respiratory system; vocal fold--respiratory system; superficial lamina propria--respiratory system; epithelium-- respiratory system Common Taxonomic Terms: Animals; Chordates; Humans; Mammals; Primates; Vertebrates Diseases: ectasia--respiratory system disease, surgery; polyp--neoplastic disease, surgery; varices--respiratory system disease, surgery; cysts--neoplastic disease, surgery; papilloma--neoplastic disease, surgery; granuloma-- neoplastic disease, surgery; Reinke's edema--respiratory system disease, surgery Mesh Terms: Polyps (MeSH); Cysts (MeSH); Papilloma (MeSH); Granuloma (MeSH) Methods & Equipment: phonomicrosurgery--clinical techniques, therapeutic and prophylactic techniques; laryngoscopy--clinical techniques, therapeutic and prophylactic techniques; microlaryngoscopy--clinical techniques, therapeutic and prophylactic tech niques; phonosurgery--clinical techniques, therapeutic and prophylactic techniques Miscellaneous Terms: Concept Codes: singers; performing artists; treatment outcomes; management theories; future direction; dysphonia; nodule; varix;voice; postsurgical vocal function; voice production efficiency; patient selection; specialized vocal rehabilitation Concept Codes: 11105 Anatomy and Histology - Surgery ANEXO 4: Resultado busqueda en Dialog 12512 Pathology - Therapy 12502 Pathology - General 16004 Respiratory system - Physiology and biochemistry 16006 Respiratory system - Pathology 24004 Neoplasms - Pathology, clinical aspects and systemic effects 37013 Public health - Occupational health Biosystematic Codes: 86215 Hominidae Biosis Previews(R) (Dialog® File 5): (c) 2010 The Thomson Corporation. All rights reserved. 4/9/4 (Item 4 from file: 5) 16041867 Biosis No.: 200100213706 A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques. Guideline elaborated by the Committee on Phoniatrics of the European Laryngological Society (ELS) Author: Dejonckere Philippe H (Reprint); Bradley Patrick; Clemente Pais; Cornut Guy ; Crevier-Buchman Lise; Friedrich Gerhard; Van De Heyning Paul; Remacle Marc; Woisard Virginie Author Address: The Institute of Phoniatrics, University Medical Centre Utrecht, AZU F.02.504, NI-3508 GA, Utrecht, Netherlands**Netherlands Journal: European Archives of Oto-Rhino-Laryngology 258 ( 2 ): p 77-82 February, 2001 2001 Medium: print ISSN: 0937-4477 Document Type: Article; Literature Review Record Type: Abstract Language: English Abstract: The proposal of this basic protocol is an attempt to reach better agreement and uniformity concerning the methodology for functional assessment of pathologic voices. The purpose is to allow relevant comparisons with the literature when presenting / publishing the results of voice treatment, e.g. a phonosurgical technique, or a new / improved instrument or procedure for investigating the pathological voice. Metaanalyses of the results of voice treatments are generally limited and may even be impossible owing to the major diversity in the ways functional outcomes are assessed. A multidimensional set of minimal basic measurements suitable for all "common" dys phonias is proposed. It includes five different approaches: perception (grade, roughness, breathiness), videostroboscopy (closure, regularity, mucosal wave and symmetry), acoustics (jitter, shimmer, Fo-range and softest intensity), aerodynamics (phonation quo tient), and subjective rating by the patient. The protocol is elaborated on the basis of an exhaustive review of the literature, of the experience of the Committee members, and of plenary discussions within the European Laryngological Society. Instrumentation is kept to a minimum, but it is considered essential forprofessionals performing phonosurgery. DESCRIPTORS: Major Concepts: Speech Pathology--Allied Medical Sciences; Otolaryngology--Human Medicine, Medical Sciences; Methods and Techniques Biosystematic Names: Hominidae--Primates, Mammalia, Vertebrata, Chordata, Animalia Organisms: human (Hominidae)--patient Common Taxonomic Terms: Animals; Chordates; Humans; Mammals; Primates; Vertebrates Diseases: dysphonia--respiratory system disease; vocal fold nodules-- respiratory system disease ANEXO 4: Resultado busqueda en Dialog Methods & Equipment: phonosurgical treatment--surgical method, therapeutic method; voice pathology functional assessment protocol--assessment method Miscellaneous Terms: Concept Codes: Committee on Phoniatrics of the European Laryngological Society guidelines; functional outcome; Literature Review Concept Codes: 12502 Pathology - General 11105 Anatomy and Histology - Surgery 12512 Pathology - Therapy 16006 Respiratory system - Pathology 20006 Sense organs - Pathology 20008 Sense organs - Deafness, speech and hearing Biosystematic Codes: 86215 Hominidae Biosis Previews(R) (Dialog® File 5): (c) 2010 The Thomson Corporation. All rights reserved. 3/9/5 (Item 5 from file: 5) 15967337 Biosis No.: 200100139176 [Vocal disorders in students of Teaching College] Original Language Title: Ocena stanu narzadu glosu u studentow szkoly pedagogicznej Author: Sliwinska-Kowalska Mariola (Reprint); Fiszer Marta (Reprint); Niebudek-Bogusz Ewa (Reprint); Kotylo Piotr (Reprint); Rzadzinska Agnieszka (Reprint) Author Address: Sw. Teresy 8, 90-950, Lodz, Poland**Poland Journal: Medycyna Pracy 51 ( 6 ): p 573-580 2000 2000 Medium: print ISSN: 0465-5893 Document Type: Article Record Type: Abstract Language: Polish Abstract: Vocal disorders are very common occupation-related disease in teachers. Their remarkable incidence might be associated with inappropriate techniques of speech and poor vocal hygiene. The aim of this study was to assess the function of vocal organ including voice emission technique in persons starting their teaching occupation. The study group included 66 female students at Teaching College. Their were thoroughly interviewed and subjected to laryngological, phoniatric and videostroboscopic examina tions. All subjects reported subjective symptoms after vocal effort. Hoarseness and throat dryness were the most common. In the majority of students functional vocal dis orders were observed. In 30% of them insufficiency of glottis and in four (6.1%) students soft vocal nodules were found. Signs and symptoms of vocal diseases were more frequent in a subgroup of students exposed to increased vocal effort during theirprofessional education. The results indicate that young teachers are not sufficiently prepared for increased vocal strain, apparently associated with theirprofession. It is indeed necessary to introduce preventive programs including special training of appropriate speech technique, into the curricula of schools for teachers. DESCRIPTORS: Major Concepts: Occupational Health--Allied Medical Sciences; Speech Pathology-- Allied Medical Sciences Biosystematic Names: Hominidae--Primates, Mammalia, Vertebrata, Chordata, Animalia Organisms: human (Hominidae) Organisms: Parts Etc: glottis--respiratory system, insufficiency; throat--dryness Common Taxonomic Terms: Animals; Chordates; Humans; Mammals; Primates; Vertebrates ANEXO 4: Resultado busqueda en Dialog Diseases: occupational disease--disease-miscellaneous; vocal disorders --disease-miscellaneous, signs, symptoms Methods & Equipment: appropriate speech technique training--prevention method; laryngological examination--examination method; phoniatric examination--examination method ; videostroboscopic examination--examination method Miscellaneous Terms: Concept Codes: hoarseness; soft vocal nodules; teacher-vocal disorders Concept Codes: 37013 Public health - Occupational health 16004 Respiratory system - Physiology and biochemistry 20006 Sense organs - Pathology 20008 Sense organs - Deafness, speech and hearing Biosystematic Codes: 86215 Hominidae Biosis Previews(R) (Dialog® File 5): (c) 2010 The Thomson Corporation. All rights reserved. 3/9/6 (Item 6 from file: 5) 13796817 Biosis No.: 199799430877 Vocal disturbances in vocalists caused by benign node neoplasms of the vocal cords: Treatment and rehabilitation Author: Matveeva N V Author Address: Phoniatr. Dep., Conservatoire, M. Dzhalil Opera and Ballet Theatre, Kazan, Russia**Russia Journal: Vestnik Otorinolaringologii 0 ( 6 ): p 30-32 1996 1996 ISSN: 0042-4668 Document Type: Article Record Type: Abstract Language: Russian Abstract: The paper presents data on 5-year followup of 105 patients with neoplasms of the vocal cords. All the examinees belonged to vocal profession(actors, singers, musical students). Among the new growths of the vocal cords true or false vocal nodules occurred most frequently (84%). The second in frequency were fibromas and polyps (15%). Contact granulema occurred only in 2 males with long smoking history. The dia gnosis and treatment efficacy assessment were performed using measurement of maximal phonation time, electrone laryngostroboscopy, electrone glottography. DESCRIPTORS: Major Concepts: Behavior; Oncology--Human Medicine, Medical Sciences; Pathology; Psychiatry --Human Medicine, Medical Sciences; Respiratory System--Respiration; Toxic ology Biosystematic Names: Hominidae--Primates, Mammalia, Vertebrata, Chordata, Animalia Organisms: human (Hominidae) Common Taxonomic Terms: Animals; Chordates; Humans; Mammals; Primates; Vertebrates Miscellaneous Terms: Concept Codes: BENIGN NODOSE VOCAL CORD NEOPLASMS; DIAGNOSTIC METHOD; ELECTRON GLOTTOGRAPHY; ELECTRON LARYNGOSTROBOSCOPY; FALSE; MALE; MAXIMAL PHONATION TIME MEASUREMENT; ONCOLOGY; PATIENT; RESPIRATORY SYSTEM; RESPIRATORY SYSTEM DISEASE; SINGER; SMOKING; TREATMENT; TRUE; VOCAL CORD FIBROMA;VOCAL CORD GRANULOMA; VOCAL CORD POLYPS; VOCAL DISTURBANCES Concept Codes: 07004 Behavioral biology - Human behavior 12504 Pathology - Diagnostic ANEXO 4: Resultado busqueda en Dialog 12512 Pathology - Therapy 16001 Respiratory system - General and methods 21004 Psychiatry - Addiction: alcohol, drugs, smoking 22501 Toxicology - General and methods 24002 Neoplasms - General Biosystematic Codes: 86215 Hominidae Biosis Previews(R) (Dialog® File 5): (c) 2010 The Thomson Corporation. All rights reserved. 3/9/7 (Item 7 from file: 5) 12313952 Biosis No.: 199497335237 Vocal problems among aerobic instructors and aerobic participants Author: Heidel Sandra E (Reprint); Torgerson John K Author Address: 803 Douglas Rd., Weyburn, Saskatchewan, SK S4H 2M9, Canada**Canada Journal: Journal of Communication Disorders 26 ( 3 ): p 179-191 1993 1993 ISSN: 0021-9924 Document Type: Article Record Type: Abstract Language: English Abstract: A questionnaire to determine the characteristics of vocal problems was distributed to 75 female aerobic instructors and 75 female aerobic participants ranging in age from 20 to 40 years. Of the questionnaires returned, 50 from each group, with completed replies to all questions, were selected for inclusion in the study. The question naires, constructed by the investigator, included pertinent questions relative to length of teaching/participating experience, average number of classes taught/participated in weekly, number of classes taught/participated sequentially, type of aerobics, medical his tory and history of vocal problems and/or conditions, water intake daily and during in structing/participating, sleep habits, and smoking habits. The results indicated that aer obic instructors generally experienced more hoarseness and episodes of voice loss during and after instructing and a significantly higher prevalence of nodules. The group differ ences in reported unrelated episodes of hoarseness, however, were quite similar. The results suggest that aerobic instructors experience a higher prevalence of vocal problems when compared to individuals participating in aerobics. DESCRIPTORS: Major Concepts: Human Ecology--Anthropology; Occupational Health--Allied Medical Sciences; Pulmonary Medicine--Human Medicine, Medical Sciences; Sense Organs--Sens ory Reception Biosystematic Names: Hominidae--Primates, Mammalia, Vertebrata, Chordata, Animalia Organisms: human (Hominidae) Common Taxonomic Terms: Animals; Chordates; Humans; Mammals; Primates; Vertebrates Miscellaneous Terms: Concept Codes: HOARSENESS; NODULE; VOICE LOSS Concept Codes: 05500 Social biology and human ecology 12010 Physiology - Exercise and physical therapy 16006 Respiratory system - Pathology 20006 Sense organs - Pathology 20008 Sense organs - Deafness, speech and hearing 37013 Public health - Occupational health Biosystematic Codes: 86215 Hominidae ANEXO 4: Resultado busqueda en Dialog Biosis Previews(R) (Dialog® File 5): (c) 2010 The Thomson Corporation. All rights reserved. 3/9/8 (Item 8 from file: 5) 10764812 Biosis No.: 199192010583 MANAGEMENT OF VOCAL NODULES A REGIONAL SURVEY OF OTOLARYNGOLOGISTS AND SPEECH-LANGUAGE PATHOLOGISTS Author: ALLEN M S (Reprint); PETTIT J M; SHERBLOM J C Author Address: CONLEY SPEECH HEARING CENTER, UNIV MAINE, ORONO, MAINE 04469, USA**USA Journal: Journal of Speech and Hearing Research 34 ( 2 ): p 229-235 1991 ISSN: 0022-4685 Document Type: Article Record Type: Abstract Language: ENGLISH Abstract: This study surveyed 21 otolaryngologists (70% return) and 32 speech-language pathologists (46% return) in Maine about the treatment of vocal nodules in chil dren and adults, referral patterns, effectiveness of therapy, and adequacy of speech-language pathologists' training. Differences in opinions between the two professional groups were found in treatment of children and referral patients. Descriptors: HUMAN REFERRAL PATTERN THERAPY EFFECTIVENESS MEDICAL TRAINING MAINE USA DESCRIPTORS: Major Concepts: Public Health--Allied Medical Sciences; Pulmonary Medicine--Human Medicine, Medical Sciences; Sense Organs--Sensory Reception Biosystematic Names: Hominidae--Primates, Mammalia, Vertebrata, Chordata, Animalia Common Taxonomic Terms: Animals; Chordates; Humans; Mammals; Primates; Vertebrates Concept Codes: 00514 General biology - General textbooks and audio-visual aids 05500 Social biology and human ecology 12512 Pathology - Therapy 16006 Respiratory system - Pathology 20006 Sense organs - Pathology 20008 Sense organs - Deafness, speech and hearing 37012 Public health - Health services and medical care Biosystematic Codes: 86215 Hominidae Biosis Previews(R) (Dialog® File 5): (c) 2010 The Thomson Corporation. All rights reserved. 4/9/9 (Item 9 from file: 5) 10492109 Biosis No.: 199141004735 STRUCTURAL AND NEUROLOGICAL DISORDERS AND SURGERY OF THE VOICE Book Title: SATALOFF, R. T. PROFESSIONAL VOICE: THE SCIENCE AND ART OF CLINICAL CARE. XVII+542P. RAVEN PRESS: NEW YORK, NEW YORK, USA. ILLUS Author: SATALOFF R T (Reprint) Author Address: DEP OTOLARNYGOL, THOMAS JEFFERSON UNIV, 1721 PINE ST, PHILADELPHIA, PA 19103, USA**USA p 267-300 1991 ISBN: 0-88167-737-X ANEXO 4: Resultado busqueda en Dialog Document Type: Book Record Type: Citation Language: ENGLISH Descriptors: HUMAN ARYTENOID SPASMODIC DYSPHONIA PARALYSIS TRAUMA NODULES POLYPS VOICE ABUSE CYSTS GRANULOMA ULCER REINKES EDEMA HEMORRHAGE MYASTHENIA GRAVIS DESCRIPTORS: Major Concepts: Cardiovascular Medicine--Human Medicine, Medical Sciences; Clinical Endocrinology--Human Medicine, Medical Sciences; Muscular System--Movement and Support; Neurology--Human Medicine, Medical Sciences; Pathology; Psychiatry--Human Medicine, Medical Sciences; Pulmonary Medicine--Human Medicine, Medical Sciences; Respiratory System--Respiration; Sense Organs-- Sensory Reception; Surgery--Medical Sciences Biosystematic Names: Hominidae--Primates, Mammalia, Vertebrata, Chordata, Animalia Common Taxonomic Terms: Animals; Chordates; Humans; Mammals; Primates; Vertebrates Concept Codes: 07004 Behavioral biology - Human behavior 11105 Anatomy and Histology - Surgery 12503 Pathology - Comparative 12508 Pathology - Inflammation and inflammatory disease 12512 Pathology - Therapy 14508 Cardiovascular system - Blood vessel pathology 16002 Respiratory system - Anatomy 16006 Respiratory system - Pathology 17506 Muscle - Pathology 18002 Bones, joints, fasciae, connective and adipose tissue - Anatomy 20006 Sense organs - Pathology 20008 Sense organs - Deafness, speech and hearing 20506 Nervous system - Pathology 21002 Psychiatry - Psychopathology, psychodynamics and therapy 34508 Immunology - Immunopathology, tissue immunology 37013 Public health - Occupational health Biosystematic Codes: 86215 Hominidae Biosis Previews(R) (Dialog® File 5): (c) 2010 The Thomson Corporation. All rights reserved. 4/9/10 (Item 10 from file: 5) 10125632 Biosis No.: 199089043523 A SPECTRAL ANALYSIS OF THE VOICE BEFORE AND AFTER THE SURGICAL REMOVAL OF THE VOCAL POLYP AND NODULE Author: YANG G (Reprint) Author Address: DEP OTORHINOLARYNGOL, THIRD AFFILIATED HOSP Journal: Journal of China Medical University 18 ( 3 ): p 228-229, 236 1989 ISSN: 0258-4646 Document Type: Article Record Type: Abstract Language: CHINESE Abstract: Effects of the surgical removal of the vocal polyps and nodules in 33 patients were evaluated by spectral analysis. A comparison of the vocal register, falsetto as well as noise component was made pre- and postoperatively. The human voices of these cases were showed in digital and graphic forms under the control of computer. In order to obtain a statistical analysis comparisons of data of mean values were made using the ANEXO 4: Resultado busqueda en Dialog Students t-test. According to the results from the present study, it could be concluded that the effects of the surgical procedures could be evaluated objectively and quantitat ively, and that spectral analysis could provide reliable evidence for the comparison of the effects of various surgical procedures and for the evaluation of vocal ability following the phonosurgery for the patients who were professional singers or other speakers such as teachers and shop assistants. Descriptors: SINGER VOICE TEACHER PHONOSURGERY DESCRIPTORS: Major Concepts: Mathematical Biology--Computational Biology; Occupational Health-Allied Medical Sciences; Oncology--Human Medicine, Medical Sciences; Sense Organs-Sensory Reception; Surgery--Medical Sciences Biosystematic Names: Hominidae--Primates, Mammalia, Vertebrata, Chordata, Animalia Common Taxonomic Terms: Animals; Chordates; Humans; Mammals; Primates; Vertebrates Concept Codes: 00530 General biology - Information, documentation, retrieval and computer applications 04500 Mathematical biology and statistical methods 11105 Anatomy and Histology - Surgery 19001 Dental - General and methods 20001 Sense organs - General and methods 20008 Sense organs - Deafness, speech and hearing 24008 Neoplasms - Therapeutic agents and therapy 37013 Public health - Occupational health Biosystematic Codes: 86215 Hominidae Biosis Previews(R) (Dialog® File 5): (c) 2010 The Thomson Corporation. All rights reserved. 4/9/11 (Item 11 from file: 5) 09640029 Biosis No.: 198987087920 CLINICAL EFFECT OF VOICE THERAPY USING YAWNING BREATHING PATTERN Author: XU J (Reprint); KOMIYAMA S; RYU S Author Address: DEP OTORHINOLARYNGOL, FAC MED, KYUSHU UNIV, FUKUOKA 812, JPN**JAPAN Journal: Otologia Fukuoka 34 ( 6 ): p 1448-1452 1988 Document Type: Article Record Type: Abstract Language: JAPANESE Abstract: As most specialists know, one of the most important factors for professional singers is the ability to master correct breathing. It has been observed that the breathing pattern used when yawning is very similar to the breathing pattern used while singing the Italian Bel Canto. The authors treated 91 cases suffering from singers nodules, recurrent nerve paralysis and glottal chink. Patients were given clinical voice train ing utilizing the "yawning" breathing pattern. In judging the results, objective standards were designed for evaluation of phono-exams. The effects have been analysed statistically. They showed that the therapy using the yawning-like breathing pattern is effective for those dysophonic symptoms. Descriptors: HUMAN DYSPHONIA SINGER'S NODULES NERVE PARALYSIS GLOTTAL CHINK DESCRIPTORS: Major Concepts: Neurology--Human Medicine, Medical Sciences; Pulmonary Medicine-Human Medicine, Medical Sciences; Respiratory System--Respiration; Sense Organs-- ANEXO 4: Resultado busqueda en Dialog Sensory Reception Biosystematic Names: Hominidae--Primates, Mammalia, Vertebrata, Chordata, Animalia Common Taxonomic Terms: Animals; Chordates; Humans; Mammals; Primates; Vertebrates Concept Codes: 07004 Behavioral biology - Human behavior 12512 Pathology - Therapy 16001 Respiratory system - General and methods 16006 Respiratory system - Pathology 20006 Sense organs - Pathology 20008 Sense organs - Deafness, speech and hearing 20506 Nervous system - Pathology 21003 Psychiatry - Psychophysiology Biosystematic Codes: 86215 Hominidae Biosis Previews(R) (Dialog® File 5): (c) 2010 The Thomson Corporation. All rights reserved. 4/9/12 (Item 12 from file: 5) 09137171 Biosis No.: 198885106062 DESCRIPTION OF LARYNGEAL PATHOLOGIES BY AGE SEX AND OCCUPATION IN A TREATMENT-SEEKING SAMPLE Author: HERRINGTON-HALL B L (Reprint); LEE L; STEMPLE J C; NIEMI K R; MCHONE M M Author Address: SPEECH PATHOL, M L 379, UNIV CINCINNATI, CINCINNATI, OHIO 45221, USA**USA Journal: Journal of Speech and Hearing Disorders 53 ( 1 ): p 57-64 1988 ISSN: 0022-4677 Document Type: Article Record Type: Abstract Language: ENGLISH Abstract: The purpose of the present investigation was to describe the occurrence of laryngeal pathologies and their distribution across age, sex, and occupation in a group of persons seeking physician treatment. Data were collected on 1,262 patients seen by eight otolaryngologists from three different residential areas. The five most frequent pathologies reported were nodules, edema, polyps, laryngeal cancer, and vocal fold paralysis. For the total sample, pathologies occurred more frequently in females than in males; however, certain pathologies were more common to one sex than the other. The voice-disordered population appears to be getting older. The top five occupations associated with laryngeal pathologies were retired persons, homemakers, factory workers, unemployed, and executive/managers. Comparisons with similar investigations were made. Descriptors: HUMAN VOICE DISORDERS NODULES EDEMA POLYPS LARYNGEAL CANCER VOCAL FOLD PARALYSIS FEMALE ORIENTED RETIREE HOMEMAKERS FACTORY WORKERS DESCRIPTORS: Major Concepts: Development; Occupational Health--Allied Medical Sciences; Public Health--Allied Medical Sciences; Pulmonary Medicine--Human Medicine, Medical Sci ences; Sense Organs--Sensory Reception Biosystematic Names: Hominidae--Primates, Mammalia, Vertebrata, Chordata, Animalia Common Taxonomic Terms: Animals; Chordates; Humans; Mammals; Primates; Vertebrates ANEXO 4: Resultado busqueda en Dialog Concept Codes: 03510 Genetics - Sex differences 12504 Pathology - Diagnostic 12508 Pathology - Inflammation and inflammatory disease 12512 Pathology - Therapy 15010 Blood - Other body fluids 16006 Respiratory system - Pathology 20006 Sense organs - Pathology 20008 Sense organs - Deafness, speech and hearing 24004 Neoplasms - Pathology, clinical aspects and systemic effects 25508 Development and Embryology - Morphogenesis 37012 Public health - Health services and medical care 37013 Public health - Occupational health Biosystematic Codes: 86215 Hominidae Biosis Previews(R) (Dialog® File 5): (c) 2010 The Thomson Corporation. All rights reserved. 3/9/13 (Item 13 from file: 5) 08828541 Biosis No.: 198834057432 COMMON DIAGNOSES AND TREATMENTS IN PROFESSIONAL VOICE USERS Author: SATALOFF R T (Reprint) Author Address: 1721 PINE STREET, PHILADELPHIA, PA 19103, USA**USA Journal: Medical Problems of Performing Artists 2 ( 1 ): p 15-20 1987 ISSN: 0885-1158 Document Type: Article Record Type: Citation Language: ENGLISH Descriptors: HUMAN GASTRIC REFLUX LARYNGITIS LARYNGOPATHIA GRAVIDARUM VOICE ABUSE ANXIETY SUBSTANCE ABUSE REINKES EDEMA VOCAL NODULE DESCRIPTORS: Major Concepts: Behavior; Dental Medicine--Human Medicine, Medical Sciences; Gastroenterology--Human Medicine, Medical Sciences; OccupationalHealth--Allied Medical Sciences; Pathology; Psychiatry--Human Medicine, Medical Sciences; Pulmonary Medi cine--Human Medicine, Medical Sciences; Reproductive System--Reproduction Biosystematic Names: Hominidae--Primates, Mammalia, Vertebrata, Chordata, Animalia Common Taxonomic Terms: Animals; Chordates; Humans; Mammals; Primates; Vertebrates Concept Codes: 07004 Behavioral biology - Human behavior 10011 Biochemistry - Physiological water studies 12504 Pathology - Diagnostic 12508 Pathology - Inflammation and inflammatory disease 12512 Pathology - Therapy 14006 Digestive system - Pathology 15010 Blood - Other body fluids 16006 Respiratory system - Pathology 16504 Reproductive system - Physiology and biochemistry 19001 Dental - General and methods 19006 Dental - Pathology 21003 Psychiatry - Psychophysiology 21004 Psychiatry - Addiction: alcohol, drugs, smoking 22504 Toxicology - Pharmacology 24001 Neoplasms - Diagnostic methods 37013 Public health - Occupational health ANEXO 4: Resultado busqueda en Dialog Biosystematic Codes: 86215 Hominidae Biosis Previews(R) (Dialog® File 5): (c) 2010 The Thomson Corporation. All rights reserved. 4/9/14 (Item 14 from file: 5) 08182588 Biosis No.: 198682028975 THE USE OF PERCEPTUAL METHODS BY NEW CLINICIANS FOR ASSESSING VOICE QUALITY Author: BASSICH C J (Reprint); LUDLOW C L Author Address: SPEECH PATHOL UNIT, HUMAN MOTOR CONTROL SECT, MNB-NINCDS, BUILD 10, ROOM 5N226, BETHESDA, MD 20892, USA**USA Journal: Journal of Speech and Hearing Disorders 51 ( 2 ): p 125-132 1986 ISSN: 0022-4677 Document Type: Article Record Type: Abstract Language: ENGLISH Abstract: The purpose of this study was to determine the validity and reliability of using perceptual ratings for assessing voice quality in patients with vocal fold nodules or polyps. A 13-dimension perceptual rating system was modeled after systems currently in clinical use. To meet the criterion of 80% mean interjudge reliability, eight hours of train ing were required for four previously inexperienced listeners. Extended vowel phonations of patients and controls were then rated blindly by the same listeners. Interjudge reliab ility was greater than .90 for three dimensions judged in the pathological phonations, while intrajudge test-retest agreement was less than 75% on five dimensions. Validity was demonstrated with 100% correct assignment to group by computing a discriminant function employing all dimensions. Despite the extensive training procedures used, our reliability data were not comparable to those reported when highly experienced judges have been used, suggesting that the task of perceptually rating voice quality is difficult and requires extensive professional experience. Descriptors: VOCAL FOLD NODULE POLYPS PHONATION DIAGNOSIS STATISTICS DESCRIPTORS: Major Concepts: Behavior; Pathology; Pulmonary Medicine--Human Medicine, Medical Sciences; Sense Organs--Sensory Reception Biosystematic Names: Hominidae--Primates, Mammalia, Vertebrata, Chordata, Animalia Common Taxonomic Terms: Animals; Chordates; Humans; Mammals; Primates; Vertebrates Concept Codes: 04500 Mathematical biology and statistical methods 07004 Behavioral biology - Human behavior 12504 Pathology - Diagnostic 16006 Respiratory system - Pathology 20004 Sense organs - Physiology and biochemistry 20006 Sense organs - Pathology 20008 Sense organs - Deafness, speech and hearing 21003 Psychiatry - Psychophysiology Biosystematic Codes: 86215 Hominidae Biosis Previews(R) (Dialog® File 5): (c) 2010 The Thomson Corporation. All rights reserved. 3/9/15 (Item 15 from file: 5) ANEXO 4: Resultado busqueda en Dialog 06684232 Biosis No.: 198324018175 DIAGNOSIS AND TREATMENT OF ORGANIC VOICE DISORDERS Author: VAUGHAN C W (Reprint) Author Address: SECT OTOLARYNGOL, BOSTON VA MED CENT, 150 S HUNTINGTON AVE, BOSTON, MA 02130, USA**USA Journal: New England Journal of Medicine 307 ( 14 ): p 863-866 1982 ISSN: 0028-4793 Document Type: Article Record Type: Citation Language: ENGLISH Descriptors: CHILDREN TREATMENT SURGERY OCCUPATIONAL HEALTH LARYNGITIS NODES POLYPS GRANULOMA NEOPLASIA PARALYSIS DESCRIPTORS: Major Concepts: Muscular System--Movement and Support; Neurology--Human Medicine, Medical Sciences; Oncology--Human Medicine, Medical Sciences; Pediatrics--Human Medicine, Medical Sciences; Pulmonary Medicine--Human Medicine, Medical Sciences; Sense Organs--Sensory Reception; Surgery--Medical Sciences Biosystematic Names: Hominidae--Primates, Mammalia, Vertebrata, Chordata, Animalia Common Taxonomic Terms: Animals; Chordates; Humans; Mammals; Primates; Vertebrates Concept Codes: 11105 Anatomy and Histology - Surgery 12508 Pathology - Inflammation and inflammatory disease 16001 Respiratory system - General and methods 16006 Respiratory system - Pathology 17501 Muscle - General and methods 17506 Muscle - Pathology 20001 Sense organs - General and methods 20006 Sense organs - Pathology 20008 Sense organs - Deafness, speech and hearing 20501 Nervous system - General and methods 20506 Nervous system - Pathology 24001 Neoplasms - Diagnostic methods 24007 Neoplasms - Carcinogens and carcinogenesis 25000 Pediatrics 37013 Public health - Occupational health Biosystematic Codes: 86215 Hominidae Biosis Previews(R) (Dialog® File 5): (c) 2010 The Thomson Corporation. All rights reserved. 3/9/16 (Item 16 from file: 5) 06082216 Biosis No.: 198120031183 FUNCTIONAL DISORDERS OF THE VOICE AND THEIR TREATMENT Author: HABERMANN G (Reprint) Author Address: BEETHOVENSTRASSE 7, D-6232 BAD SODEN A TS, BUNDESREPUBLIK DEUTSCHLAND**WEST GERMANY Journal: Archives of Oto-Rhino-Laryngology 227 ( 1-2 ): p 171-345 1980 ISSN: 0302-9530 Document Type: Article Record Type: Citation Language: GERMAN Descriptors: HUMAN OCCUPATIONAL HEALTH HOARSENESS VOCAL CORD NODULE VOICE THERAPY ANEXO 4: Resultado busqueda en Dialog DESCRIPTORS: Major Concepts: Behavior; Occupational Health--Allied Medical Sciences; Pulmonary Medicine--Human Medicine, Medical Sciences; Sense Organs--Sensory Reception Biosystematic Names: Hominidae--Primates, Mammalia, Vertebrata, Chordata, Animalia Common Taxonomic Terms: Animals; Chordates; Humans; Mammals; Primates; Vertebrates Concept Codes: 07004 Behavioral biology - Human behavior 12010 Physiology - Exercise and physical therapy 12512 Pathology - Therapy 16001 Respiratory system - General and methods 16006 Respiratory system - Pathology 20001 Sense organs - General and methods 20006 Sense organs - Pathology 20008 Sense organs - Deafness, speech and hearing 20504 Nervous system - Physiology and biochemistry 21003 Psychiatry - Psychophysiology 37013 Public health - Occupational health Biosystematic Codes: 86215 Hominidae Biosis Previews(R) (Dialog® File 5): (c) 2010 The Thomson Corporation. All rights reserved. 4/9/17 (Item 17 from file: 5) 05884466 Biosis No.: 198019060955 CRITERIA OF DIAGNOSIS OF OCCUPATIONAL DISEASES OF THE VOCAL APPARATUS AND PROBLEMS OF MEDICAL EXPERT EVALUATION OF WORKING CAPACITY Author: VASILENKO YU S (Reprint); PANKOVA V B; KUDINOVA O V Author Address: MOSC RES INST EAR NOSE THROAT, MINIST HEALTH RSFSR, MOSCOW, USSR**USSR Journal: Vestnik Otorinolaringologii ( 5 ): p 75-77 1979 ISSN: 0042-4668 Document Type: Article Record Type: Citation Language: RUSSIAN Descriptors: HUMAN VOCAL FOLD NODULE PHONASTHENIA HYPER KINETIC DYSTROPHY LARYNGITIS VASO MOTOR MONO CORDITIS POLYPS CONTACT ULCER DESCRIPTORS: Major Concepts: Occupational Health--Allied Medical Sciences; Pulmonary Medicine-Human Medicine, Medical Sciences; Sense Organs--Sensory Reception Biosystematic Names: Hominidae--Primates, Mammalia, Vertebrata, Chordata, Animalia Common Taxonomic Terms: Animals; Chordates; Humans; Mammals; Primates; Vertebrates Concept Codes: 12504 Pathology - Diagnostic 12508 Pathology - Inflammation and inflammatory disease 14508 Cardiovascular system - Blood vessel pathology 16006 Respiratory system - Pathology 17504 Muscle - Physiology and biochemistry 20006 Sense organs - Pathology 20008 Sense organs - Deafness, speech and hearing 37013 Public health - Occupational health Biosystematic Codes: ANEXO 4: Resultado busqueda en Dialog 86215 Hominidae Biosis Previews(R) (Dialog® File 5): (c) 2010 The Thomson Corporation. All rights reserved. 4/9/18 (Item 1 from file: 162) 0005492248 CAB Accession Number: 20093136108 Health monitoring protocol for teachers regarding occupational diseases. Original Title: Protocolo para la vigilancia de la salud del profesorado con atencion a la enfermedad profesional. Ranchal Sanchez, A.; Vaquero Abellan, M. Universidad de Cordoba, Cordoba, Spain. Medicina y Seguridad del Trabajo vol. 54 ( 211 ): p.47-60 Publication Year: 2008 ISSN: 0465-546x Publisher: Escuela Nacional de Medicina del Trabajo, Ciudad Universitaria Pabellon , Spain Language: Spanish Summary Language: English Record Type: Abstract Document Type: Journal article Teaching is one of the main economical sectors. Teachers require an optimum level of occupational health to adequately perform their task. Since the entry into force of Real Decreto 1299/2006, "Nodules of the vocal cords because of the sustained efforts of the voice for professional reasons" constitute an occupationaldisease for teachers, a new issue for this group. The purpose of this paper is the proposal of a procedure for monitoring the health of the teaching staff. This is a matter that arises from an epidemi ological research in order to find out how a representative sample of secondary education teaching staff could fall ill, considering variables of occupational health. The most frequent pathology appearing in the surveyed population was analysed, among which disorders of the voice were found including vocal cord nodules. The importance of diagnosing this disease requires it to be included in medical check-ups done to the teaching staff for the Health Surveillance. Hence, a procedure to facilitate the specific health exam, as well as the approach for its possible diagnosis were proposed. 19 ref. Descriptors: diagnosis; human diseases; laryngeal cancer; monitoring; neoplasms; nodules; occupational disorders; occupational hazards; occupationalhealth; teachers; voice Identifiers: cancers; surveillance systems Organism Descriptors: man Geographic Names: Spain Broader Terms: Homo; Hominidae; Primates; mammals; vertebrates; Chordata; animals; eukaryotes; Southern Europe; Europe; Mediterranean Region; Developed Countries; European Union Countries; OECD Countries CABICodes: Non-communicable Human Diseases and Injuries (VV600); Diagnosis of Human Disease, (New March 2000) (VV720); Occupational Health and Safety (VV900) Global Health (Dialog® File 162): (c) 2010 CAB International. All rights reserved. 4/9/19 (Item 1 from file: 34) 20291659 Genuine Article#: 556QA Number of References: 16 Title: The Prevalence of Laryngeal Pathology in a Treatment-Seeking Population With Dysphonia Author: Van Houtte E (REPRINT) ; Van Lierde K; D'Haeseleer E; Claeys S Author Email Address: evelyne.vanhoutte@ugent.be Corporate Source: Univ Ziekenhuis Ghent,Neus Keel Oorhelkunde 1P1,De Pintelaan 185/B-9000 Ghent//Belgium/ (REPRINT); Ghent Univ Hosp,Dept Otolaryngol,B-9000 ANEXO 4: Resultado busqueda en Dialog Ghent//Belgium/ Journal: LARYNGOSCOPE , 2010 , V 120 , N2 ( FEB ) , P 306-312 ISSN: 0023-852X Publication Date: 20100200 Digital Object Identifier: 10.1002/lary.20696 Publisher: JOHN WILEY & SONS INC , 111 RIVER ST, HOBOKEN, NJ 07030 USA Language: English Document Type: ARTICLE Geographic Location: Belgium Journal Subject Category: MEDICINE, RESEARCH & EXPERIMENTAL; OTORHINOLARYNGOLOGY Abstract: Objectives/Hypothesis. This article describes the prevalence of laryngeal pathology in a treatment-seeking population with dysphonia in the Flemish part of Belgi um. Study Design. Retrospective investigation. Methods. During a period of 5 years (2004-2008), data were collected from 882 patients who consulted with dysphonia at the ear, nose, and throat department of the Uni versity Hospital in Ghent (Belgium). Laryngeal pathology was diagnosed using video stroboscopy. Ages ranged from 4 years to 90 years. Results. Functional voice disorders were most frequently diagnosed (30%), followed by vocal fold nodule (15%), and pharyngolaryngeal reflux (9%). The role of age, gender, and occupation was investigated. Pathologies were significantly more common in females than in males, representing 63.8% and 36.2% of the population, respectively. Professional voice users accounted for 41% of the workforce population, with teachers as main subgroup. In professional voice users, functional dysphonia occurred in 41%, vocal fold nodules in 15%, and pharyngolaryngeal reflux in 11%. Our data were compared with data from other countries. Conclusions. Functional voice disorders were overall the most common cause of voice disorders (except in childhood), followed by vocal fold nodules and pharyngolaryn geal reflux. Professional voice users accounted for almost one half of the active population, with functional voice disorders as the main cause of dysphonia. Descriptors: SCIAuthor Keywords: Prevalence ; voice disorders ; dysphonia ; laryngeal pathology ; stroboscopy Identifiers: KeyWord Plus(R): VOICE PROBLEMS; TENSION DYSPHONIA; TEACHERS; DISORDERS; NODULES; AGE Cited References: ALTMAN KW, 2005, V19, P261, J VOICE CARDING PN, 2006, V20, P623, J VOICE COHEN SM, 2008, V118, P363, LARYNGOSCOPE COYLE SM, 2001, V15, P424, J VOICE DEJONG FICRS, 2006, V58, P186, FOLIA PHONIATR LOGO FORTES FS, 2007, V73, P27, REV BRAS OTORRINOLAR HERRINGTONHALL BL, 1988, V53, P57, J SPEECH HEAR DISORD JIANG JJ, 1998, V107, P603, ANN OTO RHINOL LARYN KILIC MA, 2004, V68, P409, INT J PEDIATR OTORHI MORRISON MD, 1983, V12, P302, J OTOLARYNGOL MORRISON MD, 1993, V113, P428, ACTA OTO-LARYNGOL ROY N, 2004, V47, P281, J SPEECH LANG HEAR R ROY N, 2003, V11, P144, CURR OPIN OTOLARYNGO RUSSELL A, 1998, V12, P467, J VOICE SMITH E, 1998, V12, P328, J VOICE SULKOWSKI WJ, 2005, V18, P341, INT J OCCUP MED ENV SciSearch(R) Cited Ref Sci (Dialog® File 34): (c) 2010 The Thomson Corp. All rights reserved. ANEXO 4: Resultado busqueda en Dialog 4/9/20 (Item 2 from file: 34) 19283117 Genuine Article#: 452XQ Number of References: 81 Title: Vocal hygiene for the voice professional Author: Behlau M (REPRINT) ; Oliveira G Corporate Source: CEV,Ctr Voice Studies,Rua Machado Bittencourt 361/BR-04044001 Sao Paulo//Brazil/ (REPRINT); CEV,Ctr Voice Studies,BR-04044001 Sao Paulo//Brazil/; Univ Fed Sao Paulo,UNIFESP, Dept Speech Language Pathol & Audiol,Sao Paulo//Brazil/ Journal: CURRENT OPINION IN OTOLARYNGOLOGY & HEAD AND NECK SURGERY , 2009 , V 17 , N3 ( JUN ) , P 149-154 ISSN: 1068-9508 Publication Date: 20090600 Publisher: LIPPINCOTT WILLIAMS & WILKINS , 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA Language: English Document Type: ARTICLE Geographic Location: Brazil Journal Subject Category: OTORHINOLARYNGOLOGY Abstract: Purpose This article presents the current state of knowledge regarding vocal hygiene for the voice professional. Recent findings Research regarding vocal hygiene has primarily focused on two areas: vocal hygiene as a preventive strategy, and vocal hygiene as a management technique for individuals with voice disorders. It is difficult to assess the effectiveness of vocal hygiene as a pre ventive tool as programs are often expensive leading to limited data. Vocal hygiene as a sole strategy for the treatment of voice disorders has shown minimal, but favorable results. As a component of a comprehensive therapeutic program, it is difficult to isolate the influence of vocal hygiene. However, limited components of vocal hygiene including hy dration and vocal rest have been associated with improved therapeutic outcomes. In ad dition, the current literature proposes a paradigm shift away from more restrictive therapy approaches to a holistic approach to vocal well being. Summary Vocal hygiene should be considered only as a component of a broad vocal rehabilitation program. The role of vocal hygiene as a means to prevent voice disorders remains unproven. Additionally, some of the findings may be applied to both dysphonic and healthy individuals in order to facilitate vocal well being. Descriptors: SCIAuthor Keywords: actors ; professional voice users ; singers ; teachers ; vocal hygiene ; voice care Identifiers: KeyWord Plus(R): PHONATION THRESHOLD PRESSURE; RANDOMIZED CLINICAL-TRIAL; WARM-UP; LARYNGOPHARYNGEAL REFLUX; LARYNGEAL NODULES; RISK-FACTORS; TEACHERS; SINGERS; DISORDERS; HYDRATION Cited References: ABITBOL J, 1999, V13, P424, J VOICE BEHAU M, 2001, P 25 WORLD C INT ASS BEHLAU M, 2008, J VOICE IN PRESS BEHLAU M, 1996, P179, VOICE THERAPY BENIGN BEHRMAN A, 2008, V51, P350, J SPEECH LANG HEAR R BEHRMAN A, 2003, V113, P2182, LARYNGOSCOPE BOVE MJ, 2008, V22, P326, J VOICE BOVO R, 2007, V21, P705, J VOICE BRAUNJANZEN C, 2008, J VOICE IN PRESS BROADDUSLAWRENCE PL, 2000, V14, P58, J VOICE CAMMAROTA G, 2007, V132, P890, GASTROENTEROLOGY ANEXO 4: Resultado busqueda en Dialog CARDING PN, 1999, V13, P72, J VOICE CARROLL T, 2006, V135, P595, OTOLARYNG HEAD NECK CESARI U, 2004, V24, P13, ACTA OTORHINOLARYNGO DIETRICH M, 2008, V22, P472, J VOICE DUFFY OM, 2004, V18, P63, J VOICE ELLIOT N, 1995, V9, P37, J VOICE FERREIRA AE, 1999, P 2 WORLD VOIC C 5 I FLETCHER HA, 2007, V21, P80, J VOICE GILMAN M, 2007, J VOICE IN PRESS GOTTLIEBSON RO, 2007, V21, P699, J VOICE HAMDAN AL, 2006, V132, P547, ARCH OTOLARYNGOL HERMAN HH, 2005, V2, P757, PROFESSIONAL VOICE S HILLMAN RE, 2006, V115, P795, ANN OTO RHINOL LARYN HOFFMANRUDDY B, 2001, V15, P543, J VOICE ILOMAAKI I, 2008, V33, P83, LOGOP PHONIATR VOCO JIANG J, 2000, V109, P568, ANN OTO RHINOL LARYN KAMBEYANDA D, 1997, V9, P95, ASSIST TECHNOL KARKOS PD, 2007, V116, P24, ANN OTO RHINOL LARYN KIESEHIMMEL C, 1998, V255, P296, EUR ARCH OTO-RHINO-L KITCH JA, 1994, V8, P207, J VOICE KLEINSASSER O, 1982, V91, P378, ANN OTO RHINOL LARYN KOUFMAN J, 1996, V10, P215, J VOICE KOUFMAN J, 1989, V3, P87, J VOICE KRECICKI T, 2004, V17, P279, INT J OCCUP MED ENV LAW RYW, 2007, V53, P91, AUST J PHYSIOTHER LEINO T, 2008, V60, P199, FOLIA PHONIATR LOGO LUNDY DS, 1999, V121, P69, OTOLARYNG HEAD NECK MCALEAVY GJ, 2008, V122, P691, PUBLIC HEALTH MCHENRY M, 2008, J VOICE IN PRESS MCNAIR PJ, 2001, V33, P354, MED SCI SPORT EXER MILBRATH RL, 2003, V46, P422, J SPEECH LANG HEAR R MORAES JPP, 2002, V97, P241, AM J GASTROENTEROL MOTEL T, 2003, V17, P160, J VOICE MURRY T, 2000, V14, P575, J VOICE NAVALTA JW, 2007, V21, P1305, J STRENGTH COND RES NEELY JL, 2000, V14, P272, J VOICE PONTES PAD, 1999, V109, P289, LARYNGOSCOPE 1 PUNT NA, 1974, V26, P287, FOLIA PHONIATR RAPHAEL BN, 2005, VOCAL HLTH PEDAGOGY RICHTER B, 2002, V16, P72, J VOICE ROSEN DC, 2005, V2, P557, PROFESSIONAL VOICE S ROY N, 2001, V44, P286, J SPEECH LANG HEAR R ROY N, 2003, V46, P670, J SPEECH LANG HEAR R ROY N, 2002, V45, P625, J SPEECH LANG HEAR R RUBIN AD, 2006, V20, P121, J VOICE RUOTSALAINEN JH, 2007, V17, COCHRANE DB SYST REV SATALOFF RT, 2005, V2, P481, PROFESSIONAL VOICE S SATALOFF RT, 2005, V2, P987, PROFESSIONAL VOICE S SATALOFF RT, 1994, V73, P717, ENT-EAR NOSE THROAT SATALOFF RT, 2005, V3, P1291, PROFESSIONAL VOICE S SCHNEIDER B, 2005, V262, P272, EUR ARCH OTO-RHINO-L SOLOMON NP, 1989, V32, P161, J SPEECH HEAR RES SOLOMON NP, 2000, V14, P341, J VOICE STASNEY CR, 1996, P23, ATLAS DYNAMIC LARYNG TANNER K, 2007, V50, P635, J SPEECH LANG HEAR R THIBEAULT SL, 2004, V14, P786, ANN EPIDEMIOL THOMAS L, 2007, V1, P49, DISORD REV ANEXO 4: Resultado busqueda en Dialog TIMMERMANS B, 2004, V56, P120, FOLIA PHONIATR LOGO TIMMERMANS B, 2005, V19, P202, J VOICE TITZE I, 1999, V24, P49, LOG PHON VOCOL VANDERSLUIJS JA, 2004, V13, P218, J PEDIATR ORTHOP B VERDOLINIMARSTON K, 1994, V8, P30, J VOICE VERDOLINIMARSTON K, 1990, V4, P142, J VOICE VERDOLINI K, 2002, V45, P268, J SPEECH LANG HEAR R VERDOLINIMARSTON K, 1995, V9, P74, J VOICE VERDOLINI K, 1994, V37, P1001, J SPEECH HEAR RES VILKMAN E, 2000, V52, P120, FOLIA PHONIATR LOGO WILLIAMS NR, 2005, OCCUPATIONAL VOICE L WOODS K, 2007, V37, P1089, SPORTS MED YIU EML, 2003, V17, P216, J VOICE SciSearch(R) Cited Ref Sci (Dialog® File 34): (c) 2010 The Thomson Corp. All rights re served. 3/9/21 (Item 3 from file: 34) 19072487 Genuine Article#: 428TN Number of References: 15 Title: Voice diagnostics in professional sopranos Author: Echternach M (REPRINT) ; Arndt S; Zander MF; Richter B Corporate Source: Univ Klin,Freiburger Inst Musikermed,Breisacherstr 60/D-79106 Freiburg//Germany/ (REPRINT); Univ Klin,Freiburger Inst Musikermed,D-79106 Freiburg//Germany/; Univ Klin,Klin Hals Nasen Ohrenheilkunde,D-79106 Freiburg//Ger many/ Journal: HNO , 2009 , V 57 , N3 ( MAR ) , P 266-272 ISSN: 0017-6192 Publication Date: 20090300 Publisher: SPRINGER , 233 SPRING ST, NEW YORK, NY 10013 USA Language: German Document Type: ARTICLE Geographic Location: Germany Journal Subject Category: OTORHINOLARYNGOLOGY Abstract: The European Laryngological Society (ELS) has published a protocol for the evaluation of vocal function. Using this protocol, we evaluated 17 female sopranos, of whom 11 had laryngostroboscopic findings of organic alterations and six did not. Singers with increased subjective impressions of hoarseness, or of whom the examiner had increased perceptions of hoarseness, showed significant differences regarding impairment of the maximum phonation time, the frequency range, and the dysphonia severity index. No such differences were found regarding the presence of alterations of the vocal folds. These data suggest that organic alterations in professional singers are not necessarily associated with impaired vocal performance or vocal function or with measured values of the ELS protocol. For professional singers, therapy should be indicated not just on the basis of stroboscopy but on a broader basis using multifactorial voice analysis such as the ELS protocol. Descriptors: SCIAuthor Keywords: Soprano ; Singer node ; European Laryngological Society ; Voice ; Dysphonia Identifiers: KeyWord Plus(R): LARYNGOLOGICAL SOCIETY ELS; HANDICAP INDEX; QUALITY; VALIDATION; PROTOCOL Cited References: COHEN SM, 2007, V116, P402, ANN OTO RHINOL LARYN DEJONCKERE PH, 2001, V258, P77, EUR ARCH OTO-RHINO-L DEJONCKERE PH, 2003, V124, P279, REV LARYNGOL OTOL RH FRIEDRICH G, 2005, V84, P744, LARYNGO RHINO OTOL FROHLICH M, 1998, V46, P684, HNO HAKKESTEEGT MM, 2007, V22, P138, J VOICE MORSOMME D, 2005, V126, P305, REV LARYNGOL OTOL RH NAWKA T, 2003, V51, P921, HNO NAWKA T, 1994, V18, P130, SPRACHE-STIMME-GEHOR ANEXO 4: Resultado busqueda en Dialog PTOK M, 2006, V54, P132, HNO PTOK M, 2006, V54, P793, HNO SEIDNER W, 2004, SANGERSTIMME SMITS I, 2005, V19, P187, J VOICE TIMMERMANS B, 2002, V16, P372, J VOICE WUYTS FL, 2000, V43, P796, J SPEECH LANG HEAR R SciSearch(R) Cited Ref Sci (Dialog® File 34): (c) 2010 The Thomson Corp. All rights reserved. 3/9/22 (Item 4 from file: 34) 18047463 Genuine Article#: 322YS Number of References: 41 Title: Epidemiological study of voice disorders among teaching professionals of La Rioja, Spain Author: Preciado-Lopez J (REPRINT) ; Perez-Fernandez C; Calzada-Uriondo M; PreciadoRuiz P Corporate Source: Hosp San Millan,Dept Otorhinolaryngol,San Pedro La Rioja,C Autonomia La Rioja 3/Logrono//Spain/ (REPRINT); Hosp San Millan,Dept Otorhinolaryngol,Logrono//Spain/ Journal: JOURNAL OF VOICE , 2008 , V 22 , N4 ( JUL ) , P 489-508 ISSN: 0892-1997 Publication Date: 20080700 Publisher: MOSBY-ELSEVIER , 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA Language: English Document Type: ARTICLE Geographic Location: Spain Journal Subject Category: OTORHINOLARYNGOLOGY Abstract: The purpose of the present study was to calculate the prevalence and incidence of voice disorders among teaching staff and find out the associatedoccupational risk factors. A case-control study was performed with 905 teachers, 579 cases and 326 controls; 492 were randomly selected and 413 volunteered. All teachers were asked to fill out a standard questionnaire. Next, a complete laryngeal exam, was performed in cluding a general ear, nose, and throat evaluation and videolaryngostroboscopy. The prevalence of voice disorders among teaching staff was 57%. The most prevalent lesions were vocal overstrain (18%), nodular lesions (14%), and hyperfunctional dysphonia (8%). The incidence rate was 3.87 new cases per year per 1000 teachers. Women had organic lesions three times more than men (odds ratio [OR]: 3.52, confidence interval [CI]: 2.04-6.09). However, men had chronic laryngitis three times more than women (OR: 2.93, CI: 1.50-5.71) and functional dysphonia nearly twice more than women (OR: 1.81, CI: 1.21-2.69). We find a significant risk of suffering voice disorders in teachers who smoke daily (OR: 2.31, Cl: 1.58-3.37) and who drink several cups of coffee or tea (OR: 1.87, CI: 1.36-2.56). It is advisable to carry out an annual evaluation of all teaching staff on account of the high prevalence of voice disorders among them. Descriptors: SCIAuthor Keywords: voice disorders ; epidemiological study ; case-control study ; prevalence ; risk factors ; teachers ; vocal symptoms ; videolaryngostroboscopy ; vocal nodules ; functional dysphonia ; larynx Identifiers: KeyWord Plus(R): RISK-FACTORS; VOCAL FOLD; TEACHERS; PREVALENCE; FREQUENCY; GENDER; WORK Cited References: *I NAC EST, 2004, AN EST ESP 2002 2003 ARGIMON JM, 1999, P205, METODOS INVESTIGACIO ARIAS C, 1992, V113, P359, REV LARYNGOL OTOL RH BONET M, 1985, THESIS U BARCELONA B BOUCHAYER M, 1994, P1, PHONOSURGERY BENIGN BUTLER JE, 2001, V111, P907, LARYNGOSCOPE DUFFY OM, 2004, V18, P63, J VOICE GARCIATAPIA R, 1996, P217, DIAGNOSTICO TRATA IN GARCIATAPIA R, 1996, P107, DIAGNOSTICO TRATA MI ANEXO 4: Resultado busqueda en Dialog GRAY SD, 1987, V1, P109, J VOICE GRAY SD, 1995, V104, P8, ANN OTO RHINOL LARYN HIRANO M, 1993, VIDEOSTROBOSCOPIC EX LETON E, 1998, GRUPO PROGR DISENO E LLINAS M, 1986, V93, P104, ACT 14 C NAC LOG FON MATTISKE JA, 1998, V12, P489, J VOICE MILLER MK, 1995, V9, P348, J VOICE PRECIADO J, 2000, V12, P111, ZUBIA MONOGRAFICO PRECIADO JA, 1997, THESIS U NAVARRA PAM PRECIADO JA, 1998, V49, P137, ACTA OTORRINOLARINGO RANTALA L, 2002, V16, P344, J VOICE ROY N, 2003, V46, P670, J SPEECH LANG HEAR R ROY N, 2004, V47, P281, J SPEECH LANG HEAR R RUSSELL A, 1998, V12, P467, J VOICE SALA E, 2001, V15, P413, J VOICE SARFATI J, 1989, V110, P393, REV LARYNGOL OTOL RH SATALOFF RT, 1991, P69, SCI ART CLIN CARE SIMBERG S, 2004, V18, P363, J VOICE SMITH E, 1997, V11, P81, J VOICE SMITH E, 1998, V12, P328, J VOICE SMITH E, 1998, V12, P480, J VOICE SODERSTEN M, 2002, V16, P356, J VOICE SOLOMON NP, 2000, V14, P341, J VOICE STEMPLE JC, 1995, V9, P127, J VOICE THIBEAULT SL, 2004, V14, P786, ANN EPIDEMIOL TITZE IR, 1994, PRINCIPLES VOICE PRO TITZE IR, 2003, V46, P919, J SPEECH LANG HEAR R URRUTIKOETXEA A, 1995, V116, P255, REV LARYNGOL OTOL RH VILKMAN E, 2004, V56, P220, FOLIA PHONIATR LOGO WELHAM NV, 2003, V17, P21, J VOICE WINTERBOTTOM MI, 1970, V1, MARCO FABI QUINTILIA WINTERBOTTOM MI, 1970, V2, MARCO FABI QUINTILIA SciSearch(R) Cited Ref Sci (Dialog® File 34): (c) 2010 The Thomson Corp. All rights reserved. 3/9/23 (Item 5 from file: 34) 17627658 Genuine Article#: 281PH Number of References: 37 Title: The treatment and results of voice therapy amongst professional classical singers with vocal fold nodules Author: Chernobelsky SI (REPRINT) Corporate Source: Dubrovinsky St 56-20/Krasnoyarsk 660049//Russia/ (REPRINT); State Opera & Ballet,Voice Res Lab, Dept Phoniat,Krasnoyarsk//Russia/; Mus Coll,Krasno yarsk//Russia/ Journal: LOGOPEDICS PHONIATRICS VOCOLOGY , 2007 , V 32 , N4 , P 178-184 ISSN: 1401-5439 Publication Date: 20070000 Publisher: INFORMA HEALTHCARE-TAYLOR & FRANCIS , 4 PARK SQUARE, MILTON PARK, ABINGDON, OXFORSHIRE OX14 4RN, ENGLAND Language: English Document Type: ARTICLE Geographic Location: Russia Journal Subject Category: OTORHINOLARYNGOLOGY Abstract: In order to test the hypotheses that nonsurgical treatment and elimination of inappropriate use of the voice is sufficient for disappearance of vocal fold nodules (VN), 28 classical singers with these lesions were examined for a period of up to 24 years after establishing this diagnosis. Twenty vocally healthy female singers constituted the control group. Laryngoscopy, microlaryngoscopy, laryngostroboscopy and acoustic voice analyses were used to carry out this research. It was found that VN, having once occurred, ANEXO 4: Resultado busqueda en Dialog tended to reoccur despite nonsurgical treatment and the elimination of incorrect singing. It was concluded that physiologically correct singing leads only to a temporary disap pearance of soft nodules and does not promote the resolution of hard nodules. Descriptors: SCIAuthor Keywords: acoustic voice analyses ; laryngostroboscopy ; singing voice ; vocal abuse Identifiers: KeyWord Plus(R): MANAGEMENT; HYDRATION; OUTCOMES; LESIONS; POLYPS Cited References: BAKEN RJ, 2000, CLIN MEASUREMENT SPE BASTIAN RW, 1996, V10, P389, J VOICE BOERSMA P, 1993, V17, P97, P I PHONETIC SCI BOUCHAYER M, 1992, V44, P155, FOLIA PHONIATR CHAGNON F, 1996, P219, ORGANIC VOICE DISORD CHERNOBELSKY SI, 2002, V54, P2, FOLIA PHONIATR LOGO DIKKERS FG, 1993, V113, P98, ACTA OTO-LARYNGOL DMITRIEV LB, 1990, PHONIATRICS LOGOPEDI ERMOLAEV VG, 1970, MANUAL PHONIATRICS FRENZEL H, 1986, P39, VOCAL FOLD HISTOPATH GRAY SD, 1991, P21, VOCAL FOLD PHYSL ACO HIRANO M, 1980, P10, TRANSCR 9 S CAR PROF HOGIKYAN ND, 1999, V13, P128, J VOICE HOLMBERG EB, 2003, V3, P269, J VOICE HOLMBERG EB, 2001, V15, P395, J VOICE HSIUNG M, 2004, V2, P186, ACTA OTO-LARYNGOL KITZING P, 1985, V14, P151, J OTOLARYNGOL KLEINSASSER O, 1982, V91, P378, ANN OTO RHINOL LARYN LAWRENCE VL, 1991, P115, VOCAL HLTH SCI LAWRENCE VL, 1991, P11, VOCAL HTLH SCI LEVIDOV, 1939, SINGING VOICE HLTH D MCCRORY E, 2001, V36, P19, INT J LANG COMM DI S MCFARLANE SC, 1990, V11, P47, SEMINARS SPEECH LANG MILLER R, 1986, STRUCTURE SINGING MURRY T, 1992, V6, P271, J VOICE POHLMAN G, 1948, ULTRASCHALLTHERAPIE SATALOFF RT, 1991, P40, VOCAL HLTH SCI SATALOFF RT, 1987, V1, P283, J VOICE SONNINEN A, 1972, V24, P321, FOLIA PHONIATR TARNEAUD J, 1935, NODULE CORDE VOCALE VASILENKO US, 1975, V3, P45, VESTN OTORINOLARYNG VERDOLINIMARSTON K, 1990, V4, P142, J VOICE VERDOLINIMARSTON K, 1994, V8, P30, J VOICE WALLIS L, 2004, V1, P125, J VOICE YAMAGUCHI H, 1986, V38, P372, NONSURGICAL THERAPY YUMOTO E, 1984, V27, P2, J SPEECH HEAR RES ZEITELS SM, 2002, V111, P21, ANN OTO RHINO S190 2 SciSearch(R) Cited Ref Sci (Dialog® File 34): (c) 2010 The Thomson Corp. All rights reserved. 4/9/24 (Item 6 from file: 34) 16981480 Genuine Article#: 216DO Number of References: 38 Title: Vocal fold masses Author: Altman KW (REPRINT) Corporate Source: Mt Sinai Sch Med,Dept Otolaryngol,1 Gustave L Levy Pl,Box 1189/New York//NY/10029 (REPRINT); Mt Sinai Sch Med,Dept Otolaryngol,New York//NY/10029 Journal: OTOLARYNGOLOGIC CLINICS OF NORTH AMERICA , 2007 , V 40 , N5 ( OCT ) , ANEXO 4: Resultado busqueda en Dialog P 1091-+ ISSN: 0030-6665 Publication Date: 20071000 Publisher: W B SAUNDERS CO-ELSEVIER INC , 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA Language: English Document Type: ARTICLE Geographic Location: USA Journal Subject Category: OTORHINOLARYNGOLOGY Abstract: Vocal fold masses are often complex in nature and can have a devastating result on the professional voice. These lesions are usually multifactorial with synergistic contributions over time from voice use demands and technique, medical conditions, medications, and the environment. General categories of benign vocal fold masses in professional voice include nodules, polyps, and cysts, but other pathology should be considered, such as reactive lesions, intracordal scarring, feeding varices, and reparative granuloma. A perspective on these issues is essential for proper diagnosis and manage ment. Video procedures for nodule and polyp surgery accompany this content online. Identifiers: KeyWord Plus(R): PHARYNGEAL ACID REFLUX; NODULES; LESIONS; POLYPS; CORD; PHONATION; DISORDERS; DYSPHONIA; VIBRATION; FEATURES Cited References: ABITBOL J, 1999, V13, P424, J VOICE ALTMAN KW, 2005, V19, P261, J VOICE BOUCHAYER M, 1985, V95, P1087, LARYNGOSCOPE COLDEN D, 2001, V110, P293, ANN OTO RHINOL LARYN COUREY MS, 1996, V105, P525, ANN OTO RHINOL LARYN DAILEY SH, 2006, V39, P23, OTOLARYNG CLIN N AM DEBODT MS, 2007, V21, P151, J VOICE DESLOGE RB, 2000, V109, P385, ANN OTO RHINOL LARYN GEREIN V, 2006, V70, P2061, INT J PEDIATR OTORHI HANSEN JK, 2006, V20, P110, J VOICE HIRANO S, 2006, V115, P253, ANN OTO RHINOL LARYN HOCEVARBOLTEZAR I, 1997, P134, ACTA OTO-LARYNG S527 HOGIKYAN ND, 1999, V13, P128, J VOICE HSIUNG MW, 2004, V124, P186, ACTA OTO-LARYNGOL IVEY CM, 2007, TRIOL SOC 2007 COMB JIANG JJ, 1998, V107, P603, ANN OTO RHINOL LARYN JIANG J, 2004, V113, P277, ANN OTO RHINOL LARYN KIESEHIMMEL C, 1995, V9, P449, J VOICE KOTBY MN, 1988, V105, P477, ACTA OTOLARYNGOL STO KUHN J, 1998, V108, P1146, LARYNGOSCOPE 1 MICHAELS L, 1984, PATHOLOGY LARYNX NAGATA K, 1983, V10, P27, AURIS NASUS LARYNX S ROSEN CA, 2000, V109, P823, ANN OTO RHINOL LARYN ROY N, 2000, V14, P521, J VOICE RUIZ DMCF, 2006, V58, P392, FOLIA PHONIATR LOGO SARFATI J, 1989, V110, P393, REV LARYNGOL OTOL RH SATALOFF RT, 1991, V100, P725, ANN OTO RHINOL LARYN SCHWEINFURTH JM, 2001, V110, P811, ANN OTO RHINOL LARYN SCIROMPOTONG S, 2004, V35, P169, SE ASIAN J TROP MED SHOHET JA, 1996, V106, P19, LARYNGOSCOPE 1 SMOLANDER S, 2006, V31, P166, LOGOPED PHONIATR VOC SULKOWSKI WJ, 2005, V18, P341, INT J OCCUP MED ENV TAO C, 2007, V40, P2191, J BIOMECH THIBEAULT SL, 2002, V111, P302, ANN OTO RHINOL LARYN ULUALP SO, 1999, V121, P725, OTOLARYNG HEAD NECK YANO J, 1982, V9, P105, AURIS NASUS LARYNX ZEITELS SM, 2006, V115, P571, ANN OTO RHINOL LARYN ZHANG Y, 2004, V115, P1266, J ACOUST SOC AM ANEXO 4: Resultado busqueda en Dialog SciSearch(R) Cited Ref Sci (Dialog® File 34): (c) 2010 The Thomson Corp. All rights reserved. 4/9/25 (Item 7 from file: 34) 16738541 Genuine Article#: 190AA Number of References: 64 Title: Treatment outcomes for professional voice users Author: Wingate JM (REPRINT) ; Brown WS; Shrivastav R; Davenport P; Sapienza CM Corporate Source: Univ Florida,Dept Commun Sci & Disorders,457 Dauer Hall,POB 117420/Gainesville//FL/32611 (REPRINT); Univ Florida,Dept Commun Sci & Disorders,Gainesville//FL/32611; Univ Florida,Dept Physiol Sci,Gainesville//FL/32611 Journal: JOURNAL OF VOICE , 2007 , V 21 , N4 ( JUL ) , P 433-449 ISSN: 0892-1997 Publication Date: 20070700 Publisher: MOSBY-ELSEVIER , 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA Language: English Document Type: ARTICLE Geographic Location: USA Journal Subject Category: OTORHINOLARYNGOLOGY Abstract: Professional voice users comprise 25% to 35% of the U.S. working population. Their voice problems may interfere with job performance and impact costs for both employers and employees. The purpose of this study was to examine treatment outcomes of two specific rehabilitation programs for a group ofprofessional voice users. Eighteen professional voice users participated in this study; half had complaints of throat pain or vocal fatigue (Dysphonia Group), and half were found to have benign vocal fold lesions (Lesion Group). One group received 5 weeks of expiratory muscle strength training followed by six sessions of traditional voice therapy. Treatment order was reversed for the second group. The study was designed as a repeated measures study with independent variables of treatment order, laryngeal diagnosis (lesion vs non-lesion), gender, and time. Dependent variables included maximum expiratory pressure (MEP), Voice Handicap Index (VHI) score, Vocal Rating Scale (VRS) score, Voice Effort Scale score, phonetogram measures, subglottal pressures, and acoustic and perceptual measures. Results showed significant improvements in MEP, VHI scores, and VRS scores, sub glottal pressure for loud intensity, phonetogram area, and dynamic range. No significant difference was found between laryngeal diagnosis groups. A significant difference was not observed for treatment order. It was concluded that the combined treatment was responsible for the improvements observed. The results indicate that a combined modality treatment may be successful in the remediation of vocal problems for professional voice users. Descriptors: SCIAuthor Keywords: professional voice ; voice therapy ; treatment outcomes Identifiers: KeyWord Plus(R): RISK-FACTORS; MULTIPLE-SCLEROSIS; LARYNGEAL NODULES ; HANDICAP INDEX; VOCAL FATIGUE; TEACHERS; DYSPHONIA; THERAPY; PHONETOGRAMS; DISORDERS Cited References: AARTS H, 1997, V12, P363, HEALTH EDUC RES AKERLUND L, 1993, V113, P102, ACTA OTO-LARYNGOL BAKER SE, 2003, THESIS U FLORIDA GAI BAKEN RJ, 2000, CLIN MEASUREMENT SPE BASIOUNY S, 1998, V50, P146, FOLIA PHONIATRI LOGO BASIOUNY S, 1998, V50, P146, FOLIA PHONIATRI LOGO BENNINGER MS, 1994, VOCAL ARTS MED CARE BOONE DR, 1977, VOICE VOICE THERAPY CARDING P, 2000, V321, P1544, BRIT MED J CASE JL, 1991, CLIN MANAGEMENT VOIC COLEMAN RF, 1993, V7, P1, J VOICE COLTON RH, 1990, UNDERSTANDING VOICE COYLE SM, 2001, V15, P424, J VOICE DIPIETRO L, 2000, V28, P77, PHYSICIAN SPORTSMED ANEXO 4: Resultado busqueda en Dialog FROLICH M, 2000, V43, P706, J SPEECH LANG HEAR R GELFER MP, 1986, V79, PS83, J ACOUST SOC AM S1 GOSSELINK R, 2000, V81, P747, ARCH PHYS MED REHAB GOTAAS C, 1993, V45, P120, FOLIA PHONIATR GRAMMING P, 1991, V43, P79, FOLIA PHONIATR HAAS E, 2002, V58, P1157, J CLIN PSYCHOL HEMANACKAH YD, 2002, V16, P81, J VOICE HIXON TJ, 1987, RESP FUNCTION SPEECH HOFFMANRUDDY B, 2001, V15, P543, J VOICE HOFFMANRUDDY B, 2001, THESIS U FLORIDA GAI HOLMBERG EB, 2001, V15, P395, J VOICE HOLMBERG EB, 2003, V17, P269, J VOICE IKEDA Y, 1999, V256, PS51, EUR ARCH OTO-RHIN S1 JACOBSON BH, 1997, V6, P66, AM J SPEECH-LANG PAT JONES K, 2002, V128, P571, ARCH OTOLARYNGOL KOSTYK BE, 1998, V12, P287, J VOICE LIN PT, 1991, V5, P74, J VOICE LONG J, 1998, V12, P197, J VOICE MA EPM, 2001, V44, P511, J SPEECH LANG HEAR R MACKENZIE K, 2001, V323, P658, BRIT MED J MICHAELIS D, 1997, V83, P700, ACUSTICA OHLSSON AC, 1987, V39, P98, FOLIA PHONIATR POBURKA BJ, 1998, V12, P513, J VOICE RAMIG LO, 2004, V25, P169, SEMIN SPEECH LANG ROSEN CA, 2000, V14, P619, J VOICE ROSEN CA, 2000, V14, P370, J VOICE ROY N, 2003, V46, P670, J SPEECH LANG HEAR R SAPIR S, 1993, V28, P177, EUR J DISORDER COMM SAPIENZA CM, 2002, V16, P495, J VOICE SATALOFF RT, 1997, PROFESSIONAL VOICE S SHRIVASTAV R, 2003, 33 ANN S VOIC FDN CA SMELTZER SC, 1996, V77, P909, ARCH PHYS MED REHAB SMITHERAN JR, 1981, V39, P322, J SPEECH HEAR RES SMITH E, 1998, V12, P480, J VOICE SMITH E, 1997, V11, P81, J VOICE SPEYER R, 2003, V7, P44, J VOICE STALOFF RT, 1991, PROFESSIONAL VOICE S STEMPLE JC, 1994, V8, P271, J VOICE STEMPLE JC, 1984, CLIN VOICE PATHOLOGY SUZUKI S, 1995, V50, P366, THORAX TITZE IR, 1997, V11, P254, J VOICE TITZE I, 1994, PRINCIPLES VOICE PRO VALLIS M, 2003, V26, P1468, DIABETES CARE VERDOLINIMARSTON K, 1994, V8, P30, J VOICE VERDOLINIMARSTON K, 1995, V9, P74, J VOICE VERDOLINI K, 2001, V26, P37, LOGOPED PHONIATR VOC VILKMAN E, 2000, V52, P20, FOLIA PHONIATRI LOGO VINTTURI J, 2001, V15, P36, J VOICE WILSON JA, 2002, V27, P179, CLIN OTOLARYNGOL YIU EML, 2002, V16, P215, J VOICE SciSearch(R) Cited Ref Sci (Dialog® File 34): (c) 2010 The Thomson Corp. All rights re served. 4/9/26 (Item 8 from file: 34) 16082891 Genuine Article#: 133ZK Number of References: 10 Title: A grading scale for pediatric vocal fold nodules ANEXO 4: Resultado busqueda en Dialog Author: Shah RK (REPRINT) ; Feldman HA; Nuss RC Corporate Source: Childrens Natl Med Ctr,Div Otolaryngol,111 Michigan Ave NW/Washington//DC/20010 (REPRINT); Childrens Natl Med Ctr,Div Otolaryngol,Washington//DC/20010; Harvard Univ,Sch Med, Childrens Hosp, Clin Res Program,Boston//MA/; Harvard Univ,Sch Med, Childrens Hosp, Dept Otolaryngol,Boston//MA/ Journal: OTOLARYNGOLOGY-HEAD AND NECK SURGERY , 2007 , V 136 , N2 ( FEB ) , P 193-197 ISSN: 0194-5998 Publication Date: 20070200 Publisher: MOSBY-ELSEVIER , 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA Language: English Document Type: ARTICLE Geographic Location: USA Journal Subject Category: OTORHINOLARYNGOLOGY; SURGERY Abstract: OBJECTIVE: To design a grading scale for vocal fold nodules in pediatric pa tients. STUDY DESIGN AND SETTING: We conducted a prospective study in which a grading scale for vocal nodule size and contour based on static fiberoptic images of pediatric larynges was developed to achieve the scale presented here. RESULTS: Twenty-eight health care professionals each rated 28 images of pediatric vocal fold nodules. The intraclass correlation for nodule size was strong (0.77; 95% confidence interval, 0.67-0.87). The kappa statistic for nodule contour was mild (0.35; 95% confidence interval, 0.33-0.37). Agreement between experienced and other raters found no significant difference for the nodule size or contour grade of a given image. CONCLUSIONS: A grading scale for pediatric vocal fold nodules is presented. Interrater reliability for nodule size is high and can be reliably used by health care professionals with varying levels of experience. SIGNIFICANCE: A validated grading scale facilitates objective analysis of outcomes when studying and following patients with vocal nodules. (C) 2007 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved. Cited References: FLEISS JL, 1981, P212, STAT METHODS RATES P GRAY SD, 1995, V104, P13, ANN OTO RHINOL LARYN HIRSCHI SD, 2002, V16, P310, J VOICE KILIC MA, 2004, V68, P409, INT J PEDIATR OTORHI KRAEMER HC, 2002, V21, P2109, STAT MED LANDIS JR, 1977, V33, P363, BIOMETRICS LITTELL RC, 1996, SAS SYSTEM MIXED MOD NUSS RC, 2003, ANN M AM SOC PED OT SHAH RK, 2005, V69, P903, INT J PEDIATR OTORHI ZEITELS SM, 2003, V349, P882, NEW ENGL J MED SciSearch(R) Cited Ref Sci (Dialog® File 34): (c) 2010 The Thomson Corp. All rights reserved. 4/9/27 (Item 9 from file: 34) 16006854 Genuine Article#: 126YA Number of References: 66 Title: Voice care knowledge among clinicians and people with healthy voices or dysphonia Author: Fletcher HA; Drinnan MJ; Carding PN (REPRINT) Corporate Source: Freeman Rd Hosp,Dept Speech Voice & Swallowing,Newcastle Upon Tyne NE7 7DN/Tyne & Wear/England/ (REPRINT); Freeman Rd Hosp,Dept Speech Voice & Swallowing,Newcastle Upon Tyne NE7 7DN/Tyne & Wear/England/; Univ Newcastle Upon ANEXO 4: Resultado busqueda en Dialog Tyne,Sch Med,Newcastle Upon Tyne NE1 7RU/Tyne & Wear/England/; Freeman Rd Hosp,Dept Reg Med Phys,Newcastle Upon Tyne/Tyne & Wear/England/; Dumfries & Galloway Royal Infirm,Speech & Language Therapy Serv,Dumfries//Scotland/ Journal: JOURNAL OF VOICE , 2007 , V 21 , N1 ( JAN ) , P 80-91 ISSN: 0892-1997 Publication Date: 20070100 Publisher: MOSBY-ELSEVIER , 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA Language: English Document Type: ARTICLE Geographic Location: England; Scotland Subfile: AHSearch Journal Subject Category: OTORHINOLARYNGOLOGY Abstract: An important clinical component in the prevention and treatment of voice dis orders is voice care and hygiene. Research in voice care knowledge has mainly focussed on specific groups of professional voice users with limited reporting on the tool and evidence base used. In this study, a questionnaire to measure voice care knowledge was developed based on "best evidence." The questionnaire was validated by measuring specialist voice clinicians' agreement. Preliminary data are then presented using the voice care knowledge questionnaire with 17 subjects with nonorganic dysphonia and 17 with healthy voices. There was high (89%) agreement among the clinicians. There was a highly significant difference between the dysphonic and the healthy group scores (P = 0.00005). Furthermore, the dysphonic subjects (63% agreement) presented with less voice care knowledge than the subjects with healthy voices (72% agreement). The questionnaire provides a useful and valid tool to investigate voice care know ledge. The findings have implications for clinical intervention, voice therapy, and health prevention. Descriptors: SCIAuthor Keywords: dysphonia ; healthy voices ; voice care ; vocal hygiene ; voice therapy Identifiers: KeyWord Plus(R): PHONATION THRESHOLD PRESSURE; ELECTRIC SOUNDAMPLIFICATION; PROFESSIONAL VOICE; LARYNGEAL NODULES; WORKING DAY; WARM-UP; TEACHERS; HYDRATION; SINGERS; HYGIENE Cited References: AKHTAR S, 1999, V113, P341, J LARYNGOL OTOL ANDREWS ML, 1995, MANUAL VOICE TREATME ARONSON AE, 1990, CLIN VOICE DISORDERS BEHRMAN A, 2003, V113, P2182, LARYNGOSCOPE BENNINGER MS, 1994, VOCAL ARTS MED CARE BISHOP D, 2003, V33, P483, SPORTS MED BLOOD GW, 1994, V3, P57, AM J SPEECH-LANG PAT BOONE D, 1997, IS YOUR VOICE TELLIN BROADDUSLAWRENC.PL, 2000, V14, P59, J VOICE CARDING P, 2000, V321, P1544, BRIT MED J CASPER JK, 2000, V33, P983, OTOLARYNG CLIN N AM CATTARUZZA MS, 1996, V32, P293, ORAL ONCOL B CEDRASCHI C, 1996, V27, P235, PATIENT EDUC COUNS CHAN RWK, 1994, V8, P279, J VOICE COHEN L, 1982, STAT SOCIAL SCI INTR DEARY IJ, 2003, V28, P374, CLIN OTOLARYNGOL DUNNET CP, 1997, V32, P333, EUR J DISORDER COMM DUROSE CL, 2004, V104, P35, J AM DIET ASSOC EMERICH KA, 2003, V11, P149, CURRENT OPINION OTOL FALLOWFIELD L, 1995, V72, P76, ARCH DIS CHILD FROESCHELS E, 1943, V38, P122, ARCHIV OTOLARYNGOL GLENTON C, 2002, V5, P319, HLTH EXPECTATIONS HANSON DG, 2000, V108, PS112, AM J MED S4A IRVING RM, 1997, V22, P202, CLIN OTOLARYNGOL JASANI K, 1999, V28, PS15, AUST FAM PHYS S1 ANEXO 4: Resultado busqueda en Dialog JOHNSON T, 1985, VARP VOCAL ABUSE RED JONSDOTTIR V, 2003, V55, P267, FOLIA PHONIATR LOGO JONSDOTTIR V, 2002, V27, P29, LOGOP PHONIATR VOCOL JONSDOTTIR V, 2001, V26, P76, LOGOP PHONIATR VOCOL JONSDOTTIR V, 2001, V26, P118, LOGOPED PHONIATR VOC JONSDOTTIR V, 2002, V54, P282, FOLIA PHONIATR LOGO MANN EA, 1999, V13, P294, J VOICE MARTIN S, 2000, WORKING VOICE DISORD MATHIESON L, 2001, GREENE MATHIESONS V MCCORMICK CA, 2002, V16, P502, J VOICE MOORE A, 1995, V1, P91, BANDOLIER MOTEL T, 2003, V17, P160, J VOICE MURRY T, 2000, V33, P967, OTOLARYNG CLIN N AM NELSON HE, 1991, NATL ADULT READING T OPPENHEIM AN, 1992, QUESTIONNAIRE DESIGN PANNBACKER M, 1998, V7, P49, AM J SPEECH-LANG PAT PRATER RJ, 1984, MANUAL VOICE THERAPY ROBERTSTHOMSON KE, 1999, V44, P253, AUST DENT J ROY N, 2002, V45, P625, J SPEECH LANG HEAR R SAPIENZA CM, 1999, V13, P375, J VOICE SAPIR S, 1996, V31, P193, EUR J DISORDER COMM SATALOFF RT, 1991, PROFESSIONAL VOICE S SATALOFF RT, 1987, V1, P92, J VOICE SATALOFF RT, 1987, V1, P283, J VOICE SCHUTZ A, 2002, V52, P194, ARZNEIMITTEL-FORSCH SIVASANKAR M, 2002, V16, P172, J VOICE SOLOMON NP, 2000, V14, P341, J VOICE STEMPLE JC, 2000, CLIN VOICE PATHOLOGY STREINER DL, 1989, HLTH MEASUREMENT SCA TERNSTROM S, 2002, V16, P195, J VOICE TIMMERMANS B, 2003, V28, P127, LOGOPED PHONIAT VOCO TITZE IR, 1994, V8, P99, J VOICE TSUNODA K, 1997, V106, P41, ANN OTO RHINOL LARYN VERDOLINI K, 1994, V37, P1001, J SPEECH HEAR RES VERDOLINIMARSTON K, 1994, V8, P30, J VOICE VERDOLINIMARSTON K, 1995, V9, P74, J VOICE VINTTURI J, 2001, V53, P338, FOLIA PHONIATR LOGO WIESMILLER K, 2003, V28, P304, CLIN OTOLARYNGOL YIU EML, 2003, V17, P216, J VOICE YIU EML, 2002, V16, P215, J VOICE ZEINE L, 2002, V16, P229, J VOICE SciSearch(R) Cited Ref Sci (Dialog® File 34): (c) 2010 The Thomson Corp. All rights re served. 4/9/28 (Item 10 from file: 34) 15624874 Genuine Article#: 090ER Number of References: 16 Title: Office steroid injections of the larynx Author: Mortensen M; Woo P (REPRINT) Author Email Address: peak.woo@mssm.edu Corporate Source: Grabscheid Voice Ctr,5 E 98th St,Box 1653/New York//NY/10029 (REPRINT); Mt Sinai Sch Med,Dept Otolaryngol Head & Neck Surg,New York//NY/ Journal: LARYNGOSCOPE , 2006 , V 116 , N10 ( OCT ) , P 1735-1739 ISSN: 0023-852X Publication Date: 20061000 Publisher: LIPPINCOTT WILLIAMS & WILKINS , 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA Language: English Document Type: ARTICLE ANEXO 4: Resultado busqueda en Dialog Geographic Location: USA Journal Subject Category: MEDICINE, RESEARCH & EXPERIMENTAL; OTORHINOLARYNGOLOGY Abstract: Objective: Steroid injection into the larynx has been sporadically reported as helpful in benign lesions of the larynx. Its role in laryngology remains unclear. This study reviews the indications and results of 47 steroid injections in 34 patients in an office set ting. Methods: The authors conducted a retrospective review of 47 injections in 34 patients. Methylprednisolone acetate suspension, USP (40 mg/mL), was injected by indirect laryngoscopy under local anesthesia. Results were evaluated by stroboscopy and by perceptual evaluation of the GRABS scale before and after injection. Pre- versus postinjection ratings were compared by paired t test. Results: Indications for injection were: 1) postoperative scar with local stiffness (12 patients), 2) vocal nodules and polyp (18 pa tients), and 3) sarcoidosis/granuloma (4 patients). Steroid injections were done in professional singers instead of repeated oral administration of steroids and/or to avoid sur gery in patients with polyps and cysts. Improvement was noted in 28 of 34 (82%). Eleven of the 18 patients with polyps and nodules had significant improvement and avoided surgery. Vocal fold scars improved after injection with an improved voice grade (P <.01), an improved amplitude (P <.05), and improved mucosal wave (P <.05). There were no complications. Only two patients could not tolerate office injection. Conclusion: Office steroid injections are a valuable adjunct in management of vocal fold scars, polyps, nod ules, and granulomas. Descriptors: SCIAuthor Keywords: vocal nodules ; office steroid injection ; vocal fold scar ; polyps Identifiers: KeyWord Plus(R): SARCOIDOSIS; STENOSIS Cited References: AMIR O, 2004, V12, P180, CURR OPIN OTOLARYNGO BASTIAN RW, 1996, V106, P1280, LARYNGOSCOPE COBB WB, 1972, V96, P52, ARCH OTOLARYNGOL COLEMAN JR, 1999, V108, P119, ANN OTO RHINOL LAR 1 GULATI SP, 1997, V39, P125, INDIAN J CHEST DIS KAIRYS SW, 1989, V83, P683, PEDIATRICS KRESPI YP, 1987, V96, P713, ANN OTO RHINOL LARYN KUMAZAWA H, 1997, V107, P671, LARYNGOSCOPE LEE SBJP, 2000, V114, P646, J LARYNGOL OTOL MULLINAX MC, 1996, V3, P102, EUROPEAN J EMERGENCY OSSOFF RH, 1980, V90, P1155, LARYNGOSCOPE PEERLESS SA, 1981, V90, P512, ANN OTO RHINOL LARYN RIDDER GJ, 2000, V109, P1146, ANN OTO RHINOL LAR 1 ROSEKRANS JA, 1998, V73, P1102, MAYO CLIN PROC TEITEL AD, 1992, V22, P203, SEMIN ARTHRITIS RHEU YANAGIHARA N, 1964, V57, P496, PRACTICA OTORHINOLAR SciSearch(R) Cited Ref Sci (Dialog® File 34): (c) 2010 The Thomson Corp. All rights reserved. 4/9/29 (Item 11 from file: 34) 11494542 Genuine Article#: 659LT Number of References: 30 Title: Voice activity limitation and participation restriction in the teaching profession: The need for preventive voice care Author: Yiu EML (REPRINT) ; Ma EPM Corporate Source: Univ Hong Kong,Prince Philip Dent Hosp, Dept Speech & Hearing Sci, Voice Res Lab,5-F,34 Hosp Rd/Hong Kong/Hong Kong/Peoples R China/ (REPRINT) ; Univ Hong Kong,Prince Philip Dent Hosp, Dept Speech & Hearing Sci, Voice Res Lab,Hong Kong/Hong Kong/Peoples R China/ Journal: JOURNAL OF MEDICAL SPEECH-LANGUAGE PATHOLOGY , 2002 , V 10 , N1 ( MAR ) , P 51-60 ISSN: 1065-1438 Publication Date: 20020300 ANEXO 4: Resultado busqueda en Dialog Publisher: DELMAR LEARNING , EXECUTIVE WOODS, 5 MAXWELL DR, CLIFTON PARK, NY 12065 USA Language: English Document Type: ARTICLE Geographic Location: Peoples R China Journal Subject Category: CLINICAL NEUROLOGY Abstract: Teachers are prone to developing voice problems because of the specific occupational demand of teaching. Voice problems impose difficulties or limitations not only on their teaching activities but also on other daily voice activities. Activity limitation and participation restriction are two separate dimensions introduced in the International Classification of Impairments, Disabilities, and Handicaps by the World Health Organiza tion (1997). Teachers with voice problems may face difficulties or limitations in their teaching activities. However, they may have little choice but to continue participating in these teaching activities. This study reports the extent of voice problems and their im pact on 30 self-selected teachers enrolled for a workshop to improve their teaching voice. The findings show that job, daily communication, social communication, and emo tion were all affected in the majority of the teachers. It also points to the need of imple menting preventive voice care for the teaching profession. Identifiers: KeyWord Plus(R): TEACHERS; DISORDERS; PREVALENCE; FREQUENCY; NODULES; IMPACT Cited References: *WHO, 1997, INT CLASS IMP ACT PA *WHO, 1980, INT CLASS IMP DIS HA *WHO, 2001, INT CLASS FUNCT DIS *WHO, 1999, INT CLASS FUNCT DIS BENNINGER MS, 1998, V12, P540, J VOICE BOONE DR, 1999, VOICE VOICE THERAPY BRINDLE B, 1979, V12, P439, J COMMUN DISORD CHAN RWK, 1994, V8, P279, J VOICE COMINS R, 1992, P8, HUMAN COMMUN AUG ENDERBY P, 1997, THERAPY OUTCOME MEAS FRITZELL B, 1996, V21, P7, LOGOPED PHONIATR VOC GOTAAS C, 1993, V45, P120, FOLIA PHONIATR HOGIKYAN ND, 1999, V13, P557, J VOICE JACOBSON BH, 1997, V6, P66, AM J SPEECH-LANG PAT KOSCHKEE DC, 1993, VOICE DISABILITY IND MA EPM, 2001, V44, P511, J SPEECH LANG HEAR R RAAJIMAKERS MF, 1998, V50, P71, FOLIA PHONIATR LOGO RAMIG LO, 1998, V41, PS101, J SPEECH LANG HEAR R RUSSELL A, 1998, V12, P467, J VOICE SAPIR S, 1993, V28, P177, EUR J DISORDER COMM SIMBERG S, 2000, V14, P231, J VOICE SMITH E, 1996, V4, P223, J MED SPEECH-LANG PA SMITH E, 1998, V12, P480, J VOICE SMITH E, 1997, V11, P81, J VOICE SMITH E, 1998, V12, P551, J VOICE URRUTIKOETXEA A, 1995, 1 WORLD VOIC C PORT VERDOLINIMARSTON K, 1994, V8, P30, J VOICE YIU E, 1991, V19, P45, AUSTR J HUMAN COMMUN YIU EML, 2001, V2, CLIN VOICE ASSESSMEN YIU E, 1999, SIMPLE GUIDE BETTER SciSearch(R) Cited Ref Sci (Dialog® File 34): (c) 2010 The Thomson Corp. All rights re served. 4/9/30 (Item 12 from file: 34) 10010386 Genuine Article#: 473PR Number of References: 17 Title: The prevalence of voice disorders among day care center teachers com- ANEXO 4: Resultado busqueda en Dialog pared with nurses: A questionnaire and clinical study Author: Sala E (REPRINT) ; Laine A; Simberg S; Pentti J; Suonpaa J Corporate Source: Turku Univ,Cent Hosp, Dept Otorhinolaryngol,POB 52/FIN-20521 Turku//Finland/ (REPRINT); Turku Univ,Cent Hosp, Dept Otorhinolaryngol,FIN-20521 Turku//Finland/; Turunmaa Hosp,Turku//Finland/; Reg Inst Occupat Hlth,Turku//Finland/ Journal: JOURNAL OF VOICE , 2001 , V 15 , N3 ( SEP ) , P 413-423 ISSN: 0892-1997 Publication Date: 20010900 Publisher: SINGULAR PUBLISHING GROUP INC , 401 WEST A ST, STE 325, SAN DIEGO, CA 92101-7904 USA Language: English Document Type: ARTICLE Geographic Location: Finland Journal Subject Category: OTORHINOLARYNGOLOGY Abstract: The acceptance of voice disorders by day care center teachers as an occupational disease is not an invariably established practice. This is due to the lack of reliable evidence of a higher risk for voice disorders in this profession. To find out the risk of voice disorders, an epidemiological study was conducted among day care center teachers (n = 262)., using hospital nurses (n = 108) as a control group. Symptoms were charted by a questionnaire. In a clinical examination made by a laryngologist, the voice quality was assessed and the laryngeal status noted. Teachers at day care centers had significantly more voice disorders than did nurses. Vocal nodules and laryngitis findings ap peared significantly more frequently among day care center teachers than among those in the control group. The results prove voice disorders to be more frequent among day care center teachers than among control group subjects, and also that the main cause for this may be a higher vocal loading among day care center teachers than among control group subjects. Descriptors: SCIAuthor Keywords: day care center teachers ; nurses vocal symptoms ; voice disorders ; vocal nodules ; laryngitis ; larynx Identifiers: KeyWord Plus(R): FREQUENCY Cited References: FRITZELL B, 1996, V21, P7, LOGOPED PHONIATR VOC GOTAAS C, 1993, V45, P120, FOLIA PHONIATR GRAY SD, 1987, V1, P109, J VOICE HIRANO M, 1981, V5, P81, DISORDERS HUMAN COMM MATTISKE JA, 1998, V12, P489, J VOICE NAGATA K, 1983, V10, P27, AURIS NASUS LARYNX S PEKKARINEN E, 1992, V17, P113, SCAND J LOGOP PHONIA PEKKARINEN E, 1991, V20, P257, SCAND AUDIOL RUSSELL A, 1998, V12, P467, J VOICE SALA E, 1996, V21, P42, CLIN OTOLARYNGOL SAPIR S, 1993, V28, P177, EUR J DISORDER COMM SIMBERG S, 2000, V14, P231, J VOICE SIMBERG S, IN PRESS LOG PHON VO SMITH E, 1998, V12, P480, J VOICE SMITH E, 1997, V11, P81, J VOICE TITZE IR, 1997, V11, P254, J VOICE VILKMAN E, 1998, V23, P11, LOGOP PHONIATR VOCOL SciSearch(R) Cited Ref Sci (Dialog® File 34): (c) 2010 The Thomson Corp. All rights reserved. 4/9/31 (Item 13 from file: 34) 09011600 Genuine Article#: 356HF Number of References: 3 Title: Voice handicap index in singers Author: Rosen CA (REPRINT) ; Murry T Corporate Source: EYE & EAR INST PITTSBURGH,SUITE 500, 200 LOTHROP ST/PITTSBURGH//PA/15213 (REPRINT); UNIV PITTSBURGH,VOICE CTR, DEPT OTOLARYNGOL HEAD & NECK SURG, SCH MED/PITTSBURGH//PA/15260 ANEXO 4: Resultado busqueda en Dialog Journal: JOURNAL OF VOICE , 2000 , V 14 , N3 ( SEP ) , P 370-377 ISSN: 0892-1997 Publication Date: 20000900 Publisher: SINGULAR PUBLISHING GROUP INC , 401 WEST A ST, STE 325, SAN DIEGO, CA 92101-7904 Language: English Document Type: ARTICLE Geographic Location: USA Subfile: CC CLIN--Current Contents, Clinical Medicine; Journal Subject Category: OTORHINOLARYNGOLOGY Abstract: The Voice Handicap Index (VHI) was developed to assess patients' perception of the severity of their voice disorder. The purpose of this study was to determine the degree of handicap expressed by professional and recreational presenters with a voice complaint. Singers (n = 106) and nonsingers (n = 369) with voice symptoms were studied. The results of the VIII for singers indicate that singers score significantly lower (less severe) on the VHI compared to nonsingers. Singers with vocal fold nodules had a lower mean VHI than singers with vocal fold cysts or polyps. Singers who perform classical mu sic had the lowest mean VHI of all types of singers studied. A low VHI in singers may represent a significant handicap and should not be ignored when considering the severity of a singer's voice problem. Descriptors: SCIAuthor Keywords: voice handicap index ; vocal fold nodules ; nonsingers Cited References: BENNINGER MS, 1997, P789, PROFESSIONAL VOICE S JACOBSON BH, 1997, V6, P66, AM J SPEECH LANG PAT WOODSON GE, 1992, V6, P338, J VOICE SciSearch(R) Cited Ref Sci (Dialog® File 34): (c) 2010 The Thomson Corp. All rights reserved. 4/9/32 (Item 14 from file: 34) 08750872 Genuine Article#: 325TB Number of References: 19 Title: The frequency of hard glottal attacks in patients with muscle tension dysphonia, unilateral benign masses and bilateral benign masses Author: Andrade DF; Heuer R; Hockstein NE; Castro E; Spiegel JR; Sataloff RT (REPRINT) Corporate Source: 1721 PINE ST,/PHILADELPHIA//PA/19103 (REPRINT); JEFFERSON MED COLL,/PHILADELPHIA//PA/; THOMAS JEFFERSON UNIV,GRAD HOSP/PHILADELPHIA//PA/ Journal: JOURNAL OF VOICE , 2000 , V 14 , N2 ( JUN ) , P 240-246 ISSN: 0892-1997 Publication Date: 20000600 Publisher: SINGULAR PUBLISHING GROUP INC , 401 WEST A ST, STE 325, SAN DIEGO, CA 92101-7904 Language: English Document Type: ARTICLE Geographic Location: USA Subfile: CC CLIN--Current Contents, Clinical Medicine; AHSearch; Journal Subject Category: OTORHINOLARYNGOLOGY Abstract: Hard or abrupt glottal attack (HGA) is one of the vocal behaviors often associ ated with benign lesion of the vocal folds. This study was designed to determine whether the frequency of HGA was different in hyperfunctional voice patients with and without vocal fold masses. One hundred and forty-seven subjects were studied. All subjects re ceived a complete otolaryngological evaluation including strobovideolaryngoscopy, ob jective voice measures, and evaluation by a speech-language pathologist. Thirty-two pa tients were diagnosed with muscle tension dyshonia (19 male, 13 female) without vocal fold masses. Fifty-seven patients were diagnosed with unilateral vocal fold masses (29 male, 28 female), most of which were cysts. Fifty-eight patients were diagnosed with bi lateral vocal fold masses (13 male, 45 female). Of the 45 females with bilateral vocal fold masses, 26 had a vocal cyst and reactive nodule and 19 had bilateral vocal fold nodules. The control group was balanced and matched based on sex and on percentage of singers ANEXO 4: Resultado busqueda en Dialog and nonsingers. It consisted of 49 subjects with no vocal fold pathology (20 male, 29 fe male). The group was composed of professional speakers, singers, and nonprofessional speakers. AU voice disordered groups demonstrated higher frequencies of HGA than the control group. Differences were found between the male and female subjects in this study. No differences were found between the various disorders. Differences were also found between the subgroups of bilateral masses, where the bilateral nodules group presented a higher frequency of HGA than the cyst and contralateral reactive nodule. Descriptors: SCIAuthor Keywords: hard glottal attack ; muscle tension dysphonia ; dys phonia ; unilateral mass ; bilateral masses ; trained singers ; untrained singers ; professional voice users ; nonprofessional voice users ; vocal fold cyst ; vocal fold nodule Cited References: ANDREWS ML, 1995, P208, MANUAL VOICE TREATME BOONE DR, 1982, P114, VOICE VOICE THERAPY COLTON RH, 1996, P79, UNDERSTANDING VOICE COLTON RH, 1996, P98, UNDERSTANDING VOICE HEUER R, 2000, V14, P236, J VOICE KOUFMAN JA, 1995, P359, DIAGNOSIS TREATMENT MORRISON MD, 1983, V12, P302, J OTOLARYNGOL MORRISON MD, 1983, V12, P319, J OTOLARYNGOL PERSHALL KE, 1985, P277, TRANSCRIPTS 14 S CAR RAMMAGE LA, 1992, V1, P64, J VOICE RAMMAGE LA, 1987, MUSCULAR TENSION DYS ROSS JA, 1998, V12, P84, J VOICE RUBIN JS, 1995, P144, DIAGNOSES TREATMENT RULNICK RK, 1993, P217, VOICE SURG SATALOFF RT, 1991, V100, P725, ANN OTO RHINOL LARYN SATALOFF RT, 1987, V1, P283, J VOICE SATALOFF RT, 1997, P207, PROFESSIONAL VOICE S SATALOFF RT, 1997, P518, PROFESSIONAL VOICE S WARD PH, 1980, V88, P262, OTOLARYNGOL HEAD NEC SciSearch(R) Cited Ref Sci (Dialog® File 34): (c) 2010 The Thomson Corp. All rights re served. 3/9/33 (Item 15 from file: 34) 08377951 Genuine Article#: 278RN Number of References: 16 Title: Vocal fold nodules in adult singers: Regional opinions about etiologic factors, career impact, and treatment. A survey of otolaryngologists, speech pathologists, and teachers of singing Author: Hogikyan ND (REPRINT) ; Appel S; Guinn LW; Haxer MJ Corporate Source: UNIV MICHIGAN,MED CTR, DEPT OTOLARYNGOL, TAUBMAN CTR 1904, 1500 E MED CTR DR/ANN ARBOR//MI/48109 (REPRINT); UNIV MICHIGAN,VOCAL HLTH CTR/ANN ARBOR//MI/48109; UNIV MICHIGAN,SCH MUS, DIV VOCAL ARTS/ANN ARBOR//MI/48109 Journal: JOURNAL OF VOICE , 1999 , V 13 , N1 ( MAR ) , P 128-142 ISSN: 0892-1997 Publication Date: 19990300 Publisher: SINGULAR PUBLISHING GROUP INC , 401 WEST A ST, STE 325, SAN DIEGO, CA 92101-7904 Language: English Document Type: ARTICLE Geographic Location: USA Subfile: CC CLIN--Current Contents, Clinical Medicine; Journal Subject Category: OTORHINOLARYNGOLOGY Abstract: This study was undertaken to better understand current regional opinions regarding vocal fold nodules in adult singers. A questionnaire was sent to 298 persons representing the 3 professional groups most involved with the care of singers with vocal nodules: otolaryngologists, speech pathologists, and teachers of singing. The question - ANEXO 4: Resultado busqueda en Dialog naire queried respondents about their level of experience with this problem, and their beliefs about causative factors, career impact, and optimum treatment. Responses within and between groups were similar, with differences between groups primarily in the magnitude of positive or negative responses, rather than in the polarity of the responses. Prevailing opinions included: recognition of causative factors in both singing and speak ing voice practices, optimism about responsiveness to appropriate treatment, enthusi asm for coordinated voice therapy and voice training as first-line treatment, and accept ance of microsurgical management as appropriate treatment if behavioral management fails. Descriptors: SCIAuthor Keywords: vocal fold nodules (VFN) ; survey opinions ; etiology ; treatment Identifiers: KeyWord Plus(R): MANAGEMENT Cited References: *ASHA NATS, 1993, V35, P63, ASHA ALLEN MS, 1991, V34, P229, J SPEECH HEAR RES BASTIAN RW, 1991, P619, DIS NOSE THROAT EAR BASTIAN RW, 1993, P1905, OTOLARYNGOLOGY HEAD COLTON RH, 1990, P91, UNDERSTANDING VOICE CORNUT G, 1989, V3, P269, J VOICE FORD CN, 1994, V104, P1369, LARYNGOSCOPE GOULD WJ, 1995, P142, DIAGNOSIS TREATMENT GOULD WJ, V2281, P91, OTOLARYNGOLOGY LANCER JM, 1988, V13, P43, CLIN OTOLARYNGOL MORAN MJ, 1987, V18, P172, LANGUAGE SPEECH HEAR MURRY T, 1992, V6, P271, J VOICE OSSOFF RH, 1996, P405, LARYNX MULTIDISCIPLI SATALOFF RT, 1991, P267, PROFESSIONAL VOICE S SHUMRICK KA, 1996, P301, LARYNX MULTIDISCIPLI STRINGER SP, 1991, P2260, OTOLARYNGOLOGY SciSearch(R) Cited Ref Sci (Dialog® File 34): (c) 2010 The Thomson Corp. All rights reserved. 4/9/34 (Item 16 from file: 34) 05864962 Genuine Article#: XC820 Number of References: 8 Title: The ''singing-acting'' child: The laryngologist's perspective - 1995 Author: Reilly JS (REPRINT) Corporate Source: ALFRED I DUPONT INST,CHILDRENS HOSP, DEPT PEDIAT OTOLARYNGOL, 1600 ROCKLAND RD/WILMINGTON//DE/19899 (REPRINT); THOMAS JEFFERSON UNIV,JEFFERSON MED COLL, DEPT OTOLARYNGOL/PHILADELPHIA//PA/19107 Journal: JOURNAL OF VOICE , 1997 , V 11 , N2 ( JUN ) , P 126-129 ISSN: 0892-1997 Publication Date: 19970600 Publisher: LIPPINCOTT-RAVEN PUBL , 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 Language: English Document Type: ARTICLE Geographic Location: USA Subfile: CC CLIN--Current Contents, Clinical Medicine; Journal Subject Category: OTORHINOLARYNGOLOGY Abstract: A survey of pediatric otolaryngologists about voice disorders in children sug gests that similar to 1% of children examined were noted to have voice problems, and in only one fifth of these children (0.2%) were the voice problems related to professional use of the voice, such as singing. Direct flexible laryngoscopy was the sole method of examination for 80% of the children examined by these pediatric specialists. Voice ther apy for 6 months was generally recommended (88%). The survey represents an estimated clinical experience of > 160,000 children per year, and it achieved a response rate of 40% of pediatric otolaryngologists (48/120). Results suggest that the use of video and ANEXO 4: Resultado busqueda en Dialog stroboscopy for examination of the pediatric voice would enhance understanding and assure correct diagnosis and treatment. Descriptors: SCIAuthor Keywords: voice disorders ; children ; survey ; diagnosis ; vocal nodule Cited References: GRAY SD, 1995, V104, P13, ANN OTO RHINOL LARYN HIRANO M, 1981, ASHA MACARTHUR CJ, 1995, DIAGNOSIS TREATMENT MASUDA T, 1993, V113, P547, ACTA OTO-LARYNGOL SENIOR BA, 1994, V110, P203, OTOLARYNGOL HEAD NEC SENTURIA BH, 1968, V77, P1027, ANN OTO RHINOL LARYN SILVERMAN E, 1975, V40, P211, J SPEECH HEAR DISORD VONLEYDEN H, 1985, V64, P473, ENT J SciSearch(R) Cited Ref Sci (Dialog® File 34): (c) 2010 The Thomson Corp. All rights reserved. 4/9/35 (Item 1 from file: 35) 01153261 ORDER NO: AAD13-41870 INCIDENCE OF SELF-REPORTED RECURRENCE OF SYMPTOMS FOLLOWING THERAPY FOR VOCAL NODULES Author: MORRIS, JENNIFER SUE Degree: M.A. Year: 1990 Corporate Source/Institution: TEXAS WOMAN'S UNIVERSITY ( 0925 ) Source: Volume 29/02 of MASTERS ABSTRACTS. of Dissertations Abstracts International. PAGE 276 . 79 PAGES Descriptors: HEALTH SCIENCES, SPEECH PATHOLOGY Descriptor Codes: 0460 This descriptive study was designed to investigate the incidence of self-reported recurrence of symptoms of vocal nodules in adults following voice therapy by a speech-lan guage pathologist, in order to determine the efficacy of the voice therapy received. Twenty-eight subjects who were between 2 and 130 months post-therapy answered a questionnaire. Using a chi-square analysis, a relationship was found between (a) the duration of symptoms prior to therapy and recurrence of symptoms after therapy, (b) months of therapy and months post-therapy when recurrence of symptoms occurred, and (c) duration of symptoms prior to therapy and months post-therapy when recurrence of symptoms occurred. While 19 subjects (68%) reported a recurrence of vocal symptoms following therapy, only seven (25%) experienced vocal symptoms severe enough to seek additional professional help. Based on these findings, and within the limits of this study, voice therapy was found to be effective and beneficial. Dissertation Abs Online (Dialog® File 35): (c) 2010 ProQuest Info&Learning. All rights reserved. 3/9/36 (Item 1 from file: 45) 0005539700 EMCARE No: 354436067 Medical management of the professional singer;An Overview Jahn A.F. Clinical Otolaryngology, Columbia University, College of Physicians and Surgeons, New York, NY; Westminster Choir School, Princeton, NJ; Department of Otology/Neuro-Otology, St Luke's Roosevelt Hospital Center, 425 West 59th St., New York, NY 10019 AUTHOR EMAIL: afjahn@aol.com CORRESP. AUTHOR/AFFIL: Jahn A. F.: Department of Otology/Neuro-Otology, St ANEXO 4: Resultado busqueda en Dialog Luke's Roosevelt Hospital Center, 425 West 59th St., New York, NY 10019 CORRESP. AUTHOR EMAIL: afjahn@aol.com Medical Problems of Performing Artists ( Med. Probl. Perform. Artists ) ( United States ) March 1, 2009 , 24/1 (3-9) PUBLISHER: Science and Medicine Inc. CODEN: MPPAE ISSN: 0885-1158 DOCUMENT TYPE: Journal ; Review RECORD TYPE: Abstract LANGUAGE: English SUMMARY LANGUAGE: English NUMBER OF REFERENCES: 10 Caring for the professional singer, whether an operatic performer or serious amateur, involves careful consideration of both physical and emotional components, as it does in other performing artists. However, because the head and neck contain representatives of other major organ systems in close proximity to the phonating larynx, singing is addi tionally vulnerable to a range of diseases of the respiratory, gastrointestinal, and endo crine systems. This review provides an overview of the conditions typically encountered in singers These include occupational disorders (muscle tension dysphonia, vocal nodules, vocal hemorrhage and polyps, chronic voice deterioration), general health issues with vocal implications (respiratory diseases, gastric reflux, endocrine problems, medica tion usage), as well as lifestyle considerations. BRAND NAME/MANUFACTURER NAME: fluticasone/Glaxo SmithKline; salmeterol/Glaxo SmithKline MANUFACTURER NAMES: Glaxo SmithKline DESCRIPTORS: * antacid agent; *antihistaminic agent; *decongestive agent; *fluticasone propionate plus salmeterol; *leukotriene receptor blocking agent; * occupationaldisease; *proton pump inhibitor asthma; bronchitis; common cold; dysphonia; fluticasone; gastroesophageal reflux; health; human; hypothyroidism; lifestyle; muscle tone; occupation; respiratory tract al lergy; review; salmeterol; singing; surgical technique; vocal cord disorder; voice TERMS (UNCONTROLLED): vocal deterioration; vocal hemorrhage; vocal nodule; vocal polyp EMCare (Dialog® File 45): (c) 2010 Elsevier B.V. All rights reserved. 3/9/37 (Item 2 from file: 45) 0005406642 EMCARE No: 352194579 A clinical study of cases with vocal fold nodules Kusuyama T.; Mori Y.; Sato M.; Ito T.; Sato T.; Nakagawa H.; Tamura E.; Niimi S.; Fukuda H. Tokyo Voice Center, International University of Health and Welfare, 8-10-16 Akasaka, Minato-ku, Tokyo 107-0052, Japan CORRESP. AUTHOR/AFFIL: Kusuyama T.: Tokyo Voice Center, International University of Health and Welfare, 8-10-16 Akasaka, Minato-ku, Tokyo 107-0052, Japan Japan Journal of Logopedics and Phoniatrics ( Jpn. J. Logop. Phoniatr. ) ( Japan ) 1, 2008 , 49/3 (149-154) PUBLISHER: Japan Society of Logopedics and Phoniatrics CODEN: ONGIA ISSN: 0030-2813 DOCUMENT TYPE: Journal ; Article RECORD TYPE: Abstract LANGUAGE: Japanese SUMMARY LANGUAGE: English; Japanese NUMBER OF REFERENCES: 10 July During the 5-year period from 2001 to 2005, 902 patients with vocal fold nodules were examined and treated at Tokyo Voice Center. In this paper the clinical records of those ANEXO 4: Resultado busqueda en Dialog patients were studied statistically. The results were as follows. 1. Of the 902 patients, 113 were males and 789 were females. The incidence was higher in males in children aged 10 and under, and higher in females over age 10. The average age was 32.9. 2. Seventy percent of the cases were professionalvoice users. 3. In 165 patients treated by voice therapy alone, the complete remission (CR) rate was 43%. In these CR cases, average treatment time was 3.1 months. The CR rate was significantly higher in cases whose duration of hoarseness prior to the first visit was within three months. 4. In 222 patients who underwent steroid therapy, the CR rate was 56%. In these CR cases, average treatment time was 2.8 weeks. 5. Surgical treatments were chosen in 250 cases. Although recurrences were seen in 42%, 74% of those patients obtained CR after additional treatments such as steroid therapy. As 58% had no recurrence, in total 90% of the surgical patients were doing well. The CR rate was significantly higher in the surgical pa tients than in cases who received any other treatment. DESCRIPTORS: * clinical study; *therapy; *vocal cord; *voice aged; child; female; hoarseness; Japan; male; patient; remission; steroid therapy; sur gery; surgical patient EMCare (Dialog® File 45): (c) 2010 Elsevier B.V. All rights reserved. 4/9/38 (Item 3 from file: 45) 0005172201 EMCARE No: 47320692 Voice Surgery ISSUE TITLE: The Professional Voice Sataloff R.T.; Hawkshaw M.J.; Divi V.; Heman-Ackah Y.D. Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, 1721 Pine Street, Philadelphia, PA 19103, United States AUTHOR EMAIL: rtsataloff@phillyent.com CORRESP. AUTHOR/AFFIL: Sataloff R.T.: Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, 1721 Pine Street, Philadelphia, PA 19103, United States CORRESP. AUTHOR EMAIL: rtsataloff@phillyent.com Otolaryngologic Clinics of North America ( Otolaryngol. Clin. North Am. ) ( United States ) October 1, 2007 , 40/5 (1151-1183) PUBLISHER: W.B. Saunders CODEN: OCNAB ISSN: 0030-6665 PUBLISHER ITEM IDENTIFIER: S0030666507001119 DOI: 10.1016/j.otc.2007.05.015 Item Identifier (DOI): 10.1016/j.otc.2007.05.015 DOCUMENT TYPE: Journal ; Review RECORD TYPE: Abstract LANGUAGE: English SUMMARY LANGUAGE: English NUMBER OF REFERENCES: 62 There have been many advances in microsurgery for voice professionals over the last three decades. Driven by a greater understanding of the anatomy and physiology of phonation, most of the advances provide greater surgical precision through improved ex posure and more delicate instrumentation. Laryngologists who perform laryngoscopic surgery should be familiar with the current state-of-the-art and should use the latest techniques and technology for all voice patients and particularly for voice professionals. Video procedures for surgical management of voice disorders accompany this content online. (c) 2007 Elsevier Inc. All rights reserved. DESCRIPTORS: * dexamethasone; *larynx surgery; *steroid adrenalin; bleeding; botulinum toxin; cidofovir; collagen; general anesthesia; human; in - ANEXO 4: Resultado busqueda en Dialog formed consent; laryngopharyngeal reflux; laryngoscopy ; larynx edema; larynx granuloma; larynx papillomatosis; local anesthesia; medical instrumentation; microsurgery; mitomycin C; patient selection; review; speech rehabilitation; speech therapy; thyroid cyst; thyroid nodule; varicosis; voice TERMS (UNCONTROLLED): reinke edema EMCare (Dialog® File 45): (c) 2010 Elsevier B.V. All rights reserved. 4/9/39 (Item 1 from file: 73) 0081957683 EMBASE/MEDLINE No: 2007392046 Vocal fold nodules. risk factors in teachers. A case control study design Nodulos de cuerdas vocales. Factores de riesgo en los docentes. Estudio de casos y controles Perez Fernandez C.A.; Preciado Lopez J. Servicio ORL, Hospital San Millan, Logrono. La Rioja; C/ Avenida Principal 61, 24271 Llamas de la Ribera. Leon Author email: arapi61@hotmail.com Corresp. Author/Affil: Perez Fernandez C.A.: C/ Avenida Principal 61, 24271 Llamas de la Ribera. Leon Corresp. Author Email: arapi61@hotmail.com Acta Otorrinolaringologica Espanola ( Acta Otorrinolaringol. Esp. ) ( Spain ) 2003 , 54/4 (253-260) CODEN: AOTEA ISSN: 0001-6519 URL: http://external.doyma.es/prepdf/water.asp?pident_ articulo=13097204&pident_usuario=797308&pident_ revista=102&fichero=102v54n4a13097204pdf001.pdf&ty=143&accion=L &origen=doyma&web=www.doyma.es&lan=es Document Type: Journal ; Article Record Type: Abstract Language: Spanish Summary language: English; Spanish Number of References: 27 April 1, Vocal nodules are structural lesions very common amongst professional voice users such as teachers. We have studied the risk factors that predispose the development of vocal nodules in teachers. Two hundred and forty-two teachers were selected: 120 with vocal nodules and 120 with normal vocal folds.Professional and personal factors as well as classroom environment were studied. A complete evaluation of the voice was performed, aerodynamic measures, tone and extension of the voice, acoustic analysis, perceptual evaluation of the voice as well as a videolaryngostroboscopy which was definitive in the diagnosis. Younger teachers with less years of teaching experience a greater have tendency to develop vocal nodules than the rest. Class-room 's dryness, loudness and echo are correlated with the pathological group. The most relevant personal factors in the pathological group were previous vocal pathology, laryngeal surgery, nasal surgery and gastroesophageal reflux. Vocal intensity and vocal frequency ranks were shorter in the pathological group. We could also see that, fonatory flow was less effective in the pathological group. Medical Descriptors: * vocal cord disorder--etiology--et adult; article; auditory discrimination; case control study; controlled study; environ ment; female; gastroesophageal reflux; human; larynx surgery; loudness; major clinical study; male; nose surgery; occupational disease; pathology; perception; risk factor; speech discrimination; teacher ; vocal cord; voice Medical Terms (Uncontrolled): vocal fold nodule--etiology--et SECTION HEADINGS: Otorhinolaryngology General Pathology and Pathological Anatomy ANEXO 4: Resultado busqueda en Dialog EMBASE (Dialog® File 73): (c) 2010 Elsevier B.V. All rights reserved. 4/9/40 (Item 2 from file: 73) 0077567907 EMBASE/MEDLINE No: 1999054038 Functional impact of nodules: A case-comparison study Smith E.; Taylor M.; Mendoza M.; Lemke J.; Hoffman H. Department of Preventive Medicine, College of Medicine, University of Iowa, Iowa City, IA, United States; Department of Preventative Medicine, 2800 SB, College of Medicine, Iowa City, IA 52242, United States Corresp. Author/Affil: Smith E.: Department of Preventative Medicine, College of Medicine, Iowa City, IA 52242, United States Journal of Voice ( J. Voice ) ( United States ) December 1, 1998 , 12/4 (551-558) CODEN: JOVOE ISSN: 0892-1997 Document Type: Journal ; Article Record Type: Abstract Language: English Summary language: English Number of References: 9 Patients diagnosed with nodules(NO = 40) in a large university hospital clinic and an age-stratum matched nondiseased group (ND = 200) described adverse outcomes of vocal impairment on work and work-related communications. NOs were significantly more likely than NDs to report symptoms of hoarseness (73% vs. 26%), high-note difficulty (70% vs. 20%), difficulty speaking with a lower voice (53% vs. 13%) and a tired voice (50% vs. 10%), and their greatest source of physical discomfort was associated with scratchiness (61% vs. 3%). The average number of symptoms was four in NOs and less than one in NDs. Nodule patients were most concerned about the effects their voice problem would have on their future career (78% vs. 24%) and 49% of NOS reported their voice problem had an adverse work effect in the past compared with 4% of NDs. Having a voice condition limited current job performance in 39% of the NO group but only in 2% of the ND group. The results suggest that a diagnosis of nodules plays a ma jor role in disrupting careers and work activities and that available educational programs and additional research are needed for improving their functional ability and preventing adverse outcomes in the lives of individuals with voice disorders. Medical Descriptors: * larynx disorder--therapy--th; *vocal cord adolescent; adult; article; career; clinical article; controlled study; female; functional disease--complication--co; functional disease--therapy --th; hoarseness; human; job performance; patient education; psychological aspect; questionnaire; social aspect; speech therapy; symptom SECTION HEADINGS: Otorhinolaryngology Rehabilitation and Physical Medicine Occupational Health and Industrial Medicine EMBASE (Dialog® File 73): (c) 2010 Elsevier B.V. All rights reserved. 4/9/41 (Item 3 from file: 73) 0077163049 EMBASE/MEDLINE No: 1998071590 Bilateral vocal fold masses: Cysts versus reactive nodules Sataloff R.T.; McCarter A.A.; Hawkshaw M. Thomas Jefferson University, Department of Otolaryngology, Allegheny University Hospitals, Philadelphia, PA, United States Corresp. Author/Affil: Sataloff R.T.: Thomas Jefferson University, Department of Otolaryngology, Allegheny University Hospitals, Philadelphia, PA, United States ANEXO 4: Resultado busqueda en Dialog Ear, Nose and Throat Journal ( Ear Nose Throat J. ) ( United States ) April 22, 1998 , 77/2 (86) CODEN: ENTJD ISSN: 0145-5613 Document Type: Journal ; Article Record Type: Citation Language: English Medical Descriptors: * cyst--diagnosis--di; *cyst--surgery--su; *larynx disorder--diagnosis--di; * larynx dis order--surgery--su; *vocal cord adult; article; case report; female; human; laryngitis--diagnosis--di; laryngitis-surgery--su; laryngoscopy; larynx surgery; medical photography; singing; voice SECTION HEADINGS: Otorhinolaryngology Occupational Health and Industrial Medicine EMBASE (Dialog® File 73): (c) 2010 Elsevier B.V. All rights reserved. 4/9/42 (Item 4 from file: 73) 0076956838 EMBASE/MEDLINE No: 1997249996 Chinese traditional medicine treatment modalities for adult vocal cord nodules in China Shu R.; Tsukuda M.; Furukawa M.; Ikema Y.; Sawaki S. Yokohama City University, School of Medicine, Yokohama City, Japan Corresp. Author/Affil: Shu R.: Yokohama City University, School of Medicine, Yokohama City, Japan Practica Otologica, Supplement ( PRACT. OTOL. SUPPL. ) ( Japan ) 1997 , -/92 (61-63) CODEN: JIRHE ISSN: 0912-1870 Document Type: Journal ; Article Record Type: Abstract Language: Japanese Summary language: English; Japanese Number of References: 3 September 2, There are more patients with vocal cord nodules in China than in Japan. The occupation of these patients consists mainly of female singers or teachers. On the basis of the etiology and pathology of Chinese traditional medicine, there are three different treatment modalities for this disease. Shikunshi-to, Toninsibutsu-to and Zoueki-to. These Chinese traditional medicine treatment modalities have been characterized by the combined use of Chinese medical herbs according to each individual patient's status. Drug Descriptors: * chinese drug--drug therapy--dt unclassified drug Medical Descriptors: * polyp--diagnosis--di; *vocal cord article; chinese medicine; human; occupational hazard; risk factor; singing; teacher Drug Terms (Uncontrolled): shikunshi to--drug therapy--dt; toninsi butsu to--drug therapy--dt; zoueki to--drug therapy--dt SECTION HEADINGS: Otorhinolaryngology Drug Literature Index EMBASE (Dialog® File 73): (c) 2010 Elsevier B.V. All rights reserved. 4/9/43 (Item 5 from file: 73) 0076247438 EMBASE/MEDLINE No: 1995295566 Recurrent laryngeal palsy and mediastinal lymphadenopathy [2] ANEXO 4: Resultado busqueda en Dialog Hughes P.; McGavin C.; Dahl R. Plymouth Chest Clinic, Freedom Fields Hospital, Plymouth, United Kingdom Corresp. Author/Affil: Hughes P.: Plymouth Chest Clinic, Freedom Fields Hospital, Ply mouth, United Kingdom Respiratory Medicine ( RESPIR. MED. ) ( United Kingdom ) October 12, 1995 , 89/8 (584-585) CODEN: RMEDE ISSN: 0954-6111 Item Identifier (DOI): 10.1016/0954-6111(95)90166-3 Document Type: Journal ; Letter Record Type: Citation Language: English Medical Descriptors: * larynx; *lymphadenopathy; *mediastinum lymph node; *nerve paralysis --complication--co aged; calcification; case report; female; human; letter; male; priority journal; sarcoidos is; silicosis; vocal cord paralysis--complication --co SECTION HEADINGS: Otorhinolaryngology Chest Diseases, Thoracic Surgery and Tuberculosis Occupational Health and Industrial Medicine EMBASE (Dialog® File 73): (c) 2010 Elsevier B.V. All rights reserved. 4/9/44 (Item 6 from file: 73) 0075931435 EMBASE/MEDLINE No: 1994357899 Pathogenesis of vocal nodules: Biomechanical aspects ASPECTS BIOMECANIQUES DE LA PATHOGENIE DES NODULES VOCAUX Dejonckere P.; Laloyaux P.; Lebacq J.; Plaghki L. Institut de Phoniatrie, Universite d'Utrecht, GREL, BP 85500, 3508 GA Utrecht, Netherlands Corresp. Author/Affil: Dejonckere P.: Institut de Phoniatrie, Universite d'Utrecht, GREL, BP 85500, 3508 GA Utrecht, Netherlands Revue de Laryngologie Otologie Rhinologie ( REV. LARYNGOL. OTOL. RHINOL. ) ( France ) December 7, 1994 , 115/4 (267-276) CODEN: RLORA ISSN: 0035-1334 Document Type: Journal ; Article Record Type: Abstract Language: French Summary language: English Considering epidemiologic, histopathologic, and aerodynamic date, and according to in formation provided by laryngostroboscopic observations, a biomechanical hypothesis accounting for the pathogenesis of vocal nodules is worked out. It is based on a chronic re ciprocal microtrauma of a specific portion of the vocal fold edge. Computer modelling points out that three conditions are necessary and sufficient for generating such a local ized microtrauma when vocal folds oscillate: oscillation axes of vocal fold edges need to be slightly bowed; dorsal extremities need to be disjoined; oscillation amplitude needs to be sufficient: anatomical physiological and behavioral correlates for these three requirements could be found in the structure of the conus elasticus, the hypotony of adductor and vocalis muscles due to fatigue related to intensive ( professional) voice use, and as this results in undesirable acoustic changes, a compensatory hyperkinetic phonatory ex piration. Medical Descriptors: * larynx disorder--diagnosis--di; *larynx disorder--epidemiology--ep; *larynx disorder-etiology--et; *singing; *vocal cord adolescent; adult; article; biomechanics; female; histopathology; human; human tissue; ANEXO 4: Resultado busqueda en Dialog major clinical study; male; stroboscopy SECTION HEADINGS: Otorhinolaryngology EMBASE (Dialog® File 73): (c) 2010 Elsevier B.V. All rights reserved. 4/9/45 (Item 7 from file: 73) 0072747387 EMBASE/MEDLINE No: 1984027803 Varix of the vocal cord in the professional voice user Feder R.J. Chief Division of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, CA, United States Corresp. Author/Affil: : Chief Division of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, CA, United States Otolaryngology - Head and Neck Surgery ( OTOLARYNGOL. HEAD NECK SURG. ) ( United States ) December 1, 1983 , 91/4 (435-436) CODEN: OTOLD ISSN: 0194-5998 Document Type: Journal ; Article Record Type: Abstract Language: English Singers and actors who abuse their voices may develop either polyps, nodules, contact ulcer, and/or contact granuloma. Rarely a vascular lesion consisting of a hypertrophic vessel projecting above the medial or superior mucosal surface of the vocal cord is encountered that may contain a small knucklelike deformity. Clinically this is not dissimilar in appearance to a vessel found on the anterior nasal septum that is responsible for epistaxis. When the voice is strained, these vessels can rupture, causing recurrent submu cosal hemorrhages in the professional voice user. The case described is that of a wellknown actress in whom vocal abuse did not produce a submucosal hemorrhage from the varix but rather an edematous change and symptoms identical to those of a soft, early vocal cord nodule. Medical Descriptors: * dysphonia; *vocal cord case report; diagnosis; human; larynx; therapy Medical Terms (Uncontrolled): actor; singer; vocal cord nodule SECTION HEADINGS: Otorhinolaryngology Occupational Health and Industrial Medicine EMBASE (Dialog® File 73): (c) 2010 Elsevier B.V. All rights reserved. 4/9/46 (Item 8 from file: 73) 0071703777 EMBASE/MEDLINE No: 1980083508 Vocal cord dysfunction - an industrial health hazard Rontal E.; Rontal M.; Jacob H.J.; Rolnick M.I. Dept. ORL, Univ. Michigan Med. Sch., Ann Arbor, Mich., United States Corresp. Author/Affil: : Dept. ORL, Univ. Michigan Med. Sch., Ann Arbor, Mich., United States Annals of Otology, Rhinology and Laryngology ( ANN. OTOL. RHINOL. LARYNGOL. ) ( United States ) December 1, 1979 , 88/6 I (818-821) CODEN: AORHA ISSN: 0003-4894 Document Type: Journal ; Article Record Type: Abstract Language: English ANEXO 4: Resultado busqueda en Dialog Vocal cord dysfunction has a definite incidence of association with high environmental noise levels. The authors' study has shown roughly an 8% incidence of vocal cord dysfunction (vocal cord nodules, vocal cord polyps and chronic laryngitis) in individuals working in high noise environments. In addition, those individuals who have surgery for vocal cord nodules and who work in high noise environments will have over a 30% incidence of recurrent vocal cord dysfunction following surgery. The study indicates that females tend to be more at risk in high noise environments than males. Medical Descriptors: * dysphonia; *laryngitis; *noise auditory system; diagnosis; ecology; etiology; hearing impairment; larynx; major clinical study; sex difference Medical Terms (Uncontrolled): vocal cord nodule; vocal cord polyp SECTION HEADINGS: Otorhinolaryngology Occupational Health and Industrial Medicine EMBASE (Dialog® File 73): (c) 2010 Elsevier B.V. All rights reserved. 4/9/47 (Item 9 from file: 73) 0071344740 EMBASE/MEDLINE No: 1979076884 Singer's nodes: etiology, clinical picture and treatment Donchev H. Kat. ORL Bol., Inst. Ochni ORL Bol., Med. Akad., Sofia, Bulgaria Corresp. Author/Affil: : Kat. ORL Bol., Inst. Ochni ORL Bol., Med. Akad., Sofia, Bulgaria Oto-Rino-Laringologiya ( OTO-RINO-LARINGOLOGIYA ) ( Bulgaria ) 1978 , 15/3 (103-106) CODEN: ORLSA Document Type: Journal Record Type: Abstract Language: Bulgarian Summary language: English; Russian December 1, On the basis of experience with the treatment of twenty six patients with singer's nodes, the most typical and frequently observed clinical signs of the condition are out lined. Emphasis is laid on the role played by the mechanical factor as a contributory cause. The occupational conditioning of the formation of singer's nodes is underlined. It is established that among the patients with so-called vocal professions their incidence amounts to 87.47%. In conclusion it is pointed out that the teaching profession is the most frequently affected. All the patients are subjected to operation through microlaryn gosurgery, and the results attained are estimated to be very good. Finally, prophylactical measures are recommeded aimed at preventing the formation of singer's nodes. Medical Descriptors: etiology; larynx; short survey; therapy Medical Terms (Uncontrolled): vocal cord nodule SECTION HEADINGS: Otorhinolaryngology EMBASE (Dialog® File 73): (c) 2010 Elsevier B.V. All rights reserved. 4/9/48 (Item 10 from file: 73) 0070873081 EMBASE/MEDLINE No: 1978012401 Catamnestic studies of patients with nodules and polyps of the vocal cords KATAMNESTISCHE ERHEBUNGEN BEI PATIENTEN MIT STIMMLIPPENKNOTCHEN UND -POLYPEN ANEXO 4: Resultado busqueda en Dialog Riess F.; Wendler J. Phoniat. Audiol. Zent., HNO Klin., Ber. Med., Humboldt Univ., Berlin, German Democratic Republic Corresp. Author/Affil: : Phoniat. Audiol. Zent., HNO Klin., Ber. Med., Humboldt Univ., Berlin, German Democratic Republic HNO PRAX December 1, 1976 , 1/2 (111-116) Document Type: Journal Record Type: Abstract Language: German Catamnestic evaluations in 763 patients suffering from vocal cord nodules and polyps show distributions related to age, sex and profession and give materials for critical consideration about therapeutic methods in use. During childhood an active treatment of nodules remains doubtful, parent counceling should be preferred. In adults a combined method including microscopical removal of pathological tissue leads to the best results, provided that the pathological changes have existed for a longer period of time; in other cases silence followed by voice training can be recommended now as before. Medical Descriptors: * larynx surgery; *speech therapy age; diagnosis; therapy Medical Terms (Uncontrolled): vocal cord polyp SECTION HEADINGS: Otorhinolaryngology EMBASE (Dialog® File 73): (c) 2010 Elsevier B.V. All rights reserved. 4/9/49 (Item 11 from file: 73) 0070369968 EMBASE/MEDLINE No: 1975153807 Occupational vocal disorders BERUFSSTIMMSTORUNGEN Boehme G. Strahlenfelser Str. 23, Munchen, Germany Corresp. Author/Affil: : Strahlenfelser Str. 23, Munchen, Germany Munchener Medizinische Wochenschrift ( MUNCH. MED. WOCHENSCHR. ) 1974 , 116/40 (1721-1726) CODEN: MMWOA ISSN: 0341-3098 Document Type: Journal Record Type: Abstract Language: German December 1, Numerous occupations demand an optimal speaking capacity. If occupational vocal disorders (occupational dysphonias) occur, these impair interpersonal communication and professional performance. Vocal disorders in and as a result of vocal professions must be differentiated. In general, an increased frequency of professional dysphonia is to be observed because numerous new occupational groups demand intensive speech performances. The findings are largely polysymptomatic and may include psycho genic disturbances. Questions of treatment, professional ability and prognosis are discussed. Medical Descriptors: * dysphonia; *noise; *occupational disease; *speech; *speech disorder; *speech therapy; *stress; *vocal cord; *voice diagnosis; etiology Medical Terms (Uncontrolled): vocal cord nodule SECTION HEADINGS: Otorhinolaryngology ANEXO 4: Resultado busqueda en Dialog Occupational Health and Industrial Medicine EMBASE (Dialog® File 73): (c) 2010 Elsevier B.V. All rights reserved. 4/9/50 (Item 12 from file: 73) 0070031971 EMBASE/MEDLINE No: 1974032008 Remarks on the treatment of singer's nodes ENKELE OPMERKINGEN OVER DE BEHANDELING VAN ZANGKNOBBELS Van Deinse J.B.; Berg J.P. Afd. ORL, Ziekenh. Westeinde, Den Haag, Netherlands Corresp. Author/Affil: : Afd. ORL, Ziekenh. Westeinde, Den Haag, Netherlands LOGOPEDIE FONIAT. December 1, 1973 , 45/6 (109-116) CODEN: LOFOA Document Type: Journal Record Type: Abstract Language: Dutch Singer's nodes are small thickenings localized at the junction of the anterior and middle thirds of the vocal cords. They are frequent conditions which are not due to inflammation but to excessive use of the voice. This mechanical factor in straining the voice has a traumatic effect on the larynx. The prognosis of singer's nodes has been considerably improved by associating microsurgery with postoperative speech training. Quicker and better results are attained, with complete recovery of the voice. The intervention is harmless and can be advised for all forms of nodules of the vocal cords. Medical Descriptors: * larynx surgery; *musician; *occupational disease; *speech disorder; *speech therapy; *stress; *vocal cord; *voice therapy Medical Terms (Uncontrolled): actor; singer; vocal cord polyp SECTION HEADINGS: Rehabilitation and Physical Medicine Occupational Health and Industrial Medicine Otorhinolaryngology EMBASE (Dialog® File 73): (c) 2010 Elsevier B.V. All rights reserved. 4/9/51 (Item 13 from file: 73) 0068399648 EMBASE/MEDLINE No: 12501772 Treatment of vocal fold nodules in singers Lechenie pri uzelkakh golosovykh skladok u vokalistov. Pavlikhin O.G. Corresp. Author/Affil: Pavlikhin O.G. Vestnik otorinolaringologii ( Vestn. Otorinolaringol. ) ( Russian Federation ) December 27, 2002 , -/6 (34-36) ISSN: 0042-4668 Document Type: Journal ; Article Record Type: Abstract File Segment: Medline Language: Russian Vocal nodules (singer's nodules) are a typical professional disease of the vocal apparatus. This disease occurs more frequently in 20- to 50-year-old singers. The nodules form because of vascular disorders secondary to overstrain of the vocal apparatus in phonation and disorders of vegetative innervation. 43 opera singers were treated whose age and singing history ranged from 22 to 57 years and 3 to 26 years, respectively. The treatment combined psychotherapy, medicines with phlogenzym as a basic drug, physio - ANEXO 4: Resultado busqueda en Dialog therapy and phonopedia. Phlogenzym allows to avoid "silence regimen", surgical inter vention. This improves treatment efficacy, shortens the time of disability for singers. Drug Descriptors: potassium iodide--drug administration--ad Medical Descriptors: * larynx disorder--therapy--th; *music; *occupational disease--therapy --th; *vocal cord adult; article; female; human; iontophoresis; male; middle aged; psychotherapy; time; voice CAS Registry Number: 7681-11-0 (potassium iodide) EMBASE (Dialog® File 73): (c) 2010 Elsevier B.V. All rights reserved. 4/9/52 (Item 14 from file: 73) 0065658221 EMBASE/MEDLINE No: 6659260 Vocal nodules: diagnosis, clinical manifestations and treatment Uzelki golosovykh skladok, diagnostika, klinika, lechenie. Ibragimova S.I.; Teleliaeva L.M. Corresp. Author/Affil: Ibragimova S.I. Vestnik otorinolaringologii ( Vestn. Otorinolaringol. ) ( Russian Federation ) November 1, 1983 , -/6 (44-47) ISSN: 0042-4668 Document Type: Journal ; Article Record Type: Citation File Segment: Medline Language: Russian Medical Descriptors: * larynx disorder--diagnosis--di; *larynx disorder--therapy--th; * occupational disease--diagnosis--di; *occupational disease --therapy--th; *vocal cord; *voice adult; article; female; human; male; middle aged EMBASE (Dialog® File 73): (c) 2010 Elsevier B.V. All rights reserved. 4/9/53 (Item 15 from file: 73) 0064440690 EMBASE/MEDLINE No: 4670040 Occurrence of vocal cord nodules in singers Das Vorkommen von Stimmlippenknotchen bei den Sangern. Lacina O. Corresp. Author/Affil: Lacina O. Folia phoniatrica ( Folia Phoniatr (Basel) ) ( Switzerland ) December 1, 1972 , 24/5 (345-354) ISSN: 0015-5705 Document Type: Journal ; Article Record Type: Citation File Segment: Medline Language: German Medical Descriptors: * occupational disease; *stress; *vocal cord adult; article; female; human; larynx disorder--epidemiology--ep; male; middle aged; vibration EMBASE (Dialog® File 73): (c) 2010 Elsevier B.V. All rights reserved. 4/9/54 (Item 1 from file: 135) 0002241121 (THIS IS THE FULLTEXT) Germany Telecommunications Report Q4 2010 - at the End of June 2010 the ANEXO 4: Resultado busqueda en Dialog German Mobile Market Held about 107.712Mn Subscribers Telecommunications Weekly, October 20, 2010, p.630 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 632 TEXT: Research and Markets (http://www.researchandmarkets.com/research/c12e3f/germany telecommun) has announced the addition of the "Germany Telecommunications Report Q4 2010" report to their offering. The Germany Telecommunications Report provides industry professionals and strategists, corporate analysts, telecommunication associations, government departments and regulatory bodies with independent forecasts and competitive intelligence on Germany's telecommunications industry. The latest quarterly report on Germany's telecoms market includes a comprehensive coverage of recent developments in the country's mobile, fixed voice and broadband sectors. We have also included key activities in the cable TV, pay-TV and IPTV markets, along with regulatory and industry developments across the entire telecoms sector. At the end of June 2010, German mobile market held about 107.712mn subscribers, reflecting a net loss of 525,000 subscribers in the second quarter of the year. Market leader T-Mobile was the main culprit for the third consecutive quarter as it shed 1.568mn subscribers, bring ing the net subscriber loss between Q309 and Q210 to 2.354mn. The operator attributes the subscriber losses to continued discounting of inactive SIMs and is hopeful of return ing to growth when the process is completed. The three other mobile operators Vodafone Germany, E Plus and Telefonica O2 Germany all saw very strong net additions in the quarter. However, all three of them also reported worse subscriber mixes compared to Q110, implying a vigorous drive at attracting prepaid customers to boost market share. Mobile operators that acquired spectrum in the 800MHz band in the April 2010 auctions have started making plans to roll out LTE networks in the country. In July 2010, Voda fone selected equipment manufacturers Huawei Technologies and Ericsson as technology partners for deploying an LTE network in largely targeted at underserved areas. Vodafone plans to start deploying LTE at the end of September 2010, with around 1,500 base stations planned to have LTE technology by the end of 2011. In August 2010, FinnishGerman telecoms equipment and solutions vendor Nokia Siemens Networks (NSN) was selected to provide a pilot LTE network in Halle for O2. Under the contract, NSN will rollout base stations and enhanced packet core (EPC) nodes to provide broadband capacity and coverage in Halle and its suburb Teutschenthal. The pilot network in Halle will oper ate in the 2.6 GHz band, while the network in Teutschenthal will operate in the 800 MHz band. The network is expected to go into pre-commercial operation by the end of 2010. In the fixed-line and broadband markets, Deutsche Telekom and O2 recorded decline to fixed-line subscriptions as the regulator reported an uptrend in DSL-based VoIP usage. This aligns with one of our views is that the growing popularity of VoIP services will en hance subscriber losses to traditional fixedline services. However, Deutsche Telekom is hopeful that the rapid uptake of its IPTV service and the roll of fibre optic broadband to cover more areas in the country will help stave off the decline in fixed-line services which will be sold in bundled packages with the more advanced data services. Meanwhile, the pay-TV sector is set to increased competition as Sky Deutschland has revealed that it is in talks with leading cable operators and other content distributors to set up content dis tribution partnerships for high demand programs, such as the German football league, in order to counter the rapid growth of Deutsche Telekoms IPTV service. Key Topics Covered: SWOT Analysis Business Environment Industry Forecast Scenario Market Data Analysis Regional Outlook Country Outlook Mobile Operator Data Regulatory Environment & Industry Developments Industry Developments Competitive Landscape Company Monitor Country Snapshot: Germany Demographic Data For more information visit http://www.researchandmarkets.com/research/c12e3f/germany telecommun Keywords: ANEXO 4: Resultado busqueda en Dialog Broadband, Communications, Electronics, Research and Markets, Telecommunications. This article was prepared by Telecommunications Weekly editors from staff and other reports. Copyright 2010, Telecommunications Weekly via VerticalNews.com. DESCRIPTORS: Broadband; Communications; Electronics; Research and Markets; Telecommunications SUBJECT HEADING: Research and Markets (c)Copyright 2010, Telecommunications Weekly via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/55 (Item 2 from file: 135) 0002189079 (THIS IS THE FULLTEXT) China Telecom deploys first CDMA Push-to-Talk service in China with Alcatel-Lucent Computers, Networks & Communications, October 7, 2010, p.122 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 519 TEXT: Providing 3G voice value-added services to vertical and enterprise markets Shanghai - Alcatel-Lucent (Euronext Paris and NYSE: ALU) announced that it has successfully deployed its CDMA High Performance Push-To-Talk (PTT) service for China Telecom. This new service, a first in China, will target vertical and enterprise customers and will be commercialized across the country by the end of August. The commercial contract was secured by Alcatel-Lucent Shanghai Bell the flagship company of Alcatel-Lucent in China which previously deployed China Telecom's CDMA EVDO-based solution. Alcatel-Lucent's CDMA HP-PTT end-to-end solution will provide China Telecom's 3G customers with imme diate voice interaction across geographically dispersed groups of workers to meet their productivity needs, without the costs and delays associated with traditional cir cuit-switched voice services. HP-PTT service allows one-to-one (private) and one-tomany (group) calls to be established across the wireless service coverage area at the push of a single button. China Telecom's 3G subscribers will thus be able to enjoy con venient and reliable voice, data and PTT services all in one handset. Alcatel-Lucent provided its high-capacity, high-performance CDMA end-to-end solution including sys tems for registration management, group management, data management, new lease line application, and network management. Alcatel-Lucent also provided professional integration and system development services to integrate such services as radio access network (RAN) and Packet Data Serving Node (PDSN) deployed by various suppliers on many sorts of handsets. Alcatel-Lucent acted as project leader to provide a customized solution and manage and coordinate all relevant vendors in the process. As a breakthrough voice service on China Telecom's CDMA network, the new High Performance Push-to-Talk service, will greatly stimulate China Telecom's mobile business and revenue, Alcatel-Lucent's solution fully meets stringent quality of service (QoS) require ments associated to the use of the voice-over Internet Protocol (VoIP) technologies for PTT systems which will enable China Telecom to extend its experience in providing high quality 3G and next generation IP based services. "The project further enhances our long-term partnership with China Telecom and confirms Alcatel-Lucent's leading position in the CDMA market in China," said Romano Valussi, president of Alcatel-Lucent Shang hai Bell. "Alcatel-Lucent's advanced solution and enriched network management experi- ANEXO 4: Resultado busqueda en Dialog ence will help China Telecom provide more flexible, value-added services to the strategic vertical and enterprise markets." Alcatel-Lucent is a world leader in the CDMA market worldwide and continues to innovate in the CDMA/EVDO to keep operators competitive during the evolution to 4G. Alcatel-Lucent has more experience than any other telecom player in integrating and re-architecting networks. According to industry analyst firm Dell'Oro*, Alcatel-Lucent leads in terms of worldwide CDMA revenues with a market share of more than 40 % (2Q'10). Alcatel-Lucent has more than 70 CDMA customers in 40 countries - and supports five of the top six global CDMA operators. Keywords: Asia, China, Computer Networks, Computers. This article was prepared by Computers, Networks & Communications editors from staff and other reports. Copyright 2010, Computers, Networks & Communications via VerticalNews.com. DESCRIPTORS: Asia; China; Computer Networks; Computers SUBJECT HEADING: Computer Networks (c)Copyright 2010, Computers, Networks & Communications via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/56 (Item 3 from file: 135) 0002094451 (THIS IS THE FULLTEXT) Philippines' President Aquino III's Inauguration and State of the Nation Address Secured With Firetide Wireless Video Surveillance Network Telecommunications Weekly, September 1, 2010, p.29 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 798 TEXT: President Benigno Aquino III's inauguration, celebration event and first State of the Nation Address (SONA) were successfully secured by a rapidly deployed, real-time Firetide wireless infrastructure mesh network. The temporary video surveillance network was installed to assist the 5,000 police officers who were deployed in the Metro Manila area during the inauguration and SONA festivities. The system was installed by Firetide's leading partner in the Philippines DTSI (Diversified Technology Systems) and used net work cameras from Axis Communications and open-platform video management from Milestone, both Firetide's technology solution partners. "The National Capital Region Po lice Office (NCRPO) is committed to using state-of-the art technology to improve the ef fectiveness of the police in the Metro Manila area and for special events," said Director Roberto Rosales of NCRPO. "We chose Firetide for the temporary surveillance network because we are currently using their mesh network for the video surveillance backbone infrastructure of the NCRPO Command Center. We knew that their wireless mesh technology would deliver the real-time, high-performance video needed to help keep the President safe." After several weeks of planning, the wireless video surveillance system was installed by DTSI at the Luneta Grandstand in Manila a day before the June 30 inaugura tion, to monitor the crowd and help provide security for the event. DTSI deployed Firetide outdoor infrastructure mesh nodes and the Axis network cameras on area light poles and the stage itself. A mobile command and control vehicle was equipped with Milestone's video management system and a Samsung monitor to receive real-time video feeds of the area under surveillance so that the NCRPO could view the activities remotely. After the event, the system was taken down and transported to Quezon City 20 kilometers away to provide security for the night celebration. The entire system was put ANEXO 4: Resultado busqueda en Dialog up two hours before the start of the party. Over 10,000 people attended the event, with various locations - stage, backstage, overhead stage, entrances, exits -- monitored by the video surveillance system. Using the same system, DTSI then provided security for the first SONA of the President on July 26. Firetide mesh nodes and Axis cameras were placed strategically to help police monitor a crowd of more than 6,000 people. "In each instance, we were able to set up and deploy the network and deliver real-time, high-per formance video feeds of key areas to the command center within a matter of hours," said Joel Somontina, head of the Information Transport System of DTSI. "To be able to do this so quickly and easily was amazing." In addition to the temporary network, Firetide's MIMO infrastructure mesh is currently being used by the Philippine National Po lice as a cost-effective alternative to fiber for backhauling video feeds from disparate se curity installations throughout the metro area. The network aggregates more than 400 security camera feeds and delivers them in real-time to the NCRPO Command Center. The NCRPO has plans to expand the Metro Manila network and to continue using portable mesh installations in future events. "Today, Firetide wireless infrastructure mesh techno logy plays an increasingly important role in helping public safety agencies keep citizens safe," said Bo Larsson, chief executive officer of Firetide. "Nowhere is this safety more critical than at major events such as the Philippines presidential inauguration and state of the nation address, involving crowds in the tens of thousands. With its choice of Firetide for this unique and special deployment, NCRPO has validated that our technology meets their most critical requirements and sets the standard for reliable, secure and rapidly-deployable wireless video surveillance." About Firetide Inc. Firetide is the leading provider of wireless infrastructure mesh networks that enable concurrent video, voice, and data for municipal, public safety, and industrial applications. Firetide provides reli able high performance wireless infrastructure mesh and access solutions for video surveillance, Internet access, public safety networks and temporary networks wherever rapid deployment, mobility and ease of installation are required. Headquartered in Los Ga tos, Calif., Firetide is a privately held company with worldwide product distribution. http://www.firetide.com About DTSI DTSI is a leading global systems integrator that designs, builds, deploys, and manages communications solutions and facilities for their customers who include much of the Fortune 500. It is best reputed as a contact center and BPO expert, with over 100,000 seats enabled in the United States and the Philippines. DTSI's portfolio includes business communications, turnkey contact center solu tions both on and offshore, hosted and managed services, and an extensive array of professional and consulting services. www.dtsi.com.ph Photos/Multimedia Gallery Available: http://www.businesswire.com/cgi-bin/mmg.cgi?eid=6400358&lang=en Keywords: Asia, Firetide Inc., Philippines, Technology. This article was prepared by Tele communications Weekly editors from staff and other reports. Copyright 2010, Telecommunications Weekly via VerticalNews.com. DESCRIPTORS: Asia; Firetide Inc.; Philippines; Technology SUBJECT HEADING: Firetide Inc. (c)Copyright 2010, Telecommunications Weekly via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/57 (Item 4 from file: 135) 0002019352 (THIS IS THE FULLTEXT) ADC's Wireless Solutions Serve Crowds at Texas Tech University's Jones AT&T Stadium Telecommunications Business, August 4, 2010, p.47 DOCUMENT TYPE: Editor's Choice LANGUAGE: English ANEXO 4: Resultado busqueda en Dialog RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 430 TEXT: ADC (NASDAQ: ADCT) (www.adc.com) announced that its InterReach Fusion(R) and FlexWave(TM) Prism distributed antenna systems (DAS) have been deployed to provide high-capacity cellular services throughout Texas Tech University's Jones AT&T Stadium. Deployed after Phase I construction of an $84 million renovation to the 52,000-seat stadium (which included construction of a new, 175,000 square foot West Side Stadium Building), the ADC DAS ensures that any AT&T subscriber within the complex can place calls and use mobile broadband services, even during capacity-crowd events. "We often have more than 50,000 fans in our stadium for a game and they had problems placing calls or had calls drop," said David Hougland, director of sports broadcasting for Texas Tech University. "Now, with the ADC system, we have the capacity to handle the call needs of our fans." The ADC systems deployed at the stadium include a combination of the FlexWave Prism higher power nodes and the InterReach Fusion low power nodes. The systems support 850 and 1900 MHz frequencies for users of AT&T's 2G and 3G mobile voice and data services. In all, the systems divide coverage into nine specific sec tors to ensure maximum frequency re-use and maximum available bandwidth to any portion of the stadium. "Our combination of Prism and Fusion deliver a one-two punch to the capacity challenges at Texas Tech," said John Spindler, vice president of product management for ADC. "The Prism remote units cover large areas of the stadium seating, while the Fusion system brings coverage inside the West Side Stadium Building. This is a great example of how ADC's broad product portfolio allows us to create precision coverage and capacity solutions for any venue." About ADC Network Solutions ADC's Network Solutions Business Unit offers products that help service providers and enterprises deliv er high-performance wireless coverage and capacity to business and consumer subscribers in any indoor or outdoor location. ADC is the global leader in advanced, in-build ing wireless solutions, and in solutions that enhance coverage and manage capacity in macro networks. About ADC ADC provides the connections for wireline, wireless, cable, broadcast, and enterprise networks around the world. ADC's innovative network infrastructure equipment and professional services enable high-speed Internet, data, video, and voice services to residential, business and mobile subscribers. ADC (NASDAQ: ADCT) has sales into more than 130 countries. Learn more about ADC at www.adc.com. ADC-G Keywords: ADC. This article was prepared by Telecommunications Business editors from staff and other reports. Copyright 2010, Telecommunications Business via VerticalNews.com. DESCRIPTORS: ADC SUBJECT HEADING: ADC (c)Copyright 2010, Telecommunications Business via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/58 (Item 5 from file: 135) 0001985035 (THIS IS THE FULLTEXT) Portuguese Cable Operator ZON Multimedia Adopts IBM Software to Improve Customer Service Computers, Networks & Communications, July 29, 2010, p.429 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT ANEXO 4: Resultado busqueda en Dialog AUDIENCE: Professional WORD COUNT: 428 TEXT: IBM (NYSE:IBM) announced that ZON Multimedia, the leader of the pay TV market in Portugal, has adopted its software to consolidate ZON's IT and network management into a single view for improved quality and distribution of cable services to its con sumers. The recently signed agreement represents an investment of 1.2 million euros in the cable operator's strategy to continuously improve customer service. ZON needed an intelligent network management and IT monitoring solution that could aggregate the various components of its infrastructure into a centralized view. While IT and networking have traditionally been managed separately, IBM's integrated service management solutions connect these domains to deliver greater visibility, control and automation to the enterprise. IBM software can quickly identify and highlight problems in the network, en abling ZON's operational team to plan and schedule maintenance to ensure signal and distribution quality. The real-time, centralized monitoring of complex networks and IT domains delivers scalability that exceeds millions of events per day. As a result, ZON will be able to ensure high levels of customer service as it continues to expand its services offerings such as HDTV, high-speed internet access, digitalvoice, security, music and gaming. IBM's holistic approach to ZON's challenge, sophisticated offerings and professional services were key differentiators in winning ZON's preference over competitors such as HP and replacing HP Network Node Manager with IBM Tivoli Netcool. "A superior centralized platform for operational management is the foundation to meet ZON's future technical and business needs more efficiently," said Paulo Ribeiro, board member of ZON TVCabo, a company from ZON Multimedia group. "IBM software enables our network operations and IT staff to hone in on the most critical problems and even automate the isolation and resolution of those problems before impacting customers." "Having a single, real-time view to manage the network can help ZON improve efficiencies and costs associated with maintaining network systems, while delivering consistently high levels of ser vice to customers' homes," said Scott Stainken, general manager, IBM Global Telecommunications Industry. "IBM is pleased to be working with ZON as they exploit the capab ilities of our service management solutions to deliver a differentiated customer experience in their marketplace." ZON will leverage a portfolio of IBM service management software to automate and integrate its IT and networking systems across the company's entire infrastructure. This includes Tivoli Netcool and Monitoring, Composite Application Manager, OMNibus and Network Manager. Keywords: Software, IBM. This article was prepared by Computers, Networks & Communications editors from staff and other reports. Copyright 2010, Computers, Networks & Communications via VerticalNews.com. DESCRIPTORS: Software; IBM SUBJECT HEADING: IBM (c)Copyright 2010, Computers, Networks & Communications via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/59 (Item 6 from file: 135) 0001921761 (THIS IS THE FULLTEXT) Vendor Focus - Recent IT Developments - Issue 5, 2010 with News from IBM, HP and Microsoft Chemicals & Chemistry Business, July 9, 2010, p.965 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT ANEXO 4: Resultado busqueda en Dialog AUDIENCE: Professional WORD COUNT: 1299 TEXT: Research and Markets (http://www.researchandmarkets.com/research/f15b5f/vendor focus rec) has announced the addition of the "Vendor Focus - Recent IT Developments - Issue 5, 2010" report to their offering. These Vendor Focus reports keep you up to date on the latest developments in the IT market In this edition, we look at a collection of 9 Vendor Focus - Recent IT Developments in May 2010 1. CA World 2010 Mainframe Announcements: CustomerDriven Innovation Shapes the Future of Mainframe Management This report centers around key announcements at CA World 2010 in the application management space. Although there were multiple announcements related to virtualization, Cloud, and main frame, this report centers on the mainframe. It is still the platform of choice for the ma jority of applications running in today's mid- to enterprise-sized companies, and sorely in need of modernized management products. Today's companies are well-aware that many mainframe specialists are nearing retirement. The new generation of IT specialists largely lacks mainframe skills, putting a host of critical applications at risk as baby boomers retire from the workforce. CA's mainframe-related announcements address this problem with a collaborative workspace, an installation/maintenance platform that re duces cost of ownership by streamlining tools administration, and a modernized Graphic al User Interface (GUI). EMA sees CA's investments in the mainframe space as being clear differentiators against competitors who have not invested in updating mainframe toolsets. Discussions with customers indicate the new products are generating significant interest within the mainframe community. 2. HP Unifies Network Fault, Availability and Performance Management with NNMi9 On April 21, 2010, HP Software announced a major upgrade to its network management solutions offerings with the release of Network Node Manager i-Series (NNMi) version 9.0. In parallel, HP released extensions and enhancements across its full line of NNM Smart Plug In (iSPI) add-on modules, including the new iSPI Performance for QA. HP also announced the availability of its Automated Network Management solutions bundle, a combination of products which encompasses the vast majority of network management functionalities required by todays network engineering and operations practitioners. These new releases represent a major refresh across HPs network management portfolio with a focus on unifying network fault, avail ability and performance management while extending the solution with new features for dealing with virtualized infrastructures. 3. Integrating with the Cloud: IBM Acquires Cast Iron Systems IBM recently announced the acquisition of Cast Iron Systems, an applica tion integration vendor, for an undisclosed sum. The acquired company is a leader in its respective space and well positioned with a product line spanning physical and virtual ap pliances, as well as the cloud. Cast Iron Systems was one of the first to market with con nectors for cloud-based solutions such as Salesforce.com and RightNow.com. This is high-demand functionality, since many IT organizations are seeking to integrate cloudbased services with a variety of enterprise applications. EMA sees this as a win for IBM and one that will provide additional traction in the Small to Medium-sized Business (SMB) and enterprise cloud markets. However, companies should be aware that this product does not replace, but rather supplements, traditional Enterprise Application Integration (EAI) and Enterprise Service Bus (ESB) products. 4. What Terma Labs can Teach the Industry about Business Service Management The role of automation in service management is continuing to rise in importance both with the ascendant interest in Cloud Ser vices and virtualization, and with the growing recognition that automation is central to enabling and solidifying best practices across domains. Automation does this last in two respects: it hardens processes into a more consistent workflow, but it also provides ITprofessionals and managers with more time to focus on the dialogs and value-oriented initiatives that are so central to business-aligned IT services. Within the automation pan theon, Workload Automation (WLA) too often gets marginalized as a fairly well defined area with roots in job scheduling, despite its pervasiveness and rapid ROI. The need to place WLA in context with larger automation and service management capabilities is so ANEXO 4: Resultado busqueda en Dialog far not well understood both by the industry in general, and by many WLA vendors themselves. This report looks at WLA in that larger context and presents a true service management vision of what WLA can and should become. The report also introduces Terma Software Labs JAWS, as the only solution in the market today that meaningfully bridges that gap, with both an eye to present integrations and future possibilities as a unifying system for job automation from a service impact perspective. 5. CloudSleuth: An Independent, Open Approach to Cloud Performance Monitoring In April, 2010, beta availability was announced for CloudSleuth - an innovative new open community focused on measuring and reporting the health and performance of cloud service providers. CloudSleuth has been created as a collaborative platform for developing best practices around cloud ecosystems while also delivering an independent voice and viewpoint which can help IT organizations select and monitor providers. The initiative has initially been conceived and sponsored by Compuware and Gomez (a Compuware subsidiary) with the stated intent to welcome any practitioners and technology providers who have an interest in promoting the long-term reliability, predictability, and maturity of cloud services. 6. Microsoft Releases SQL Server 2008 R2 Aimed at Delivering Pervasive Insight The Microsoft Server 2008 R2 release brings new features and upgrades to the SQL Server platform. The new offerings include Master Data Services, Complex Event Processing and PowerPivot the free ad-on module that enables Excel to become an application development tool and scale to millions of rows of data for more powerful analytics. Coupled with other technologies in the Microsoft suite SQL Server 2008 R2 makes significant strides towards enabling mass adoption of business intelligence across the enter prise. 7. SAS Delivers Enterprise Social Media Analytics SAS delivers Version 1.0 of their Enterprise Social Media Analytics. The solution combines best of breed technologies from SASs data integration, web analytics, text analytics, data mining and predictive analytics suites to deliver insights into social media based conversations and communities. 8. In foblox Acquires Netcordia, Takes Aim at Network Infrastructure Automation On May 4, 2010, Infoblox announced it had closed the acquisition of Netcordia, provider of the NetMRI family of advanced Network Change and Configuration Management (NCCM) solutions. Infoblox, a leader in the DNS/DHCP/IPAM (DDI) sector, will keep the Netcordia team intact and plans product integrations to advance the state of the art in DDI solu tions through improved discovery, compliance, and automation. Infoblox will also intro duce the NetMRI solution to their existing global customer and channel base. This com bination reflects the fact that DDI and NCCM, typically parallel areas of concern and re sponsibility for the network engineering and operations team, are converging around the need for broader network infrastructure automation to effectively deal with the runaway rates of change evoked by virtualization and cloud services. 9. OpTier Announces Experience Manager Plus BTM Starter Edition In April of 2010, OpTier introduced a new product bundle combining OpTier CoreFirst and OpTier Experience Manager. The combined products were introduced to the market as Experience Manager Plus BTM (Business Transaction Management) Starter Edition. Starter Edition provides a scaled-down BTM option for medium-sized companies, or a departmental and/or 'try before you buy' path for larger companies. The product bundle includes single licenses for OpTier Experience Manager (end-user experience monitoring) and BTM Server (transaction analytics), up to five dual-core licenses of CoreFirst for web servers (back-end visibility), and ten days of deployment services. It supports up to 1,000 concurrent users. With this announcement, OpTier plans on extending its distinctive transaction management offerings to companies in the Global 5000 or smaller range. Keywords: Iron, Transition Elements, Research and Markets. This article was prepared by Chemicals & Chemistry Business editors from staff and other reports. Copyright 2010, Chemicals & Chemistry Business via VerticalNews.com. DESCRIPTORS: Iron; Transition Elements; Research and Markets SUBJECT HEADING: Research and Markets (c)Copyright 2010, Chemicals & Chemistry Business via NewsRx.com ANEXO 4: Resultado busqueda en Dialog NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/60 (Item 7 from file: 135) 0001746211 (THIS IS THE FULLTEXT) Singers Get a Spring Tune Up With Free Voice Screening at The New York Eye and Ear Infirmary Immunotherapy Weekly, May 12, 2010, p.558 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 532 TEXT: MAY 12 - (NewsRx.com) -- A medley of rock 'n rollers, sopranos and musical theater singers in the New York area received a comprehensive voice check-up and a stroboscopic exam of their vocal cords as part of an annual Voice Screening for Professional Singers, sponsored by The New York Eye and Ear Infirmary and MusiCares, the charitable arm of the national Recording Academy. The screening program was begun as a meaningful way to observe World Voice Day in New York City, one of the entertainment capitals of the world (see also Allergies). "We found fairly extensive voice problems among professional singers, which is proof positive there is a large unmet need for vocal care within the show business community," said Michael Pitman, MD, director of New York Eye and Ear's Voice & Swallowing Institute. "Vocal folds are a singers' instrument and livelihood, so getting a comprehensive voice exam is a smart way to ensure a singing career over the long term," he said. Almost three-quarters of the singers also complained of allergies (pollen producing trees bloomed early and profusely in the city this year), and it was striking how few knew which products would be most beneficial or harmful in treatment of allergies. "Over the counter or prescribed oral allergy medication can be extremely drying," Dr. Pitman noted. "Professional voice users should protect their instrument with medications that are targeted at the area of their allergy symptoms without the systemic side effects that can affect their voice." Asked to hit high and low notes, each singer's vocal fold was simultaneously photographed and recorded during a thorough, half-hour assessment by one of four speech language pathologists. Then, each singer had a private consultation with Dr. Pitman and Amy Lebowitz, a singing voice specialist, who provided them with a personalized folder of voice care recommendations that included vivid, colorful images of their vocal folds which can be used as a base line reference for future exams. Also included in eachsinger's take-home packet was a voice conservation tip sheet, applicable to singers of all stripes. More than half of the 37 singers who were screened discovered they had vocal problems resulting from nodules and polyps on their vocal folds, atrophy, muscle tension dysphonia, allergy or acid reflux. The screening is one of many events held nationally in celebration of World Voice Day of the American Academy of Otolaryngology -- Head and Neck Surgery Foundation. KayPentax, a medical instrument company, also helped sponsor the New York screening The New York Eye and Ear Infirmary, founded in 1820 and the first specialty hospital in the United States, is a teaching affiliate of the New York Medical College and member of Continuum Health Partners. NYEEI handles approximately 224,500 outpatient visits and performs over 25,000 surgical procedures per year. It has one of the nation's most extensive eye, ear, nose and throat clinics. Keywords: Allergic Disease, Allergies, Allergy Medicine, Pulmonology, The New York Eye && Ear Infirmary. This article was prepared by Immunotherapy Weekly editors from staff and other reports. Copyright 2010, Immunotherapy Weekly via NewsRx.com. ANEXO 4: Resultado busqueda en Dialog DESCRIPTORS: Allergic Disease; Allergies; Allergy Medicine; Pulmonology; The New York Eye & Ear Infirmary; Immunology; Immunotherapy SUBJECT HEADING: Allergies (c)Copyright 2010, Immunotherapy Weekly via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/61 (Item 8 from file: 135) 0001712799 (THIS IS THE FULLTEXT) TA Associates Completes Secondary Investment in Aurora Networks Mergers & Acquisitions Business, April 28, 2010, p.114 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 715 TEXT: TA Associates, a leading growth private equity firm, announced it has acquired, through a secondary purchase from existing shareholders, a minority stake in Aurora Networks, Inc., an optical transport solution provider delivering a cost-effective, optim ized platform for next-generation cable services. Terms of the investment were not disclosed. Founded in 1999, Aurora Networks is the only pure-play optical transport solution provider focused solely on cable network operators. The company's broad array of optical network products and technology includes optical transmitters, node platforms and Ethernet equipment that deliver enhanced services and greater bandwidth to subscribers while reducing the cable operator's total cost of ownership. Aurora Networks' systems simplify network design and maintenance, offer greater flexibility and scalability, and po sition operators to provide competitive, next-generation cable services. The company is based in Santa Clara, California. "Aurora Networks is precisely the type of profitable, growing company in which TA seeks to invest," said Jason P. Werlin, a Vice President at TA Associates who will join the company's Board of Directors. "Aurora Networks' continued growth is fueled by an innovative suite of products and services that deliver truly compelling benefits to cable companies throughout the world. We look forward to assisting Aurora Networks' talented management team to further build value in the company." "We are very pleased to welcome TA as an investor in Aurora Networks," said Guy Sucharczuk, Chairman, President and CEO, Aurora Networks. "We are confident that TA will be a valuable partner as we continue to expand our offering of industry-leading tech nology to support next-generation cable services." Cable operators worldwide are making significant investments to improve networks and increase available bandwidth. Cable subscribers are increasingly demanding more bandwidth-intensive and latency-sensitive services such as HDTV and two-way services such as personalized video-on-demand (VOD), high-speed Internet access and voice-over-IP (VoIP). Analysts project 24 percent compounded annual growth in worldwide HDTV subscribers and 9 percent compounded annual growth in U.S. VOD-enabled digital subscribers, between 2008 and 2013. "Cable operators continue to build and upgrade network infrastructure to counter increasingly competitive threats from telephone companies, satellite operators and Internet content providers," said Kurt R. Jaggers, a Managing Director at TA Associates. "As a result, the addressable market for Aurora Networks' products is large and growing. Given the rapid rise in bandwidth consumption and ever-increasing demand for enhanced products and greater broadband speeds, we anticipate continued significant growth for Aurora Networks." TA Associates has more than four decades of investing experience, focusing on profitable growth companies. TA's prior investments in the communications sector include FreeWave Technologies, Idea Cellular, MetroPCS Communications, Micro- ANEXO 4: Resultado busqueda en Dialog max Informatics Limited, SBA Communications, TARGUSinfo, TEOCO and Weather Investments S.p.A. Goodwin Procter LLP provided legal counsel to TA Associates. Wilson Sonsini served as legal advisor to Aurora Networks. About Aurora Networks Aurora Networks is evolving cable by focusing on innovative solutions that build future-proof net works to accommodate the cable subscriber services of today and tomorrow. Aurora Networks is the only pure-play optical transport solution provider that is focused solely on cable MSOs. Using its proven understanding of cable networks, Aurora Networks delivers unique solutions - such as its Fiber Deep architecture and digital return technology - to address specific issues of the cable industry. Aurora Networks enables leading MSOs across the globe to compete with a cost-effective, optimized launch pad for next-genera tion cable services. To learn more about Aurora Networks' core cable solutions, please visit www.aurora.com. About TA Associates Founded in 1968, TA Associates is one of the largest and most experienced middle market private equity firms. The firm has invested in nearly 400 companies and manages more than $16 billion in capital. With offices in Boston, London, Menlo Park and Mumbai, TA Associates leads buyouts and minority re capitalizations of profitable growth companies in the technology, financial services, busi ness services, healthcare and consumer industries. More information about TA Associates can be found at www.ta.com. Keywords: Bandwidth, Broadband, Electronics, Ethernet, Fiber-optic Network, Finance, Financial, Financial Services, Investing, Investment, Net works, Private Equity, Professional Services, TA Associates, Technology. This article was prepared by Mergers & Acquisitions Business editors from staff and other reports. Copyright 2010, Mergers & Acquisitions Business via VerticalNews.com. DESCRIPTORS: Bandwidth; Broadband; Electronics; Ethernet ; Fiber-optic Network; Fin ance; Financial; Financial Services; Investing; Investment; Networks; Private Equity; Professional Services; TA Associates; Technology SUBJECT HEADING: TA Associates (c)Copyright 2010, Mergers & Acquisitions Business via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/62 (Item 9 from file: 135) 0001668955 (THIS IS THE FULLTEXT) Department of Defense Enhances Global Reach with SES WORLD SKIES Information Technology Newsweekly, April 13, 2010, p.66 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 715 TEXT: Leveraging its advanced teleport and a long-term alliance with DRS Technical Ser vices, SES WORLD SKIES, a division of SES S.A. (Paris:SESG)(LuxX:SESG), announced it is hosting a new, mission-critical Department of Defense communications node near the nation's capital. By installing a Defense Information Systems Network (DISN) connection point at SES WORLD SKIES' media port in Manassas, Virginia, the U.S. government has greatly enhanced its access to World Skies bandwidth and global connectivity. The ad vanced uplinking facility is a strategic communications crossroads with access to some of the most robust fiber and satellite networks, including the worldwide SES fleet and DRS Technical Services' Global Communications Network (GCN). DRS Technical Services, through its Global Enterprise Solutions business unit, is a primary communications ser vices provider to the U.S. government, under the Defense Satellite Transmission Services ANEXO 4: Resultado busqueda en Dialog - Global Procurement Program managed by the Defense Information Systems Agency (DISA). Together with SES WORLD SKIES, DRS enables a broad range of mission-critical applications that enable real-time collaboration between headquarters and field opera tions around the world. "The installation of a communications node within our Virginia teleport gives the U.S. government easy access to powerful global connectivity options," explained Robert Bednarek, President and CEO of SES WORLD SKIES. "While the Defense Information Systems Network carries the majority of U.S. government voice, video and data traffic, government agencies increasingly depend on SES WORLD SKIES and DRS Technical Services for anywhere to anywhere communications." "For nearly a decade, SES WORLD SKIES and DRS Technical Services have joined forces to meet the growing global demand for government and enterprise communications services," said Jim Scott, Vice President and General Manager of Global Enterprise Solutions for DRS Technical Services. "The DISN installation at the SES WORLD SKIES facility, just minutes from DISA, The Pentagon, and other strategic Capitol-area locations, opens the door to a new level of network expandability in virtually every corner of the world." About DRS Technical ServicesDRS Technical Services Inc., a wholly-owned subsidiary of DRS Defense Solutions Inc., is headquartered in Herndon, VA and provides turnkey, full lifecycle communications and security systems to defense organizations as well as other federal and state government organizations. DRS Defense Solutions LLC is headquartered in Bethesda, MD and is composed of seven lines of business with more than 3000 employees around the globe. DRS Defense Solutions provides advanced products, services and systems integration in the areas of intelligence and sensor technologies, security, cyber warfare, sonar, communications, electronic warfare, training systems, satellite communications, control systems and unmanned technologies. About SES WORLD SKIESSES WORLD SKIES is the new global division of SES, created through the combination of the former SES NEW SKIES and SES AMERICOM. The company operates a fleet of 25 satellites - part of the 41 spacecraft of the SES group - delivering services as diverse as television distribution and broadcast, internet access, data transmission and business and government communications to customers worldwide. SES WORLD SKIES currently has five additional satellites under construction. The company's unique customer-focused ap proach allows it to offer the best satellite solutions for a host of business and government requirements, with a view toward helping customers meet their short-term challenges and realize their longer-term goals. SES WORLD SKIES comprises a world-class team of customer care and technicalprofessionals located in Princeton (NJ), The Hague, Washington D.C., Singapore, Beijing, London, Sao Paulo, Mexico City, Sydney, Accra and Johannesburg. Visit www.ses.com for more information. About SESSES (Paris:SESG) (LuxX:SESG) wholly owns the market-leading satellite operators SES ASTRA and SES WORLD SKIES as well as participations in Ciel in Canada, QuetzSat in Mexico and satel lite infrastructure start-up O3b Networks. SES provides outstanding satellite communica tions solutions via a global fleet of 41 satellites in 26 orbital locations. For further inform ation: www.ses.com Keywords: Aerospace, Asia, Bandwidth, Contracts, Data Manage ment, Data Systems, Data Traffic, Data Transmission, Defense, Defense Information Systems Agency, Department Of Defense, Electronics, Homeland Security, Information Systems, Information Technology, Military, Networks, Other Government, Politics, Public Policy and Government, SES WORLD SKIES, Satellite, Satellite Networks, Singapore, Spacecraft, State Government, Technology, Telecommunications, Television. This article was prepared by Information Technology Newsweekly editors from staff and other reports. Copyright 2010, Information Technology Newsweekly via VerticalNews.com. DESCRIPTORS: Aerospace; Asia; Bandwidth; Contracts; Data Management; Data Systems; Data Traffic; Data Transmission; Defense; Defense Information Systems Agency; Department Of Defense; Electronics; Homeland Security; Information Systems; Information Technology; Military; Networks; Oth SUBJECT HEADING: SES WORLD SKIES (c)Copyright 2010, Information Technology Newsweekly via NewsRx.com ANEXO 4: Resultado busqueda en Dialog NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/63 (Item 10 from file: 135) 0001633237 (THIS IS THE FULLTEXT) AT&T Deploys Network Disaster Recovery Resources to Chile to Ensure Business Continuity to Enterprise Customers Telecommunications Weekly, March 31, 2010, p.218 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 393 TEXT: AT&T* announced that it has deployed Network Disaster Recovery (NDR) resources to Chile as a preventive measure to ensure business continuity of the AT&T node in Santiago. The action is in response to a series of natural disasters that have affected the South American country since the devastating earthquake of February 27, which was followed by tsunamis and various aftershocks. The NDR resources include trained managers, engineers and technicians of AT&T's NDR team and a recovery trailer equipped with high-tech equipment, cables and connections. The professionals have already prepared the equipment on site in Santiago as part of AT&T's comprehensive business continuity plan. While the AT&T Global Network node in Chile is currently operational, AT&T has deployed the NDR resources so that communications can be restored quickly to customers in the unlikely event of additional disaster-related disruptions to the network. "Our thoughts and prayers are with the people in Chile who have lost their lives, and those who are facing the challenges of the natural disasters," said Eduardo Farinelli, AT&T Business Solutions sales center vice president for South America. "In the quest for recovery, we are committed to supporting our business customers by providing continuity of international communications with clients, vendors and other stakeholders." During the last 15 years, AT&T has invested more than $500 million in its NDR program, which includes specially trained managers, engineers and technicians from across the United States, as well as a fleet of more than 300 self-contained equipment trailers and support vehicles that house the same equipment and components as an AT&T data-routing orvoice-switching center. Since 1992, the NDR team has been activated more than a dozen times in response to disasters, including restoring service after the tornadoes in Oklahoma in 1999; the September 11 attacks at the World Trade Center in 2001; wildfires in San Diego in 2003 and 2007; Hurricanes Katrina and Rita in 2005; and Hurricanes Gustav, Dolly and Ike in 2008. More information on AT&T's NDR program is available at www.att.com/ndr. *AT&T products and services are provided or offered by subsidiaries and affiliates of AT&T Inc. under the AT&T brand and not by AT&T Inc. Keywords: AT&T, AT&T Inc., Economics, Telecommunications, World Trade This article was prepared by Telecommunications Weekly editors from staff and other reports. Copyright 2010, Telecommunications Weekly via VerticalNews.com. DESCRIPTORS: AT&T; AT&T Inc.; Economics; Telecommunications; World Trade SUBJECT HEADING: AT&T Inc. (c)Copyright 2010, Telecommunications Weekly via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/64 (Item 11 from file: 135) ANEXO 4: Resultado busqueda en Dialog 0001580329 (THIS IS THE FULLTEXT) New tuberculosis data have been reported by S. Aerts and co-authors Tuberculosis Week, March 15, 2010, p.18 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 228 TEXT: MAR 15 - (NewsRx.com) -- "Tuberculosis of the thyroid gland is,I very rare condition," scientists writing in the journal Acta Chirurgica Belgica report. "A case of a 47-year-old female with a history of a cuthyroid multi-nodular goitre is presented The patient developed hoarseness due to right recurrent laryngeal nerve paralysis (see also Tuberculosis). confirmed with indirect laryngoscopy Oil repeated ultrasound. volu metric progression of I dominant nodule in the inferior part of the right thyroid lobe was noticed. Fine needle aspiration Was inconclusive," wrote S. Aerts and colleagues. The researchers concluded: "Diagnosis was ultimately based on histopathology of the surgical resection specimen." Aerts and colleagues published their study in Acta Chirurgica Bel gica (Tuberculosis of the Thyroid Gland. A Case Report. Acta Chirurgica Belgica , 2009;109(6):805-807). Additional information can be obtained by contacting S. Aerts, Academy Surg Center Stuivenberg, ZNA Stuivenberg, ZNA Campus Stuivenberg, Lange Beeldekensstr 267, B-2060 Antwerp, Belgium. The publisher of the journal Acta Chirurgica Belgica can be contacted at: Acta Medical Belgica, Avenue Circulaire 138 a, B-1180 Brussels, Belgium. Keywords: City:Antwerp, Country:Belgium, Hoarseness, Mycobacteria, Mycobacterium Tuberculosis, Paralysis, Thyroiditis, Vocal Cord Paralysis This article was prepared by Tuberculosis Week editors from staff and other reports. Copyright 2010, Tuberculosis Week via NewsRx.com. DESCRIPTORS: City:Antwerp; Country:Belgium; Hoarseness; Mycobacteria; Mycobacterium Tuberculosis; Paralysis; Thyroiditis; Vocal Cord Paralysis; Top News; All News; Professional News SUBJECT HEADING: Tuberculosis (c)Copyright 2010, Tuberculosis Week via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/65 (Item 12 from file: 135) 0001528866 (THIS IS THE FULLTEXT) Research results from University of Wisconsin update understanding of surgery Obesity, Fitness & Wellness Week, March 6, 2010, p.3793 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 356 TEXT: MAR 6 - (NewsRx.com) -- Investigators publish new data in the report 'Use of lasers in laryngeal surgery.' According to recent research from the United States, "Lasers are a ANEXO 4: Resultado busqueda en Dialog relatively recent addition to laryngeal surgery (see also Surgery). Since their invention, laser use and applications have expanded rapidly." "In this article, we discuss the bene fits and disadvantages of lasers for different procedures, as well as ways to overcome commonly faced clinical problems. The use of lasers in surgery has offered a time-and cost-efficient alternative to cold surgical techniques, and has been used in the treatment of numerous laryngeal pathologies, including stenoses, recurrent respiratory papillo matosis, leukoplakia, nodules, malignant laryngeal disease, and polypoid degeneration (Reinke's edema). However, lasers can incur adjacent tissue damage and vocal fold scarring. These problems can be minimized through understanding the mechanisms by which lasers function and correctly manipulating the parameters under a surgeon's control. By varying fluence, power density, and pulsation, tissue damage can be de creased and lasers can be used with greater confidence. The various types of lasers and their applications to the treatment of specific pathologies are reviewed with the intention of helping surgeons select the best tool for a given procedure," wrote Y. Yan and colleagues, University of Wisconsin. The researchers concluded: "Recent applications of lasers to treat benign laryngeal lesions and severe laryngomalacia demonstrate that additional research must be conducted to realize the full potential of this surgical tool." Yan and colleagues published their study in the Journal of Voice (Use of lasers in laryngeal surgery. Journal of Voice , 2010;24(1):102-9). For additional information, contact Y. Yan, University of Wisconsin School of Medicine and Public Health, University of Wisconsin School of Medicine and Public Health, Division of Otolaryngology - Head and Neck Surgery, Madison, Wisconsin USA. Keywords: City:Madison, State:Wisconsin, Country:United States, Edema, Laryngeal Disease, Leukoplakia, Papilloma, Pathology, Surgery, Therapy, Treatment. This article was prepared by Obesity, Fitness && Wellness Week editors from staff and other reports. Copyright 2010, Obesity, Fitness && Wellness Week via NewsRx.com. DESCRIPTORS: City:Madison; State:Wisconsin; Country:United States; Edema; Laryn geal Disease; Leukoplakia; Papilloma; Pathology; Surgery; Therapy; Treatment; All News; Professional News; Obesity/Fitness/Wellness SUBJECT HEADING: Surgery (c)Copyright 2010, Obesity, Fitness & Wellness Week via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/66 (Item 13 from file: 135) 0001527431 (THIS IS THE FULLTEXT) New digital imaging research reported from University of Wisconsin Life Science Weekly, March 2, 2010, p.1975 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 417 TEXT: MAR 2 - (NewsRx.com) -- Fresh data on digital imaging are presented in the report 'Efficient and effective extraction of vocal fold vibratory patterns from high-speed digital imaging.' According to recent research published in the Journal of Voice , "High-speed digital imaging can provide valuable information on disordered voice production in voice science (see also Digital Imaging). However, the large amounts of high-speed image data with limited image resolutions produce significant challenges for computer analysis, and thus effective and efficient image edge extraction methods allowing for the batch ANEXO 4: Resultado busqueda en Dialog analysis of high-speed images of vocal folds is clinically important." "In this paper, a nov el algorithm for automatic image edge detection is proposed to effectively and efficiently process high-speed images of the vocal folds. The method integrates Lagrange in terpolation, differentiation, and Canny edge detection, which allow objective extraction of aperiodic vocal fold vibratory patterns from large numbers of high-speed digital images. This method and two other popular algorithms, histogram and active contour, are performed on 10 sets of high-speed video data from excised larynx experiments to compare their performances in analyzing high-speed images. The accuracy in computing glottal area and the computation time of these methods are investigated. The results show that our proposed method provides the most accurate and efficient detection, and is applic able when processing low-resolution images. In this study, we focus on developing a method to effectively and efficiently process high-speed image data from excised larynges," wrote Y. Zhang and colleagues, University of Wisconsin. The researchers concluded: "However, in addition we show the clinical potential of this method by use of ex ample high-speed image data obtained from a patient with vocal nodules.The proposed automatic image-processing algorithm may provide a valuable biomedical application for the clinical assessment of vocal disorders by use of high-speed digital imaging." Zhang and colleagues published their study in the Journal of Voice (Efficient and effective extraction of vocal fold vibratory patterns from high-speed digital imaging. Journal of Voice , 2010;24(1):21-9). For additional information, contact Y. Zhang, University of Wisconsin Medical School, University ofWisconsin Medical School, Division of Otolaryngology Head and Neck Surgery, Madison, Wisconsin USA. Keywords: City:Madis on, State:Wisconsin, Country:United States, Digital Imaging. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2010, Life Science Weekly via NewsRx.com. DESCRIPTORS: City:Madison; State:Wisconsin; Country:United States; Digital Imaging; All News; Professional News SUBJECT HEADING: Digital Imaging (c)Copyright 2010, Life Science Weekly via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/67 (Item 14 from file: 135) 0001527132 (THIS IS THE FULLTEXT) Study findings from University of Wisconsin provide new insights into digital imaging Life Science Weekly, March 2, 2010, p.320 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 420 TEXT: MAR 2 - (NewsRx.com) -- According to recent research published in the Journal of Voice , "High-speed digital imaging can provide valuable information oil disordered voice production in voice science (see also Digital Imaging). However, the large amounts of hi-h-speed image data with limited image resolutions produce significant challenges for computer analysis, and thus effective and efficient image edge extraction methods allow ing for the batch analysis of high-speed images of vocal folds is clinically important." "In this paper, a novel algorithm for automatic image edge detection is proposed to effectively and efficiently process high-speed images of the vocal folds. The method integ - ANEXO 4: Resultado busqueda en Dialog rates Lagrange interpolation, differentiation, and Canny edge detection, which allow ob jective extraction of aperiodic vocal fold vibratory patterns front large numbers of highspeed digital images. This method and two other popular algorithms, histogram and active contour, are performed on 10 sets of high-speed Video data from excised larynx experiments to compare their performances in analyzing high-speed images. The accuracy in computing glottal area and the computation time of these methods are investig ated. The results Show that Our proposed method provides the Most accurate and efficient detection, and is applicable when processing low-resolution images. In this Study, we focus oil developing a method to effectively and efficiently process high-speed image data from excised larynges. However. in addition we show the clinical potential of this method by use of example high-speed image data obtained from a patient with vocal nodules," wrote Y. Zhang and colleagues, University of Wisconsin. The researchers concluded: "The proposed automatic image-processing algorithm may provide a Valuable biomedical application For the clinical assessment of vocal disorders by use of high-speed digital imaging." Zhang and colleagues published their study in the Journal of Voice (Efficient and Effective Extraction of Vocal Fold Vibratory Patterns from High-Speed Digital Imaging. Journal of Voice , 2010;24(1):21-29). For additional information, contact Y. Zhang, University of Wisconsin, Dept. of Surg, Div OtolaryngolHead & Neck Surg, Sch Medical, 5745 Med Sci Center, 1300 University Avenue, Madison, WI 53706, USA. The publisher's contact information for the Journal of Voice is: Mosby-Elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA. Keywords: City:Madison, State:WI, Country:United States, Digital Imaging This article was prepared by Life Science Weekly edit ors from staff and other reports. Copyright 2010, Life Science Weekly via NewsRx.com. DESCRIPTORS: City:Madison; State:WI; Country:United States; Digital Imaging; All News; Professional News SUBJECT HEADING: Digital Imaging (c)Copyright 2010, Life Science Weekly via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/68 (Item 15 from file: 135) 0001525919 (THIS IS THE FULLTEXT) New surgery study findings have been published by Y. Yan and colleagues Health & Medicine Week, March 1, 2010, p.1848 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 343 TEXT: MAR 1 - (NewsRx.com) -- According to recent research published in the Journal of Voice , "Lasers are a relatively recent addition to laryngeal surgery (see also Surgery). Since their invention, laser use and applications have expanded rapidly." "In this article, we discuss the benefits and disadvantages of lasers for different procedures, as well as ways to overcome commonly faced clinical problems. The use of lasers in Surgery has offered a time- and cost-efficient alternative to cold Surgical techniques, and has been used in the treatment of numerous laryngeal pathologies, including stenoses, recurrent respiratory papillomatosis, leukoplakia, nodules, malignant laryngeal disease, and polyp oid degeneration (Reinke's edema). However, lasers can incur adjacent tissue damage and vocal fold scarring These problems can be minimized through understanding the mechanisms by which lasers function and correctly manipulating the parameters under ANEXO 4: Resultado busqueda en Dialog a surgeon's control. By varying fluence, power density, and pulsation, tissue damage can be decreased and lasers can be used with greater confidence. The various types of lasers and their applications to the treatment of specific pathologies are reviewed with the in tention of helping surgeons select the best tool for a given procedure," wrote Y. Yan and colleagues. The researchers concluded: "Recent applications of lasers to treat benign laryngeal lesions and severe laryngomalacia demonstrate that additional research must be conducted to realize the full potential of this surgical tool." Yan and colleagues pub lished their study in the Journal of Voice (Use of Lasers in Laryngeal Surgery. Journal of Voice , 2010;24(1):102-109). For additional information, contact P.Y. Zhuang, 1300 University Avenue, 5745 Med Sci Center, Madison, WI 53706, USA. The publisher's contact information for the Journal of Voice is: Mosby-Elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA. Keywords: City:Madison, State:WI, Country:United States, Edema, Laryngeal Disease, Leukoplakia, Papilloma, Pathology, Surgery This article was prepared by Health && Medicine Week editors from staff and other reports. Copyright 2010, Health && Medicine Week viaNewsRx.com. DESCRIPTORS: City:Madison; State:WI; Country:United States; Edema; Laryngeal Dis ease; Leukoplakia; Papilloma ; Pathology; Surgery; All News;Professional News ; General Health SUBJECT HEADING: Surgery (c)Copyright 2010, Health & Medicine Week via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/69 (Item 16 from file: 135) 0001522543 (THIS IS THE FULLTEXT) Studies from University Hospital, Department of Otolaryngology update current data on dysphonia therapy Biotech Business Week, March 1, 2010, p.2095 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 349 TEXT: MAR 1 - (NewsRx.com) -- Researchers detail in 'The prevalence of laryngeal pathology in a treatment-seeking population with dysphonia,' new data in dysphonia (see also Dysphonia Therapy). "This article describes the prevalence of laryngeal pathology in a treatment-seeking population with dysphonia in the Flemish part of Belgium. Retro spective investigation. During a period of 5 years (2004-2008), data were collected from 882 patients who consulted with dysphonia at the ear, nose, and throat department of the University Hospital in Ghent (Belgium)," researchers in Ghent, Belgium report. "Laryngeal pathology was diagnosed using videostroboscopy. Ages ranged from 4 years to 90 years. Functional voice disorders were most frequently diagnosed (30%), followed by vocal fold nodule (15%), and pharyngolaryngeal reflux (9%). The role of age, gender, and occupation was investigated. Pathologies were significantly more commonin females than in males, representing 63.8% and 36.2% of the population, respectively. Professional voice users accounted for 41% of the workforce population, with teachers as main subgroup. In professional voice users, functional dysphonia occurred in 41%, vocal fold nodules in 15%, and pharyngolaryngeal reflux in 11%. Our data were compared with data from other countries. Functional voice disorders were overall the most common cause of voice disorders (except in childhood), followed by vocal fold nod- ANEXO 4: Resultado busqueda en Dialog ules and pharyngolaryngeal reflux," wrote Houtte E. Van and colleagues, University Hospital, Department of Otolaryngology. The researchers concluded: "Professional voice users accounted for almost one half of the active population, with functional voice disorders as the main cause of dysphonia." Van and colleagues published their study in The Laryngoscope (The prevalence of laryngeal pathology in a treatment-seeking population with dysphonia. The Laryngoscope , 2010;120(2):306-12). For additional information, contact E. Van Houtte, University Hospital Ghent, Dept. of Otolaryngology, Ghent, Belgium. Keywords: City:Ghent, Country:Belgium, Dysphonia Therapy, Dysphonia, Otolaryngology, Pathology, Therapy, Treatment, Voice Disorder, Voice Disorders. This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2010, Biotech BusinessWeek via NewsRx.com. DESCRIPTORS: City:Ghent; Country:Belgium; Dysphonia Therapy; Dysphonia; Otolaryngology; Pathology; Therapy; Treatment; Voice Disorder; VoiceDisorders ; All News; Professional News SUBJECT HEADING: Dysphonia Therapy (c)Copyright 2010, Biotech Business Week via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/70 (Item 17 from file: 135) 0001513353 (THIS IS THE FULLTEXT) SpiderCloud Wireless Has Raised a Total of $40 Million to Commercialize Its Enterprise Radio Access Network System for Mobile Operators Computers, Networks & Communications, February 18, 2010, p.54 DOCUMENT TYPE: Editor's Choice LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 565 TEXT: SpiderCloud(R) Wireless, Inc., a developer of wireless technologies and the pioneer of the Enterprise Radio Access Network (E-RAN) platform developed for mobile operators, announced the closing of its Series B financing round. The $25 million round was led by Opus Capital along with new investments from Shasta Ventures and existing Series A investors Charles River Ventures and Matrix Partners. "Investing in SpiderCloud Wireless means investing in a solution to address the network capacity issues facing mobile oper ators today," said Rob Coneybeer, managing director at Shasta Ventures. "The indoor wireless E-RAN platform has the potential to change how radio access networks are deployed for years to come." The company also announced the addition of Behrooz Parsay as its new senior vice president of engineering and operations. Mr. Parsay has over 20 years experience in bringing wire-line and wireless products and systems to market and has previously held RF engineering and management positions with Aperto Networks, Ericsson, DIVA, Kestrel, and Lantern Communications. Mr. Parsay holds a Bachelor of Science in Electrical Engineering from Chico State University and a Master of Science in En gineering Management from Santa Clara University. "SpiderCloud Wireless is unique in its approach to solving the indoor capacity and coverage problems for mobile operators," said Behrooz Parsay. "I'm excited to join a company comprised of so many people with proven success in the wireless industry and look forward to making my contributions to the company, its customers and partners." "Behrooz Parsay is a great addition to our team and with his broad network experience, I am confident that we will deliver a worldclass system to our valued customers," said Peter Wexler, co-founder and board member ANEXO 4: Resultado busqueda en Dialog of SpiderCloud Wireless. "I have had the pleasure of pulling together an outstanding en gineering team to develop the initial product and look forward to making continued con tributions to the company." "We are excited to start the New Year on a high note with in vestments secured and a well-rounded executive team," said Michael Gallagher, CEO of SpiderCloud Wireless, Inc. "The funds will allow SpiderCloud to deepen its partnerships with enterprise solution providers to introduce a new class of mobile Internet services." SpiderCloud Wireless is speaking at Mobile World Congress in Barcelona, February 1518.Michael Gallagher, CEO, will participate on the panel, "Taking Enterprise Solutions to Market," which is taking place on Wednesday, February 17 at 14:00 (CET). SpiderCloud Wireless' E-RAN platform is a scalable system comprised of a SmartCloud(R) Services Node (SCSN) and Radio Nodes (SCRN). Advanced features bring 'zero touch' installation and low-cost routing options for voiceand data to the world of mobile radio access networks. The result is a purpose-built and self-organizing wireless network capable of extending the enterprise's full suite of voice and data applications and services to any standard handset or computing device. E-RAN brings together the functionality and se curity of cellular networks with the utility and economics of enterprise Wi-Fi data net works. Keywords: Cellular Network, Data Application, Data Management, Data Network, Electrical Engineering, Electronics, Engineering, Finance, Information Technology, Manu facturing, Mobile and Wireless, Networks, Professional Services, Security, Technology, Telecommunications, VoIP, Wireless Network, Wireless Technology, SpiderCloud Wireless Inc. This article was prepared by Computers, Networks & Communications editors from staff and other reports. Copyright 2010, Computers, Networks & Communications via VerticalNews.com. DESCRIPTORS: Cellular Network; Data Application; Data Management; Data Network; Electrical Engineering; Electronics; Engineering; Finance; Information Technology; Manu facturing; Mobile and Wireless; Networks ; Professional Services; Security; Technology; Telecommunications; VoIP; Wire SUBJECT HEADING: SpiderCloud Wireless, Inc. (c)Copyright 2010, Computers, Networks & Communications via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/71 (Item 18 from file: 135) 0001505602 (THIS IS THE FULLTEXT) Findings from E. Niebudekbogusz et al in dysphonia reported Health & Medicine Week, February 15, 2010, p.1372 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 344 TEXT: FEB 15 - (NewsRx.com) -- According to recent research from Lodz, Poland, "The aim of this study was to investigate the relationship between acoustic analysis and bio psychosocial implications of voice problems, evaluated by the Voice Handicap Index (VHI) (see also Dysphonia). The study comprised 120 female teachers with voice disorders, evaluated by videolaryngostroboscopy. 60.8% of this group were diagnosed as having functional dysphonia and 39.2% had dysphonia with benign vocal fold masses (nodules and polyps)." "The controls consisted of 30 euphonic women. The correlations between VHI and acousticanalysis were assessed in both groups using the Pearson correlation coefficient and regression analysis. In teachers, the total VHI score was over ANEXO 4: Resultado busqueda en Dialog 5 times as high as in controls (p < 0.001). Moreover, in teachers, significant positive cor relations were found between the total VHI score and the frequency perturbation parameters and amplitude perturbation parameters when both statistical methods were used. These acoustic parameters also significantly correlated with the score on the functional and emotional subscales, but rarely with the physical subscale of the VHI. The study re vealed a significant relationship between the objective voice measurements and the VHI," wrote E. Niebudekbogusz and colleagues. The researchers concluded: "The results confirmed that VHI can be a valuable tool for assessing biopsychosocial implications of occupational dysphonia and should be incorporated in multidimensional voice evalu ation." Niebudekbogusz and colleagues published their study in Folia Phoniatrica Et Logopaedica (Correlation between Acoustic Parameters and Voice Handicap Index in Dysphonic Teachers. Folia Phoniatrica Et Logopaedica , 2010;62(1-2):55-60). For additional information, contact E. Niebudekbogusz, Nofer Inst Occupat Medical, Dept. of Audiol & Phoniatr, Ul Teresy 8, PL-91348 Lodz, Poland. Publisher contact information for the journal Folia Phoniatrica Et Logopaedica is: Karger, Allschwilerstrasse 10, CH-4009 Basel, Switzerland. Keywords: City:Lodz, Country:Poland, Dysphonia, Polyps, Voice Disorder, Voice Disorders This article was prepared by Health & Medicine Week editors from staff and other reports. Copyright 2010, Health && Medicine Week via NewsRx.com. DESCRIPTORS: City:Lodz; Country:Poland; Dysphonia; Polyps; Voice Disorder; Voice Disorders; All News; Professional News; General Health SUBJECT HEADING: Dysphonia (c)Copyright 2010, Health & Medicine Week via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/72 (Item 19 from file: 135) 0001503430 (THIS IS THE FULLTEXT) Data on esophageal cancer discussed by researchers at University College Cancer Weekly, February 16, 2010, p.725 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 438 TEXT: FEB 16 - (NewsRx.com) -- A new study, 'Thoracoscopic esophagectomy for esophageal cancer: feasibility and safety of robotic assistance in the prone position,' is now available (see also Esophageal Cancer). According to recent research from Seoul, Korea, "To assess the feasibility and safety of robot-assisted thoracoscopic esophagectomy for esophageal cancer in the prone position. Twenty-one patients underwent robot-assisted thoracoscopic esophagectomy in the prone position by a surgical oncologist who had no prior experience with thoracoscopic esophagectomy." "Hemodynamic and respiratory parameters were serially recorded to monitor changes in prone positioning. All thoracoscopic procedures were completed with a robot-assisted technique followed by cervical esophagogastrostomy. R0 resection was achieved in 20 patients (95.2%), and the number of dissected nodes was 38.0 + or -14.2. Robot console time was significantly reduced from 176.3 + or -12.3 minutes in the initial 6 patients (group 1) to 81.7 + or -16.5 minutes in the latter 15 patients (group 2) (p=.000). In group 2, there was less blood loss (p=.018), more patients could be extubated in the operating room (p=.004), and the number of dissected mediastinal nodes tended to be increased (p=.093). There was no incidence of pneumonia or 90-day mortality. Major complications included ana- ANEXO 4: Resultado busqueda en Dialog stomotic leakage in 4 patients, vocal cord palsy in 6 patients, and intra-abdominal bleed ing in 1 patient. The prone position led to an elevation of central venous pressure and mean pulmonary arterial pressure and a decrease in static lung compliance. However, cardiac index and mean arterial pressure were well maintained with the acceptable range of partial pressure of arterial oxygen and carbon dioxide. Robotic assistance in the prone position is technically feasible and safe," wrote D.J. Kim and colleagues, University Col lege. The researchers concluded: "Prone positioning was well tolerated, but preoperative risk assessment and meticulous anesthetic manipulation should be carried out." Kim and colleagues published their study in the Journal of Thoracic and Cardiovascular Surgery (Thoracoscopic esophagectomy for esophageal cancer: feasibility and safety of robotic assistance in the prone position. Journal of Thoracic and Cardiovascular Surgery , 2010;139(1):53-59.e1). For additional information, contact D.J. Kim, Yonsei University College of Medicine, Dept. of Thoracic and Cardiovascular Surgery, 250 Seongsan-no, Seodaemun-gu, 120-752 Seoul, Korea. Keywords: City:Seoul, Country:Korea, Cardiology, Cardiovascular, Esophageal Cancer, Esophageal Carcinoma, Esophagectomy, Gastroenterology, Oncology, Surgery, Surgical Oncology. This article was prepared by Cancer Weekly editors from staff and other reports. Copyright 2010, Cancer Weekly via NewsRx.com. DESCRIPTORS: City:Seoul; Country:Korea; Cardiology; Cardiovascular; Esophageal Cancer; Esophageal Carcinoma; Esophagectomy; Gastroenterology; Oncology; Surgery; Surgical Oncology; All News; Professional News SUBJECT HEADING: Esophageal Cancer (c)Copyright 2010, Cancer Weekly via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/73 (Item 20 from file: 135) 0001496755 (THIS IS THE FULLTEXT) Insafe and Liberty Global Launch New, Interactive e-Safety Website www.esafetykit.net to Help Protect Children Across Europe Internet Business Newsweekly, February 22, 2010, p.4 DOCUMENT TYPE: Editor's Choice LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 904 TEXT: Liberty Global, Inc. ("Liberty Global") (Nasdaq: LBTYA) (Nasdaq: LBTYB) (Nasdaq: LBTYK) and Insafe, the European network of Awareness Centers promoting safe, responsible use of the internet, announced the launch of a new, interactive e-safety website (www.esafetykit.net) designed to help protect children on the web. The site is tar geted at children in a fun way, and also has sections for parents and school teachers. Esafetykit.net was developed by Insafe with the support of Liberty Global, one of its main partners, and its operating companies in Europe under the brands of UPC, Cable com, Telenet, and Unitymedia and is endorsed by the European Commission. Today's launch is part of the European Commission's 'Safer Internet Day' initiatives. The website is initially available in eight country versions and will soon be accessible in many other countries with local language versions. The site aims to make internet safety fun, enga ging and non-threatening through the use of interactive exercises, educating families on how to reduce the risk of cyber-bullying or other predatory behavior such as online grooming. 'Think Before You Post' Liberty Global and its companies also support Insafe's ANEXO 4: Resultado busqueda en Dialog European 'Think before you post' public service announcement and will air this campaign on local websites, and various TV channels across its European footprint. To view: Safer Internet Day 2010: Think B4 U post The 7th edition of Safer Internet Day is celebrated this year with many events organized in over fifty countries. On this occasion, the European Commission has organized a round-table meeting in the European Parliament, in Strasbourg, to discuss the awareness minors have about the risks of posting images and personal information online. Manuel Kohnstamm, Managing Director Public Policy and Communications of Liberty Global said: "The dynamic nature of the internet places a particular responsibility on us, as a service provider, to take action to ensure children's online safety. The launch of the e-Safetykit website and the 'Think before you post' campaign are important steps forward in our long-term effort to make this possible. We aim to build upon our successful relationship with Insafe and our ongoing commitment to empower children and families by providing free, easily accessible tools that enable con sumers as much as possible to control digital threats." The Interactive Toolkit The esafety website, available at www.esafetykit.net, will be distributed through a range of channels, including Insafe's internet safety awareness centers, Liberty Global affiliates, NGO partners and schools. The site is based on the printed 'family toolkit,' which was de veloped in 2008 by Insafe and Liberty Global. The family toolkit consists of a comprehensive parent's guide, an activity-based guidebook designed specifically for children between 6-12 years old, stickers, a family certificate and situation cards. The e-Safety website will extend the reach of the printed version. Over 300,000 hard copies of the toolkit have already been distributed in 11 languages and across 18 countries. The Liberty Global and Insafe Partnership Liberty Global's partnership with Insafe is part of the Company's Corporate Responsibility program with a key focus on 'Protecting Minors' and 'Digital Inclusion' by widening access, enhancing skills and creating opportunities. The internet safety toolkit promotes 'enhancing skills' by helping to ensure that people are able and qualified to use digital products and services safely, securely and effectively. As a 'Gold' partner of Safer Internet Day 2010, Liberty Global and Insafe also developed an online collaboration platform for professionals (www.sidfair.org) that showcases best practices on safer internet. Liberty Global's operating companies celebrated the day in many countries with local internet safety activities. Liberty Global Liberty Global is the leading international cable operator offering advanced video, voice and broadband internet services to connect its customers to the world of entertainment, communications and information. As of September 30, 2009, Liberty Global operated state-of-the-art networks that served approximately 17 million customers across 14 countries principally located in Europe, Japan, Chile, and Australia. Liberty Global's operations also include significant programming businesses such as Chellomedia in Europe. Insafe & Safer Inter net Day Safer Internet Day is a yearly event celebrated in over 60 countries in the month of February and organized by INSAFE. February 9, 2010 is the 7th edition of the event. Insafe, based in Brussels, is a network of national nodes that coordinate internet safety awareness in Europe. The network is set up and co-funded within the framework of the European Commission's Safer Internet plus Program. The mission of the Insafe cooperation network is to empower citizens to use the internet, as well as other online technologies, positively, safely and effectively. The network calls for shared responsibility for the protection of the rights and needs of citizens, in particular children and youths, by gov ernment, educators, parents, media, industry and all other relevant actors. Insafe part ners work closely together to share best practice, information and resources. The network interacts with industry, schools and families in the aim of empowering people to bridge the digital divide between home and school and between generations. www.safer internet.org For more information, please visit www.lgi.com. Keywords: Asia, Audio and Video, Broadband, Broadband Internet, Children, Consumer, Education, Electronics, En tertainment, Internet, Internet Safety, Japan, Networks, Other Consumer, Other Education, Parenting, Pediatrics, Technology, Telecommunications, VoIP, World Wide Web, Liberty Global Inc. This article was prepared by Internet Business Newsweekly editors from staff and other reports. Copyright 2010, Internet Business Newsweekly via VerticalNews.com. ANEXO 4: Resultado busqueda en Dialog DESCRIPTORS: Asia; Audio and Video; Broadband; Broadband Internet; Children; Consumer; Education; Electronics; Entertainment; Internet; Internet Safety; Japan; Net works; Other Consumer; Other Education; Parenting; Pediatrics; Technology; Telecommunications; VoIP; World Wide Web SUBJECT HEADING: Liberty Global, Inc. (c)Copyright 2010, Internet Business Newsweekly via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/74 (Item 21 from file: 135) 0001465161 (THIS IS THE FULLTEXT) Studies in the area of esophageal cancer reported from Yonsei University Cancer Weekly, February 9, 2010, p.370 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 459 TEXT: FEB 9 - (NewsRx.com& NewsRx.net) -- In this recently published article, scientists in Seoul, South Korea conducted a study "To assess the feasibility and safety of robot-assisted thoracoscopic esophagectomy for esophageal cancer in the prone position (see also Esophageal Cancer). Twenty-one patients underwent robot-assisted thoracoscopic esophagectomy in the prone position by a surgical oncologist who had no prior ex perience with thoracoscopic esophagectomy." "Hemodynamic and respiratory parameters were serially recorded to monitor changes in prone positioning. All thoracoscopic procedures were completed with a robot-assisted technique followed by cervical esophagogastrostomy. R0 resection was achieved in 20 patients (95.2%), and the number of dissected nodes was 38.0 +/- 14.2. Robot console time was significantly reduced from 176.3 +/12.3 minutes in the initial 6 patients (group 1) to 81.7 +/- 16.5 minutes in the latter 15 patients (group 2) (P =000). In group 2, there was less blood loss (P =018), more patients could be extubated in the operating room (P =004), and the number of dissected mediastinal nodes tended to be increased (P =093). There was no incidence of pneumonia or 90-day mortality. Major complicationsincluded anastomotic leakage in 4 patients, vocal cord palsy in 6 patients, and intra-abdominal bleeding in 1 patient. The prone posi tion led to an elevation of central venous pressure and mean pulmonary arterial pressure and a decrease in static lung compliance. However, cardiac index and mean arterial pressure were well maintained with the acceptable range of partial pressure of arterial oxygen and carbon dioxide. Robotic assistance in the prone position is technically feas ible and safe," wrote D.J. Kim and colleagues, Yonsei University. The researchers concluded: "Prone positioning was well tolerated, but preoperative risk assessment and me ticulous anesthetic manipulation should be carried out. (J Thorac Cardiovasc Surg 2010; 139:53-9)." Kim and colleagues published their study in the Journal of Thoracic and Car diovascular Surgery (Thoracoscopic esophagectomy for esophageal cancer: Feasibility and safety of robotic assistance in the prone position. Journal of Thoracic and Cardiovascular Surgery , 2010;139(1):53-U97). For additional information, contact D.J. Kim, Yonsei University, Dept. of Thorac && Cardiovasc Surg, Coll Medical, 250 Seongsan No, Seoul 120752, South Korea. The publisher's contact information for the Journal of Thoracic and Cardiovascular Surgery is: Mosby-Elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA. Keywords: City:Seoul, Country:South Korea, Cardiology, Cardiovascular, Esophageal Cancer, Esophageal Carcinoma, Esophagectomy, Gastroenterology, Oncology, Surgery, Surgical Oncology, Yonsei University. This article was prepared ANEXO 4: Resultado busqueda en Dialog by Cancer Weekly editors from staff and other reports. Copyright 2010, Cancer Weekly via NewsRx.com& NewsRx.net. Rx.net. DESCRIPTORS: City:Seoul; Country:South Korea; Cardiology ; Cardiovascular; Esophageal Cancer; Esophageal Carcinoma; Esophagectomy; Gastroenterology; Oncology; Surgery; Surgical Oncology; All News; Professional News SUBJECT HEADING: Esophageal Cancer (c)Copyright 2010, Biotech Business Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/75 (Item 22 from file: 135) 0001422633 (THIS IS THE FULLTEXT) Fitch Affirms Qwest's IDR at 'BB'; Maintains Stable Outlook Investment Weekly News, January 16, 2010, p.99 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 1261 TEXT: Fitch Ratings has affirmed Qwest Communications International, Inc.'s (Qwest) Is suer Default Rating (IDR) at 'BB'. Additionally, Fitch has affirmed the IDRs of Qwest's wholly owned subsidiaries, including Qwest Corporation (QC) as well as the specific issue ratings as highlighted below. The Rating Outlook for Qwest and its subsidiaries remains Stable. Approximately $14.1 billion of debt outstanding as of Sept. 30, 2009 is affected by Fitch's action. Overall the ratings assigned to Qwest and its subsidiaries incorporate the scope, scale and relatively consistent cash flow generated by Qwest Corporation's local exchange business, and the stable operating trends of Qwest's enterprise segment. Fitch believes that Qwest has sufficient capacity within the current ratings to withstand the continued pressure on its operating profile due to ongoing competitive, technology substitution and economic factors. The ratings are supported by Qwest's ability to con tinually enhance operating margins and efficiently invest capital into its physical plant, positioning the company to generate relatively consistent levels of EBITDA and free cash flow (defined as cash flow from operations less capital expenditures and dividends). Fitch continues to believe that Qwest's credit profile is strong within the current ratings cat egory, however, its competitive position is weaker when compared to its regional bell operating company (RBOC) peer group. In Fitch's opinion when compared to its RBOC peer group, Qwest lacks revenue diversity and revenue growth opportunities, particularly a strong facilities-based wireless business, that can offset technology, economic and com petitive issues that continue to erode Qwest's land-line business. Qwest's business profile is more wire-line voice and consumer centric relative to its RBOC peer group. These businesses arguably are most exposed to competitive and technology threats. The current economic environment - in particular slower housing starts and higher unemploy ment - only exasperate the competitive and wireless substitution threats. Qwest's primary strategy to address the threats to its consumer wire-line business and to im prove the company's overall competitive position centers on its fiber-to-the-node deployment. As of the end of the third quarter of 2009, Qwest has deployed its fiber-tothe-node platform to approximately 3 million homes within its service area. Going forward Fitch expects Qwest to expand its fiber-to-the-node deployment by 1 million to 1.5 million homes during 2010. While the rate of access line erosion improves in markets where the fiber-to-the-node has been deployed, the strategy has yet to slow the pace of ANEXO 4: Resultado busqueda en Dialog revenue erosion within the company's Mass Market business segment. Qwest's Mass Market segment revenue decline was 7.9% (on a year over year basis and excluding its wireless business), which ranks highest among its RBOC peer group. Balancing the operational concerns is Fitch's expectation that Qwest will continue to generate relatively stable amounts of free cash flow as Fitch believes that the company has a sufficient level of flexibility within its capital budget to manage free cash flow generation. During the first nine months of 2009, the company generated approximately $1 billion of free cash flow, marking a significant increase when compared with $426 million of free cash flow generated during the same period last year. Contributing to the large free cash flow growth was a 28% year over year reduction in capital expenditures. The weaker economy (slow housing starts) as well as operating efficiencies and cost reductions pro duced the lower capital spending. Looking ahead Fitch expects Qwest will generate ap proximately $1 billion of free cash flow during the ratings horizon. Qwest's liquidity posi tion and overall financial flexibility are strong and are supported by expected free cash flow generation, cash on hand ($2.1 billion as of Sept. 30, 2009) and available borrowing capacity from Qwest's new $1.035 billion senior secured revolver, which expires Sept. 30, 2013. Overall, Qwest's capital structure strategy continues to revolve around refinancing the debt maturing at QC while using free cash flow generation to retire Qwest and Qwest Capital Funding (QCF) scheduled maturities. Importantly, Fitch believes that Qw est management is committed to maintaining QC's strong credit profile. Fitch does not expect Qwest to increase leverage at QC to fund investments, share repurchases or refinance debt issued at QCF or Qwest. Fitch cautions however, that Qwest's liquidity posi tion and financial flexibility will be put under pressure during the near term as the com pany addresses a total of $4.3 billion of debt scheduled to mature during 2010 and 2011. The liquidity pressure is mitigated somewhat by Fitch's expectation that Qwest will con tinue to generate meaningful amounts of free cash flow during this timeframe. Addition ally Fitch's concern is further mollified by Qwest's ongoing access to capital markets and the company's successful renewal of its senior secured revolver. Scheduled maturities during 2010 total approximately $2.2 billion, including Qwest's 3.5% convertible notes due 2025 and QC's $500 million term loan. QC's senior note offering in April 2009 removes re-financing risk related to the QC maturity. Fitch expects holders of the convertible notes to exercise a put option on Nov. 15, 2010. Fitch anticipates that Qwest intends to re-finance the convertible notes during 2010 and to that end issued $550 million of senior notes in September, leaving a $715 million re-financing risk in 2010. The re-financing risk is back-stopped by borrowing capacity under Qwest's new revolver. Finally Fitch expects that approximately $403 million of QCF maturities will be retired through free cash flow generation. Existing cash, coupled with expected free cash flow generation during 2011 should be sufficient to address $1.3 billion of Qwest and QCF maturities while $825 million of QC notes are expected to be re-financed. Leverage, as of the latest 12-month (LTM) period ended Sept. 30, 2009, was 3.11 times (x), reflecting a modest increase of 17 basis points relative to year-end 2008. QC's leverage metric for the LTM period ended Sept. 30, 2009, increased 23 basis points to 1.76x. From Fitch's perspective Qwest's leverage is somewhat elevated due to two note issuances during 2009 totaling approximately $1.4 billion that are expected to re-finance 2010 scheduled maturities. Fitch believes that the company's leverage will be approximately 3.2x as of year end 2009. Expected debt reduction during 2010 and 2011 as Qwest and QCF scheduled maturities are retired with existing cash and free cash flow generation provide the impetus for further improvement of Qwest's credit profile. Assuming the successful refinancing of the convertible notes, Fitch anticipates that Qwest's leverage will approach 3.0x by year end 2010 and improve to 2.8x as of year end 2011. The Stable Rating Outlook reflects Fitch's expectation that the company's operating strategies, in particular the continued strengthening of Qwest's service bundle and investment in high speed data, will preserve operating margins and slow the rate of erosion of Qwest's Mass Market operating segment. Operational issues will, in Fitch's opinion have the greatest influence when consid ering negative rating actions. Key among these issues will be Qwest's ability to maintain or enhance operating margins, continue to generate consistent levels of free cash flow, and stabilize revenue and access line erosion. While acknowledging a potential strength - ANEXO 4: Resultado busqueda en Dialog ening of Qwest's credit profile, positive ratings actions would likely be considered as Fitch observes a persistent trend of positive revenue growth in each of the company's operating segments along with stable operating margins. Keywords: Banking, Capital Markets, Communications, Finance, Financial, Fitch Ratings, Investing, Investment, Professional Services, Qwest Communications International, Qwest Communications International Inc, Technology, Telecommunications. This article was prepared by Investment Weekly News editors from staff and other reports. Copyright 2010, Investment Weekly News via VerticalNews.com. DESCRIPTORS: Banking; Capital Markets; Communications; Finance; Financial; Fitch Ratings; Investing; Investment ; Professional Services; Qwest Communications International; Qwest Communications International Inc; Technology; Telecommunications SUBJECT HEADING: Fitch Ratings (c)Copyright 2010, Investment Weekly News via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/76 (Item 23 from file: 135) 0001397978 (THIS IS THE FULLTEXT) ADC Adds Aricent Access Service Node Software To Its WiMAX Ecosystem Information Technology Newsweekly, December 15, 2009, p.33 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 546 TEXT: ADC (NASDAQ:ADCT) (www.adc.com) announced that Aricent(TM), a global innova tion, technology and services company focused exclusively on communications, will provide its WiMAX Access Service Node (ASN) software as part of the ADC WiMAX ecosystem. With the addition of Aricent's software-based ASN as an option for WiMAX sys tems based on ADC's compact, place-anywhere FlexWave(TM) MMX base stations, ADC enables enterprises, universities, and wireless Internet service providers (WISPs) to deploy WiMAX systems while saving up to 40 percent over the cost of a traditional hard ware-based ASN. ADC's ecosystem approach to WiMAX solutions combines the best-of-breed, industry standard products into a reliable, tested network solution. With the addition of Aricent's ASN, ADC can offer turnkey WiMAX systems based on its pico and micro-class WiMAX base stations and distributed antenna systems. "ADC is a leading supplier of small, easily-deployable WiMAX base stations and antenna systems, and our ASN software is an excellent complement to these solutions," said Rakesh VIJ, assistant vice president for Aricent. "Aricent's ASN software will help reduce the overall cost of WiMAX deployments and we believe that our partnership with ADC will drive a wider range of users to adopt WiMAX networks." ADC WiMAX systems can support networks of any size for WISPs, public facilities, urban cores, enterprise campuses or universities. ADC performs system integration for the projects and ensures interoperability and flexibility of the end-to-end WiMAX network. This ecosystem approach reduces network CAPEX spend and eliminates the technical and financial risks of purchasing a WiMAX system from a proprietary vendor. "As a major provider of WiMAX software solutions, Aricent adds a new layer of flexibility to our WiMAX portfolio," said Dick Parran, president of the Network Solutions Business Unit for ADC. "Aricent's standards-based software approach to the ASN fits in perfectly with our strategy of offering best-of-breed solutions for WiMAX, and will allow us to offer significant savings for our customers." About ADC Net - ANEXO 4: Resultado busqueda en Dialog work Solutions ADC's Network Solutions Business Unit offers products that deliver highperformance wireless coverage and capacity to business and consumer subscribers in any indoor or outdoor location. ADC is the global leader in advanced in-building wireless solutions and compact network systems, and is a leader in solutions that enhance cover age in macro networks. About Aricent Aricent combines the leading innovation capabilit ies of frog design with unparalleled domain expertise in communications as a strategic supplier to the world's foremost infrastructure, application and service providers. The company's investors include Kohlberg Kravis Roberts & Co., Sequoia Capital, The Family Office and The Canadian Pension Plan Investment Board. For more information, visit http://www.aricent.com About ADC ADC provides the connections for wireline, wireless, cable, broadcast, and enterprise networks around the world. ADC's innovative network infrastructure equipment and professional services enable high-speed Internet, data, video, and voice services to residential, business and mobile subscribers. ADC (NASDAQ:ADCT) has sales into more than 130 countries. Learn more about ADC at www.adc.com. ADC-G Keywords: ADC, Data Management, Enterprise Network, Finance, Financial, Investing, Investment, Networks, Software, Technology, Wireless Internet, Wireless Technology. This article was prepared by Information Technology Newsweekly editors from staff and other reports. Copyright 2009, Information Technology Newsweekly via VerticalNews.com. DESCRIPTORS: ADC; Data Management; Enterprise Network; Finance; Financial; In vesting; Investment; Networks; Software; Technology; Wireless Internet; Wireless Technology SUBJECT HEADING: ADC (c)Copyright 2009, Information Technology Newsweekly via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/77 (Item 24 from file: 135) 0001393959 (THIS IS THE FULLTEXT) Integrity Networks, LLC: Local Businesses Get New Technologies without Hefty Capital Expenses Technology Business Journal, December 8, 2009, p.46 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 535 TEXT: Midwest wholesale voice and data service provider, Integrity Networks has seen a sizable increase in profits and customers since offering a hosted Ciscovoice solution for small and medium-size businesses. Looking for ways to help businesses keep current with technology without making hefty capital expenses, Ben Rife, Integrity president and CEO, developed a new hosted Cisco voice offering and turned a traditional capital expense (a phone system purchase) into an operating expense. "At the beginning of this year we were approached by a customer requesting a hosted voice solution, so we partnered with 123Net to help us build it," said Rife. Midwest wholesale voice and data service provider, Integrity Networks has seen a sizable increase in profits and customers since offering a hosted Cisco voice solution for small and medium-size businesses. iSekurity, one of the nation's largest, most sophisticated fraud detection and resolution companies relied heavily on two-way communications among its customers, satellite of fices and headquarters in Washington DC. To her embarrassment, iSekurity CEO Sue ANEXO 4: Resultado busqueda en Dialog Kampe discovered calls coming into the call center were often either missed or the voice quality was poor. "When you run a business like ours, or any for that matter, you absolutely need clear, reliable communication and we suffered losses because of the poor quality. We were referred to Integrity by Cisco and they came up with a viable, cost-effective solution, resulting in three times better quality. Integrity is a willing and hardworking partner and they went out on a limb to come up with an innovative, viable solution and we are looking to them for other technology support," said Kampe. Since of fering hosted voice, Integrity averages five new clients per quarter, an achievement Rife attributes in part to the customer benefits. "There's no upfront capital expense with our VoIP solution. We provide an affordable voice solution and support, all for a flat monthly per phone price. We do away with the confusing telecom billing and iron-clad contracts. It's not uncommon for us to provide a complete VoIP solution including all hardware and services for less than what our clients are paying for their telecom circuits alone." said Rife. About Integrity Established in 2003, Integrity Networks, LLC is a leading provider of managed services and Cisco Unified Communication Solutions. From its headquarters in Troy, Michigan, Integrity strives to deliver the best voice and data network solutions possible, including hosted voice, managed network, managed backup and managed internet services. For more information visit www.IntegrityNet.net or call 248-247-7200. About 123Net With headquarters in Southfield, Michigan, 123Net provides IT services to ISPs, CLECs and other telecommunications companies. 123Net delivers Michigan High Speed Internet Services through its vast and growing optical fiber network with 750 route miles and over 34 nodes spanning across the state of Michigan and is the sole provider of 4G WiMAX wireless network. For more information visit www.123.net. Keywords: Communications, Data Management, Data Network, Hardware, Integrity Networks, Internet, Networks, Wireless Network, Wireless Technology, Professional Services, Security, Small Business, Software, Technology, Telecommunications, VoIP, Wire less Technology. This article was prepared by Technology Business Journal editors from staff and other reports. Copyright 2009, Technology Business Journal via VerticalNews.com. DESCRIPTORS: Communications; Data Management; Data Network; Hardware; Integrity Networks; Internet; Networks; Wireless Network; Wireless Technology; Professional Services; Security; Small Business; Software; Technology; Telecommunications; VoIP; Wireless Technology SUBJECT HEADING: Integrity Networks (c)Copyright 2009, Technology Business Journal via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/78 (Item 25 from file: 135) 0001379594 (THIS IS THE FULLTEXT) OAISYS Tracer Delivers Affordable, Enterprise-Class Quality Assurance and Workforce Optimization Technology Business Journal, November 24, 2009, p.91 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 725 TEXT: OAISYS(R), a leading provider of call recording and contact center management solutions, announced the immediate availability of Tracer version 6.0, the industry's lead - ANEXO 4: Resultado busqueda en Dialog ing digital recording solution for contact centers. Tracer 6.0 delivers new feature enhancements to better support large-scale, enterprisewide deployment of the award-winning Tracer professional interaction management solution. Tracer's live call and auto call monitoring functionality, as well as improved agent coaching and evaluation features, reduce training costs and increase revenue, driving overall profitability for contact cen ters. "OAISYS provides enterprise users with the tools they need to effectively address their customer service objectives, regulatory compliance requirements and unique business challenges throughout the entire enterprise," said Brian Spencer, president of OAISYS. "The feature enhancements in this latest release of Tracer were driven by the direct feedback of our contact center customers. Our willingness to listen and actively re spond to the voice of our customers with innovative, reliable and affordable solutions helps them to achieve low-cost, efficient and profitable contact center operations." Tracer utilizes patent-pending OAISYS Portable VoiceDocument (PVD(TM)) technology to capture telephone-based interactions as digital call recordings, or voice documents, that are available to store, organize, play back, annotate and share with others as needed. This core PVD functionality is paired with Tracer's advanced contact center management features, including employee performance evaluations, the ability to live monitor calls and generate quality and resource utilization reporting. Now, customers can experience even greater ease of use along with new, unique and powerful capabilities that improve upon the robust Tracer feature set. New Tracer feature enhancements include: Live Call Monitor: Tracer's integrated Live Call Monitor feature allows users to connect to one or more Tracer systems, each with up to 192 channels, to easily and efficiently monitor agent in teractions with customers in real time. Benefits include easy monitoring access to calls occurring across all nodes of the enterprisevoice network, such as those handled in a remote or branch office. Auto Call Monitor: Tracer's Auto Call Monitor feature provides real-time automatic live monitoring of calls meeting criteria predefined by management. Supervisors may begin hearing a call that meets desired conditions instantly, or they can receive an immediate visual and/or audible notification of a situation requiring their at tention. For instance, an agent call with an upset customer can be identified and resolved before resulting in potentially negative and costly consequences. Live Annotations and Coaching: Tracer's live annotations and coaching capabilities enable supervisors to add text annotations directly to calls during live monitoring, permitting their observations to be captured in real time. Integrated instant messaging lets supervisors coach agents dir ectly and unobtrusively, allowing them to influence the quality of interactions. All annota tions and coaching sessions are logged in context with the voice recording, providing an easy way to reconstruct contact center scenarios. Quality Control Work Queues: Tracer's quality control work queues allow users to create rules for the count and types of calls that supervisors must evaluate. This improves the speed and efficiency with which agent evaluations are completed, while also ensuring supervisor objectivity. Automated Call Or ganization: Tracer's automated call organization feature identifies calls that meet set cri teria based on call filters, such as agent ID or extension lists, and categorizes them with in a specific search folder, which streamlines performance evaluation. For example, a manager can easily review a folder comprised of only his or her sales agents' calls. Owner's Report: Tracer's Owner's Report feature clearly reveals who is using Tracer, how often and for what purpose. This enables organizations to hold management accountable to their contact center oversight and quality assurance responsibilities. The OAISYS Tracer solution is widely used by organizations throughout a broad range of industries to obtain greater insight and understanding into the interactions that shape their everyday operations. These industries include financial services, healthcare, automotive dealer ships and, within the public sector, transportation, energy and government agencies. Businesses use this information to ensure regulatory compliance, support customer retention and promote revenue protection. Keywords: OAISYS, Technology, Data Management, Software, Audio and Video, Telecommunications, VoIP,Professional Services, , Automobiles, Finance, Financial, Financial Services, Investing, Investment, Technology, Audio and Video, Automobiles, Data Management, Finance, Financial, Financial Services, Investing, Investment, OAISYS, Professional Services, Software, Technology, Telecommunications, VoIP. This article was prepared by Technology Business Journal editors from ANEXO 4: Resultado busqueda en Dialog staff and other reports. Copyright 2009, Technology Business Journal via VerticalNews.com. DESCRIPTORS: OAISYS; Technology; Data Management; Software; Audio and Video; Telecommunications; VoIP; Professional Services; Automobiles; Finance; Financial; Financial Services; Investing; Investment; Technology; Audio and Video; Automobiles; Data Management; Finance; Financia SUBJECT HEADING: OAISYS (c)Copyright 2009, Technology Business Journal via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/79 (Item 26 from file: 135) 0001378512 (THIS IS THE FULLTEXT) Italtel and ECI Telecom Sign a Partnership for the Supply of Advanced Telecom Solutions for Service Providers Worldwide Network Weekly News, November 23, 2009, p.49 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 1189 TEXT: Italtel, one of the leading companies in the next generation IP networks sector, and ECI Telecom, global provider of networking infrastructure solutions optimized for nextgeneration network (NGN) migration, announced that they have signed a partnership agreement for the sale and customization of optical transport systems for metropolitan networks and access platforms for voice, data, IP video and fixed/mobile convergence. As such, Italtel will be a preferred vendor and system integrator for ECI Telecom technology in the building of integrated communication networks for service providers, commu nications providers and utility companies in the "Quadruple Play" (data, voice, video, mobile) access and transport markets. Under this agreement, Italtel has become one of ECI's Global Partners. "As the telecom sector continues to evolve, strategic partnerships such as this new agreement between ECI Telecom and Italtel, will be critical for the suc cess of telecom equipment suppliers, especially in an increasingly competitive and ma ture market. ECI brings a best-in-class Access platform in the Hi-FOCuS portfolio and a leading multi-service transport platform in the XDM, while Italtel brings an impressive presence in EMEA and Latin America, as well as valuable expertise in system integra tion, voice over IP and mobility. This partnership makes perfect business and technology sense," said Erik M. Keith, Principal Analyst for Broadband Infrastructure at Current Ana lysis. "The partnership with Italtel strengthens our presence in important and growing in ternational markets. With our access and transport portfolio, Italtel will be able to provide their customers with high-end platforms that are optimized for next-generation evolution. In Italtel, we have found a partner with the required ability and expertise that are complementary to our own, in addition to a strong and recognised specialisation in system integration," noted Tony Scarfo, Head of Global Channel Sales, and Partners of ECI Telecom. "The agreement with ECI is part of our plan to develop into specific foreign markets and to widen the perimeter of our products and services," commented Claudio Chiarenza, Head of Planning, Marketing & Business Development of Italtel. "This partner ship allows us to extend our portfolio of solutions for service providers in the EMEA and Latin America markets with products for access and optical transport, and to adopt a structured approach to a market segment that is potentially attractive, represented by ANEXO 4: Resultado busqueda en Dialog European service providers and utilities with their own network infrastructure." The partnership between Italtel and ECI Telecom will cover the integration and customisation, at the customers' premises, of ECI's Multi-Service Access Node (MSAN) Hi-FOCuS(TM), and the metro edge BroadGate(R) line of products. The Hi-FOCuS supports voice, data and video over one, converged IP platform, while the BroadGate line is an advanced multi-service provisioning platform for the transporting of data streams over fibre optic in metropolitan networks. Market Background Despite the economic downturn, which caused capex to decline in 2009, with service providers putting on hold some of their major infrastructure investments, the telecom market still remains one of the most dy namic and competitive sectors in today's world, as subscribers and network traffic keep growing. Service providers face many challenges - the need to migrate to IP networks, the blurring of boundaries between different types of providers, the demand for advanced services, in addition to lower margins, reduced revenues and increased competition. According to Infonetics Research, service providers today are transforming into vertically integrated multimedia providers. Infonetics expects broadband and corporate traffic to continue to grow, as IP video, IPTV and personalization of services take hold. IPTV traffic patterns will cause a continual push for more network capacity over the years. There is increased adoption of broadband data services and of mobile telephony and data traffic. "Worldwide, we expect over 600M fixed broadband subscribers in 2013. Much of this growth is coming from emerging markets, such as China, Southeast Asia, and Russia, as more mature markets in Japan, Korea, North America and Western Europe reach saturation," said Michael Howard, Principal Analyst, Infonetics Research. "Subscribers are attracted to new services brought on by broadband investment in IP video, including IPTV, broadcast TV, video-on-demand, HDTV, network PVR, online gam ing, music downloads, video telephony, and home automation and security services." Worldwide telco IPTV subscribers reached 26M in CY08 and are expected to grow to 155M by CY13, as operators rely on video services to increase ARPU and to retain fixed broadband subscribers. Fixed broadband services have some of the highest margins of any services offered, which is why layering on "sticky" services like IPTV is so critical to their bundling efforts. Links High-resolution graphics are available for download at flickr. com/photos/ecitelecom Follow ECI Telecom news updates on Twitter at twitter.com/ecitelecom Follow ECI Telecom news updates on Facebook TAGS/Keywords Italtel, ECI Telecom, Global Partner Program, System Integration, VoIP, NGN, IPTV, 3G Wireless, Quadruple Play, transport, access, metro networks, Multi-Service Provisioning Platform, MSPP, Carrier Ethernet, Multi-Service Access Node(MSAN), Hi-FOCuS, BroadGate (BG) The Italtel Group Italtel designs, develops, implements solutions for Next-Generation Networks and Services, based on the Internet Protocol (IP). Italtel provides proprietary products, systems, and solutions; Professional Services dedicated to the design, development, maintenance of telecommunication networks; IT System Integration Services (BSS, CRM, Saas, Data Center Consolidation, Integrated Network Security); Network Integration activities, in terms of third party products and technologies customization and software development for the creation of new Web 2.0 services, for IP Unified Communication design and deployment. Born in 1921, Italtel has designed and implemented telecommunication networks that are among the most innovative worldwide and counts among its customers more than 40 of the world's top TLC Operators and Service Providers. In Italy Italtel is also reference partner of Enterprises and Public Sector for the deployment of IP Next-Generation Networks and for the development of multimedia convergent services for their customers. Italtel has around 2,200 employees; almost half of them are D&I specialists. Italtel is present in 25 countries including France, UK, Spain, Germany, Belgium, Russia, Poland, Argentina, Brazil, United Arab Emirates, Saudi Arabia. Italtel's headquarters are in Milan (Italy) with R&D Labs in Milan and Palermo. Sales offices are in Rome. Website: www.italtel.com About ECI Telecom ECI Telecom delivers innovative communications platforms to carriers and service providers worldwide. ECI provides efficient platforms and solutions that enable customers to rap idly deploy cost-effective, revenue-generating services. Founded in 1961, Israel-based ECI has consistently delivered customer-focused networking solutions to the world's largest carriers. The Company is also a market leader in many emerging markets. ECI ANEXO 4: Resultado busqueda en Dialog provides scalable broadband access, transport and data networking infrastructure that provides the foundation for the communications of tomorrow, including next-genera tion voice, IPTV, mobility and other business solutions. For more information, please vis it www.ecitele.com. Keywords: Italtel ECI Telecom, Technology, Networks, Software, Telecommunications, Mobile and Wireless, Internet, Advertising, Asia, Broadband, China, Communication Network, Communications, Data Management, Data Network, Data Networking, Data Traffic, Electronics, Ethernet, Information Technology, Internet Protocols, Japan, Marketing, Network Security, Networks, Software, Technology, Telecommunications, World Wide Web. This article was prepared by Network Weekly News editors from staff and other reports. Copyright 2009, Network Weekly News via VerticalNews.com. DESCRIPTORS: Italtel ECI Telecom; Technology; Networks; Software; Telecommunications; Mobile and Wireless; Internet; Advertising; Asia; Broadband; China; Communica tion Network; Communications; Data Management; Data Network; Data Networking; Data Traffic; Electronics ; Ether SUBJECT HEADING: Italtel ECI Telecom (c)Copyright 2009, Network Weekly News via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/80 (Item 27 from file: 135) 0001376207 (THIS IS THE FULLTEXT) Unisys Solutions for Latest Microsoft Software Boost Clients' Productivity Options - from Data Centers to Mobile Offices Information Technology Business, November 24, 2009, p.48 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 1159 TEXT: Unisys Corporation (NYSE:UIS) announced at the Microsoft TechEd Europe conference that it is providing multiple services-based solutions for the new Microsoft Windows 7, Microsoft Windows Server 2008 R2 and Microsoft Exchange Server 2010 environments. The solutions include data center transformation solutions whose value is demon strated by Unisys proof-point tests, as well as end-user services and a unified communic ations service that Unisys is hosting for Microsoft Corp. "When Microsoft delivers software innovations, Unisys is there with innovative solutions that help clients realize the full value of the products," said Colin Lacey, vice president, Systems and Storage, Unisys. "We're doing that again for these latest Microsoft offerings to help users improve their operations and make their people better able to do business anywhere at any time." These Unisys solutions are designed to help enterprises boost information workers' productivity no matter where they are or how they work, improve the IT infrastructure so it supports business more efficiently, and reduce the costs of IT service delivery and support. "Unisys deep understanding of both data centers and end-user experiences adds an extra dimension that helps Microsoft customers realize new efficiencies in computing across the enterprise," said Betsy Frost, general manager, UC Marketing Management at Microsoft Corp. "We are impressed at the range and depth of solutions that Unisys is offering to support Microsoft Windows 7, Microsoft Windows Server 2008 R2 and Microsoft Exchange Server 2010." Tests Show that Unisys Data Center Transformation Solutions Boost Windows Server 2008 R2 Unisys builds on expertise and best practices in virtualized infrastructure - especially through Unisys Data Center Transformation ANEXO 4: Resultado busqueda en Dialog Services, Infrastructure Management Suite of solutions, and family of Enterprise Servers - to help clients use Windows Server 2008 R2 to transform their data centers for greater efficiency at lower cost. Unisys recently conducted proof-point tests that demonstrate the power of Windows Server 2008 R2 in a virtualized environment. In the first test, Unisys demonstrated that the Unisys ES7000 Model 7600R Enterprise Server provides a powerful platform for Microsoft SQL Server 2008 R2 database consolidation. Using Windows Server 2008 R2 Datacenter Edition, a single Unisys ES7000 server supported the same workload as 32 dual-socket quad-core commodity servers, each running two 85-gigabyte SQL Server 2008 R2 databases, while providing better response times. Unisys achieved those results while quadrupling the utilization rate of the commodity servers and using 55 percent less power. The 32:1 consolidation ratio shows that Unisys can help clients configure and manage their SQL Server database infrastructure more efficiently and significantly reduce their facilities, server maintenance and support costs. In the second proof-point test, Unisys demonstrated high availability for virtualized SQL Server 2008 R2 workloads delivered through the new Live Migration capability of Microsoft Hyper-V. In the past, clients' inability to move virtual machines (VMs) from one host to another without any perceived downtime or service interruption - a capability especially import ant in large-scale clustered SQL Server environments - has been a key barrier to virtualizing SQL Server workloads with Hyper-V. Unisys solved this challenge with the Hyper-V Live Migration capability. Unisys migrated 12 VMs, with each running two 85-gigabyte databases in a single instance of SQL Server 2008 R2 with 20 concurrent users, between two nodes of an ES7000 Model 7600R clustered server. During the Live Migration process, users experienced virtually no loss of performance or interruption of service. A third test supported the Unisys decision framework that helps clients make the right vir tualization choices for their environment. Unisys demonstrated the significant perform ance and total-cost-of-ownership (TCO) advantages delivered by Hyper-V. The proofpoint test revealed that a 12-socket Unisys ES7000 Model 7600R can support 384 VMs the maximum currently supported under Windows Server 2008 R2 - with a three-year TCO per VM of $578. In contrast, a two-socket server using the latest generation of Intel processors could support only 16 VMs at a far higher three-year TCO per VM of $2,035. End-User Services Extend Benefits of Exchange Server 2010 and Windows 7 Unisys EndUser Productivity Services enable IT organizations to realize the full business potential of Exchange Server 2010 and Windows 7. These services provide multiple options for end users to securely access key productivity environments - whether running centrally managed applications locally on mobile devices such as netbooks and smartphones, access ing them through cloud-based services or using a mixture of delivery options. For ex ample, users of Exchange Server 2010 can benefit from Unisys Unified Communications as a Service (UCaaS), which delivers Microsoft Exchange, Microsoft Office SharePoint Server and Microsoft Office Communicator applications in a multi-tenant environment through Unisys Secure Cloud Solution. In addition, Unisys provides migration and man agement support for Windows 7 to help clients deploy the new environment most efficiently and effectively. Also, the advanced desktop management, support and flexible ap plications delivery capabilities of Unisys End-User Productivity Services give Windows 7 users anywhere, anytime access to their critical productivity environments. Unified Com munications Solutions Help End-Users Explore the Possibilities Based on Unisys expertise in managed services, Microsoft has selected Unisys to build and manage the Microsoft Unified Communications Virtual Experience for Exchange Server 2010 and Office Communications Server 2007 R2. This cloud-based trial service enables enterprise users to try, free of charge, the latest Microsoft UC technology. The service gives organizations worldwide the opportunity to test key new features of the Microsoft offerings, such as multi-party instant messaging and voice and video conferencing, and evaluate the potential benefits of Microsoft unified communications for their business. It also helps them assess how they can help employees collaborate more productively using the devices and technologies that best suit their work styles - whether PCs, web browsers or mobile phones. Organizations interested in participating in a 60-day virtual experience should visit http://www.microsoft.com/uc/en/us/try-it.aspx. About Unisys Unisys is a worldwide information technology company. We provide a portfolio of IT services, software, and ANEXO 4: Resultado busqueda en Dialog technology that solves critical problems for clients. We specialize in helping clients secure their operations, increase the efficiency and utilization of their data centers, enhance support to their end users and constituents, and modernize their enterprise applications. To provide these services and solutions, we bring together offerings and capabilities in outsourcing services, systems integration and consulting services, infrastructure ser vices, maintenance services, and high-end server technology. With more than 26,000 employees, Unisys serves commercial organizations and government agencies throughout the world. For more information, visit www.unisys.com. RELEASE NO.: 1109/9031 Unisys is a registered trademark of Unisys Corporation. All other brands and products referenced herein are acknowledged to be trademarks or registered trademarks of their respective holders. Keywords: Unisys Corporation, Technology, Data Management, Hardware, Networks, Software, Professional Services, Consulting, Information, Advertising, Data Management, Information Technologies, Marketing, Software, Technology. This article was prepared by Information Technology Business editors from staff and other reports. Copyright 2009, Information Technology Business via VerticalNews.com. DESCRIPTORS: Unisys Corporation; Technology; Data Management; Hardware; Networks; Software; Professional Services; Consulting; Information; Advertising; Data Management; Information Technologies; Marketing; Software; Technology SUBJECT HEADING: Unisys Corporation (c)Copyright 2009, Information Technology Business via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/81 (Item 28 from file: 135) 0001367981 (THIS IS THE FULLTEXT) IT Service Management Expert Matrix42 Partners with Technical Systems Integrators to Expand Offerings Information Technology Newsweekly, November 17, 2009, p.51 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 495 TEXT: IT service and systems management leader, Matrix42 (www.matrix42.com) announced that they have partnered with Technical Systems Integrators (TSI) to expand their IT and systems management offerings and increase implementation support. "As a service provider and sales team, we are always looking for the best products and tools to offer our customers," said Gene Rascle, CIO of TSI. "The partnership with Matrix42 gives our customers a top-of-the-line suite of systems management tools that stand out from other offerings in the market place from a pricing perspective, but also in their ease of use." TSI is a consultation and installation company specializing in computer systems, telephone systems, wireless systems, information technology management and leading edge technology research. The partnership will let Matrix42 work with TSI in implementing IT service and systems management in education, local government and mid-size companies. "At Matrix42 we are constantly looking into ways we can expand our reach," said Shane Eliason, president of Matrix42 USA. "This partnership lets us leverage TSI's expertise and relationships to give customers a solution that ensures maximum transpar ency and smooth processes for any IT department." For more information about the Matrix42, visit www.matrix42.com. For more information about the TSI, visit www.tsillc.us. About Matrix42 Matrix42 combines systems management and IT services into IT-Com- ANEXO 4: Resultado busqueda en Dialog merce, this combination gives Matrix42's customers and potential customers the ability to have a single pane of glass for management of the end node and servicing of the IT customers. With Empirum and Service Store, Matrix42 redefines how IT departments interact with their customers, the customer is no longer helpdesk dependent to fulfill soft ware requests or other IT related services. Based on Microsoft Workflow Engine, IT departments can now automate many tasks that today are labor intensive, because of the current legacy technology deployed. Matrix42 is reshaping how IT departments manage the environment by aligning the IT department to their company goals and objectives to reduce cost and maintain current level or services. About TSI Founded in 2002, TSI is a national service provider for Hardware, Software, Audio Visual and Asset Recovery. Additionally, TSI has a strong consulting practice with experience including Fortune 500 com panies, K-12, High Ed, Local Government and mid-size companies. Our mission is to provide quality consultation in products and services that enables our customers to com municate efficiently through voice, data and video media. To this end, we provide aprofessional service that is responsive to the needs of our clients. TSI is a Dell Certified Partner and also partners with many other leading technology companies including Intel. TSI is pleased to be adding Matrix42 as our newest partner. Keywords: Matrix42, Education, University, Technology, Data Management, Hardware, Internet, Networks, Software, Other Technolo, Computers, Data Management, Government, Information Technologies, Local Government, Politics, Software, Technology, Technology Management. This article was prepared by Information Technology Newsweekly editors from staff and other reports. Copyright 2009, Information Technology Newsweekly via VerticalNews.com. DESCRIPTORS: Matrix42; Education; University; Technology ; Data Management; Hardware; Internet; Networks; Software; Other Technolo; Computers; Data Management; Government; Information Technologies; Local Government; Politics; Software; Technology; Technology Management SUBJECT HEADING: Matrix42 (c)Copyright 2009, Information Technology Newsweekly via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/82 (Item 29 from file: 135) 0001354238 (THIS IS THE FULLTEXT) Tecore Integrates 3G RNC Into iCore, Lowering Rural Operators' Cost of Entry To UMTS Network Business Weekly, October 26, 2009, p.36 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 604 TEXT: Tecore Networks, a global supplier of multi-technology 2G, 3G and 4G mobile network infrastructure, announced the evolution of iCore(R), its all-IP multi-technology core network, with the integration of a 3G Radio Network Controller (RNC). Together with the iCore UMTS Mobile Switching Center (UMSC) and Home Subscriber Server (HSS), the RNC enhances support for 3G services and further streamlines the smallest multi-technology network-in-a-box in the industry. Rural and emerging mobile network operators can optimize total cost of ownership by avoiding the expense of separate RNCs, and supporting multi-vendor radio access networks from one core network. These operators can utilize Tier-1 3G NodeBs with iCore for their RNC and core network elements. iCore is a scal- ANEXO 4: Resultado busqueda en Dialog able, all-IP core network platform capable of supporting 2G GSM and CDMA and 3G networks simultaneously. Tecore has adopted 3GPP for 3G and 4G infrastructure due to the robustness of end-to-end transport via IP, the introduction of the IP Multimedia Subsys tem (IMS) core network, and support for multiple access technologies, all of which have been principal features of Tecore's current architecture. The RNC controls the NodeBs, performs radio resource management, handles security functions and admission control, and delivers voice traffic to the media gateway and data traffic to the Serving GPRS Support Node (SGSN). Tecore's RNC is compliant with 3GPP releases 5, 6 and 7, for an IP-centric solution with interfaces to a range of other vendors' NodeBs. Given the continuing dominance of voice traffic compared to data, the iCore's capability to switch voice traffic in a centralized manner represents a significant network cost saving for the operator. Although rural and emerging mobile network operators lagged the national carriers in deploying 3G services, the industry is moving swiftly to catch up. These operators need a lower threshold of investment, the ability to scale the network with the subscriber base, and a built-in path to 4G. Tecore provides the optimal solution by en abling UMTS on a multi-technology core network that can bridge protocols and genera tions. Tecore is currently conducting interoperability testing with RAN vendors, and is in viting others to participate as well. Interested vendors should contact Tecore at partnerlab@tecore.com. "Tecore helped the rural and emerging cellular market get off the ground by giving operators a compliant alternative beyond the large-scale infrastructure offerings, and our announcement today demonstrates our continued commitment to this market," said Jay Salkini, President and Chief Executive Officer of Tecore Networks. "Now that rural and emerging operators are accelerating their 3G deployment plans, we offer a proven network platform supporting UMTS and beyond." About Tecore Networks Tecore Networks is a global supplier of multi-technology 2G, 3G and 4G mobile network infrastructure. Built with the same standards-based voice and data technologies available to global carriers on an IP-based architecture, we have dramatically enhanced functionality while minimizing space requirements, installation time and cost of ownership. We also offer integrated value-added features to enable our customers to increase ARPU and retention. Our solutions include core as well as radio access network infrastructure, supported by state-of-the-art professionalservices. Founded in 1991, Tecore is ISO 9001:2008 certified, and is a three-time winner of the Global Mobile (3GSM) Award. For more information, visit www.tecore.com. All rights reserved. Keywords: Tecore Networks, Technology, Hardware, Internet, Networks, Software, Telecommunications, Other Technology, Satellite, Mobil, Data Management, Data Technologies, Data Traffic, Information Technology, Mobile Network, Networks, Technology. This article was prepared by Network Business Weekly editors from staff and other reports. Copyright 2009, Network Business Weekly via VerticalNews.com. DESCRIPTORS: Tecore Networks; Technology; Hardware; Internet; Networks; Software; Telecommunications; Other Technology; Satellite; Mobil; Data Management; Data Tech nologies; Data Traffic; Information Technology; Mobile Network; Networks; Technology SUBJECT HEADING: Tecore Networks (c)Copyright 2009, Network Business Weekly via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/83 (Item 30 from file: 135) 0001336608 (THIS IS THE FULLTEXT) Vertical Introduces Powerful Array of Cost-Effective Voice Applications for Wave IP Electronics Newsweekly, October 14, 2009, p.310 DOCUMENT TYPE: Expanded Reporting ANEXO 4: Resultado busqueda en Dialog LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 1287 TEXT: Vertical Communications, a leading provider of next-generation IP-based phone sys tems and voice applications, announced the release of three new voiceapplications Wave Contact Center, WaveNet and Wave Call Classifier - available as a software upgrade on its award winning Wave IP 2500TM and Wave IP 500 TM Business Communications Systems, the industry's first comprehensive IP PBX with the unique Applications InsideTM architecture. "Today's release illustrates the power of Wave IP's Applications Inside architecture - the ability to deliver high-value voice applications integrated with VoIP telephony as a single system, and made available as a software upgrade," said Peter Bailey, Senior Vice President Product Management and Business Development for Vertical Communications. "Wave IP offers customers a full portfolio of voice applications that can enhance business operations, increase productivity through best practices, and drive sav ings in operational and management costs. As a fully integrated "on-the-box" solution, these capabilities do not require any additional infrastructure investment and can be de ployed and managed through Wave IP's Global Administrator console. With the addition of a Wave Contact Center agent license, a customer service or accounts receivable employee can be transformed into a full-scale call center agent and realize an increase in productivity as well as quality of customer service. With the addition of a WaveNet li cense, users across multiple Wave IP sites can easily connect and collaborate, while sys tem administrators can add and intelligently network sites with a few simple mouse clicks." The Wave IP Business Communications System is a comprehensive IP business phone system family designed for enterprises of all sizes. Cost-sensitive small- to medi um-sized businesses, and larger distributed organizations seeking to reduce overhead associated with managing business communications can easily transform their legacy telephony infrastructure into an application-rich, next-generation VoIP solution by de ploying Wave IP. As a fully integrated solution, Wave IP offers customers ultimate flexibil ity and features - unified communications, contact center, call recording, reporting, net working, management, custom call routing applications and IVR - in a single system. "We have been using Wave Contact Center in our customer service department for the last three months, the applications are just great and very easy to configure. In fact, it took less than 20 minutes for our customer service queues, agents, in queue announcements and call recording to be setup and in production," said Chet Lytle, Jr., President, Communications Diversified, Inc. "The full integration of Wave Contact Center with View Point allowed our supervisors to access real-time queue and agent information instantly. Wave Contact Center Reporter provides a broad range of historical reports, again, conveniently from within ViewPoint. The ability to create any desired custom reports utilizing Crystal Reports is an added bonus. Wave Contact Center is a winner!" "Using Vertical's WaveNet application we where able to quickly convert the discreet Wave IP systems in our network into one single communications system. Doing so was a very seamless exercise using the Wave Global Administrator and was accomplished through just a few simple mouse clicks! With WaveNet, our users can now call other users on a different Wave IP system as if they are on the same system. Using ViewPoint we can now see the status of different users all across the network. WaveNet is a great addition to the suite of applications on the Wave IP system," said Matt Tesdell, Vice President, Tesdell Electric Ltd. New Applications: WaveNet WaveNet creates an enterprise-wide Wave IP-PBX infrastructure that streamlines all aspects of administration and enables your organization to operate more efficiently. WaveNet aggregates multiple locations into a single telephone system, combining users from various locations to present a single network wide extension list and dial plan. Employees everywhere can reach each other through seamless intercom dialing, view presence & personal status (via phone or ViewPoint) and seamlessly exchange voice mails without the need to remember location or complicated dialing codes. WaveNet dramatically simplifies administration by eliminating repetitive manual ANEXO 4: Resultado busqueda en Dialog tasks. Adding a node or changing a user on the network only takes a few mouse clicks as WaveNet automatically handles the configuration, dial plan synchronization, inter-site call routing and ongoing management tasks to keep all systems synchronized. Depend ing on system configuration and site preferences, WaveNet can route enterprise calls using either SIP over a VoIP network or traditional PSTN via PRI or Analog for maximum flexibility. WaveNet uses a peer-to-peer architecture to eliminate any single points of fail ure - this enables offices to continue to function even if intra-office networks are inter rupted, or if an individual location loses power. Robust error recovery and fault management mechanisms built into WaveNet ensures that information such as voicemail, pres ence status etc are automatically cached and synchronized when network connectivity is reestablished. WaveNet is certified to support networking of up to 100 Wave IP nodes. Wave Contact Center Traditionally, small to medium size business in need of contact cen ter functionality have had to make a choice between expensive full featured solutions or compromise for less sophisticated ACD functionality. Wave Contact Center changes the game by providing robust enterprise class contact center management functionality at marginal incremental cost. Leveraging Vertical's Applications Inside architecture, Wave Contact Center runs "on-the-box" and thereby eliminates need for any additional hardware or complex integration. Unlike other contact center solutions that require custom scripting, programming or complex flowchart design, Wave Contact Center lets adminis trators control all aspects of contact center management including queue management, routing, agents, supervisors, tracking, and reporting with a simple point and click unified interface. For example, with a few mouse clicks you can choose how calls in a queue are distributed to agents, customize the callers' hold experience by playing single or repeat ing messages, prompt callers to enter data, configure call priority, setup automatic call routing and more. It's just as easy to move, add and change agents, setup and change agent or supervisor permissions, grant permissions to individuals or groups, record hold prompts, change routing, manage the queue's voice mail or take the queue off-line. Calls can be distributed within queues based on various key attributes such as time of day, longest idle agent, least busy agent etc along with some advanced routing models such as agent cost or agent skills based routing, priority queuing based on caller etc traditionally available in higher end contact center solutions. Wave Contact Center seam lessly integrates with Vertical's award winning desktop call management application, ViewPoint, to provide a single intuitive interface for agents and supervisors alike to man age calls and monitor performance. Using ViewPoint, supervisors can monitor queues, coach agents, monitor real-time metrics and service levels and optimize overall contact center performance. Wave Contact Center comes built in with a reporter that provides a powerful set of reports (over 35 distinct reports) that are designed to keep supervisors and managers informed on key performance metrics and allow them to spot trends in queue and agent performance. Wave Contact Center is certified to support 100 call center agents. Wave Call Classifier Wave Call Classifier empowers organizations to dramatically improve their customer service and competitive advantage with advanced call rout ing based on real-time lookup of customer data. Serviceprofessionals using Wave Call Classifier are informed about the caller and the origin of the lead source or relevant promotion before they answer a call. Wave Call Classifier can provide agents with detailed caller information from any ODBC database (local or external), and intelligently route calls based on who is calling and what they are calling about. Keywords: Vertical Com munications, Inc., Technology, Data Management, Hardware, Networks, Software, Telecommunications, Other Technology, Professi, Analog, Communications Systems, Elec tronics, Software, VoIP Network This article was prepared by Electronics Newsweekly editors from staff and other reports. Copyright 2009, Electronics Newsweekly via VerticalNews.com. DESCRIPTORS: Vertical Communications; Inc.; Technology; Data Management; Hardware; Networks; Software; Telecommunications; Other Technology; Professi; Analog; Communications Systems; Electronics; Software; VoIP Network SUBJECT HEADING: Vertical Communications, Inc. ANEXO 4: Resultado busqueda en Dialog (c)Copyright 2009, Electronics Newsweekly via NewsRx.com NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/84 (Item 31 from file: 135) 0001209828 (THIS IS THE FULLTEXT) New surgical technologies study findings have been reported by researchers at Kaohsiung Medical University Hospital Life Science Weekly, January 26, 2010, p.2354 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 425 TEXT: JAN 26 - (NewsRx.com& NewsRx.net) -- "of review Since the introduction of endolaryngeal microsurgery, several basic microsurgical techniques have been described for the removal of benign vocal fold lesions (see also Surgical Technologies). These techniques include conventional incision or dissection, bimanual retraction and cutting, mi croflap technique and the CO2 laser," scientists in Kaohsiung, Taiwan report. "Until re cently, only a few microsurgical methods have emerged as new choices for the treatment of benign vocal fold lesions. This article introduces an innovative method that can pre cisely remove benign sessile vocal fold lesions with epithelial keratosis or hyperplasia without jeopardizing the intermediate or deep layer of the lamina propria. Recent findings Instead of using conventional vertically opening microinstruments, this microsurgic al pressing excision technique (MPET) utilized two pairs of custom-made horizontally leftopening or right-opening, curved microscissors/curved cupped microforceps to remove right or left vocal fold lesions accordingly. Using one instrument at a time, the lesion was subsequently removed with the microscissors and microforceps in a press-evert-cut manner. Among a total of 553 cases, the treatment results were satisfactory, with 520 (94%) patients retaining a satisfactory/normal (GO) voice 2 months postoperatively. More importantly, no patient's voice was worse postoperatively. This technique has several advantages: utilizing one instrument at a time can maximize exposure of the narrow endoscopic view, adjusting the pressing force makes precise excision easy in a well controlled horizontal plane. The MPET is particularly useful for removing sessile vocal nodules (especially those with epithelial keratosis), epithelial hyperplasia and leukoplakia in patients with difficult endolaryngeal exposure," wrote K.W. Lee and colleagues, Kaohsiung Medical University Hospital. The researchers concluded: "This could be a well tol erated and precise microsurgical technique." Lee and colleagues published their study in Current Opinion in Otolaryngology && Head and Neck Surgery (Current practice and feasibility in microlaryngeal surgery: microsurgical pressing excision technique. Current Opinion in Otolaryngology && Head and Neck Surgery , 2009;17(6):431-435). For more information, contact K.W. Lee, Kaohsiung Med University Hospital, Dept. of Otolaryngo logy, Kaohsiung, Taiwan. Publisher contact information for the journal Current Opinion in Otolaryngology && Head and Neck Surgery is: Lippincott Williams && Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA. Keywords: City:Kaohsiung, Country:Taiwan, Dermatology, Hyperplasia, Keratosis, Laryngeal Disease, Medical Device, Microsurgery, Microsurgical, Microtechnology, Otolaryngology, Surgery, Surgical Technologies This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2010, Life Science Weekly via NewsRx.com& NewsRx.net. DESCRIPTORS: City:Kaohsiung; Country:Taiwan; Dermatology; Hyperplasia; Keratosis; ANEXO 4: Resultado busqueda en Dialog Laryngeal Disease; Medical Device; Microsurgery; Microsurgical; Microtechnology; Otolaryngology; Surgery; Surgical Technologies; All News; Professional News SUBJECT HEADING: Surgical Technologies (c)Copyright 2010, Life Science Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/85 (Item 32 from file: 135) 0001209827 (THIS IS THE FULLTEXT) Data on surgical technologies published by M.W. Hsiung and colleagues Life Science Weekly, January 26, 2010, p.2353 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 340 TEXT: JAN 26 - (NewsRx.com& NewsRx.net) -- According to a study from Taiwan, "Of review Innovative otolaryngologists speech language pathologists and voice scientists have continued to move forward in understanding the etiology and treatment of vocal nodules (see also Surgical Technologies). The presentarticle reviews the publications with respect to the advances in this area." "Recent findings There is support for the notion that there is a positive relationship between vocal nodules and the presence of a posterior glottic chink (PGC). Generalized tension in all the laryngeal muscle is often associated with the PGC due to persistent posterior cricoarytenoid muscle pull during phona tion. This phenomenon leads to secondary mucosal change with formation of vocal nodules. Fat augmentation after microsurgical removal of vocal nodules can reduce both the occurrence of a PGC and posterior cricoarytenoid muscle activity and subsequently decrease vocal nodule recurrence. Therefore, the treatment efficiency and protocol are direct and fast. Finally, long-term outcomes studies havedemonstrated improvements in vocal disability with both objective and subjective evaluation," wrote M.W. Hsiung and colleagues. The researchers concluded: "Fat augmentation is an effective autogenous implant which may be considered in the management of patients after mi crosurgical removal of nodules." Hsiung and colleagues published the results of their re search in Current Opinion in Otolaryngology & Head and Neck Surgery (Augmentation after microsurgical removal of vocal fold nodules. Current Opinion in Otolaryngology & Head and Neck Surgery , 2009;17(6):436-439). For additional information, contact M.W. Hsiung, 114, Sec 2, Zhongshan Rd., Banqiao City 220, Taipei County, Taiwan. The publisher of the journal Current Opinion in Otolaryngology && Head and Neck Surgery can be contacted at: Lippincott Williams && Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA. Keywords: Country:Taiwan, Medical Device, Microsurgical, Microtechnology, Otolaryngology, Pathology, Surgery, Surgical Technologies This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2010, Life Science Weekly via NewsRx.com& NewsRx.net. DESCRIPTORS: Country:Taiwan; Medical Device; Microsurgical; Microtechnology; Otolaryngology; Pathology; Surgery; Surgical Technologies; All News;Professional News SUBJECT HEADING: Surgical Technologies (c)Copyright 2010, Biotech Business Week via NewsRx.com & NewsRx.net ANEXO 4: Resultado busqueda en Dialog NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/86 (Item 33 from file: 135) 0001209813 (THIS IS THE FULLTEXT) New surgery research reported from S.M. Ragab and co-authors Life Science Weekly, January 26, 2010, p.2342 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 275 TEXT: JAN 26 - (NewsRx.com& NewsRx.net) -- "of review To describe the current support in the literature for radiophonosurgery in cases of vocal fold nodules (see also Surgery). Recent findings Radiophonosurgery, is a recent innovation in the field of laryngeal surgery," investigators in Kuwait report. "It is emerging as a reliable and practical method for treating benign superficial vocal fold lesions that is increasingly becoming popular. It induces an excellent subjective and objective improvement in voice parameters. Histologically, it produces unremarkable lateral thermal damage and char penetration, which is quite crucial in a functionalsurgery such as in phonosurgery. Well designed probes are still lacking in the market. Radiophonosurgery provides a new approach for patients with vocal fold nodules," wrote S.M. Ragab and colleagues. The researchers concluded: "It combines the advantages of both cold knife and laser phonosurgery and is easy, well tolerated, precise and effective with excellent tactile and hemostatic properties." Ragab and colleagues published their study in Current Opinion in Otolaryngology & Head and Neck Surgery (Radiophonosurgery of vocal fold nodules. Current Opinion in Otolaryngology & Head and Neck Surgery , 2009;17(6):445-448). For additional information, contact S.M. Ragab, POB 66482, Bayan 43755, Kuwait. The publisher of the journal Current Opinion in Otolaryngology && Head and Neck Surgery can be contacted at: Lippincott Williams && Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA. Keywords: Country:Kuwait, Histology, Otolaryngology, Surgery This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2010, Life Science Weekly via NewsRx.com& NewsRx.net. DESCRIPTORS: Country:Kuwait; Histology; Otolaryngology ; Surgery; All News; Professional News SUBJECT HEADING: Surgery (c)Copyright 2010, Life Science Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/87 (Item 34 from file: 135) 0001208525 (THIS IS THE FULLTEXT) Research data from P.D. Karkos and colleagues update understanding of life sciences Gastroenterology Week, January 25, 2010, p.76 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT ANEXO 4: Resultado busqueda en Dialog AUDIENCE: Professional WORD COUNT: 328 TEXT: JAN 25 - (NewsRx.com& NewsRx.net) -- According to a study from Chester, the United Kingdom, "Of review To review the recent literature on the etiology and pathophysiology of vocal fold nodules in adults (see also Life Sciences). Recent findings Research regarding the etiology of vocal nodules over the past 2 years supports previous thinking regarding the central role of voice misuse, overuse, and phonatory trauma." "Advanced modeling techniques have helped elucidate mechanisms by which this may occur such as vibration-induced rise in capillary pressures and varying fluid dynamics in the layered vocal fold structure. Contributory roles of personality traits, reflux, and al lergy have also been hypothesized. Current research supports long-held beliefs that phonatory trauma is a central cause of vocal fold nodule formation. Innovative basic sci ence research has unraveled mechanisms of traumatic damage and clinical research continues toidentify crucial lifestyle behavior and contributing comorbid conditions that play a role in the pathogenesis of vocal fold nodules," wrote P.D. Karkos and colleagues. The researchers concluded: "The multifactorial etiology of vocal fold nodules requires a comprehensive history to identify contributing factors and a multidisciplinary approach to optimize treatment outcome." Karkos and colleagues published their study in Current Opinion in Otolaryngology & Head and Neck Surgery (The etiology of vocal fold nodules in adults. Current Opinion in Otolaryngology & Head and Neck Surgery , 2009;17(6):420-423). For moreinformation, contact P.D. Karkos, 36 Hopkinsons Court, Walls Avenue, Chester CH1 4LN, Cheshire, UK. Publisher contact information for the journal Current Opinion in Otolaryngology && Head and Neck Surgery is: Lippincott Willi ams && Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA. Keywords: City:Chester, Country:United Kingdom, Allergies, Allergy Medicine, Laryngopharyngeal Reflux, Life Sciences, Otolaryngology, Surgery This article was prepared by Gastroenterology Week editors from staff and other reports. Copyright 2010, Gastroenterology Week via NewsRx.com& NewsRx.net. DESCRIPTORS: City:Chester; Country:United Kingdom; Allergies; Allergy Medicine; La ryngopharyngeal Reflux; Life Sciences; Otolaryngology; Surgery; Top News; All News; Professional News SUBJECT HEADING: Life Sciences (c)Copyright 2010, Biotech Business Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/88 (Item 35 from file: 135) 0001207378 (THIS IS THE FULLTEXT) New dysphonia data have been reported by A. Schindler and co-authors Life Science Weekly, January 26, 2010, p.889 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 433 TEXT: JAN 26 - (NewsRx.com& NewsRx.net) -- In this recent article published in the journal Otolaryngology - Head and Neck Surgery , scientists in Milan, Italy conducted a study "To evaluate the correlation between the Voice Handicap Index (VHI) and objective ANEXO 4: Resultado busqueda en Dialog voice measurements in patients with dysphonia ofdifferent origin (see also Dysphonia). Cross-sectional survey. Otolaryngology department in a university hospital." "One hundred fifteen patients consulting for voice disorders were enrolled in the study: 32 presented with functional dysphonia (Group 1), 24 with unilateral vocal fold paralysis (Group 2), 30 with structural dysphonia (Group 3), and 29 with nodules (Group 4). From each patient, the maximum phonation time (MPT) and a voice spectrogram were obtained: patientswith type I signal underwent perturbation analysis. Each patient completed the VHI. No significant difference across the four groups, in the VHI scores and voice measurements, was found. The correlation between the different voice measurements was good, while those between the VHI domains were very good. Considering the patients with type I signal (n = 80) all together, the correlations between VHI and voice laboratory measurements ranged between poor and good. Analyzing each patient group separately, good correlations were found between MPT and functional and physical VHI domain in Group I (r = 0.58 and 0.68), jitter and functional VHI domain in Group 2 (r = 0.61) MPT and functional VHI domain in Group 3 (r = 0.52), and physical VHI do main and jitter, shimmer, and noise-to-harmonic ratio in Group 4 (r = 0.58, 0.77, 0.76). The VHI and the voice laboratory measurements give independent information," wrote A. Schindler and colleagues. The researchers concluded: "However, the correlation between VHI and some laboratory measurements increases in populations with voice disorder of the same origin." Schindler and colleagues published their study in Otolaryngology - Head and Neck Surgery (Correlation between the Voice Handicap Index and voice measurements in four groups of patients with dysphonia. Otolaryngology Head and Neck Surgery , 2009;141(6):762-769). Additional information can be obtained by contacting F. Mozzanica, Osped L Sacco, Via GB Grassi 74, I-20157 Milan, Italy. The publisher of the journal Otolaryngology - Head and Neck Surgery can be contacted at: Mosby-Elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA. Keywords: City:Milan, Country:Italy, Dysphonia, Otolaryngology, Paralysis, Surgery, Voice Disorder, Voice Disorders This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2010, Life Science Weekly via NewsRx.com& NewsRx.net. DESCRIPTORS: City:Milan; Country:Italy; Dysphonia; Otolaryngology; Paralysis; Sur gery; Voice Disorder; Voice Disorders; All News; Professional News SUBJECT HEADING: Dysphonia (c)Copyright 2010, Anti-Infectives Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/89 (Item 36 from file: 135) 0001206736 (THIS IS THE FULLTEXT) Studies from J.E. Allen and co-researchers update current data on botulinum toxin therapy Biotech Business Week, January 25, 2010, p.589 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 328 TEXT: JAN 25 - (NewsRx.com& NewsRx.net) -- "of review Promising new techniques in the management of vocal fold nodules have been developed in the past 2years (see also Botulinum Toxin Therapy). Simultaneously, the therapeutic use of botulinum toxin has rapidly expanded," researchers in the United States report. "This review explores the ANEXO 4: Resultado busqueda en Dialog use of botulinum toxin in treatment of vocal nodules and summarizes current therapeutic concepts. Recent findings New microsurgical instruments and techniques, refinements in laser technology, radiosurgical excision and steroid intralesional injections are all promising new techniques in the management of vocal nodules. Botulinum toxin-induced 'voice rest' is a new technique we have employed in patients with recalcitrant nodules. Successfulresolution of nodules is possible with this technique, without the risk of vocal fold scarring inherent in dissection/excision techniques. Botulinum toxin usage is exponentially increasing, and large-scale, long-term studies demonstrate its safety profile," wrote J.E. Allen and colleagues. The researchers concluded: "Targeted vocal fold temporary paralysis induced by botulinum toxin injection is a new, well tolerated and ef ficacious treatment in patients with persistent vocal fold nodules." Allen and colleagues published their study in Current Opinion in Otolaryngology & Head and Neck Surgery (Botulinum toxin in the treatment of vocal fold nodules. Current Opinion in Otolaryngology & Head and Neck Surgery , 2009;17(6):427-430). For additional information, contact J.E. Allen, 2521 Stockton Blvd., Suite 7200, Sacramento, CA 95817, USA. Publisher contact information for the journal Current Opinion in Otolaryngology && Head and Neck Surgery is: Lippincott Williams && Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA. Keywords: City:Sacramento, State:CA, Country:United States, Antidystonic, Anti wrinkle, Botulinum Toxin, Botulinum Toxin Therapy, Medical Device, Microsurgical, Micro technology, Otolaryngology, Surgery, Therapy, Treatment This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2010, Biotech Business Week viaNewsRx.com& NewsRx.net. DESCRIPTORS: City:Sacramento; State:CA; Country:United States; Antidystonic; Anti wrinkle; Botulinum Toxin; Botulinum Toxin Therapy; Medical Device; Microsurgical ; Mi crotechnology; Otolaryngology; Surgery; Therapy; Treatment; All News; Professional News SUBJECT HEADING: Botulinum Toxin Therapy (c)Copyright 2010, Biotech Business Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/90 (Item 37 from file: 135) 0001183792 (THIS IS THE FULLTEXT) Data from Medical College of Georgia, Medical College provide new insights into thyroidectomy Life Science Weekly, November 24, 2009, p.1715 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 425 TEXT: 9 NOV 24 - (NewsRx.com & NewsRx.net) -- In this recent report, researchers in the United States conducted a study "To ascertain whether there are incremental risks associated with thyroid surgery in the elderly population (see also Thyroidectomy). Prospective analysis of a consecutive single-surgeon series of patients undergoing thyroid surgery at an academic health center." "Tertiary care health center. The study included patients aged 21 to 35 years and patients 65 years and older who under-went thyroidectomy. Pathology reports, complications (including rates of temporary and permanent hypocal cemia and temporary and permanent true vocal fold [TVF] paralysis), and need for ad mission or readmission were included in the analysis. There were 86 youthful patients ANEXO 4: Resultado busqueda en Dialog who underwent thyroidectomy between November 2003 and December of 2007; 44 elderly patients underwent surgery during that same time frame. There were no deaths in either cohort, no hematomas, and no cases of permanent TVF paralysis. The elderly patients had a similar rate of complications when compared with the youthful. including transient hypocalcemia (12.5% vs i 11.1%, respectively) and temporary TVF paresis (2.9% vs 3.9%), but a higher rate of readmission (4.5% vs 1.2%, P=.26). Thyroid surgeons will be faced more Often with the prospect of elective thyroid surgery in patients of advanced age as an increasingly aged population emerges and the prevalence of thyroid nodules and thyroid cancer increases. Thyroid surgery in elderly patients is safe and no more dangerous than surgery inyouthful patients," wrote M.W. Seybt and colleagues, Medical College of Georgia, Medical College. The researchers concluded: "There is a slightly higher rate of readmission." Seybt and colleagues published their study in Archives of Otolaryngology - Head && Neck Surgery (Geriatric Thyroidectomy Safety of Thyroid Surgery in an Aging Population. Archives of Otolaryngology - Head && Neck Surgery , 2009;135(10):1041-1044). For additional information, contact D.J. Terris, Medical College of Georgia, Dept. of Otolaryngology Head && Neck Surgery, Thyroid Center, 1120 15th St., Ste. BP 4109, Augusta, GA 30912, USA. Publisher contact information for the journal Archives of Otolaryngology - Head && Neck Surgery is: American Medical Association, 515 N State St., Chicago, IL 60610-0946, USA. Keywords: City:Augusta, State:GA, Country:United States, Aging, Endocrinology, Hypocalcemia, Otolaryngology, Paralysis, Pathology, Surgery, Thyroidectomy, Medical College of Georgia, Medical College. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2009, Life Science Weekly via NewsRx.com & NewsRx.net. DESCRIPTORS: City:Augusta; State:GA; Country:United States; Aging; Endocrinology; Hypocalcemia; Otolaryngology; Paralysis; Pathology; Surgery; ThyroidectomyAll News; Professional News SUBJECT HEADING: Thyroidectomy (c)Copyright 2009, Cancer Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/91 (Item 38 from file: 135) 0001090783 (THIS IS THE FULLTEXT) Research from Yonsei University, Medical Department provides new data about thyroidectomy Cancer Weekly, September 8, 2009, p.300 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 456 TEXT: 9 SEP 8 - (NewsRx.com & NewsRx.net) -- "During the past decade, various techniques of endoscopic thyroid surgery have been introduced (see alsoThyroidectomy). We have developed a novel method of gasless endoscopic thyroidectomy via an axillary ap proach," scientists in Seoul, South Korea report. "The present report describes the technique of this method, and analyzes its surgical outcome. Between Nov. 2001 and Dec. 2007 (actual operation period was 50 months), 581 patients with thyroid tumors underwent gasless endoscopic thyroidectomy via an axillary approach. The clinical and patho logic characteristics of patients, operation type, operation time, post operative hospital stay and post operative complications were analyzed retrospectively. Among the 5 8 1 patients, 171 patients had benign tumor and 410 patients had malignant tumor. There ANEXO 4: Resultado busqueda en Dialog was no conversion to open Surgery. The operating time and the length of post-operative hospital stay were 129.4 +/- 51.3 minutes, 3.3 +/- 1.7 days in benign tumor, and 135.5 +/- 47 minutes, 3.4 +/- 0.9 days in malignant tumors, respectively. The tumor size was 2.7 +/- 1.2 cm in benign tumor and 0.78 +/- 0.5 cm in malignancy. Central compart ment lymph node metastasis was found in 112 (27.3%) patients and lateral neck lymph node metastasis in 13 (3.1%) patients. As post-operative complications, transient hypo calcemia occurred in 19 patients and transient hoarseness was in 13 patients and permanent vocal cord palsy occurred in 2 patients. In the TNM stage, 366 (89.2%) patients were stage 1, 43 (10.5%) patients were stage III and (0.2%) patient was stage IVA. According to our experience, gasless endoscopic thyroidectomy using a trans-axillary ap proach is a feasible and safe method," wrote S.W. Kang and colleagues, Yonsei Univer sity, Medical Department. The researchers concluded: "Endoscopic thyroid surgery has become a new treatment modality for the patients with benign tumors and can be an effective alternative treatment for the selected patients with thyroid cancer.." Kang and colleagues published their study in Endocrine Journal (Gasless Endoscopic Thyroidectomy Using Trans-axillary Approach; Surgical Outcome of 581 Patients. Endocrine Journal , 2009;56(3):361-369). For additional information, contact W.Y. Chung, Yonsei University, College Medical, Dept. of Sur gery, 250 Seongsanno, Seoul 120752, South Korea. The publisher's contact information for the Endocrine Journal is: Japan Endocrine Society, 75 Yanaginobanba Nishiiru-Mas uya-CHO, Sanjou-Dori, Nakagyou-Ku, Kyoto, 604-8111, Japan. Keywords: South Korea, Seoul, Endocrine, Oncology, Surgery, Thyroid Cancer, Thyroid Carcinoma, Thyroidectomy, Yonsei University, Medical Department. This article was prepared by Cancer Weekly editors from staff and other reports. Copyright 2009, Cancer Weekly viaNewsRx.com & NewsRx.net. DESCRIPTORS: South Korea; Seoul; Endocrine; Oncology; Surgery; Thyroid Cancer; Thyroid Carcinoma; ThyroidectomyAll News; Professional News SUBJECT HEADING: Thyroidectomy (c)Copyright 2009, Biotech Business Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/92 (Item 39 from file: 135) 0001086498 (THIS IS THE FULLTEXT) Research from Karolinska University yields new findings on nerve injury Life Science Weekly, September 1, 2009, p.1451 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 391 TEXT: 9 SEP 1 - (NewsRx.com & NewsRx.net) -- According to recent research from Stockholm, Sweden, "Following perioperative injury to a macroscopically intact recurrent laryngeal nerve (RLN), there are two possible intraneural injury types: 1) axonal injury, including disruption of axons, and 2) conduction block, only affecting the Schwarm cells and the nodes of Ranvier (see also Nerve Injury). In this study, it was hypothesized that the functional outcome after RLN injury may depend on the type of nerve injury." "Fifteen patients with acute postoperative unilateral RLN paralysis were prospectively studied. Electrophysiological examination (laryngeal electromyography) was used to differen tiate between the two types of nerve injury. Vocal fold motions were monitored by repeated laryngoscopy during the study period (up to 6 months). Three of the pa- ANEXO 4: Resultado busqueda en Dialog tients with axonal injury were treated with the regeneration-promoting agent nimodipine. The patients with conduction block all recovered normal vocal fold motion, whereas patients with axonal injury within the nerve had a significantly worse Outcome. The 3 patients who were treated with nimodipine all recovered normal or near-normal vocal fold mobility despite the more severe axonal injury. In contrast to previous reports, our results show that laryngeal electromyography is a reliable tool for diagnosing nosing the type of injury within the injured RLN, making it possible to predict the functional outcome in these patients," wrote J. Hydman and colleagues, Karolinska University. The researchers concluded: "On the basis of the results, a future randomized study on nimodipine treatment for RLN axonal injury is suggested.." Hydman and colleagues pub lished their study in Annals of Otology Rhinology and Laryngology (Diagnosis and Prognosis of Iatrogenic Injury of the Recurrent Laryngeal Nerve. Annals of Otology Rhinology and Laryngology , 2009;118(7):506-511). For additional information, contact J. Hydman, Karolinska University Hospital, Karolinska Institute, Dept. of Clinic Neuroscience, Neurosurgery Sect, S17176 Stockholm, Sweden. Publisher contact information for the journal Annals of Otology Rhinology and Laryngology is: Annals Publ Co., 4507 Laclede Avenue, St. Louis, MO 63108, USA. Keywords: Sweden, Stockholm, Drugs, Electromyography, Laryngology, Laryngoscopy, Nerve Injury, Nimodipine, Otology, Paralysis, Pharmaceuticals, Physiology, Rhinology, Surgery, Therapy, Treatment, Karolinska University. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2009, Life Science Weekly via NewsRx.com & NewsRx.net. DESCRIPTORS: Sweden; Stockholm; Drugs; Electromyography; Laryngology; Laryngoscopy; Nerve Injury; Nimodipine; Otology; Paralysis; Pharmaceuticals; Physiology; Rhinology; Surgery; Therapy; TreatmentAll News; Professional News SUBJECT HEADING: Nerve Injury (c)Copyright 2009, Biotech Business Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/93 (Item 40 from file: 135) 0001062532 (THIS IS THE FULLTEXT) Recent findings from M.P. Ondik and co-authors highlight research in thyroid cancer Cancer Weekly, July 14, 2009, p.457 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 376 TEXT: 9 JUL 14 - (NewsRx.com & NewsRx.net) -- "Positron emission tomography with 18Ffluorodeoxyglucose ((18)FDG) has been increasingly used in the diagnostic investigation of patients with neoplasms of the head and neck (see also Thyroid Cancer). Positron emission tomography and computed tomography have also proven useful for surveillance of thyroid cancers that no longer concentrate radioiodine," researchers in the United States report. "However, certain benign or inflammatory lesions can also accumulate 18F-fluorodeoxyglucose and lead to misdiagnosis. We review and discuss the pitfalls of using positron emission tomography and computed tomography for surveillance of thyroid cancer. We present the case of a 48-year-old woman who was diagnosed with a laryngeal neoplasm on integrated positron emission tomography and computed tomo graphy scanning, after a routine ultrasound demonstrated an enlarged thyroid nodule. ANEXO 4: Resultado busqueda en Dialog On physical examination, she had a laryngeal mass overlying an immobile vocal fold. The mass was biopsied and found to harbour a Teflon granuloma. Positron emission tomography positive Teflon granulomas have previously been reported in the nasopharynx and vocal folds, and should be considered in the differential diagnosis of patients who have undergone prior surgery involving Teflon injection," wrote M.P. Ondik and colleagues. The researchers concluded: "It is important for otolaryngologists and radiologists to recognise potential causes of false positive positron emission tomography and computed tomography findings, including Teflon granulomas.." Ondik and colleagues published their study in the Journal of Laryngology and Otology (Teflon laryngeal granuloma presenting as laryngeal cancer on combined positron emission tomography and computed tomography scanning. Journal of Laryngology and Otology , 2009;123(5):575-578). For additional information, contact D. Goldenberg, Penn State Milton S Hershey Med Center, Dept. of Surgery, Division Otolaryngology Head && Neck Surgery, 500 University Dr., MCH091, Hershey, PA 17033, USA. Publisher contact information for the Journal of Laryngology and Otology is: Cambridge University Press, Edinburgh Bldg, Shaftesbury Rd., CB2 8RU Cambridge, England. Keywords: United States, Hershey, Dermatology, Diagnostics, Granuloma, Laryngeal Cancer, Laryngeal Neoplasms, Laryngology, Oncology, Otology, Paralysis, Thyroid Cancer, Thyroid Neoplasms, Vocal Cord Paralysis. This article was prepared by Cancer Weekly editors from staff and other reports. Copyright 2009, Cancer Weekly via NewsRx.com & NewsRx.net. DESCRIPTORS: United States; Hershey; Dermatology; Diagnostics; Granuloma; Laryngeal Cancer; Laryngeal Neoplasms; Laryngology; Oncology; Otology; Paralysis; Thyroid Cancer; Thyroid Neoplasms; Vocal Cord ParalysisAll News; Professional News SUBJECT HEADING: Thyroid Cancer (c)Copyright 2009, Biotech Business Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/94 (Item 41 from file: 135) 0001049652 (THIS IS THE FULLTEXT) Findings from A. Hantzakos and co-authors provide new insights into voice disorders Life Science Weekly, June 23, 2009, p.2372 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 357 TEXT: 9 JUN 23 - (NewsRx.com & NewsRx.net) -- According to recent research from Yvoir, Belgium, "There has been an ongoing confusion among pathologists in their attempt to accurately identify lesions of Reinke's space (see also Voice Disorders). Nodules, polyps and Reinke's edema fall in the same basket and differentiation between them relies largely on the clinical description of the pathologic specimen by the operating surgeon than on their distinct pathologic features." "By revising the pertinent literature, the need for an establishment of the aforementioned term still remains and is further stressed out, as confusion among the various pathologic descriptions of these lesions still exists. This is further verified by a study conducted in the Department of Otorhino laryngology-Head and Neck Surgery of the University Hospital of Louvain at MontGodinne, Belgium, involving 323 operative specimens obtained from 200 patients with macroscopic picture. Statistical analysis showed lack of agreement between surgical and ANEXO 4: Resultado busqueda en Dialog histopathologic diagnosis in almost a third of the cases (Cohen's kappa coefficient of 0.683 +/- A 0.037, P< 0.001). We, therefore, propose the term ''exudative lesions of Reinke's space'' to include Reinke's edema, polyps and nodules," wrote A. Hantzakos and colleagues. The researchers concluded: "These lesions share common histologic features, which are located in the Reinke's space and whose macroscopic appearance is largely dependent upon the presence and duration of certain causative factors." Hantzakos and colleagues published their study in European Archives of Oto - Rhino - Laryngology (Exudative lesions of Reinke's space: a terminology proposal. European Archives of Oto - Rhino - Laryngology , 2009;266(6):869-878). For additional information, contact M. Remacle, University of Hospital Louvain Mt Godinne, Dept. of Otorhinolaryngology Head && Neck Surgery, B5530 Yvoir, Belgium. Publisher contact information for the journal European Archives of Oto - Rhino - Laryngology is: Springer, 233 Spring St., New York, NY 10013, USA. Keywords: Belgium, Yvoir, Voice Disorders, Edema, Laryngology, Otorhinolaryngology, Polyps, Voice Disorder. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2009, Life Science Weekly via NewsRx.com & NewsRx.net. DESCRIPTORS: Belgium; Yvoir; Voice Disorders; Edema; Laryngology; Otorhinolaryngology; Polyps; Voice DisorderAll News; Professional News SUBJECT HEADING: Voice Disorders (c)Copyright 2009, Life Science Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/95 (Item 42 from file: 135) 0001049046 (THIS IS THE FULLTEXT) New findings from Fudan University in the area of polyps published Gastroenterology Week, June 22, 2009, p.471 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 419 TEXT: 9 JUN 22 - (NewsRx.com & NewsRx.net) -- According to a study from Shanghai, People's Republic of China, "Phonation threshold flow (PTF) may provide a tool to assess laryngeal function and could differentiate between normal and pathological voices (see also Polyps). Both polyps and nodules contribute to an increased PTF by creating an in complete glottal closure and increased vocal fold mass and thickness. Prospective study." "The Kay Elemetrics Phonatory Aerodynamic System (PAS) (Kay Elemetrics Corp., Lincoln Park, NJ) was used to collect mean flow rate (MFR) and PTF measurements from 40 normal subjects, 21 patients with vocal fold nodules, and 23 patients with vocal fold polyps. Gender-based differences were assessed using a t test. The effect of vocal pathology on PTF and MFR was determined with an ANOVA. Diagnostic potential was evaluated using a receiver operation characteristics (ROC) analysis. Both PTF (P = . 047) and MFR (P = .008) were significantly affected by gender. Using a two-way ANOVA and correcting for gender differences, the influence of pathology on PTF was determined to be significant (P < .001). Post hoc tests found a significant difference between normal and polyp subjects (P < .001) but not normal and nodule subjects (P = .177) or nodule and polyp subjects (P = .246). ROC analysis found that PTF (area under the curve [AUC] = 0.691) andMFR (AUC = 0.684) had a similar diagnostic utility. PTF can be used to dif ferentiate between normal and pathological voices. As a parameter that is experimentally ANEXO 4: Resultado busqueda en Dialog sensitive to the biomechanical parameters providing its theoretical basis, it could be used clinically to analyze laryngeal functionality," wrote P. Zhuang and colleagues, Fudan Uni versity. The researchers concluded: "Future research could focus on measuring PTF in other pathologies, such as paralysis or scarring, which would also affect the effort required to produce voice." Zhuang and colleagues published their study in Laryngoscope (Phonation Threshold Flow Measurements in Normal and Pathological Phonation. Laryngoscope , 2009;119(4):811-815). For more information, contact C.S. Wei, Fudan University, Shanghai EENT Hospital, Shanghai 200031, People's Republic of China. Publisher contact information for the journal Laryngoscope is: John Wiley && Sons Inc., 111 River St., Hoboken, NJ 07030, USA. Keywords: People's Republic of China, Shanghai, Diagnostics, Laryngoscope, Medical Device, Pathology, Polyps, Fudan Univer sity. This article was prepared by Gastroenterology Week editors from staff and other reports. Copyright 2009, Gastroenterology Week via NewsRx.com & NewsRx.net. DESCRIPTORS: People's Republic of China; Shanghai; Diagnostics; Laryngoscope; Med ical Device; Pathology; PolypsAll News; Professional News SUBJECT HEADING: Polyps (c)Copyright 2009, Blood Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/96 (Item 43 from file: 135) 0001002922 (THIS IS THE FULLTEXT) Studies from Wexham Park Hospital provide new data on dysphonia Biotech Business Week, April 6, 2009, p.601 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 542 TEXT: 9 APR 6 - (NewsRx.com & NewsRx.net) -- "The hoarse voice is a common presentation in the adult ENT clinic (see also Dysphonia). It is estimated that otolaryngology/voice clinics receive over 50 000 patients with dysphonia each year," scientists in Slough, the United Kingdom report. "Good vocal function is estimated to be required for around 1/3 of the labour force to fulfil their job requirements. The assessment and management of the patient with a hoarse voice is potentially a complex and protrac ted process as the aetiology is often multi-factorial. This article provides a guide for the clinician in the general ENT clinic to make a concise, thorough assessment of the hoarse patient and engage in an evidence based approach to investigation and management. Literature search performed on 4 October 2008 using EMBASE, MEDLINE, Cochrane databases using subject headings hoarse voice or dysphonia in combination with dia gnosis, management, investigation, treatment, intervention and surgery. General vocal hygiene is beneficial for non organic dysphonia but the evidence base for individual components is poor. There is a good evidence base for the use of voice therapy as first line treatment of organic dysphonia such as vocal fold nodules and polyps. There is little evidence for surgical intervention as first line therapy for most common benign vocal fold lesions. Surgery is, however, the treatment of choice for hoarseness due to papillomatosis. Both CO2 laser and microdissection are equally acceptable modalities for surgical resection of common benign vocal fold lesions. Laryngopharyngeal reflux is commonly cited as a cause of hoarseness but the evidence base for treatment with gastric acid suppression is poor. Despite the widespread use of proton pump inhibitors for treating laryngopharyngeal reflux, there is high quality evidence to suggest that they ANEXO 4: Resultado busqueda en Dialog are no more effective than placebo. A concise and thorough approach to assessment in the general ENT clinic will provide the diagnosis and facilitate the management of the hoarse voice in the majority of cases. Voice therapy is an important tool that should be utilised in the general ENT clinic and should not be restricted to the specialist voice clinic. If there is no improvement after initial measures, the larynx appears normal and/or the patient has failed initial speech & language therapy, referral to a specialist voice clin ic may be helpful," wrote I. Syed and colleagues, Wexham Park Hospital. The researchers concluded: "More research is still required particularly with regard to laryngopharyngeal reflux which is often cited as an important cause of hoarseness but is still poorly under stood." Syed and colleagues published their study in Clinical Otolaryngology (Hoarse voice in adults: an evidence-based approach to the 12 minute consultation. Clinical Otolaryngology , 2009;34(1):54-58). For more information, contact I. Syed, Wexham Park Hospital, Dept. of Otorhinolaryngology, Slough SL2 4HL, Berks, UK. Publisher contact information for the journal Clinical Otolaryngology is: Wiley-Blackwell Publishing, Inc., Commerce Place, 350 Main St., Malden 02148, MA, USA. Keywords: United Kingdom, Slough, Dysphonia, Hygiene, Laryngology, Otolaryngology, Polyps, Surgery, Therapy, Treatment, Voice Disorders, Wexham Park Hospital. This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2009, Biotech Business Week via NewsRx.com & NewsRx.net. DESCRIPTORS: United Kingdom; Slough; Dysphonia; Hygiene; Laryngology; Otolaryngology; Polyps; Surgery; Therapy; Treatment; Voice DisordersAll News; Professional News SUBJECT HEADING: Dysphonia (c)Copyright 2009, Gastroenterology Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/97 (Item 44 from file: 135) 0000993786 (THIS IS THE FULLTEXT) Studies from Vrije University Amsterdam further understanding of breast cancer Cancer Weekly, March 24, 2009, p.165 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 581 TEXT: 9 MAR 24 - (NewsRx.com & NewsRx.net) -- According to a study from Netherlands, " Vasomotor symptoms and bone loss are complications frequently induced by adjuvant treatment for breast cancer (see also Breast Cancer). Tibolone prevents both side-effects, but its effect on cancer recurrence is unknown." "The aim of this study was to show non-inferiority of tibolone to placebo regarding risk of recurrence in breast-cancer patients with climacteric complaints. Between July 11, 2002, and Dec 20, 2004, women surgically treated for a histologically confirmed breast cancer (T1-3N0-2M0) with vasomotor symptoms were randomly assigned to either tibolone 2.5 mg daily or placebo at 245 centres in 31 countries. Randomisation was done by use of a centralised interactive voice response system, stratified by Centre, with a block size of four. The primary endpoint was breast-cancer recurrence, including contralateral breast cancer, and was analysed in the intention-to-treat (ITT) and per-protocol populations; the margin for non-in feriority was set as a hazard ratio of 1.278. This study is registered with ClinicalTrials.gov, number NCT00408863. Findings of the 3148 women randomised, 3098 were in- ANEXO 4: Resultado busqueda en Dialog cluded in the ITT analysis (1556 in the tibolone group and 1542 in the placebo group). Mean age at randomisation was 52.7 years (SD 7.3) and mean time since surgery was 2.1 years (SD 1.3). 1792 of 3098 (58%) women were node positive and 2185 of 3098 (71%) were oestrogen-receptor positive. At study entry 2068 of 3098 (67%) women used tamoxifien and 202 of 3098 (6.5%) women used aromatase inhibitors. The mean daily number of hot flushes was 6.4 (SD 5.1). After a median follow-up of 3.1 years (range 0.01-4.99), 237 of 1556 (15.2%) women on tibolone had a cancer recurrence, compared with 165 of 1542 (10.7%) on placebo (HR 1.40 [95% CI 1.14-1.70]; p=0.001). Results in the per-protocol population were similar (209 of 1254 [16.7%] women in the tibolone group had a recurrence vs 138 of 1213 [11.4%] women in the placebo group; HR 1.44 [95% CI 1.16-1-79]; p=0.0009). Tibolone was not different from placebo with regard to other safety outcomes, such as mortality (72 patients vs 63 patients, respectively), cardiovascular events (14 vs 10, respectively), or gynaecological cancers (10 vs 10, respectively). Vasomotor symptoms and bone-mineral density improved significantly with tibolone, compared with placebo," wrote P. Kenemans and col leagues, Vrije University Amsterdam. The researchers concluded: " Tibolone increases the risk of recurrence in breast cancer patients, while relieving vasomotor symptoms and preventing bone loss." Kenemans and colleagues published the results of their research in Lancet Oncology (Safety and efficacy of tibolone in breast-cancer patients with vaso motor symptoms: a double-blind, randomised, non-inferiority trial. Lancet Oncology , 2009;10(2):135-146). For additional information, contact P. Kenemans, Vrije Universiteit Amsterdam, Medical Center, Dept. of Obstetrics && Gynecology, POB 7057, NL-1007 MC Amsterdam, Netherlands. The publisher of the journal Lancet Oncology can be contacted at: Lancet Ltd., 84 Theobalds Rd., London WC1X 8RR, England. Keywords: Netherlands, Bone, Breast Cancer, Breast Carcinoma, Endocrinology, Estrogen, Hormones, Oncology, Women's Health, Vrije University Amsterdam. This article was prepared by Cancer Weekly editors from staff and other reports. Copyright 2009, Cancer Weekly via NewsRx.com & NewsRx.net. DESCRIPTORS: Netherlands; Bone; Breast Cancer; Breast Carcinoma; Endocrinology; Estrogen; Hormones; Oncology; Women's HealthAll News;Professional News SUBJECT HEADING: Breast Cancer (c)Copyright 2009, Biotech Business Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/98 (Item 45 from file: 135) 0000974878 (THIS IS THE FULLTEXT) Research from F. Koskas and co-authors yields new data on angiology Blood Weekly, February 26, 2009, p.106 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 656 TEXT: 9 FEB 26 - (NewsRx.com & NewsRx.net) -- "The aim of this study was to evaluate the short-term and long-term results of the subadventitial resection of carotid chemod ectomas and to validate the importance of deliberate resection of the external carotid artery (ECA) (see also Angiology). From 1981 to 2006, 39 carotid chemodectomas of the carotid bifurcation or of the neighboring nerves were operated on in our department," researchers in Paris, France report. "There were 14 men and 22 women, with a mean age ANEXO 4: Resultado busqueda en Dialog 44.4 +/- 5 (range 21-78) years. One of these operations was a redo surgery for local recurrence. One female patient presented with a bilateral tumor. Two tumors were secreting catecholamines. All these tumors affected the carotid body; 10 of them were also affecting the vagus nerve, and one among these last 10 affected the sympathetic nerve as well. In 11 cases, the tumor had spread into the subparotidal space and, in one case, into the skull. In two cases, the tumor had been revealed by hemispheric ischemia and in every case by tumoral syndrome. All the patients were followed up by clinical examina tion, duplex scan, or computed tomographic scan until the end of 2006. In 38 cases, complete resection was performed; an incomplete resection was performed in one case with cranial invasion. Under general anesthesia, and most of the time without pharma ceutical preparation, surgery consisted of a deliberate sacrifice of the ECA followed by subadventitial resection of the tumor. In one case, a previous embolization had been carried out to facilitate the cleavage, which in fact rendered it more complicated. In 22 cases, resection concerned the ECA; in seven cases, it concerned the common carotid artery and the internal carotid artery (ICA): in seven cases the superior laryngeal nerve, in nine cases the vagus nerve, in five cases the sympathetic nerve, and in four cases the jugular vein. In 13 cases, node clearing was associated. In 20 cases, an additional vas cular procedure was performed: nine dilatations for spasm of the ICA,. five autogenous vein grafts, two prosthetic bypasses, and one endarterectomy associated with a patch angioplasty. All patients were followed up until 2006. At 3 months, the observed complic ations were the sequelae of a homolateral hemispheric accident due to thrombosis of a vein graft, eight peripheral facial nerve palsies, 12 vocal palsies, seven Claude Bernard-Horner (CBH) syndromes, eight palatal paralyses, and 10 nociceptive pains. Some of these complications did persist: nine vocal cord paralyses that were successfully treated by speech therapy, three mild CBH syndromes, and nociceptive pains in 6% of the cases (15.4%), incapacitating in one case. With a follow-up of 115 +/- 27 (range 1298) months, three local recurrences were recorded at 6 and 10 years. In two cases, local recurrence occurred when initial resection of the ECA had not been performed. Two patients presented with a contralateral lesion, at 12 and 16 years, respectively. At 40 months, one patient had to be reoperated on for an atheromatous stenosis," wrote F. Koskas and colleagues. The researchers concluded: "At 51 months, a female patient's death was not related to the operation. Subadventitia'." Koskas and colleagues published their study in Annals of Vascular Surgery (Carotid Chemodectomas: Long-Term Results of Subadventitial Resection with Deliberate External Carotid Resection. Annals of Vascular Surgery , 2009;23(1):67-75). For additional information, contact F. Koskas, GH Pitie Salpetriere, Service Chirurg Vascular, 47-83 Blvd. Hopital, F-75013 Paris, France. Publisher contact information for the journal Annals of Vascular Surgery is: Elsevier Science Inc., 360 Park Avenue South, New York, NY 10010-1710, USA. Keywords: France, Paris, Anesthesia, Angiology, Catecholamin, Embolization, External Carotid Artery, Ischemia, Neuro logy, Pain Medicine, Pharmaceuticals, Surgery. This article was prepared by Blood Weekly editors from staff and other reports. Copyright 2009, Blood Weekly viaNewsRx.com & NewsRx.net. DESCRIPTORS: France; Paris; Anesthesia; Angiology; Catecholamin; Embolization; Ex ternal Carotid Artery; Ischemia; Neurology; Pain Medicine; Pharmaceuticals; SurgeryAll News; Professional News; Hematology SUBJECT HEADING: Angiology (c)Copyright 2009, Life Science Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/99 (Item 46 from file: 135) 0000962381 (THIS IS THE FULLTEXT) New acid reflux disease study findings have been reported by I. Kantas and co- ANEXO 4: Resultado busqueda en Dialog researchers Biotech Business Week, February 2, 2009, p.95 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 492 TEXT: 9 FEB 2 - (NewsRx.com & NewsRx.net) -- "The aim of this clinical study was to evaluate the effect of laryngopharyngeal reflux (LPR) on the healing process of surgical laryngeal trauma (see also Acid Reflux Disease). A total of 112 consecutive patients, who suffered from LPR and were scheduled for operation of Reinke edema or laryngeal polyps/nodules (40 and 72 patients, respectively) during a period of 5 years, were included," scientists in Athens, Greece report. "Diagnosis of LPR was made on the basis of both history and dual pH probe recording during 24 h in the inferior esophagus and the hypopharynx. The reflux finding score (RFS) and the reflux symptom index (RSI) were used to estimate the clinical severity of LPR. In patients with LPR, proton pump inhibitors (PPI) were initiated in half of them, randomly chosen. Fifty LPR-free subjects operated for Reinke edema or laryngeal polyps during the same time period (19 and 31 patients, respectively) were used as controls. In six patients who had been administered PPI, resolution of the disease was observed and no surgical treatment was undertaken. The remaining patients were operated on under general anesthesia by a single surgeon. All patients had 1-year postoperative follow-up. Epithelization was complete in all vocal cords of both the control group and the group of patients who had been administered PPI. Within the group of patients who had not taken PPI, six patients presented granulation tissue or recurrence of the polyps and in two of them revision surgery was needed. RFS and RSI scores showed significant improvement postoperatively, across all the three groups of patients, with major differences observed in the group treated by PPI. Comparison of the postoperative RFS and RSI scores between the two groups of patients with LPR showed statistically significant differences in both, indicating better treatment out come in those patients who had received PPI. It may be thus concluded that LPR influ ences epithelization and recurrence of laryngeal polyps or Reinke edema in vocal cords, after partial or total decortication," wrote I. Kantas and colleagues. The researchers concluded: "Surgical outcome is superior in patients with LPR with preoperative and postoperative anti-reflux treatment." Kantas and colleagues published their study in European Archives of Oto - Rhino - Laryngology (The influence of laryngopharyngeal reflux in the healing of laryngeal trauma. European Archives of Oto - Rhino Laryngology , 2009;266(2):253-259). For more information, contact D.G. Balatsouras, 23 Achaion Str, Athens 15343, Greece. Publisher contact information for the journal European Archives of Oto - Rhino - Laryngology is: Springer, 233 Spring St., New York, NY 10013, USA. Keywords: Greece, Athens, Acid Reflux Disease, Clinical Trial Research, Edema, Esophageal, Gastroenterology, Laryngology, Laryngopharyngeal Reflux, Otolaryngology, Polyps, Voice Disorder. This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2009, Biotech Business Week viaNewsRx.com & NewsRx.net. DESCRIPTORS: Greece; Athens; Acid Reflux Disease; Clinical Trial Research; Edema; Esophageal; Gastroenterology; Laryngology; Laryngopharyngeal Reflux; Otolaryngology; Polyps; Voice Disorder; Top News; All News; Professional News SUBJECT HEADING: Acid Reflux Disease (c)Copyright 2009, Life Science Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/100 (Item 47 from file: 135) ANEXO 4: Resultado busqueda en Dialog 0000937259 (THIS IS THE FULLTEXT) Research reports on pediatric in children from Children's National Medical Center, Division of Otolaryngology provide new insights Life Science Weekly, December 9, 2008, p.2993 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Business WORD COUNT: 583 TEXT: 8 DEC 9 - (NewsRx.com & NewsRx.net) -- Current study results from the report, 'Relationship between voice quality and vocal nodule size,' have beenpublished (see also Life Sciences). According to recent research from the United States, "To determine the effect of vocal nodule size on voice in pediatric patients. Vocal nodules were graded according to a validated grading scale by three pediatric otolaryngologists." "Patients evaluated from 2003 to 2007 with a diagnosis of vocal nodules were included. Forty patients (21 female) with a mean age of 7.5 years were identified. Vocal nodules were rated as grade 1 (17 patients), grade 2 (15 patients), and grade 3 (8 patients). Pitch range was reduced in patients with larger nodules (p=0.001). There was no statistical association between nodule grade and fundamental frequency abnor mality, perturbation, shimmer, decreased respiratory support, air loss, or significant muscle tension. Voice characteristics in patients with vocal nodules were evaluated. Other than pitch reduction, objective and subjective voice measurements are not statistically different in varying vocal nodule sizes; however, many of the measures did show a trend towards significance," wrote R.K. Shah and colleagues, Children's National Medical Center, Division of Otolaryngology. The researchers concluded: "Vocal rehabilitation is complex in children with nodules and may not directly correlate with vocal nodule size." Shah and colleagues published their study in ). According to recent research from the United States, "To determine the effect of vocal nodule size on voice in pediatric patients. Vocal nodules were graded according to a validated grading scale by three pediatric otolaryngologists." "Patients evaluated from 2003 to 2007 with a diagnosis of vocal nodules were included. Forty patients (21 female) with a mean age of 7.5 years were identified. Vocal nodules were rated as grade 1 (17 patients), grade 2 (15 patients), and grade 3 (8 patients). Pitch range was reduced in patients with larger nodules (p=0.001). There was no statistical association between nodule grade and fundamental frequency abnormality, perturbation, shimmer, decreased respiratory support, air loss, or significant muscle tension. Voice characteristics in pa tients with vocal nodules were evaluated. Other than pitch reduction, objective and sub jective voice measurements are not statistically different in varying vocal nodule sizes; however, many of the measures did show a trend towards significance," wrote R.K. Shah and colleagues, Children's National Medical Center, Division of Otolaryngology. The researchers concluded: "Vocal rehabilitation is complex in children with nodules and may not directly correlate with vocal nodule size." Shah and colleagues published their study in (Relationship between voice quality and vocal nodule size. , 2008;139(5):723-6). For additional information, contact R.K. Shah, Children's National Medical Center, Division of Otolaryngology, George Washington University School of Medicine, Washington, DC USA.. Publisher contact information for the journal Otolaryngology - Head and Neck Surgery is: Mosby, Inc., 11830 Westline Industrial Dr., St. Louis, MO 63146-3318, USA. Keywords: United States, Washington, Life Sciences, Pediatric, Otolaryngology, Laryngology, Surgery. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2008, Life Science Weekly via NewsRx.com & NewsRx.net. ANEXO 4: Resultado busqueda en Dialog DESCRIPTORS: United States; Washington; Life Sciences; Pediatric; Otolaryngology; Laryngology; Surgery; All News; Professional News SUBJECT HEADING: Life Sciences (c)Copyright 2008, Anti-Infectives Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/101 (Item 48 from file: 135) 0000871478 (THIS IS THE FULLTEXT) Data on thyroid cancer risk factors detailed by researchers at University of Toronto Blood Weekly, August 14, 2008, p.75 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 320 TEXT: 8 AUG 14 - ( & NewsRx.net) -- Current study results from the report, 'Risk factors for well-differentiated thyroid carcinoma in patients with thyroid nodular disease,' have been published (see also ). According to recent research from Canada, "Evaluate current accepted risk factors for well-differentiated thyroid carcinoma, and develop a predictive model to determine one's risk of malignancy given a thyroid nodule. Retrospective analysis of 600 patients." "Patients with benign thyroid nodular disease and with well-differ entiated thyroid cancer were randomly selected. clinical, and investigational data were compared by means of univariate and multivariate regression analyses. Age, regional lymphadenopathy, ipsilateral vocal cord palsy, solid and/or calcified nodules, and an aspiration biopsy being malignant or suspicious predicted for cancer (p <0.05). Regional lymphadenopathy and vocal cord palsy are perfect predictors of malignancy. Multivariate analysis indicated age, solid and/or calcified nodules, and all fine-needle aspiration biopsy results to be significant in assessing risk (p <0.05). Taking individual risk factors in isolation is not always reliable," wrote S.N. Raza and colleagues, University of Toronto. The researchers concluded: "Using a predictive model, one can anticipate a patient's risk of malignancy when the diagnosis is unclear." Raza and colleagues published their study in Otolaryngology - Head and Neck Surgery (Risk factors for well-differentiated thyroid carcinoma in patients with thyroid nodular disease. Otolaryngology - Head and Neck Sur gery , 2008;139(1):21-6). For additional information, contact S.N. Raza, University of Toronto, Dept. of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, Toro noto, Canada. Publisher contact information for the journal Otolaryngology - Head and Neck Surgery is: Mosby, Inc., 11830 Westline Industrial Dr., St. Louis, MO 63146-3318, USA. Keywords: Canada, Thyroid Cancer Risk Factors, Hematology, Laryngology, Lymphadenopathy, Oncology, Otolaryngology, Surgery, Thyroid Cancer, Thyroid Carcinoma, Thyroid Neoplasms, Thyroid Nodule. This article was prepared by Blood Weekly editors from staff and other reports. Copyright 2008, Blood Weekly via & NewsRx.net. DESCRIPTORS: Canada; Thyroid Cancer Risk Factors; Hematology; Laryngology; Lymphadenopathy; Oncology; Otolaryngology; Surgery; Thyroid Cancer; Thyroid Carcinoma; Thyroid Neoplasms; Thyroid Nodule; Top News; All News; Professional News SUBJECT HEADING: Thyroid Cancer Risk Factors (c)Copyright 2008, Cancer Weekly via NewsRx.com & NewsRx.net ANEXO 4: Resultado busqueda en Dialog NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/102 (Item 49 from file: 135) 0000867492 (THIS IS THE FULLTEXT) Recent studies by E.T. Slotema and co-authors add new data to thyroidectomy findings Biotech Business Week, August 4, 2008, p.367 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 444 TEXT: 8 AUG 4 - ( & NewsRx.net) -- " Endoscopic thyroidectomy (ET) is a demanding sur gical technique in which dissection of the gland is entirely performed with an endoscope, in a closed area maintained by insufflation or mechanical retraction (see also ). ET by direct cervical approach (anterior or lateral) is minimally invasive, but ET using an ex tracervical access (chest wall, breast, or axillary) is not," researchers in Marseille, France report. "No technique seems to be universally accepted yet. This review was designed to clarify the existing evidence for performing endoscopic thyroid resections in the management of benign thyroid nodules. A database search was conducted in PubMed and Embase from which summaries and abstracts were screened for relevant data, matching our definition. Publications were further assessed and assigned their respective levels of evidence. Additional data derived from our own unit's experience with endoscopic thyroidectomy were included. Thirty mainly retrospective cohort studies have been published in which morbidity, such as unilateral vocal cord palsy, is poorly evaluated. ET takes from 90 to 280 minutes for lobectomy by cervical access and total thyroidectomy by chest wall approach, respectively. Cosmetic outcome in extracervical approach is less troubled by size of the resected specimen compared with direct cervical approach. Extracervical approach avoids a neck scar but implies invasiveness in terms of dissection and postoperative discomfort. Long-term cosmetic outcome comparisons with conventional thyroidectomy have not been published. Currently it is not possible to recommend the application of ET based on evidence. Reported complications stress the importance of advanced endoscopic skills. ET should only be offered to carefully selected patients and, therefore, a high volume of patients requiring thyroid surgery is needed. Superiority of endoscopic to conventional thyroidectomy has yet to be demonstrated," wrote E.T. Slotema and colleagues. The researchers concluded: "Possible advantages of endoscopic thyroid techniques and our patient's desire for the highest cosmetic outcome possible justify further development of ET in expert hands of endocrine surgeons." Slotema and colleagues published their study in World Journal of Surgery (What is the evidence for endoscopic thyroidectomy in the management of benign thyroid disease? World Journal of Surgery , 2008;32(7):13251332). For additional information, contact E.T. Slotema, University of Hospital Marseille, CHU Hopital Timone, Dept. of Endocrine Surgery, Service Chirurg General & Endocrinie, 264 Rue St. Pierre, F-13385 Marseille 05, France. Publisher contact information for the World Journal of Surgery is: Springer, 233 Spring St., New York, NY 10013, USA. Keywords: France, Marseille, Clinical Trial Research, Surgery, Thyroid Disease, Thyroid Nodule, Thyroidectomy. This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2008, Biotech Business Week via & NewsRx.net. DESCRIPTORS: France; Marseille; Clinical Trial Research; Surgery; Thyroid Disease; Thyroid Nodule; Thyroidectomy; Top News; All News; ProfessionalNews SUBJECT HEADING: Thyroidectomy ANEXO 4: Resultado busqueda en Dialog (c)Copyright 2008, Biotech Business Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/103 (Item 50 from file: 135) 0000838190 (THIS IS THE FULLTEXT) Studies from T. Takahashi and colleagues yield new information about leiomyosarcoma Life Science Weekly, June 17, 2008, p.1546 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 334 TEXT: 8 JUN 17 - ( & NewsRx.net) -- "Cases of leiomyosarcoma in the head and neck are very rare with only four reports of a leiomyosarcoma originating in the hypopharynx (see also ). A rare case of leiomyosarcoma of the hypopharynx is described," researchers in Morohongo, Japan report. "A 62-year-old woman, who had experienced slight difficulty of swallowing and hoarseness, visited our hospital. A smooth-surfaced tumor was found ex tending from the postcricoid to an area in the left pyriform sinus, and the vocal cord on the left side was fixed. Imaging studies, including FDG-PET CT imaging showed the tu mor in the postcricoid, but no distinguishable distant metastases. A total laryngectomy with a left-lobe thyroidectomy was per-formed. Since no metastases of the regional lymph nodeswere found by imaging, a neck dissection was not performed. Dense infiltration by spindle-shaped and/or round-like cells was observed histologically as the pre dominant growth pattern. In immunohistochemical staining, the tumor was positive for desmin and muscle actin, while it was negative for myoglobin, myogenin, cytokeratin, and S-100 protein. Electron microscopic examination did not show Z banding and sar comeres. Those features lead to the diagnosis of a leiomyosarcoma. No recurrence has been found at 1 year after the surgery," wrote T. Takahashi and colleagues. The researchers concluded: "Immunohistochemical staining and electron microscopic examina tion are essential for a definite diagnosis of leiomyosarcoma." Takahashi and colleagues published their study in Auris Nasus Larynx (Leiomyosarcoma of the hypopharynx: A case report. Auris Nasus Larynx , 2008;35(2):304-307). For additional information, contact R. Higo, Saitama Med University, Dept. of Otolaryngology Head & Neck Surgery, Morohongo 38, Saitama 3500495, Japan. Publisher contact information for the journal Auris Nasus Larynx is: Elsevier Science Ltd., the Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, Oxon, England. Keywords: Japan, Morohongo, Hoarseness, Laryngectomy, Leiomyosarcoma, Surgery, Thyroidectomy, Urology. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2008, Life Science Weekly via & NewsRx.net. DESCRIPTORS: Japan; Morohongo; Hoarseness; Laryngectomy; Leiomyosarcoma; Surgery; Thyroidectomy; UrologyAll News; Professional News SUBJECT HEADING: Leiomyosarcoma (c)Copyright 2008, Blood Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/104 (Item 51 from file: 135) ANEXO 4: Resultado busqueda en Dialog 0000831034 (THIS IS THE FULLTEXT) Research on thyroidectomy published by scientists at Catholic University Cancer Weekly, June 3, 2008, p.623 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 410 TEXT: 8 JUN 3 - ( & NewsRx.net) -- According to recent research from Rome, Italy, " Voice and swallowing symptoms are frequently reported after thyroidectomy even in absence of objective voice alterations (see also ). We evaluated the influence of the video-assisted approach on voice and swallowing outcome of thyroidectomy." " Sixty-five patients undergoing total thyroidectomy (TT) were recruited. Eligibility criteria were: nodule size <= 30 mm, thyroid volume <= 30 ml, no previous neck surgery. Exclusion criteria were: younger than aged 18 years and older than aged 75 years, vocal fold paralysis, history ofvoice, laryngeal or pulmonary diseases, malignancy other than papillary thyroid carcinoma. Patients were randomized for video-assisted (VAT) or conventional (CT) thyroidectomy. Videostrobolaryngoscopy (VSL), acoustic voice analysis (AVA), and maximum phonation time (MPT) evaluation were performed preoperatively and 3 months after TT. Subjective evaluation of voice (voice impairment score = VIS) and swallowing (swallowing impairment score = SIS) were obtained preoperatively, 1 week, 1 month, and 3 months after TT. Fifty-three patients completed the postoperative evaluation: 29 in the VAT group, and 24 in the CT group. No laryngeal nerves injury was shown at postoperative VSL. Mean postoperative MPT, F (0), F (low), F (high), and the number of semitones were significantly reduced in the CT group but not in the VAT group. Mean VIS 3 months after surgery was significantly higher than preoperatively in CT group but not in the VAT group. Mean SIS was significantly decreased 1 and 3 months after VAT but not after CT," wrote C.P. Lombardi and colleagues, Catholic University. The researchers concluded: " The incidence and the severity of early voice and swallowing postthyroidectomy symptoms are significantly reduced in patients who undergo VAT compared with conventional surgery." Lombardi and colleagues published their study in World Journal of Surgery (Video-assisted thyroidectomy significantly reduces the risk of early postthyroidectomy voice and swallowing symptoms. World Journal of Surgery , 2008;32(5):693-700). For additional information, contact M. Raffaelli, Sacred Heart Catholic University, Policinico A Gemelli, Division Endocrine Surgery, Dept. of Surgery, L Go A Gemelli 8, I-00168 Rome, Italy. Publisher contact information for the World Journal of Surgery is: Springer, 233 Spring Street, New York, NY 10013, USA. Keywords: Italy, Rome, Oncology, Papillary Thyroid Cancer, Paralysis, Pulmonary Disease, Surgery, Thyroid Carcinoma, Thyroidectomy, Catholic University. This article was prepared by Cancer Weekly editors from staff and other reports. Copyright 2008, Cancer Weekly via & NewsRx.net. DESCRIPTORS: Italy; Rome; Oncology; Papillary Thyroid Cancer; Paralysis; Pulmonary Disease; Surgery; Thyroid Carcinoma; ThyroidectomyAll News;Professional News SUBJECT HEADING: Thyroidectomy (c)Copyright 2008, Gastroenterology Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/105 (Item 52 from file: 135) 0000822380 (THIS IS THE FULLTEXT) ANEXO 4: Resultado busqueda en Dialog New life sciences research from Medical College of Wisconsin outlined Life Science Weekly, May 27, 2008, p.2840 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 450 TEXT: 8 MAY 27 - ( & NewsRx.net) -- Investigators publish new data in the report 'Pediatric Voice-Related Quality of Life: findings in healthy children and in common laryngeal disorders.' "Although several instruments have been validated to assess voice quality, the incidence and degree of impairment in normal, healthy children has not been widely reported (see also ). It is hypothesized that healthy children outside a medical setting do not demonstrate impairment as measured by the Pediatric Voice-Related Quality of Life (PVRQOL) instrument; in contrast, patients with vocal fold paralysis (VFP), vocal nodules (VNs), and paradoxicalvocal fold dysfunction (PVFD) have significant impairment as compared to control populations," researchers in the United States report. "The PVRQOL was measured prospectively in children with VFP, VNs, and PVFD. The findings were com pared to findings in 100 children surveyed at the 2006 Wisconsin State Fair. Of the 100 surveys of healthy children and their parents, 95 were completed correctly; their mean (+/-SD) PVRQOL score was 96.8 +/-5.85. The VFP patients (n=11; mean PVRQOL score, 70.5 +/-28.6) reported significant impairment (p <.0001, unpaired t-test). This was also true of patients with VNs (n=13; PVRQOL score, 84.8 +/-9.4; p<.0001) and PVFD (n=25; PVRQOL score, 86.7 +/-14.3; p<.0001); statistically significant differences were also noted for the Social-Emotional and Physical-Functional domains for each of the 3 disease states compared to the group of healthy children (p <.001). The PVRQOL scores of healthy children reveal essentially no self-reported vocal impairment. In contrast, common disorders such as VNs, VFP, and PVFD demonstrate statistically significant impairment in age-matched children for total PVRQOL, as well as for the Social-Emotion al and Physical-Functional domains," wrote A.L. Merati and colleagues, Medical College of Wisconsin. The researchers concluded: "This is the first report of normative PVRQOL data in children." Merati and colleagues published their study in Annals of Otology, Rhinology & Laryngology (Pediatric Voice-Related Quality of Life: findings in healthy children and in common laryngeal disorders. Annals of Otology, Rhinology & Laryngology , 2008;117(4):259-62). For additional information, contact A.L. Merati, Medical College of Wisconsin, Dept. of Otolaryngology and Communication Sci ences, Division of Laryngology and Professional Voice, Milwaukee, Wisconsin USA.. Publisher contact information for the journal Annals of Otology, Rhinology & Laryngology is: Annals Publ Co., 4507 Laclede Avenue, St. Louis, MO 63108, USA. Keywords: United States, Milwaukee, Life Sciences, Pediatric, Paralysis, Quality of Care, Quality of Life, Laryngology, Rhinology, Otology. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2008, Life Science Weekly via & NewsRx.net. DESCRIPTORS: United States; Milwaukee; Life Sciences; Pediatric; Paralysis; Quality of Care; Quality of Life; Laryngology; Rhinology; Otology; All News;Professional News SUBJECT HEADING: Life Sciences (c)Copyright 2008, Bioterrorism Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/106 (Item 53 from file: 135) 0000815901 (THIS IS THE FULLTEXT) Studies conducted at University of Wisconsin on intravascular recently pub- ANEXO 4: Resultado busqueda en Dialog lished Life Science Weekly, May 20, 2008, p.2901 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 359 TEXT: 8 MAY 20 - ( & NewsRx.net) -- A new study, 'Vocal nodules and edema may be due to vibration-induced rises in capillary pressure,' is now available (see also ). " Vocal fold vibration may physically raise intravascular pressure to levels high enough to damage capillaries and result in leakage of erythrocytes. This type of injury is commonly seen in benign vocal fold lesions and is not well explained. Theoretical, retrospective," scientists in the United States report. "The relationship of intravascular pressure to vibration fre quency and amplitude is derived and confirmed with a physical blood vessel model, then applied to published human measurements to estimate human intravascular pres sures. Vocal fold intravascular pressure is predicted to have a quadratic dependence on both frequency and amplitude. During speaking, the pressure may rise to over 20 cmH O, and may reach levels far higher for screaming and singing. Such pressure magnitudes are known to trigger inflammatory cascades and can lead to fluid leakage. They also have the potential for pharmacologic control with beta-agonists. Intravascular pressure likely rises significantly during vocal fold vibration and may lead to the type of injury seen in benign vocal fold lesions. The results support voice therapy aimed at reducing vibratory amplitude," wrote L. Czerwonka and colleagues, University of Wisconsin. The researchers concluded: "More vibratory amplitude measurements need to be performed in a wider range of subjects before the full range of human vocal fold vascular pressures can be estimated." Czerwonka and colleagues published their study in Laryngoscope (Vocal nodules and edema may be due to vibration-induced rises in capillary pressure. Laryngoscope , 2008;118(4):748-52). For more information, contact L. Czerwonka, University of Wisconsin School of Medicine and Public Health, University of Wisconsin School of Medicine and Public Health, Division of Otolaryngology Head and Neck Surgery, Madison, Wisconsin 53706 USA.. Publisher contact information for the journal Laryngoscope is: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA. Keywords: United States, Madison, Angiology, Edema, Intravascular, Laryngoscope, Medical Device. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2008, Life Science Weekly via & NewsRx.net. DESCRIPTORS: United States; Madison; Angiology; Edema; Intravascular; Laryngo scope; Medical DeviceAll News; Professional News SUBJECT HEADING: Intravascular (c)Copyright 2008, Biotech Business Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/107 (Item 54 from file: 135) 0000799013 (THIS IS THE FULLTEXT) Reports summarize arthritis risk factors research from University Hospital Biotech Business Week, April 28, 2008, p.424 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional ANEXO 4: Resultado busqueda en Dialog WORD COUNT: 382 TEXT: 8 APR 28 - ( & NewsRx.net) -- Research findings, 'Prevalence and relative risk of dysphonia in rheumatoid arthritis,' are discussed in a new report (see also ). According to a study from Maastricht, Netherlands, "Laryngeal involvement in rheumatoid arthritis is not uncommon and may include cricoarytenoid arthritis orvocal fold lesions such as vocal fold rheumatoid nodules or bamboo nodes. Dysphonia or voicing problems can be the result of such laryngeal involvement." The researchers concluded: "Laryngeal involvement in rheumatoid arthritis is not uncommon and may include cricoarytenoid arthritis or vocal fold lesions such as vocalfold rheumatoid nodules or bamboo nodes. Dysphonia or voicing problems can be the result of such laryngeal involvement. This co hort study investigates the prevalence and the relative risk of dysphonia when suffering from rheumatoid arthritis compared to that of healthy subjects. One hundred and six ty-six subjects with rheumatic arthritis and 148 healthy control subjects completed two quality-of-life questionnaires: the Voice Handicap Index and a three-item outcome scale. Both instruments measure the quality of the voice itself and the extent of impairment resulting from dysphonia as experienced by the patient in social andoccupational settings. Patients proved to have statistically significant higher prevalence and relative risk of dysphonia. Depending on the questionnaire being used, prevalence data of dysphonia in patients varied between 12% and 27%, whereas the healthy subjects showed prevalence data varying from about 3% to 8%. A patient's relative risk varied from about 3 to 4 when compared to healthy subjects. Patients suffering from rheumatoid arthritis have a clearly higher risk of dysphonia compared to healthy subjects." Speyer and colleagues published the results of their research in the Journal of Voice (Prevalence and relative risk of dysphonia in rheumatoid arthritis. Journal of Voice , 2008;22(2):232-7). For additional information, contact R. Speyer, University Hospital Maastricht, Dept. of ORL and Head and Neck Surgery, Maastricht, Netherlands. The publisher of the Journal of Voice can be contacted at: Mosby, Inc., 11830 Westline Industrial Dr., St. Louis, MO 63146-3318, USA. Keywords: Netherlands, Maastricht, Arthritis Risk Factors, Arthritis, Clinical Trial Research, Dysphonia, Quality of Life, Rheumatoid Arthritis, Voice Disorders. This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2008, Biotech Business Week via & NewsRx.net. DESCRIPTORS: Netherlands; Maastricht; Arthritis Risk Factors; Arthritis; Clinical Trial Research; Dysphonia; Quality of Life; Rheumatoid Arthritis; VoiceDisorders; Top News; All News; Professional News SUBJECT HEADING: Arthritis Risk Factors (c)Copyright 2008, Life Science Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/108 (Item 55 from file: 135) 0000735640 (THIS IS THE FULLTEXT) Findings from University of Cincinnati broaden understanding of speech Life Science Weekly, January 29, 2008, p.2170 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 404 TEXT: ANEXO 4: Resultado busqueda en Dialog 8 JAN 29 - ( & NewsRx.net) -- "Students training to be educators frequently exhibit voice disorders prior to employment (see also ). To date, there exist no similar studies of future speech-language pathologists (SLPs)," investigators in the United States report. "The study is designed as a prospective, nonrandomized survey. The objective of this study is to determine the voice problems of first year graduate students training to be SLPs. Participants were 104 first year graduate students majoring in speech-language pathology at two universities. The Quick Screen for Voice was administered. Participants who failed completed a questionnaire regarding voice problems, medical history, daily habits, and voice use. When responses further indicated voice-related problems, endoscopic examination was completed. Fourteen percent (N = 15) of the participants failed the screening by demonstrating two or more abnormal voice characteristics. These included persistent glottal fry (present in all who failed), low habitual pitch, juvenile reson ance, hoarse, breathy, or strained phonation, abnormally low pitch on sustained vowels, and voice breaks during the frequency range. Twelve percent (N = 12) failed both the screening and follow-up questionnaire. Responses included self-reported dysphonia, medical history with voice-related side effects, difficulty with excessive voice use, and voice problems occurring daily or weekly. Endoscopic evaluation showed one participant with bilateral vocal nodules. The results suggest that voice problems among future SLPs (12%) are more common than the 3-9% reported in the general population and similar to the 11% previously reported for teachers. However, future SLP voice problems are less frequent than those reported among education majors (21%) and all college students (17%)," wrote R.O. Gottliebson and colleagues, University of Cincinnati. The researchers concluded: "Faculty should identify students with voice problems and emphasize optimal voice use in classroom and clinical settings." Gottliebson and colleagues published their study in the Journal of Voice (Voice problems of future speech-language pathologists. Journal of Voice , 2007;21(6):699-704). For additional information, contact R.O. Gottliebson, University of Cincinnati, Dept. of Communicable Science & Disorders, 3202 Eden Avenue, Cincinnati, OH 45267, USA. The publisher of the Journal of Voice can be contacted at: Mosby-Elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA. Keywords: United States, Cincinnati, Pathology, Speech, Voice Disorder, University of Cincinnati. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2008, Life Science Weekly via & NewsRx.net. DESCRIPTORS: United States; Cincinnati; Pathology; Speech; Voice DisorderAll News; Professional News SUBJECT HEADING: Speech (c)Copyright 2008, Life Science Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/109 (Item 56 from file: 135) 0000735543 (THIS IS THE FULLTEXT) Researchers from Yale University, Department of Anesthesia detail new studies and findings in the area of seizure therapy Biotech Business Week, January 28, 2008, p.2673 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 403 TEXT: 8 JAN 28 - ( & NewsRx.net) -- New research, 'Vagus nerve stimulation therapy for ANEXO 4: Resultado busqueda en Dialog seizures,' is the subject of a report (see also ). "Of the 3 million patients with seizures in North America approximately 70% have effective seizure control with medications. In the group refractory to medical treatment only a minority fit the criteria for surgical therapy," investigators in the United States report. "Vagus nerve stimulation therapy seems to be a suitable nonpharmacologic therapy for reducing seizure frequency in these cases. It is a simple device with 2 electrodes and an anchor loop implanted on the midcervical portion of left vagus nerve and the impulse generator is implanted subcutaneously in the left in fraclavicular region. The left vagus is the preferred site as the right vagus innervates the sinoatrialnode and influences the heart rate. Data from laboratory studies suggest that it most probably works by increasing the release of norepinephrine in the locus ceruleus, which in turn increases the seizure threshold. More than 32,000 devices have been implanted since it was approved in 1997. There is class I evidence that vagus nerve stimulator reduces the frequency of seizures. In addition it also elevates the patients' moodindependent of seizure control. In one of the studies 50% reduction in seizure frequency was 37% in the first year and 44% in the second and third year. The side effects commonly reported are constriction in the throat, change in voice, and throat pain which most patients are able to tolerate and continue the use of the device," wrote R. Ramani and colleagues, Yale University, Department of Anesthesia. The researchers concluded: "In conclusion VNS seems to be an effective nonpharmacologic therapy for medically refractory partial onset seizures." Ramani and colleagues published their study in the Journal of Neurosurgical Anesthesiology (Vagus nerve stimulation therapy for seizures. Journal of Neurosurgical Anesthesiology , 2008;20(1):29-35). For additional information, contact R. Ramani, Yale University School of Medicine, Dept. of Anesthesia, New Haven, CT 06520-8051 USA.. The publisher of the Journal of Neurosurgical Anesthesiology can be contacted at: Lippincott Williams & Wilkins, 530 Walnut St., Phil adelphia, PA 19106-3621, USA. Keywords: United States, New Haven, Seizure Therapy, Anesthesia, Anesthesiology, Medical Device, Neurosurgery, Pain Medicine, Pharmaceutic als, Seizures, Surgery, Therapy, Treatment, Vagus Nerve Stimulation. This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2008, Biotech Business Week via & NewsRx.net. DESCRIPTORS: United States; New Haven; Seizure Therapy; Anesthesia; Anesthesiology; Medical Device; Neurosurgery ; Pain Medicine; Pharmaceuticals; Seizures; Sur gery; Therapy; Treatment; Vagus Nerve StimulationAll News; Professional News SUBJECT HEADING: Seizure Therapy (c)Copyright 2008, Biotech Business Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/110 (Item 57 from file: 135) 0000728660 (THIS IS THE FULLTEXT) Research from University of Cincinnati yields new findings on speech Life Science Weekly, January 22, 2008, p.3428 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 410 TEXT: 8 JAN 22 - ( & NewsRx.net) -- Research findings, 'Voice problems of future speechlanguage pathologists,' are discussed in a new report (see also ). "Students training to be educators frequently exhibit voice disorders prior to employment. To date, there exist no similar studies of future speech-language pathologists (SLPs)," scientists in the United ANEXO 4: Resultado busqueda en Dialog States report. "The study is designed as a prospective, nonrandomized survey. The objective of this study is to determine the voice problems of first year graduate students training to be SLPs. Participants were 104 first year graduate students majoring in speech-language pathology at two universities. The Quick Screen for Voice was administered. Participants who failed completed a questionnaire regarding voice problems, medical history, daily habits, and voice use. When responses further indicated voice-related problems, endoscopic examination was completed. Fourteen percent (N=15) of the participants failed the screening by demonstrating two or more abnormal voice characteristics. These included persistent glottal fry (present in all who failed), low habitual pitch, juvenile resonance, hoarse, breathy, or strained phonation, abnormally low pitch on sustained vowels, and voice breaks during the frequency range. Twelve percent (N=12) failed both the screening and follow-up questionnaire. Responses included selfreported dysphonia, medical history withvoice-related side effects, difficulty with excessive voice use, and voice problems occurring daily or weekly. Endoscopic evaluation showed one participant with bilateral vocal nodules. The results suggest that voice problems among future SLPs (12%) are more common than the 3-9% reported in the general population and similar to the 11% previously reported for teachers. However, future SLP voice problems are less frequent than those reported among education majors (21%) and all college students (17%)," wrote R.O. Gottliebson and colleagues, University of Cincinnati. The researchers concluded: "Faculty should identify students with voice problems and emphasize optimal voice use in classroom and clinical settings." Gottliebson and colleagues published their study in the Journal of Voice (Voice problems of future speech-language pathologists. Journal of Voice , 2007;21(6):699-704). For additional information, contact R.O. Gottliebson, University of Cincinnati, Dept. of Communication Sciences and Disorders, Cincinnati, Ohio 45267-0379 USA.. The publisher's contact information for the Journal of Voice is: Mosby, Inc., 11830 Westline Industrial Dr., St. Louis, MO 63146-3318, USA. Keywords: United States, Cincinnati, Pathology, Speech, Voice Disorder. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2008, Life Science Weekly via & NewsRx.net. DESCRIPTORS: United States; Cincinnati; Pathology; Speech; Voice DisorderAll News; Professional News SUBJECT HEADING: Speech (c)Copyright 2008, Life Science Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/111 (Item 58 from file: 135) 0000682058 (THIS IS THE FULLTEXT) New data from Taichung Veterans General Hospital, Department of Otolaryngology illuminate research in laryngeal cancer Cancer Weekly, November 13, 2007, p.578 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 316 TEXT: 7 NOV 13 - ( & NewsRx.net) -- Data detailed in 'Laryngeal tuberculosis: a review of 26 cases' have been presented (see also ). In this recently published article, scientists in Taichung, Taiwan conducted a study "To review the clinical characteristics of laryngeal tuberculosis Retrospective case series Medical records of 26 histopathology-confirmed ANEXO 4: Resultado busqueda en Dialog cases in a tertiary medical center from 1992 to 2006 The female patients were significantly younger than male patients. Hoarseness is the most common symptom (84.6%) because true vocal fold is most commonly involved (80.8%)." "Infection usually involves unilateral (66.7%) and right-side larynx but multiple subsites of the larynx (57.7%). The appearance of the affected larynx may have mixed features and change before diagnosis. Laryngeal tuberculosis is usually misdiagnosed as laryngeal cancer, especially in pa tients with malignant signs such as enlarged cervical lymph nodes and vocalfold immobility. Chest film is better than sputum examinations for screening We should be espe cially alert about TB infection when facing young female patients with unusual laryngeal lesions," wrote C.C. Wang and colleagues, Taichung Veterans General Hospital, Department of Otolaryngology. The researchers concluded: "Extensive laser excision before diagnosis should be avoided because after antituberculous treatment, prognosis is usually good and vocal fold immobility could be reversible." Wang and colleagues published their study in Otolaryngology - Head and Neck Surgery (Laryngeal tuberculosis: a review of 26 cases. Otolaryngology - Head and Neck Surgery , 2007;137(4):582-8). For more information, contact C.C. Wang, Taichung Veterans General Hospital, Dept. of Otolaryngology, Taichung, Taiwan. Publisher contact information for the journal Otolaryngology - Head and Neck Surgery is: Mosby, Inc., 11830 Westline Industrial Dr., St. Louis, MO 631463318, USA. Keywords: Taiwan, Taichung, Cutaneous Tuberculosis, Laryngeal Cancer, Laryngeal Neoplasms, Mycobacteria, Mycobacterium Tuberculosis, Oncology, Otolaryngology, Surgery. This article was prepared by Cancer Weekly editors from staff and other reports. Copyright 2007, Cancer Weekly via & NewsRx.net. DESCRIPTORS: Taiwan; Taichung; Cutaneous Tuberculosis; Laryngeal Cancer; Laryngeal Neoplasms; Mycobacteria; Mycobacterium Tuberculosis; Oncology; Otolaryngology; Sur geryAll News; Professional News SUBJECT HEADING: Laryngeal Cancer (c)Copyright 2007, Blood Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/112 (Item 59 from file: 135) 0000663159 (THIS IS THE FULLTEXT) Studies from Mount Sinai School of Medicine, Department of Otolaryngology have provided new data on life sciences Life Science Weekly, October 23, 2007, p.2417 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 253 TEXT: 7 OCT 23 - ( & NewsRx.net) -- A new study, 'Vocal fold masses,' is now available (see also ). "'Vocal fold masses are often complex in nature and can have a devastating result on the professional voice. These lesions are usually multifactorial with synergistic contributions over time from voice use demands and technique, medical conditions, medications, and the environment," investigators in the United States report. "General categories of benign vocal fold masses inprofessional voice include nodules, polyps, and cysts, but other pathology should be considered, such as reactive lesions, intracordal scarring, feeding varices, and reparative granuloma. A perspective on these issues is essential for proper diagnosis and management," wrote K.W Altman and colleagues, Mount Sinai School of Medicine, Department of Otolaryngology. The researchers concluded: ANEXO 4: Resultado busqueda en Dialog "Video procedures for nodule and polyp surgery accompany this content online." Altman and colleagues published their study in Otolaryngologic Clinics of North America (Vocal fold masses. Otolaryngologic Clinics of North America , 2007;40(5):1091-108, viii). For additional information, contact K.W. Altman, The Mount Sinai School of Medicine, Dept. of Otolaryngology, One Gustave L Levy Place, Box 1189, New York City, NY 10029 USA.. The publisher of the journal Otolaryngologic Clinics of North America can be contacted at: W B Saunders Co., Independence Square West Curtis Center, Ste. 300, Philadelphia, PA 19106-3399, USA. Keywords: United States, Box, Life Sciences. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2007, Life Science Weekly via & NewsRx.net. DESCRIPTORS: United States; Box; Life Sciences; All News ; Professional News SUBJECT HEADING: Life Sciences (c)Copyright 2007, Obesity, Fitness & Wellness Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/113 (Item 60 from file: 135) 0000648019 (THIS IS THE FULLTEXT) New glottic cancer study findings reported from M.H. Rigby and co-authors Cancer Weekly, October 9, 2007, p.523 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 407 TEXT: 7 OCT 9 - ( & NewsRx.net) -- "In Canada, endoscopic resection using a CO2 laser has been generally ignored as a treatment option (see also ). In this article, we present an introductory analysis of our clinical experience with the CO2 laser at the QEII Health Sciences Centre in Halifax, Nova Scotia," investigators in Halifax, Canada report. "Out comes from a cohort of 36 patients with glottic cancer staged as Cis-T2 (7 Cis, 17 T1, 12T2) who underwent endoscopic resection using a CO2 laser between January 2002 and June 2005 were studied retrospectively. The mean follow-up was 16.2 months (range 041 months). At the time of the study, no patient had died of laryngeal disease, one pa tient had died of another disease, and one patient was lost to follow-up. There had been three recurrences in the cohort: two local recurrences and one recurrence in a regional lymph node. After salvage, all patients with recurrences were disease free at the time of the study. There were three postoperative complications in the cohort: one postoperative myocardial infarction, one case of respiratory distress postextubation, and one case of subcutaneous emphysema. The average time for the procedure was 0.97 hours (range 0.25-2.75 hours). The average postoperative length of stay was 1.2 days (range 0-12 days). Of 35 cases with follow-up, 60% had no reported problems with voice in their last visit and 11% reported consistent hoarseness or weakness," wrote M.H. Rigby and colleagues. The researchers concluded: "Although our oncologic results do require more follow-up, based on our positive experience thus far, we believe that endoscopic management of glottic cancer is a treatment option that may be underused in the Canadian health care system." Rigby and colleagues published their study in the Journal of Otolaryngology (Endoscopic treatment of cis-t2 glottic cancer with a CO2 laser: Preliminary results from a Canadian centre. Journal of Otolaryngology , 2007;36(2):106-110). For additional information, contact M.H. Rigby, 1667 Chestnut St., Halifax, NS B3H 3T3, Canada. The publisher of the Journal of Otolaryngology can be con- ANEXO 4: Resultado busqueda en Dialog tacted at: B C Decker Inc., 50 King Street East, 2ND Floor, PO Box 620, L C D 1, Hamilton, Ontario L8N 3K7, Canada. Keywords: Canada, Halifax, Glottic Cancer, Glottic Carcinoma, Oncology, Otolaryngology. This article was prepared by Cancer Weekly editors from staff and other reports. Copyright 2007, Cancer Weekly via & NewsRx.net. DESCRIPTORS: Canada; Halifax; Glottic Cancer; Glottic Carcinoma; Oncology; OtolaryngologyAll News; Professional News SUBJECT HEADING: Glottic Cancer (c)Copyright 2007, Life Science Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/114 (Item 61 from file: 135) 0000627487 (THIS IS THE FULLTEXT) Research data from State University of New York update understanding of acid reflux disease in children Life Science Weekly, September 18, 2007, p.753 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 413 TEXT: Researchers detail in "Hoarseness in children: the role of laryngopharyngeal reflux," new data in acid reflux disease. According to a study from the United States, "The role of laryngopharyngeal reflux (LPR) in hoarseness in children is not well studied. The purpose of this study was to determine the prevalence of LPR in hoarse children." "Retrospective chart review identified 337 children with hoarseness over a 3-year period. Data collected: mode of presentation, associated symptoms, endoscopic findings, laboratory test ing, and therapeutic interventions and their outcomes. Mean age at presentation was 7.2+/-4.3 years with a male:female ratio of 1.7:1. Of the 295/337 (88%) children who underwent endoscopy, 107/295 (36%) had LPR changes alone, 86/295 (29%) had vocalfold nodules, 63/295 (20%) had both LPR and vocal fold nodules; and 22/295 (7%) had a finding other than LPR or nodules. Of the children diagnosed with LPR by endoscopy (with or without nodules), 93/170 (55%) underwent at least one additional test for reflux with 69/93 (74%) having a positive test. Of the children diagnosed with LPR by endoscopy, neither cough nor throat clearing was identified in 82/170 (48%) of children. At the first follow-up visit, an average of 3 months from initial presentation, 50% of 169 children who were treated for reflux had improved or resolved. By the second follow-up visit, 4.5 months later, 68% of those children had improved or resolved. LPR appears to be a very common cause of hoarseness in children, and is an increasingly important symptom in identifying children with LPR," wrote B.B. Block and col leagues, State University of New York. The researchers concluded: "Treatment of LPR often results in improvement of hoarseness." Block and colleagues published their study in International Journal of Pediatric Otorhinolaryngology (Hoarseness in children: the role of laryngopharyngeal reflux. . International Journal of Pediatric Otorhinolaryngology , 2007;71(9):1361-9). For more information, contact B.B. Block, State University of New York at Buffalo School of Medicine and Biomedical Sciences, Dept. of Otolaryngology, 3435 Main Street, Buffalo, New York 14214-3013 USA.. Publisher contact information for the International Journal of Pediatric Otorhinolaryngology is: Elsevier Science Ireland Ltd., Customer Relations Manager, Bay 15, Shannon Industrial Estate, Co. Clare, Ireland. Keywords: United States, Buffalo, Acid Reflux Disease, Hoarseness, Laryngopharyngeal Reflux, Otolaryngo - ANEXO 4: Resultado busqueda en Dialog logy, Otorhinolaryngology, Pediatric. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2007, Life Science Weekly via NewsRx.com & NewsRx.net. DESCRIPTORS: United States; Buffalo; Acid Reflux Disease ; Hoarseness; Laryngopharyngeal Reflux; Otolaryngology; Otorhinolaryngology; PediatricAll News; Professional News SUBJECT HEADING: Acid Reflux Disease (c)Copyright 2007, Gastroenterology Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/115 (Item 62 from file: 135) 0000615653 (THIS IS THE FULLTEXT) Recent research from University of Sao Paulo, Brazil, summarized Pharma Business Week, September 3, 2007, p.2950 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 1099 TEXT: Recent research from University of Sao Paulo, Brazil, summarized. This trend article about University of Sao Paulo, Brazil, is an immediate alert from NewsRx to identify de veloping directions of research. Study 1: Scientists discuss in " Vocal evaluation in teachers with or without symptoms" new findings in life sciences. "The aim of this study was to perform voice evaluation in teachers with and without vocal symptoms, identifying etiologic factors of dysphonia, voice symptoms,vocal qualities, and laryngeal lesions. Eighty teachers were divided into two groups: GI (without or sporadic symptoms, 40) and GII (with frequent vocalsymptoms, 40)," researchers in Sao Paulo, Brazil report. "They answered a specific questionnaire, and were subject to a perceptual vocal assessment (maximum phonation time, glottal attack, resonance, coordination of breathing and voicing, pitch, and loudness), GIRBAS scale, and to videolaryngoscopy. Females were predominant in both groups, and the age range was from 36 to 50 years. Elementary teachers predominated, working in classes with 31-40 students. Voicesymptoms and alterations in the perceptual vocal analysis and in the GIRBAS scale were more frequent in GII. In 46 teachers (GI-16; GII-30), videolaryngoscopy exams were abnormal with the vocal nodules being the most frequent lesions," wrote E.L. Tavares and colleagues, University of Sao Paulo, Department of Otolaryngology. The researchers concluded: "These results indicate that a teacher's voice is compromised, and requires more attention including control of environmental factors and associated diseases, preventive vocal hygiene, periodic laryngeal examinations, and access to adequate specialist treat ment." Tavares and colleagues published their study in the Journal of Voice (Vocal evaluation in teachers with or without symptoms. . Journal of Voice , 2007;21(4):407-14). For additional information, contact E.L. Tavares, Sao Paulo State University (UNESP), Dept. of Otolaryngology, Botucatu City, Sao Paulo, Brazil. Study 2: Ketoprofen (KP) transdermal delivery is investigated as well as the influence of dioleylphosphatidylcholine (DOPC) on skin permeation. "Considering that most inflammatory diseases occur locally and near the body surface, transdermal deliv ery of nonsteroidal anti-inflammatory drugs (NSAIDs) may be an interesting strategy for delivering these drugs directly to the diseased site. To optimize ketoprofen (KP) trans dermal delivery we investigated the influence of dioleylphosphatidylcholine (DOPC) on skin permeation," report researchers writing in the journal Pharmaceutical Research . ANEXO 4: Resultado busqueda en Dialog M.T.J. Garcia and colleagues, University of Sao Paulo, explained, "The formulations stud ied were: i) a physical mixture of KP and DOPC and ii) DOPC and KP complex, in a molar ratio of 1:3, obtained by dissolution of the components in chloroform followed by drying under a N-2 atmosphere. Both systems were dispersed in mineral oil and the in vitro percutaneous was assayed by absorption using a flow through diffusion cell. Differential Scanning Calorimetry (DSC) and H-1 NMR studies were carried out to characterize KP and DOPC interactions. "Geometry optimizations using Density Functional Theory and semiempirical methods, as well as a flexible docking procedure were carried out to obtain a binding model for KP with DOPC. KP solubility and partition studies in the formula tions, as well as skin irritation and hypersensitivity assays were also carried out. DSC de terminations in the complex showed enthalpy and temperature depressions, indicating KP and DOPC interaction." They continued, "In addition, dipole-dipole interactions between the KP carboxylic acid and OH groups in phospholipids were shown by H-1 NMR studies. Based on the NMR studies, a KP-DOPC binding model is proposed, in which KP is involved by the two long aliphatic chains of the phospholipid. Solubility studies indicated that DOPC improved drug solubility. KP permeation was enhanced by both formulations tested, but the complex also increased its skin uptake. Such behavior could be attributed to the solubilizing, melting and enhancing effects of DOPC." The researchers concluded, "Skin irritation and hypersensitivity were not significantly changed compared to control, suggesting that the formulation may be therapeutically explored for KP transdermal de livery." Garcia and colleagues published their study in Pharmaceutical Research (Trans dermal delivery of ketoprofen: The influence of drug-dioleylphosphatidylcholine interac tions. Pharm Res, 2006;23(8):1776-1785). For additional information, contact M.V.L.B. Bentley, University of Sao Paulo, Faculdade de Ciencias Farmaceuticas de Ribeirao Preto, Av do Cafe S-N, BR-14040903 Sao Paulo, Brazil. Study 3: Postsurgical infections are reduced with specialized nutrition support. According to a recently published report from Brazil, "The objective was to examine the relationship between pre-, peri-, and postoperative specialized nutritional support with immune-modulating nutrients and postoperative morbidity in patients undergoing elective surgery. "Studies were identified by searching MEDLINE, review article bibliographies, and abstracts and proceedings of scientific meet ings. All randomized clinical trials in which patients were supplemented by the IMPACT formula before and/or after elective surgery and the clinical outcomes reported were included in the meta-analysis." "Seventeen studies (n=2,305), 14 published (n=2,102), and 3 unpublished (n=203), fulfilled the inclusion criteria. Ten studies (n=1,392) ex amined the efficacy of pre- or perioperative IMPACT supplementation in patients under going elective surgery, whereas 7 (n=913) assessed postoperative efficacy. "Fourteen of the studies (n=2,083) involved gastrointestinal (GI) surgical patients. Postoperative complications, mortality, and length of stay in hospital (LOS) were major outcomes of in terest," D.L. Waitzberg and colleagues at the University of Sao Paulo wrote. "IMPACT supplementation, in general," reported investigators, "was associated with significant (39-61%) reductions in postoperative infectious complications and a significant decrease in LOS in hospital by an average of 2 days. "The greatest improvement in postoperative outcomes was observed in patients receiving specialized nutrition support as part of their preoperative treatment. In GI surgical patients, anastomotic leaks were 46% less prevalent when IMPACT supplementation was part of the preoperative treatment." Waitzberg concluded, "This study identifies a dosage (0.5-1 l/day) and duration (supplementation for 57 days before surgery) of IMPACT that contributes to improved outcomes of morbidity in elective surgery patients, particularly those undergoing GI surgical procedures. "The cost effectiveness of such practice is supported by recent health economic analysis. Findings suggest preoperative IMPACT use for the prophylaxis of postoperative complica tions in elective surgical patients." Waitzberg and colleagues published their study in World Journal of Surgery (Postsurgical infections are reduced with specialized nutrition support. World J Surg, 2006;30(8):1592-1604). For more information, contact D.L. Waitzberg, University of Sao Paulo, School Medical, Dept. of Gastroenterology, LIM 35, Sao Paulo, Brazil. Keywords: Sao Paulo, Brazil, Postoperative Infection, Nutritional Sup port, Morbidity, Elective Surgery, Gastroenterology. This article was prepared by Pharma Business Week editors from staff and other reports. Copyright 2007, Pharma Business ANEXO 4: Resultado busqueda en Dialog Week via NewsRx.com & NewsRx.net. DESCRIPTORS: All News; Professional News SUBJECT HEADING: University of Sao Paulo, Brazil (c)Copyright 2007, Biotech Business Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/116 (Item 63 from file: 135) 0000614992 (THIS IS THE FULLTEXT) Scientists at National Cancer Center Hospital East, Department of Surgery publish new data on squamous cell carcinoma Cancer Weekly, September 4, 2007, p.412 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 347 TEXT: Fresh data on squamous cell carcinoma are presented in the report "Surgical management of carcinoma of the cervical esophagus. The aim of the present study was to clarify the clinicopathological characteristics, reconstruction methods after resection, and prognosis of cervical esophageal squamous cell carcinoma. Seventy-four with squamous cell carcinomas of the cervical esophagus not previously treated who underwent cervical esophagectomy or total esophagectomy with or without laryngectomy were retrospectively analyzed," scientists in Kashiwa, Japan report. "The operative morbidity and in-hos pital mortality rates were 34% (25 patients) and 4% (3 patients), respectively. Alimentary continuity was achieved with free jejunal transfer (50 patients), gastric pull-up (19 patients), and other procedures (5 patients). The frequencies of postoperative complications and death did not differ between free jejunal transfer and gastric pull-up. The over all 3-and 5-year survival rates were 42% and 33%, respectively. The significant clinicopathological factors affecting survival were patient gender, high T factor, lymph node involvement, palpable cervical lymph nodes, vocal cord paralysis, lymphatic invasion, and extracapsular invasion. The pattern of first failure was most often locore gional (82%, 36 patients). The choice of free jejunal transfer or gastric pull-up for reconstruction after surgical resection of cervical esophageal carcinoma depends on the degree of tumor extension," wrote H. Daiko and colleagues, National Cancer Center Hospital East, Department of Surgery. The researchers concluded: "Adverse factors affecting survival should be considered when candidates for the surgery are selected." Daiko and colleagues published their study in the Journal of Surgical Oncology (Surgical manage ment of carcinoma of the cervical esophagus. . Journal of Surgical Oncology , 2007;96(2):166-72). For more information, contact H. Daiko, National Cancer Center Hospital East, Dept. of Surgery, Kashiwa, Chiba, Japan. Publisher contact information for the Journal of Surgical Oncology is: Wiley-Liss, Division John Wiley & Sons Inc., 111 River St., Hoboken, NJ 07030, USA. Keywords: Japan, Kashiwa, Esophageal, Esophagectomy, Gastroenterology, Oncology, Squamous Cell Carcinoma, Surgical Oncology. This article was prepared by Cancer Weekly editors from staff and other reports. Copyright 2007, Cancer Weekly via NewsRx.com & NewsRx.net. DESCRIPTORS: Japan; Kashiwa; Esophageal; Esophagectomy; Gastroenterology; Oncology; Squamous Cell Carcinoma; Surgical OncologyAll News;Professional News SUBJECT HEADING: Squamous Cell Carcinoma ANEXO 4: Resultado busqueda en Dialog (c)Copyright 2007, Cancer Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/117 (Item 64 from file: 135) 0000590768 (THIS IS THE FULLTEXT) Findings from Johns Hopkins University, U.S., research reported Biotech Business Week, August 13, 2007, p.2672 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 1187 TEXT: Findings from Johns Hopkins University, U.S., research reported. This trend article about Johns Hopkins University, U.S., is an immediate alert from NewsRx to identify de veloping directions of research. Study 1: A new study, "Noradrenergic projections to the song control nucleus area X of the medial striatum in male zebra finches (Taeniopygia guttata)," is now available. According to recent research from the United States, "There is considerable functional evidence implicating norepinephrine in modulating activity in the vocal control circuit of songbirds. However, our knowledge of noradrenergic inputs to the song system is incomplete." "In this study, cholera toxin subunit B (CTB) injections into area X revealed projections from the noradrenergic nuclei locus coeruleus and subcoeruleus, and injections of biotinylated dextran amines into these noradrenergic nuclei labeled fibers in area X. The nonreciprocity of this connection was demonstrated by the absence of retrogradely labeled cells in area X following injections of CTB into the locus coeruleus. Additionally, we found novel inputs to area X from the nidopallium and ar copallium, the mesencephalic central gray, and the dorsolateralis anterior (DLL) and pos terior (DLP) lateralis in the thalamus. Area X can be clearly distinguished from the sur rounding medial striatum based on cytoarchitectural and chemical neuroanatomical cri teria. We show here that neuromodulatory inputs to area X however, exhibit a considerable degree of overlap with the surrounding area. This finding suggests that regional specificity in neuromodulator action is most likely afforded by a specialization in receptor density and enzyme distribution rather than projections from the synthesizing nuclei. Our results extend current knowledge about noradrenergic projections to specialized nuclei of the song control circuit and provide neuroanatomical evidence for the functional action of norepinephrine-modulating context-dependent ZENK expression in area X," wrote C.B. Castelino and colleagues, Johns Hopkins University. The researchers concluded: "Furthermore, the novel projections to area X from telencephalic and thalamic areas could be new and interesting nodes in the striatopallidothalamic loop spanning the songbird brain." Castelino and colleagues published their study in the Journal of Comparative Neurology (Noradrenergic projections to the song control nucleus area X of the medial striatum in male zebra finches (Taeniopygia guttata). . Journal of Comparative Neurology , 2007;502(4):544-62). For additional information, contact C.B. Castelino, Johns Hopkins University, Dept. of Psychological and Brain Sciences, Baltimore, Maryland 21218 USA. Study 2: Decreasing abdominal fat appears to improve cardiac size and left ventricular diastolic function. According to a study from the United States, "To determine exercise training effects on cardiac size and left ventricular (LV) diastolic function and relationships of exercise induced changes in physiological and body composition parameters with cardiac parameters." K.J. Stewart and colleagues at the Johns Hopkins School of Medicine conducted a "prospective, randomised controlled trial. Men and women (63.6 (5.7) years, body mass index 29.5 (4.4) kg/m 2 ) with untreated hypertension (systolic blood pressure (BP) 130-159 or diastolic BP 85-99 mm Hg) [were included]. [Main outcome measures were] cardiac size and LV diastolic func - ANEXO 4: Resultado busqueda en Dialog tion, peak oxygen uptake (Vo ), muscle strength, general and abdominal fatness, and in sulin resistance. [Subjects underwent] 6 months of exercise training versus usual care." The data revealed, "When analysed by group at 6 months, cardiac size and LV diastolic function did not differ between exercisers (n=51) and controls (n=53), whereas exercisers had significantly higher peak Vo (28 v 24 mL/kg/min) and strength (383 v 329 kg), and lower fatness (34% v 37%), diastolic BP (73 v 75 mmHg) and insulin resistance (quantitative insulin sensitivity check index 0.35 v 0.34) versus controls (all pless than or equal to0.05). By regression analysis, among 6 month changes, increased peak Vo and reduced abdominal fat were associated with increased cardiac size. Increased peak Vo and reduced abdominal fat, BP and insulin resistance were associated with improved LV diastolic function. r Values ranged from 0.20 to 0.32 (pless than or equal to0.05)." The researchers concluded, "When examined by group assignment, exercise had no effect on cardiac size or LV diastolic function. When individual variations in 6 month changes were examined, participants attaining the greatest increases in fitness and re ductions in abdominal fatness, insulin resistance and BP showed a modest trend towards physiological hypertrophy characterised by increased cardiac size and improved LV dia stolic function. These results suggest that decreased abdominal fatness may have a role in improving cardiovascular health." Stewart and colleagues published the results of their research in Heart (Exercise effects on cardiac size and left ventricular diastolic function: relationships to changes in fitness, fatness, blood pressure and insulin resistance. Heart, 2006;92(7):893-898). For additional information, contact K.J. Stewart, Johns Hopkins School of Medicine, 4940 Eastern Avenue, Baltimore, MD 21224, USA. Study 3: The Adult neural stem and progenitor cell niche is altered in the amyotrophic lateral sclerosis brain. "Amyotrophic lateral sclerosis (ALS) is a fatal adult human disease caused by mo tor neuron degeneration. Stem cell therapy might be a treatment for ALS," researchers in the United States report. According to Z.P. Liu and colleagues at Johns Hopkins Uni versity, "The adult mammalian forebrain has neural stem cells (NSCs) and neural pro genitor cells (NPCs) in the anterior subventricular zone (SVZa), rostral migratory stream (RMS), olfactory bulb (OB) core, and dentate gyrus (DG). "These cells could be used to rescue or replace degenerating upper and lower motor neurons through endogenous recruitment or autologous/allogenic transplantation." "We evaluated the competency of forebrain NSCs and NPCs in transgenic (tg) mice harboring human mutant superoxide dismutase-1 (mSOD1), a model of ALS. Tg human wild-type SOD1 (wtSOD1) mice and non-tg mice were controls. "Bromodeoxyuridine (BrdU) labeling of cells, a marker for cell proliferation and other events, was reduced in a niche-specific pattern in presymptomatic and symptomatic mice, with the SVZa having greater reductions than the RMS, OB, and DG," investigators said. Scientists continued, "Different NSC and NPC complements were evaluated by localizing nestin, neural cell adhesion molecule, distalless-2 transcription factor, vimentin, and glial fibrillary acidic protein. "In symptomatic mice, NSC markers were reduced, whereas NPC markers were unchanged or elevated. Neurogenesis was preserved in symptomatic mSOD1 mice. NSC/NPC competence assessment in vitro revealed that mSOD1 SVZa cells had the ability to proliferate and form neurospheres but had an impaired response to mitogen stimulation." The authors concluded that adult "mSOD1 ALS mice have abnormalities in forebrain NSCs, but the essential features of NSC/NPCs remained in presymptomatic and symptomatic mice." Liu and colleagues pub lished their study in the Journal of Comparative Neurology (The adult neural stem and progenitor cell niche is altered in amyotrophic lateral sclerosis mouse brain. J Comp Neurol, 2006;497(3):468-488). For additional information, contact L.J. Martin, Johns Hopkins University, School Medical, Dept. of Pathology, Division Neuropathology, 558 Ross Bldg, 720 Rutland Avenue, Baltimore, MD 21205, USA. Keywords: Baltimore, Maryland, United States, Adult Neural Stem Cell Niche, Amyotrophic Lateral Sclerosis, Mouse Brain, Neurogenesis. This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2007, Biotech Business Week via NewsRx.com & NewsRx.net. DESCRIPTORS: All News; All News; Professional News SUBJECT HEADING: Johns Hopkins University, U.S. ANEXO 4: Resultado busqueda en Dialog (c)Copyright 2007, Health & Medicine Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/118 (Item 65 from file: 135) 0000586821 (THIS IS THE FULLTEXT) Findings from University Politecnica of Madrid in voice disorders pathology reported Life Science Weekly, August 7, 2007, p.4105 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 403 TEXT: New research, "Evaluation of voice pathology based on the estimation of vocal fold biomechanical parameters," is the subject of a report. According to recent research published in the Journal of Voice , " Voice disorders are a source of increasing concern as normal voice quality is a social demand for at least one third of the population in de veloped countries in cases where voice is an essential resource in professional exercise. In addition, the growing exposure to certain pathogenic factors such as smoking, alcohol abuse, air pollution, and acoustic contamination, and other problems such as gastro-esopharyngeal reflux or allergy as well as aging, aggravate voice disorders." "Voice pathologies justify the assignment of larger resources to prevention policies, early detection, and less aggressive treatments. Traditional pathology detection relies on perceptive evaluation methods (GRABS), acoustic analysis, and visual inspection (indir ect laryngoscopy, and modern fibro-endo-stroboscopy). This article describes a method for voice pathology detection based on the noninvasive estimation of vocal cord biomechanical parameters derived from voice using specific signal processing methods. Preliminary results using records from patients showing four frequent causes of voicepathology (nodules, polyps, chronic laryngitis, and Reinke's edema) are given. The results show that the alteration (distortion, unbalance, or deviation) of cord biomechanical parameters may serve as an indicator of pathology. Statistical methods based on hier archical clustering and principal component analysis reveal that combining biomechanical estimates with classic perturbation parameters increases the accuracy of acoustic analys is, improving the detection of voice pathology," wrote P. Gsmez-Vilda and colleagues, University Politecnica of Madrid. The researchers concluded: "This research could open new possibilities for noninvasive screening of vocal fold pathologies and could be used in the implantation of e-health voice care services." Gsmez-Vilda and colleagues published their study in the Journal of Voice (Evaluation of voice pathology based on the estimation of vocal fold biomechanical parameters. Journal of Voice , 2007;21(4):450-76). For additional information, contact P. Gsmez-Vilda, Universidad Politecnica de Madrid, Dept. of Arquitectura y Tecnologia de Sistemas Informaticos, Facultad de Informatica, Madrid, Spain. The pub lisher's contact information for the Journal of Voice is: Mosby, Inc., 11830 Westline Industrial Dr., St. Louis, MO 63146-3318, USA. Keywords: Spain, Madrid, Voice Disorders Pathology, Biomechanic, Biomechanics, Biotechnology, Pathology, Voice Disorder. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2007, Life Science Weekly via NewsRx.com & NewsRx.net. DESCRIPTORS: All News; Professional News; All News; Professional News SUBJECT HEADING: Voice Disorders Pathology ANEXO 4: Resultado busqueda en Dialog (c)Copyright 2007, Life Science Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/119 (Item 66 from file: 135) 0000548695 (THIS IS THE FULLTEXT) Studies from State University of New York, U.S., highlight most recent research Pharma Business Week, June 18, 2007, p.3110 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 1268 TEXT: Studies from State University of New York, U.S., highlight most recent research. This trend article about State University of New York, U.S., is an immediate alert from News Rx to identify developing directions of research. Study 1: Researchers detail in "Protecting our patients from HPV and HPV-related diseases: the role of vaccines," new data in cancer. According to recent research from the United States, "The clinical burden of disease resulting from human papillomavirus (HPV) infection is substantial and extends from genital warts to cytologic abnormalities to cervical, vaginal, and vulvar cancers and their associated precursor lesions. In addition, HPV is implicated in anal, penile, and head and neck cancers." "Thus, HPV-related disease constitutes a significant burden for both men and women. Large phase 2 and 3 clinical trials with a quadrivalent preventive HPV vaccine (HPV 6/11/16/18) and phase 2 trials with a bivalent preventive HPV vaccine (HPV 16/18) have demonstrated that both products are highly efficacious in preventing type-specific HPV infections and HPV-related disease and are well tolerated. Nearly all re cipients demonstrate a robust immunologic response that currently appears to be dur able for 4 or more years. Immunogenicity data among girls 9 to 15 years of age were used to "bridge" efficacy data from quadrivalent HPV vaccine trials completed to date. In June 2006, the US Food and Drug Administration approved the quadrivalent HPV vaccine for use among females 9 to 26 years of age. The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices has recommended the 3-dose series for girls 11 to 12 years of age, catch-up vaccination for girls and women 13 to 26 years of age, and permissive use as early as age 9. Computer models projecting the impact of these preventive HPV vaccines predict that they will be cost-effective and benefi cial to the population; the use of preventive HPV vaccines will complement continued cytologic screening programs. Trials are under way to evaluate the duration of immune response as well as efficacy among men and women 27 years of age and older," wrote M.C Mahoney and colleagues, State University of New York, Roswell Park Cancer Institute. The researchers concluded: "Girls and women within the targeted age ranges should be offered vaccination to achieve the disease prevention potential of these vaccines." Mahoney and colleagues published their study in the Journal of Family Practice (Protecting our patients from HPV and HPV-related diseases: the role of vaccines. Journal of Family Practice, 2006;Suppl():10-7). For additional information, contact M.C. Ma honey, State University of New York at Buffalo USA., Dept. of Health Behavior, Roswell Park Cancer Institute. Study 2: As part of a new study, SUNY Upstate Medical University physicians will use traffic surveillance cameras to view motor vehicle crashes and rescue operations on Central New York highways in hopes of learning how to provide better care to crash victims when they arrive in the emergency room. The study - believed to be the first of its kind in the nation - is being funded by the noted U.S. economist Alfred Kahn, who survived a car crash in 2003 and spent weeks recovering from his injuries at SUNY Upstate's teaching hospital, University Hospital. For the study, SUNY Upstate researchers will have access to nearly 20 closed-circuit video cameras installed in and around Syra - ANEXO 4: Resultado busqueda en Dialog cuse by the New York state Department of Transportation (DOT). These cameras are monitored by the DOT's Syracuse office 24 hours a day to assess traffic conditions in the area. The cameras, controlled by DOT personnel, can pan, tilt and zoom to particular areas of the roadway. Eleven cameras cover a 12-mile stretch of Interstate 81; 8 additional cameras will be in place shortly to cover a 12-mile stretch of Interstate 690. A special receiving antenna brings the real time images into a specially outfitted worksta tion located near University Hospital's trauma room. Here, medical personnel can view the crash scene and rescue efforts on a computer monitor. The technology for the workstation was provided by CXtec. When a crash occurs, DOT personnel will alert SUNY Upstate researchers and refer them to a particular camera to view the crash. Once the image is available on the computer Researchers can begin recording the images and provide the DOT staff with instructions on whether to zoom or pan the camera. "We think the ability to view real time images of the accident scene to see the extent of damage and the response from paramedics can provide us with a wealth of information that may help us better treat the accident victims when they arrive at the emergency room," said John McCabe, MD, professor and chair of the Department of Emergency Medicine at SUNY Upstate. Currently, first responders to an accident scene communicate with physicians via radio about the extent of injuries of those being transported to the hospital. They may also provide physicians with information about what the accident scene looks like and relay information about the accident from eyewitness accounts, if available. Study 3: Elective lymph node (LN) excision might reduce morbidity and improve local control in older patients with papillary thyroid cancer. Researchers in the United States conducted a study "to determine the incidence of nodal involvement and assess the role of elective LNB exploration and/or dissection in staging of tumors and treatment of pa tients with papillary thyroid cancer. One hundred patients diagnosed with papillary thyroid cancer by fine-needle aspiration or intraoperative frozen section who underwent total thyroidectomy with central compartment cervical LN exploration. [The] incidence of positive LNs in patients 45 years or older (group A) [was compared to] those younger than 45 years (group B)." "Sixteen (39%) of 41 patients in group A had positive LN status following LN exploration and/or dissection," explained M. Shindo and colleagues, State University of New York. "Seventeen (29%) of 59 patients in group B were found to have positive LNs. According to the American Joint Committee on Cancer staging system, the tumors of 11 patients (28%) in group A would be restaged from stage I/II to stage III after establishment of the positive pathologic nodal status. Lymph node metastasis was present in the central compartment in 39% of patients in group A. "Presence of LN metastasis in older patients has been reported to increase the risk of recurrence of papillary thyroid carcinoma. Furthermore, recurrence and reoperation in the central compartment is associated with a higher risk of vocal cord paralysis. In patients in group A diagnosed with papillary thyroid carcinoma, routine central compartment LN exploration and/or dissection at the time of thyroidectomy is advocated, which allows more accurate staging of tumors and appropriate treatment." The researchers concluded, "Elective excision of central compartment LNs in this older age group may improve locoregional con trol and possibly reduce morbidity in the long run." Shindo and colleagues published their study in n Archives of Otolaryngology - Head & Neck Surgery (The importance of central compartment elective lymph node excision in the staging and treatment of papillary thyroid cancer. Arch Otolaryngol Head Neck Surg, 2006;132(6):650-654). For additional information, contact M. Shindo, State University of New York, Dept. of Surgery, Division Otolaryngology Head & Neck Surgery, HSC, 19th Floor, Stony Brook, NY 11794, USA. Keywords: Stony Brook, New York, United States, Diagnostics, Endocrinology, Geriatrics, Laryngology, Diagnosis, Local Control, Morbidity, Oncology, Otolaryngology, Otorhinolaryngology, Papillary Thyroid Cancer, Paralysis, Risk Factor, Thyroid Carcinoma, Vocal Cord. This article was prepared by Pharma Business Week editors from staff and other reports. Copyright 2007, Pharma Business Week via NewsRx.com & NewsRx.net. DESCRIPTORS: All News; Professional News; All News; Professional News SUBJECT HEADING: State University of New York, U.S. ANEXO 4: Resultado busqueda en Dialog (c)Copyright 2007, Pharma Business Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/120 (Item 67 from file: 135) 0000543709 (THIS IS THE FULLTEXT) Research from University of Bern, Switzerland, provides new insights into human health Science Letter, June 12, 2007, p.3135 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 1112 TEXT: Research from University of Bern, Switzerland, provides new insights into human health. This trend article about University of Bern, Switzerland, is an immediate alert from NewsRx to identify developing directions of research. Study 1: Research findings, "Vocal cord dysfunction: dealing with aggressivity," are discussed in a new report. Ac cording to recent research from Bern, Switzerland, "QUESTIONS UNDER STUDY: Vocal cord dysfunction (VCD) is characterised by recurrent attacks of paradoxical adduction of the vocal cords during inspiration, accompanied clinically by dyspnoea attacks with inspiratory stridor lasting between minutes and hours. The aim of the study is to evalu ate the self-perception of patients suffering from VCD and how they deal with aggressivity." "The Giessen Test (GT) and the Picture Frustration Test (PFT) were used on 6 patients with VCD. Five variables show significant differences between the patients with VCD and the values of the normative groups. VCD-patients show an idealized image of themselves, ie relaxed, open, sociable, and capable of devotion. They do not reject accusations against them by others and rarely make self-criticism. In conflicts they behave passively, thus blocking their expression of aggressivity. In many cases organic disposi tion and trigger stimuli are thought to be responsible for provoking dyspnoea attacks in VCD. However, the self-perception of patients and their way of dealing with aggressivity strongly suggests that psychosocial factors play a great role in the development of VCD," wrote E. Seifert and colleagues, University of Bern. The researchers concluded: "This requires not only symptom-orientated therapy but also psychological counselling." Seifert and colleagues published their study in Swiss Medical Weekly (Vocal cord dysfunction: dealing with aggressivity. Swiss Medical Weekly, 2007;137(7-8):127-9). For additional information, contact E. Seifert, University of Bern, Division of Phoniatrics, ENT-Clinic, Head and Neck Surgery, Bern, Switzerland. Study 2: Pelvic lymph node dissection (PLND) is warranted in prostate cancer patients undergoing radical prostatectomy with a serum level of PSA <10 ng/ml. "Controversy persists concerning the role of PLND in patients with preoperative PSA values <10 ng/ml undergoing treatment for prostate cancer with a curative intent. The aim of this study was to determine the incidence of lymph node metastasis in this subgroup of patients," scientists in Switzerland reported. "Patients with clinically localized prostate cancer and a serum PSA <10 ng/ml, without neoadjuvant hormonal or radiotherapy, with negative staging examinations who under went radical retropubic prostatectomy with bilateral extended PLND and with greater than or equal to10 lymph nodes detected by the pathologist in the surgical specimen, were included in the study," explained M.C. Schumacher and colleagues, University of Bern. "A total of 231 patients with a median serum PSA of 6.7 ng/ml (range 0.4-9.98) and a median age of 62 years (range 44-76) were evaluated. A median of 20 (range 1072) nodes were removed per patient. Positive nodes were found in 26 of 231 patients (11%), the majority of which (81%) had a Gleason score greater than or equal to7 in the ANEXO 4: Resultado busqueda en Dialog surgical specimen. "Of the patients with a Gleason score greater than or equal to7 in the prostatectomy specimen 25% had positive nodes, whereas only 3% with a Gleason score less than or equal to6 were node positive. The incidence of positive nodes in patients with clinically localized prostate cancer, a serum PSA <10 ng/ml and a Gleason score greater than or equal to7 in the prostatectomy specimen was 25% after extended PLND," informed the team. The researchers concluded, "It seems that in this patient group extended PLND, including removal of nodes along the internal iliac vessels, is warranted." Schumacher and colleagues published their study in n European Urology (Is pelvic lymph node dissection necessary in patients with a serum PSA <10 ng/ml undergoing radical prostatectomy for prostate cancer? Eur Urol, 2006;50(2):272-279). For more information, contact U.E. Studer, University of Bern, Dept. of Urology, CH-3010 Bern, Switzerland. Study 3: Apolipoprotein B is a long-term predictor of mortality in type 1 diabetes mellitus. According to a study from Switzerland, "To evaluate the association of apolipoprotein B (apo B) with mortality due to all causes, to cardiac disease and to ischaemic heart disease (IHD) in subjects with type 1 diabetes mellitus. 165 subjects with type 1 diabetes included in the Swiss Cohort of the WHO Mul tinational Study of Vascular Disease in Diabetes were followed for 14.7+/-0.45 years. Causes of death were obtained from death certificates, hospital records and postmortem reports." "Using a parametric proportional hazards model the association of apo B with mortality rates was assessed by time-to-event analysis, including the absolute cumulat ive mortality risk over time for various apo B levels at baseline," wrote C. Stettler and colleagues, University of Bern. They discovered, "Apo B was positively associated with all-cause mortality [hazard ratio (HR) 2.65 per g/L increase of apo B, 95% CI: 1.116.36, p=0.029], cardiac mortality (HR 11.64, 1.03-131.11, p=0.047) and IHD mortality (HR 9.36, 1.26-69.66, p=0.029). An apo B greater than or equal to0.96 g/L translated into a duplication of overall mortality hazard (HR 1.93, 1.00-3.72, p=0.050), and a sevenfold increase of mortality because of cardiac disease or IHD (HR 7.44, 1.44-38.42, p=0.017 and HR 7.38, 0.78-69.82, p=0.081). "A baseline apo B of 1.5 g/L predicted an absolute cumulative risk to die over the next 10 years of 12.1% (5.2-31.7) for male and of 10.4% (4.7-26.1) for female subjects whereas risks were 6.3% (1.8-21.4) and 5.4% (0.8-15.8) for an apo B of 0.8 g/L." The researchers concluded, "Apo B is consistently associated with an increased mortality in type 1 diabetes." Stettler and colleagues pub lished the results of their research in the Journal of Internal Medicine (Apolipoprotein B as a long-term predictor of mortality in type 1 diabetes mellitus: a 15-year follow up. J Intern Med, 2006;260(3):272-280). For additional information, contact C. Stettler, University of Bern, Inselspital, Division Endocrinol & Diabetes, CH-3010 Bern, Switzerland. Keywords: Bern, Switzerland, Angiology, Apolipoproteins, Cardiology, Cardiovascular Risk Factors, Dermatology, Diabetes, Diabetes Mellitus, Heart Disease, Lipoprotein, Mortality, Mortality Risk, Neurology, Apolipoprotein B, Vascular Disease, Type 1 Diabetes Mellitus, Ischemic Heart Disease, Type 1 Diabetes, Cardiovascular Disease. This article was prepared by Science Letter editors from staff and other reports. Copyright 2007, Science Letter via NewsRx.com & NewsRx.net. DESCRIPTORS: All News; Professional News; All News; Professional News SUBJECT HEADING: University of Bern, Switzerland (c)Copyright 2007, Life Science Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/121 (Item 68 from file: 135) 0000534060 (THIS IS THE FULLTEXT) New data from University of Utah, U.S., detailed Biotech Business Week, May 28, 2007, p.2015 DOCUMENT TYPE: Expanded Reporting ANEXO 4: Resultado busqueda en Dialog LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 1266 TEXT: New data from University of Utah, U.S., detailed. This trend article about University of Utah, U.S., is an immediate alert from NewsRx to identify developing directions of re search. Study 1: Fresh data on behavior are presented in the report "Behavioral characteristics of children with vocal fold nodules." According to recent research published in the Journal of Voice , "Vocal fold nodules (VNs) in children are benign, bilateral lesions occurring on the mid-membranous vocalfolds. Repetitive phonotraumatic behavior leading to chronic vocal fold injury and repair is frequently cited as the primary etiology; however, specific behavioral characteristics may predispose some children toward intense and potentially phonotraumatic voice use, thereby contributing secondarily to VN formation." "The purpose of this case-control study was to determine whether children with VNs possess unique behavioral characteristics that may predispose them to VN develop ment. Parents of 26 children with VNs (20 boys, 6 girls, mean age=7.2 years, SD=2.5 years), and 29 vocally normal, medical controls (22 boys, 7 girls, mean age=6.7 years, SD=2.4), completed the Childhood Behavior Checklist (CBCL/4-18, Achenbach, 1991), a standardized parent-rating scale with strong psychometric properties. No significant between-group differences were detected on any of the behavior problem syndrome scales. Group differences approached significance for the individual items "screams a lot" and "teases a lot" (VN group >Controls). The VN group scored significantly higher than the controls on the "Social Scale," a compilation of positive ratings of the child's social activity, frequency of contacts with friends, behavior with others, and behavior by them selves," wrote N. Roy and colleagues, University of Utah. The researchers concluded: "Observed outcomes were consistent with previous characterizations of children with VN as "outgoing" or "extroverted" but were not consistent with other claims that this popu lation may be at risk for "aggressive, attentional," or "impulsive" behavior problems." Roy and colleagues published their study in the Journal of Voice (Behavioral characteristics of children with vocal fold nodules. Journ al of Voice, 2007;21(2):157-68). For additional information, contact N. Roy, The University of Utah, From the Dept. of Communication Sciences and Disorders, Salt Lake City, UT 84112-0252 USA. Study 2: It's a case of miscommunication with catastrophic consequences. Two human blood cells that help fight blood loss, infection, and inflammation are responsible as well for starting a series of molecular events that results in overproduction of Cox-2, an enzyme involved in heart attack, stroke, atherosclerosis, and other inflammatory diseases. The finding by researchers at the University of Utah and Univer sity of South Carolina means scientists may be able to develop drugs to prevent or lessen the severity of inflammatory diseases, such as atherosclerosis and heart attack. Discovery of the signaling mechanism will be invaluable in sorting out the roles Cox-2 plays in those diseases, according to Guy A. Zimmerman, MD, University of Utah School of Medicine professor of internal medicine, senior author of the study detailing the research. "This discovery has immediate clinical relevance," said Zimmerman, director of the medical school's Program in Human Molecular Biology and Genetics. "This opens the potential of developing medications for both the prevention of long-term atherosclerosis (clogged arteries) and the acute events of heart attack." The study, reported in the Journal of Clinical Investigation online, also was led by Dan A. Dixon, a former member of Zimmerman's lab now at South Carolina. The researchers identified a biochemical signaling pathway between human blood platelets, cells essential for blood clotting, and monocytes, white blood cells the body makes to fight inflammation and infection. But, according to Zimmerman, the biological systems involved in blood clotting and inflamma tion also are related to a host of human diseases. The Utah and South Carolina researchers discovered that the blood platelet signals the monocyte two times, triggering produc tion of Cox-2, an enzyme that helps regulate inflammation. But when blood platelets and monocytes get their signals crossed, it can lead to overproduction of the enzyme and ANEXO 4: Resultado busqueda en Dialog result in cardiovascular diseases that strike and kill millions of people worldwide. Zim merman compares the signaling between blood platelets and monocytes to a pair of molecular control switches that turn Cox-2 production on and off. "It's a mechanism for pre cise control of Cox-2 production," he said. "But if one of the switches is turned on too high or low, it can lead to inappropriate production of Cox-2 in disease." The first signal from the platelet tells the monocyte to turn on the gene that provides the instructions necessary to make Cox-2. These instructions are carried in small molecule called messenger RNA. When the blood platelet signals the monocyte, the cell decodes the instruc tions from the Cox-2 gene in a process called transcription. This results in production of messenger RNA that specifically codes for Cox-2. After the messenger RNA is transcribed, the blood platelet then sends a second signal to the monocyte that regulates stability of the Cox-2 messenger RNA and further decoding of the genetic information in a process called translation. This results in production of the Cox-2 protein and controls how much, and at what time point, it is produced. Drugs called non-steroidal anti-inflam matory agents, which inhibit production of Cox-2 and reduce inflammation, are some of the most widely used medications in the world for arthritis and other inflammatory dis eases. But some of these drugs, also called Cox-2 inhibitors, such as Vioxx, increase the chance of heart attack. Study 3: According to recently published research from the United States, cholesteryl oligoArg delivering vascular endothelial growth factor (VEGF) small interfering RNA (siRNA) effectively inhibits tumor growth in colon adenocarcinoma. "VEGF is a multifunctional angiogenic growth factor that is a primary stimulant of the de velopment and maintenance of a vascular network in the vascularization of solid tumors. It has been reported that a blockade of VEGF-mediated angiogenesis is a powerful method for tumor regression. "RNA interference represents a naturally occurring biological strategy for inhibition of gene expression. In mammalian systems, however, the in vivo application of small interfering RNA (siRNA) is severely limited by the instability and poor bioavailability of unmodified siRNA molecules," wrote W.L. Kim and colleagues, University of Utah. "In this study, we tested the hypothesis that a hydrophobically modified protein transduction domain, cholesteryl oligo-D-Arg (Chol-R9), may stabilize and enhance tu mor regression efficacy of the VEGF-targeting siRNA. The noncovalent complexation of a synthetic siRNA with Chol-R9 efficiently delivered siRNA into cells in vitro. "Moreover, in a mouse model bearing a subcutaneous tumor, the local administration of complexed VE GF-targeting siRNA, but not of scrambled siRNA, led to the regression of the tumor," reported the authors. The researchers concluded, "Hence, we propose a novel and simple system for the local in vivo application of siRNA through Chol-R9 for cancer therapy." Kim and colleagues published their study in Molecular Therapy (Cholesteryl oligoarginine delivering vascular endothelial growth factor siRNA effectively inhibits tumor growth in colon adenocarcinoma. Mol Ther, 2006;14(3):343-350). For additional information, contact S.W. Kim, University of Utah, Department of Pharmaceutical & Pharmaceutical Chemistry, Center of Controlled Chemical Delivery, 20 S 2030 E RM 205 BPRB, Salt Lake City, UT 84112, USA. Keywords: Salt Lake City, Utah, United States, Angiogenesis, Cancer Gene Therapy, Colon Adenocarcinoma, Oligoarginine, RNA Interference, Small Interfering RNA, Solid Cancers, Vascular Endothelial Growth Factor. This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2007, Biotech Business Week via NewsRx.com & NewsRx.net. DESCRIPTORS: All News; Professional News; All News; Professional News SUBJECT HEADING: University of Utah, U.S. (c)Copyright 2007, Biotech Business Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/122 (Item 69 from file: 135) 0000533654 (THIS IS THE FULLTEXT) Studies from University Hospital update current data on ultrasound ANEXO 4: Resultado busqueda en Dialog Life Science Weekly, May 29, 2007, p.3345 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 426 TEXT: New research, "The vascularisation of oral cavity tumours and tumour shell tissue determined by three-dimensional power Doppler sonography," is the subject of a report. "The aim of the study was to determine and quantify the vascularity of oral cavity tu mours and peritumoural tissue by using 3-D power Doppler sonography (3-D PDS) and to compare the vascularity of metastatic and nonmetastatic tumours. The investigation was carried out preoperatively on 49 patients with squamous carcinoma of the tongue and floor of the mouth," investigators in Maribor, Slovenia report. "Collected data were analysed with the help of virtual program of computer-aided analysis (VOCAL)-imaging program by which the borders of a structure could be defined and vascularity quantified by analysing 3D colour histograms. Vascularity was defined by three indices, VI-vascular isation index, FI-flow index and VFI-vascularisation-flow index. The vascularity of oral cavity tumours was determined in 4 mm and 7 mm shells surrounding the tumour. Modi fied neck dissection was performed in all of the patients and lymph nodeswere examined histologically. Peritumorous tissue vascularity was significantly higher in metastatic (N+ neck) than it was in nonmetastatic (N0 neck) tumours. Indices VI and VFI in 4 mm and 7 mm shells differed significantly between N+ and N0 tumours (p <0.01). Flow index (FI) did not show any difference between N0 and N+ necks. The difference between vascularity indices VI and VFI of peritumorous tissue and tumor was also varied significantly between N0 and N+ neck (p <0.05) and was higher in N+ tumours. With VOCAL software and 3-D power Doppler sonography, the vascularity of peritumorous tissue could be quantified successfully," wrote J. Rebol and colleagues, University Hospital. The research ers concluded: "Tumours which had metastasised showed richer vascularity in their shells and a greater difference in vascularity between the shell and tumor tissue." Rebol and colleagues published their study in Ultrasound In Medicine and Biology (The vascularisa tion of oral cavity tumours and tumour shell tissue determined by three-dimensional power Doppler sonography. . Ultrasound In Medicine and Biology , 2007;33(4):493-9). For additional information, contact J. Rebol, Maribor University Hospital, Dept. of Otorhinolaryngology and Cer vicofacial Surgery, Maribor, Slovenia. The publisher of the journal Ultrasound In Medicine and Biology can be contacted at: Elsevier Science Inc., 360 Park Avenue South, New York, NY 10010-1710, USA. Keywords: Slovenia, Maribor, Ultrasound, Diagnosis, Diagnostics. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2007, Life Science Weekly via NewsRx.com & NewsRx.net. DESCRIPTORS: All News; Professional News; All News; Professional News SUBJECT HEADING: Ultrasound (c)Copyright 2007, Life Science Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/123 (Item 70 from file: 135) 0000532612 (THIS IS THE FULLTEXT) Researchers from Johns Hopkins University publish new studies and findings in the area of neurology Life Science Weekly, May 29, 2007, p.2772 ANEXO 4: Resultado busqueda en Dialog DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 411 TEXT: A new study, "Noradrenergic projections to the song control nucleus area X of the medial striatum in male zebra finches (Taeniopygia guttata)," is now available. According to recent research from the United States, "There is considerable functional evidence implicating norepinephrine in modulating activity in the vocal control circuit of songbirds. However, our knowledge of noradrenergic inputs to the song system is incomplete." "In this study, cholera toxin subunit B (CTB) injections into area X revealed projections from the noradrenergic nuclei locus coeruleus and subcoeruleus, and injections of biotinylated dextran amines into these noradrenergic nuclei labeled fibers in area X. The nonreciprocity of this connection was demonstrated by the absence of retrogradely labeled cells in area X following injections of CTB into the locus coeruleus. Additionally, we found novel inputs to area X from the nidopallium and arcopallium, the mesencephalic central gray, and the dorsolateralis anterior (DLL) and posterior (DLP) lateralis in the thalamus. Area X can be clearly distinguished from the surrounding medial striatum based on cytoarchitec tural and chemical neuroanatomical criteria. We show here that neuromodulatory inputs to area X however, exhibit a considerable degree of overlap with the surrounding area. This finding suggests that regional specificity in neuromodulator action is most likely af forded by a specialization in receptor density and enzyme distribution rather than projec tions from the synthesizing nuclei. Our results extend current knowledge about noradrenergic projections to specialized nuclei of the song control circuit and provide neuroanatomical evidence for the functional action of norepinephrine-modulating context-dependent ZENK expression in area X," wrote C.B. Castelino and colleagues, Johns Hopkins University. The researchers concluded: "Furthermore, the novel projections to area X from telencephalic and thalamic areas could be new and interesting nodes in the striatopallidothalamic loop spanning the songbird brain." Castelino and colleagues pub lished their study in the Journal of Comparative Neurology (Noradrenergic projections to the song control nucleus area X of the medial striatum in male zebra finches (Taeniopygia guttata). . Journal of Comparative Neurology , 2007;502(4):544-62). For additional information, contact C.B. Castelino, Johns Hopkins University, Dept. of Psychological and Brain Sciences, Baltimore, Maryland 21218 USA. Publisher contact information for the Journal of Comparative Neurology is: Wiley-Liss, Division John Wiley & Sons Inc., 111 River St., Hoboken, NJ 07030, USA. Keywords: United States, Baltimore, Neurology. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2007, Life Science Weekly via NewsRx.com & NewsRx.net. DESCRIPTORS: All News; Professional News; All News; Professional News SUBJECT HEADING: Neurology (c)Copyright 2007, Genomics & Genetics Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/124 (Item 71 from file: 135) 0000529223 (THIS IS THE FULLTEXT) Medical findings published by University of Utah, U.S. Pharma Business Week, May 21, 2007, p.2882 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English ANEXO 4: Resultado busqueda en Dialog RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 1062 TEXT: Medical findings published by University of Utah, U.S. This trend article about Uni versity of Utah, U.S., is an immediate alert from NewsRx to identify developing directions of research. Study 1: Fresh data on behavior are presented in the report "Behavioral characteristics of children with vocal fold nodules." According to recent research published in the Journal of Voice , "Vocal fold nodules (VNs) in children are benign, bilateral lesions occurring on the mid-membranous vocal folds. Repetitive phonotraumatic behavior leading to chronic vocal fold injury and repair is frequently cited as the primary etiology; however, specific behavioral characteristics may predispose some children toward intense and potentially phonotraumatic voice use, thereby contributing secondarily to VN formation." "The purpose of this case-control study was to determine whether children with VNs possess unique behavioral characteristics that may predispose them to VN development. Parents of 26 children with VNs (20 boys, 6 girls, mean age=7.2 years, SD=2.5 years), and 29 vocally normal, medical controls (22 boys, 7 girls, mean age=6.7 years, SD=2.4), completed the Childhood Behavior Checklist (CBCL/4-18, Achenbach, 1991), a standardized parent-rating scale with strong psychometric proper ties. No significant between-group differences were detected on any of the behavior problem syndrome scales. Group differences approached significance for the individual items "screams a lot" and "teases a lot" (VN group >Controls). The VN group scored significantly higher than the controls on the "Social Scale," a compilation of positive ratings of the child's social activity, frequency of contacts with friends, behavior with others, and behavior by themselves," wrote N. Roy and colleagues, University of Utah. The researchers concluded: "Observed outcomes were consistent with previous characterizations of children with VN as "outgoing" or "extroverted" but were not consistent with other claims that this population may be at risk for "aggressive, attentional," or "impulsive" behavior problems." Roy and colleagues published their study in the Journal of Voice (Behavioral characteristics of children with vocal fold nodules. Journ al of Voice, 2007;21(2):157-68). For additional information, contact N. Roy, The University of Utah, From the Dept. of Communication Sciences and Disorders, Salt Lake City, UT 84112-0252 USA. Study 2: According to recent research from the United States, "High levels of factor XI have been implicated as a risk factor for deep venous thrombosis and possibly cardiovascular disease; however, the relationship between elevated factor XI activity and stroke has yet to be established." D.T. Yang and colleagues at University of Utah wrote, "We retrospectively evaluated factor XI activity, factor XI antigen, and high-sensitivity C-reactive protein (hs-CRP) values in samples from 65 patients with stroke, 13 with transient ischemic attack (TIA), and 17 with venous thrombosis, younger than 55 years with normal prothrombin and partial thromboplastin times who underwent evaluation for a hypercoagulable state." "Factor XI activity levels were more than normal in 22% of patients with stroke or TIA and 18% of patients with venous thrombosis, producing odds ratios of 5.3 and 4.1 for stroke or TIA and venous thrombosis, respectively," the scientists noted. "Factor XI activity levels correlate with factor XI antigen levels by Deming regression analysis (slope, 1.3; R=0.667) and a lack of correlation of both with hs-CRP suggests that factor XI is not an acute phase reactant." The researchers concluded, "Our findings suggest an association between elevated factor XI activity and stroke." Yang and colleagues published their study in the American Journal of Clinical Pathology (Elevated factor XI activity levels are associated with an increased odds ratio for cerebrovascular events. Am J Clin Pathol, 2006;126(3):411-415). For additional information, contact G.M. Rodgers, University of Utah Health Sciences Center, Dept. of Pathology, Division of Hematology, School of Medicine, Room 4C242-SOM, Salt Lake City, UT 84132, USA. Study 3: Baldomero "Toto" Olivera - a University of Utah biologist who seeks new medications from the toxins of poisonous cone snails - won one of medicine's top honors when he was named as a new member of the Institute of Medicine. The honor makes Olivera at least the 30th present or former University of Utah researcher to have ANEXO 4: Resultado busqueda en Dialog been elected to membership in one or more of the three groups under the umbrella organization known as the National Academies: the National Academy of Sciences, the Na tional Academy of Engineering and the Institute of Medicine. "It's great," said Olivera, a distinguished professor of biology. "I'm a basic researcher, so it was both unexpected and gratifying for our basic research to have medical applications. We certainly didn't expect that when we got started. We just wanted to understand why cone snails were capable of killing people in certain circumstances. We never dreamt at the time it would have some direct medical application. I'm very, very pleased." Olivera was among 65 new members and five foreign associates elected to the Institute of Medicine, the organization an nounced Monday. "It is a great pleasure to welcome these distinguished and influential individuals," said Institute of Medicine President Harvey V. Fineberg. "Members are elec ted through a highly selective process that recognizes people who have made major contributions to the advancement of the medical sciences, health care and public health. Election is considered one of the highest honors in the fields of medicine and health." Election to the institute is Olivera's second big honor this year. In April, he won a fouryear, $1 million award as one of 20 new "Million-Dollar Professors" named by the Howard Hughes Medical Institute. Olivera grew up in the Philippines, where cone snails were sold in seafood markets and where fishermen occasionally were stung by the snails and killed by their venom. Cone snails harpoon fish with a hypodermic needle-like tooth, injecting venom that is toxic to the nervous system, paralyzing fish so they can be reeled in and eaten. Olivera and members have his lab have identified several promising drug candid ates in the snails' nerve poisons. Prialt, sold by Ireland's Elan Corp., is pumped into fluid surrounding the spinal cord to treat chronic, intractable pain suffered by people with can cer, AIDS, injury, failed back surgery or certain nervous system disorders. This article was prepared by Pharma Business Week editors from staff and other reports. Copyright 2007, Pharma Business Week via NewsRx.com & NewsRx.net. DESCRIPTORS: All News; Professional News; All News; Professional News SUBJECT HEADING: University of Utah, U.S. (c)Copyright 2007, Science Letter via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/125 (Item 72 from file: 135) 0000511951 (THIS IS THE FULLTEXT) University of Bern, Switzerland, describe new medical findings Biotech Business Week, April 30, 2007, p.1590 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 1110 TEXT: University of Bern, Switzerland, describe new medical findings. This trend article about University of Bern, Switzerland, is an immediate alert from NewsRx to identify developing directions of research. Study 1: Research findings, "Vocal cord dysfunction: dealing with aggressivity," are discussed in a new report. According to recent research from Bern, Switzerland, "QUESTIONS UNDER STUDY: Vocal cord dysfunction (VCD) is characterised by recurrent attacks of paradoxical adduction of the vocal cords during inspiration, accompanied clinically by dyspnoea attacks with inspiratory stridor lasting between minutes and hours. The aim of the study is to evaluate the self-perception of patients suffering from VCD and how they deal with aggressivity." "The Giessen Test (GT) and the Picture Frustration Test (PFT) were used on 6 patients with VCD. Five variables ANEXO 4: Resultado busqueda en Dialog show significant differences between the patients with VCD and the values of the norm ative groups. VCD-patients show an idealized image of themselves, ie relaxed, open, so ciable, and capable of devotion. They do not reject accusations against them by others and rarely make self-criticism. In conflicts they behave passively, thus blocking their ex pression of aggressivity. In many cases organic disposition and trigger stimuli are thought to be responsible for provoking dyspnoea attacks in VCD. However, the self-perception of patients and their way of dealing with aggressivity strongly suggests that psychosocial factors play a great role in the development of VCD," wrote E. Seifert and colleagues, University of Bern. The researchers concluded: "This requires not only symptom-orientated therapy but also psychological counselling." Seifert and colleagues pub lished their study in Swiss Medical Weekly (Vocal cord dysfunction: dealing with aggressivity. Swiss Medical Weekly, 2007;137(7-8):127-9). For additional information, contact E. Seifert, University of Bern, Division of Phoniatrics, ENT-Clinic, Head and Neck Sur gery, Bern, Switzerland. Study 2: Pelvic lymph node dissection (PLND) is warranted in prostate cancer patients undergoing radical prostatectomy with a serum level of PSA <10 ng/ml. "Controversy persists concerning the role of PLND in patients with preoperative PSA values <10 ng/ml undergoing treatment for prostate cancer with a curative intent. The aim of this study was to determine the incidence of lymph node metastasis in this subgroup of patients," scientists in Switzerland reported. "Patients with clinically localized prostate cancer and a serum PSA <10 ng/ml, without neoadjuvant hormonal or radiotherapy, with negative staging examinations who underwent radical retropubic prostatec tomy with bilateral extended PLND and with greater than or equal to10 lymph nodes detected by the pathologist in the surgical specimen, were included in the study," explained M.C. Schumacher and colleagues, University of Bern. "A total of 231 patients with a me dian serum PSA of 6.7 ng/ml (range 0.4-9.98) and a median age of 62 years (range 4476) were evaluated. A median of 20 (range 10-72) nodes were removed per patient. Positive nodes were found in 26 of 231 patients (11%), the majority of which (81%) had a Gleason score greater than or equal to7 in the surgical specimen. "Of the patients with a Gleason score greater than or equal to7 in the prostatectomy specimen 25% had positive nodes, whereas only 3% with a Gleason score less than or equal to6 were node positive. The incidence of positive nodes in patients with clinically localized prostate cancer, a serum PSA <10 ng/ml and a Gleason score greater than or equal to7 in the prostatectomy specimen was 25% after extended PLND," informed the team. The researchers concluded, "It seems that in this patient group extended PLND, including re moval of nodes along the internal iliac vessels, is warranted." Schumacher and colleagues published their study in n European Urology (Is pelvic lymph node dissection necessary in patients with a serum PSA <10 ng/ml undergoing radical prostatectomy for prostate cancer? Eur Urol, 2006;50(2):272-279). For more information, contact U.E. Studer, University of Bern, Dept. of Urology, CH-3010 Bern, Switzerland. Study 3: Apolipoprotein B is a long-term predictor of mortality in type 1 diabetes mellitus. According to a study from Switzerland, "To evaluate the association of apolipoprotein B (apo B) with mortality due to all causes, to cardiac disease and to ischaemic heart disease (IHD) in subjects with type 1 diabetes mellitus. 165 subjects with type 1 diabetes included in the Swiss Cohort of the WHO Mul tinational Study of Vascular Disease in Diabetes were followed for 14.7+/-0.45 years. Causes of death were obtained from death certificates, hospital records and postmortem reports." "Using a parametric proportional hazards model the association of apo B with mortality rates was assessed by time-to-event analysis, including the absolute cumulat ive mortality risk over time for various apo B levels at baseline," wrote C. Stettler and colleagues, University of Bern. They discovered, "Apo B was positively associated with all-cause mortality [hazard ratio (HR) 2.65 per g/L increase of apo B, 95% CI: 1.116.36, p=0.029], cardiac mortality (HR 11.64, 1.03-131.11, p=0.047) and IHD mortality (HR 9.36, 1.26-69.66, p=0.029). An apo B greater than or equal to0.96 g/L translated into a duplication of overall mortality hazard (HR 1.93, 1.00-3.72, p=0.050), and a sevenfold increase of mortality because of cardiac disease or IHD (HR 7.44, 1.44-38.42, p=0.017 and HR 7.38, 0.78-69.82, p=0.081). "A baseline apo B of 1.5 g/L predicted an absolute cumulative risk to die over the next 10 years of 12.1% (5.2-31.7) for male and ANEXO 4: Resultado busqueda en Dialog of 10.4% (4.7-26.1) for female subjects whereas risks were 6.3% (1.8-21.4) and 5.4% (0.8-15.8) for an apo B of 0.8 g/L." The researchers concluded, "Apo B is consistently associated with an increased mortality in type 1 diabetes." Stettler and colleagues pub lished the results of their research in the Journal of Internal Medicine (Apolipoprotein B as a long-term predictor of mortality in type 1 diabetes mellitus: a 15-year follow up. J Intern Med, 2006;260(3):272-280). For additional information, contact C. Stettler, University of Bern, Inselspital, Division Endocrinol & Diabetes, CH-3010 Bern, Switzerland. Keywords: Bern, Switzerland, Angiology, Apolipoproteins, Cardiology, Cardiovascular Risk Factors, Dermatology, Diabetes, Diabetes Mellitus, Heart Disease, Lipoprotein, Mortality, Mortality Risk, Neurology, Apolipoprotein B, Vascular Disease, Type 1 Diabetes Mellitus, Ischemic Heart Disease, Type 1 Diabetes, Cardiovascular Disease. This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2007, Biotech Business Week via NewsRx.com & NewsRx.net. DESCRIPTORS: All News; Professional News; All News; Professional News SUBJECT HEADING: University of Bern, Switzerland (c)Copyright 2007, Life Science Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/126 (Item 73 from file: 135) 0000503484 (THIS IS THE FULLTEXT) Researchers from Sanjay Gandhi Postgraduate Institute of Medical Sciences publish new studies and findings in the area of Graves disease epidemiology Life Science Weekly, April 24, 2007, p.2074 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 486 TEXT: Data detailed in "Safety and efficacy of surgical management of hyperthyroidism: 15-year experience from a tertiary care center in a developing country" have been presented. According to a study from India, "Ideal management of toxic goiter still re mains elusive. Though surgical management of toxic multinodular goiter (MNG) is well accepted, surgical treatment of Graves' disease (GD) is still controversial in view of the presumed increased incidence of complications." "In this paper, we discuss the experience of the surgical management of hyperthyroidism at a specialized tertiary care endocrine center in a developing country, highlighting the minimal morbidity and satisfactory outcome in experienced hands. We retrospectively reviewed 325 consecutive patients with hyperthyroidism managed surgically from 1990 to 2005. The etiologic diagnoses were Graves' disease (185), toxic MNG (105), and autonomously functioning thyroid nodules (AFTN) (n=35). The indications for surgery in Graves' patients were large goiter, relapse after antithyroid drug therapy (ATD), Graves' ophthalmopathy, and presence ofnodule. The indications for surgery in toxic MNG were retrosternal extension (n=15), compressive symptoms (n=20), and large size (grade II). Among the AFTN nodule size, those greater than 4 cm (85%) formed the major indication for surgery. Subjects with GD and toxic MNG were subjected to subtotal thyroidectomy (n=93 prior to 1995) or total thyroidectomy (n=205 post-1995). Hemithyroidectomy was the procedure of choice in patients with AFTN. Patients with Graves' disease were younger in age, with shorter mean duration of goiter when compared with the other 2 groups. Eight percent of patients with Graves' disease without a clinically palpable nodule and 25% of those with nodules had associated differentiated carcinoma, including papillary, follicu - ANEXO 4: Resultado busqueda en Dialog lar, and medullary thyroid cancer. Four percent of patients with toxic MNG had malig nancy. Complications included temporary hypocalcemia (24%), permanent hypocalcemia (3%), and permanent vocal-cord palsy (1%). Surgery for hyperthyroidism has negligible mortality and acceptable morbidity in experienced hands. It is a definite option in selec ted cases. Immediate and permanent cure of hyperthyroidism is achieved, with no recurrences, after total thyroidectomy," wrote P.V. Pradeep and colleagues, Sanjay Gandhi Postgraduate Institute of Medical Sciences. The researchers concluded: "The cosmetic outcome is good, with excellent patient satisfaction and acceptance." Pradeep and col leagues published their study in World Journal of Surgery (Safety and efficacy of surgical management of hyperthyroidism: 15-year experience from a tertiary care center in a developing country. World Journal of Surgery, 2007;31(2):306-12; discussion 313). For more information, contact P.V. Pradeep, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Dept. of Endocrine Surgery, Rae-Bareillei Road, Lucknow, Uttar Pradesh, 226014, India. Publisher contact information for the e World Journal of Surgery is: Springer, 233 Spring Street, New York, NY 10013, USA. Keywords: India, Graves Disease Epidemiology, Endocrinology, Epidemiology, Goiter, Graves Disease, Graves' Disease, Hyperthyroidism, Surgery. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2007, Life Science Weekly via NewsRx.com & NewsRx.net. DESCRIPTORS: All News; Professional News; All News; Professional News SUBJECT HEADING: Graves Disease Epidemiology (c)Copyright 2007, Immunotherapy Weekly via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/127 (Item 74 from file: 135) 0000493674 (THIS IS THE FULLTEXT) Studies from Tel-Aviv University yield new data on otology in children Life Science Weekly, April 10, 2007, p.3085 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 425 TEXT: Investigators publish new data in the report "Glottal function index: a predictor of glottal disorders in children. Hyperkinetic laryngeal behaviors may be used to achieve glottal closure in the presence of vocal cord disorders. In adults, the Glottal Function Index (GFI) is a validated self-administered survey used to evaluate glottal insufficiency," researchers in Israel report. "In children, the relationships between glottal closure and vocal cord lesions have not been examined. We undertook to evaluate the efficacy of the GFI in detecting disorders of the vocal cords in children. We evaluated 100 consecutive children who underwent flexible fiberoptic laryngoscopy. A 4-item GFI question naire was administered to the parents of each study subject on study entry. The video tapes of the examinations were evaluated and scored by 3 investigators in a blinded manner. The GFI scores were compared in subjects with and without vocal cord findings. The final analysis included 100 children 2 to 16 years of age. The-mean age of the study group was 7.3 years (+/-3.9 years). Of the 100 patients, 54 had vocal cord disorders. The most common was vocal cord nodules, in most cases combined with bowing of the vocal cords; the two variables were highly correlated (p <<.01). We performed a receiver operating characteristics test between the presence of vocal cord disorders and the GFI score. We found that the "optimal" score, on which the sensitivity and specificity ANEXO 4: Resultado busqueda en Dialog curves cross, was 3. Of the 54 patients who had vocal cord disorders, the index identified 38 patients (70%), whereas the patients' complaints identified only 30 patients (55.6%). This difference was statistically significant (p <.05)," wrote J.T. Cohen and col leagues, Tel-Aviv University. The researchers concluded: "The GFI is a reliable 4-item symptom index with excellent correlation to the presence of vocal cord lesions in children." Cohen and colleagues published their study in Annals of Otology, Rhinology & Laryngology (Glottal function index: a predictor of glottal disorders in children. Annals of Otology, Rhinology & Laryngology, 2007;116(2):81-4). For additional information, contact J.T. Cohen, Voice and Swallowing Disorders Clinic, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Publisher contact inform ation for the journal l Annals of Otology, Rhinology & Laryngology is: Annals Publ Co., 4507 Laclede Avenue, St. Louis, MO 63108, USA. Keywords: Israel, Laryngology, Otology, Rhinology. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2007, Life Science Weekly via NewsRx.com & NewsRx.net. DESCRIPTORS: All News; Professional News; All News; Professional News SUBJECT HEADING: Otology (c)Copyright 2007, Biotech Business Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/128 (Item 75 from file: 135) 0000492677 (THIS IS THE FULLTEXT) Scientists at University of Antwerp target life sciences Life Science Weekly, April 10, 2007, p.2557 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 388 TEXT: Current study results from the report, "Evolution of vocal fold nodules from childhood to adolescence," have been published. "Bilateral (quasi) symmetrical lesions of the anterior third of the vocal folds, commonly called vocal fold nodules (VFNs) are the most frequent vocal fold lesions in childhood caused by vocalabuse and hyperfunction. This study evaluates their long-term genesis with or without surgery and voice therapy," investigators in Antwerp, Belgium report. The researchers concluded: "" Bilateral (quasi) symmetrical lesions of the anterior third of the vocal folds, commonly called vocal fold nodules (VFNs) are the most frequent vocal fold lesions in childhood caused by vocal abuse and hyperfunction. This study evaluates their long-term genesis with or without surgery and voicetherapy. A group of 91 postmutational adolescents (mean age, 16 years), in whom VFNs were diagnosed in childhood, were questioned to analyze the evolution of their complaints. Thirty four of them could be clinically reexamined by means of the European Laryngological Society-protocol, including a complete laryngolo gical investigation and voice assessment. A total of 21% of the questioned group (n=91) had voice complaints persisting into postpubescence with a statistically significant differ ence (p <or=0.001) between boys (8%) and girls (37%). VFNs were still present in 47% of the girls and 7% of the boys of the clinically evaluated group (n=34). Analysis of the data before and after puberty shows that the variables gender, allergy, and degree of dysphonia ("G") in childhood enable a fairly correct prediction of persisting voice complaints in adolescence (sensitivity of 89% and specificity of 67%). The results of this study show a clearly different evolution for both sexes, with significant higher long-term ANEXO 4: Resultado busqueda en Dialog risks for dysphonic girls with allergy." De and colleagues published their study in the Journal of Voice (Evolution of vocal fold nodules from childhood to adolescence. Journal of Voice, 2007;21(2):151-6). For additional information, contact M.S. De Bodt, University of Antwerp, From the Dept. of Otorhinolaryngology and Communication Disorders, Antwerp, Belgium. The publisher of the e Journal of Voice can be contacted at: Mosby, Inc., 11830 Westline Industrial Dr., St. Louis, MO 63146-3318, USA. Keywords: Belgium, Antwerp, Life Sciences. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2007, Life Science Weekly via NewsRx.com & NewsRx.net. DESCRIPTORS: All News; Professional News; All News; Professional News SUBJECT HEADING: Life Sciences (c)Copyright 2007, Biotech Business Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/129 (Item 76 from file: 135) 0000489532 (THIS IS THE FULLTEXT) Investigators at University of Utah publish new data on behavior in children Biotech Business Week, April 9, 2007, p.480 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 389 TEXT: Fresh data on behavior are presented in the report "Behavioral characteristics of children with vocal fold nodules." According to recent research published in the Journal of Voice , " Vocal fold nodules (VNs) in children are benign, bilateral lesions occurring on the mid-membranous vocal folds. Repetitive phonotraumatic behavior leading to chronic vocal fold injury and repair is frequently cited as the primary etiology; however, specific behavioral characteristics may predispose some children toward intense and po tentially phonotraumatic voice use, thereby contributing secondarily to VN formation." "The purpose of this case-control study was to determine whether children with VNs possess unique behavioral characteristics that may predispose them to VN development. Parents of 26 children with VNs (20 boys, 6 girls, mean age=7.2 years, SD=2.5 years), and 29 vocally normal, medical controls (22 boys, 7 girls, mean age=6.7 years, SD=2.4), completed the Childhood Behavior Checklist (CBCL/4-18, Achenbach, 1991), a standardized parent-rating scale with strong psychometric properties. No significant between-group differences were detected on any of the behavior problem syndrome scales. Group differences approached significance for the individual items "screams a lot" and "teases a lot" (VN group >Controls). The VN group scored significantly higher than the controls on the "Social Scale," a compilation of positive ratings of the child's social activity, frequency of contacts with friends, behavior with others, and behavior by them selves," wrote N. Roy and colleagues, University of Utah. The researchers concluded: "Observed outcomes were consistent with previous characterizations of children with VN as "outgoing" or "extroverted" but were not consistent with other claims that this popu lation may be at risk for "aggressive, attentional," or "impulsive" behavior problems." Roy and colleagues published their study in the Journal of Voice (Behavioral characteristics of children with vocal fold nodules. Journ al of Voice, 2007;21(2):157-68). For additional information, contact N. Roy, The University of Utah, From the Dept. of Communication Sciences and Disorders, Salt Lake City, UT 84112-0252 USA. The publisher's contact information for the Journal of Voice is: ANEXO 4: Resultado busqueda en Dialog Mosby, Inc., 11830 Westline Industrial Dr., St. Louis, MO 63146-3318, USA. Keywords: United States, Salt Lake City, Behavior, Clinical Trial Research. This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2007, Biotech Business Week via NewsRx.com & NewsRx.net. DESCRIPTORS: Top News; All News; Professional News; All News; Professional News SUBJECT HEADING: Behavior (c)Copyright 2007, Biotech Business Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/130 (Item 77 from file: 135) 0000417616 (THIS IS THE FULLTEXT) Studies from Nagoya University, Department of Otorhinolaryngology add new findings in the area of radiation therapy Drug Week, January 26, 2007, p.923 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 338 TEXT: Fresh data on radiation are presented in the report "Vascular evaluation in laryngeal diseases: comparison between contact endoscopy and laser Doppler flowmetry." In this recent report, researchers in Nagoya, Japan conducted a study "To determine the efficacies of 2 methods for evaluating vascular changes in laryngeal diseases. Prospective comparative study.". "University hospital. Twenty-four adults planning to undergo laryngomicrosurgery for unilateral lesions in their vocal cords. Vascular evaluation was performed using contact endoscopy and laser Doppler flowmetry during laryngomicrosurgery. Morphological and physiological variables of the vascular changes. Contact endoscopy examinations re vealed changes in the fine vascular network patterns in the vocal cords. Hypervascularity was present in patients with polyps but not in those with nodules, and the degree of vascularity was variable in patients with malignant neoplasms. Patients with papillomas and patients in the postradiation therapy group showed hypovascularity with losses in the capillary network. Laser Doppler flowmetry revealed high mean blood flows in patients with polyps, dysplasia, and malignant neoplasms, whereas patients with papillo mas and those in the postradiation therapy group had low blood flows," wrote M. Sone and colleagues, Nagoya University, Department of Otorhinolaryngology. The researchers concluded: "The variables measured by laser Doppler flowmetry and endoscopy were strongly correlated. Evaluations of morphological and physiological changes of vascularity in laryngeal diseases are important for understanding their patho physiology, and combining contact endoscopy and laser Doppler flowmetry is useful in such evaluations." Sone and colleagues published their study in(Vascular evaluation in laryngeal dis eases: comparison between contact endoscopy and laser Doppler flowmetry. Archives of Otolaryngology--head & Neck Surgery, 2006;132(12):1371-4). For additional information, contact M. Sone, Nagoya University Graduate School of Medicine, Dept. of Otorhinolaryngology, Nagoya, Japan. Publisher contact information for the journal is: American Medical Association, 515 N State St., Chicago, IL 60610, USA. Keywords: Japan, Nagoya, Laryngeal Disease, Medical Device, Microsurgery, Micro- ANEXO 4: Resultado busqueda en Dialog technology, Polyps, Radiation Therapy, Surgery. This article was prepared by Drug Week editors from staff and other reports. Copyright 2007, Drug Week via NewsRx.com & NewsRx.net. DESCRIPTORS: Japan; Laryngeal Disease; Laryngology; Medical Device; Microsurgery; Microtechnology; Nagoya; Nagoya University, Japan; Otorhinolaryngology; Polyps; Radi ation Therapy; Surgery; All News; Professional News SUBJECT HEADING: Radiation Therapy (c)Copyright 2007, Drug Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/131 (Item 78 from file: 135) 0000409486 (THIS IS THE FULLTEXT) Research from University of Athens, Department of Surgery yields new data on thyroid cancer risk factors Clinical Oncology Week, January 15, 2007, p.523 DOCUMENT TYPE: Expanded Reporting LANGUAGE: English RECORD TYPE: FULLTEXT AUDIENCE: Professional WORD COUNT: 450 TEXT: Research findings, "Total thyroidectomy for the treatment of thyroid diseases in an endemic area," are discussed in a new report. According to a study from Athens, Greece, "Thyroidectomy is a common operation with very low mortality and an acceptable morbidity rate. Total thyroidectomy has become the predominant type of surgery used today for the treatment of thyroid diseases.". "In this retrospective study, we analyzed the complications of thyroid surgery according to the operative technique used in our department. A retrospective analysis was per formed for all patients who underwent thyroid surgery during the previous 11 years. The period under study was divided into two sections: phase A (1995-1999) and phase B (2000-2005). Patient characteristics, type of operation, histologic diagnoses and postoperative complications were compared in the two study periods according to the type of surgery. A total of 264 patients between the ages of 18 and 89 underwent thyroid surgery during the study period (133 in phase A and 131 in phase B). Overall histopatholo gical diagnoses were nodular goiter (54.9%), hyperplastic nodules (14.7%), adenoma (8.3%), thyroid cancer (18.2%), and Hashimoto thyroiditis (3.8%). Total thyroidectomy was performed in 91 patients in phase A versus 115 patients in phase B (p <0.001), whereas the use of subtotal thyroidectomy and lobectomy decreased over time. A trend toward increased morbidity was noted in phase B. Seven patients had hypocalcemia in phase A, whereas 11 patients had hypocalcemia in phase B. Similarly, 5 patients had some degree of vocal cord paralysis in phase A, compared with 7 in phase B (p >0.05). Morbidity was significantly increased in the case of cancer or reoperation. Despite the slightly higher risk of complication associated with total thyroidectomy, this has gradually replaced more conservative approaches for the treatment of both benign and malignant thyroid diseases," wrote E.P. Misiakos and colleagues, University of Athens, Department of Surgery. The researchers concluded: "Reoperations and surgery for thyroid cancer carried a higher risk of complications." Misiakos and colleagues published their study in Southern Medical Journal (Total thyroidectomy for the treatment of thyroid diseases in an endemic area. Southern Medical Journal, 2006;99(11):1224-9). ANEXO 4: Resultado busqueda en Dialog For more information, contact E.P. Misiakos, Attikon University Hospital, 3rd Dept. of Surgery, University of Athens School of Medicine, Athens, Greece. Publisher contact information for the Southern Medical Journal is: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA. Keywords: Greece, Athens, Thyroid Cancer Risk Factors, Endocrinology, Hypocalcemia, Oncology, Thyroid Cancer, Thyroid Disease, Thyroid Neoplasms, Tumors. This article was prepared by Clinical Oncology Week editors from staff and other reports. Copyright 2007, Clinical Oncology Week via NewsRx.com & NewsRx.net. DESCRIPTORS: Athens; Endocrinology; Greece; Hypocalcemia ; Oncology; Thyroid Cancer; Thyroid Cancer Risk Factors; Thyroid Disease; Thyroid Neoplasms; Tumors; University of Athens, Greece; All News; Professional News SUBJECT HEADING: Thyroid Cancer Risk Factors (c)Copyright 2007, Clinical Oncology Week via NewsRx.com & NewsRx.net NewsRx Weekly Reports (Dialog® File 135): (c) 2010 NewsRx. All rights reserved. 4/9/132 (Item 79 from file: 135) 0000395236 (THIS IS THE FULLTEXT) Studies from Johann Wolfgang Goethe University, Institute of Pathol