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Distonias são desordens orgânicas do processamento motor central caracterizadas por contrações musculares involuntárias e espasmos à fonação nas formas laríngeas adutoras, com quebras de sonoridade. O diagnóstico é clínico e baseado na avaliação perceptivo-auditiva da voz e nasofibroscopia. OBJETIVO: O nosso objetivo é propor e avaliar um protocolo de exame de nasofibrolaringoscopia que contemple tarefas que evidenciem os espasmos e tarefas que diminuam ou façam desaparecer os espasmos, visando facilitar a análise e o diagnóstico. MATERIAL E MÉTODO: Estudo transversal. Análise de imagens de 15 videonasolaringoscopias de pacientes com distonia laríngea de adução por meio do protocolo proposto. RESULTADOS: A maior parte das tarefas de fala e não-fonatórias permitiram a identificação de espasmos e a diminuição ou desaparecimento destes. Propomos a exclusão de duas delas que não acrescentaram dados à avaliação. CONCLUSÃO: O protocolo foi útil na avaliação dos pacientes, mostrando mudança de comportamento da musculatura nas estruturas estudadas conforme as tarefas executadas.Dystonias are organic central motor processing disorders characterized by involuntary muscular contractions or incontrollable spasms induced by task-specific movements. Adduction laryngeal dystonias present with important speech impairments, with inappropriate spasms and abrupt voice breaks. The diagnosis is based on clinical features, evaluation by a speech therapist and transnasal fiber optic laryngoscopy. AIM: Our objective is to propose and evaluate a task-oriented transnasal fiber optic laryngoscopy protocol, which shows the spasms, and propose maneuvers that reduce or make them disappear, in order to facilitate the diagnosis. METHODS: transversal study. Analysis of the transnasal fiber optic laryngoscopy records of 15 patients with adductor laryngeal dystonia using the proposed protocol. RESULTS: most of the speech and non-vocal tasks allowed us to identify the spasms and reduce or make them disappear. We propose the exclusion of two of the maneuvers that don’t bring new data to the evaluation. CONCLUSION: the protocol was useful for the evaluation of the patients, showing changes in muscle behavior in the structure under investigation.

Plasmodium falciparum causes the most severe form of malaria and is responsible for the majority of deaths worldwide. The mechanism of cell cycle control within intra-erythrocytic stages has been examined as a potential means of a promising way to identifying how to stop parasite development in red blood cells. Our group determined that melatonin increases parasitemia in P. falciparum and P. chabaudi through a complex signalling cascade. In vertebrates, melatonin controls the expression of transcription factors, leading us to postulate rather that the indoleamine would affect PfNF-YB expression in human malaria parasites. We show here that PfNF-YB transcription factor is highly expressed and colocalized in the nucleus in mature parasites during intra-erythrocytic stages, thus suggesting an important role in cell division. Moreover, we demonstrate for the first time that melatonin and cAMP modulate the PfNF-YB transcription factor expression in P. falciparum at erythrocytic stages. In addition, PfNF-YB is found to be more ubiquitinated in the presence of melatonin. Finally, the proteasome inhibitor bortezomib is able to modulate PfNF-YB expression as well. Taken together, our dada reinforce the role played by melatonin in the cell cycle control of P. falciparum and point this indolamine as a target to develop new antimalarial drugs.

INTRODUÇÃO: A Síndrome pós-poliomielite (SPP) caracteriza-se por um novo episódio de atrofia ou fraqueza muscular em indivíduos acometidos por poliomielite prévia. Os sintomas iniciam-se após um período prolongado de estabilidade clínica que varia de 20 a 40 anos depois do quadro inicial da poliomielite. Dentre os mecanismos fisiopatológicos, o mais provável é que a síndrome represente um processo de desgaste e exaustão metabólica neuronal devido a um processo contínuo de desnervação-reinervação que se inicia após o quadro agudo inicial. OBJETIVO: Revisar as características clínicas e fisiopatológicas da SPP, assim como apresentar a abordagem em casos com manifestações faringo-laríngeas. RELATO DO CASO: Apresentamos o caso clínico de um paciente masculino com 48 anos de idade, com queixas principais disfonia e disfagia e história prévia de poliomielite. O paciente foi submetido à investigação diagnóstica, na qual encontram-se descritos os achados psicoacústicos da voz, laringoscópicos, eletromiográficos e da videoendoscopia da deglutição compatíveis com SPP. O tratamento consistiu em fonoterapia num total de 11 sessões semanais e orientações gerais para deglutição com melhora satisfatória dos sintomas. COMENTÁRIOS FINAIS: As manifestações faringo-laríngeas da SPP são passíveis de tratamento, obtendo-se resultados satisfatórios com melhora na qualidade de vida dos pacientes. INTRODUCTION: The post-polio syndrome (PPS) is characterized by a new episod of atrophy or muscle weakness in individuals previously affected by poliomyelitis. The symptoms start from an extended period of clinical stability ranging from 20 to 40 years, after the initial chart of polio. Among the pathophysiological mechanisms, the most likely is that the syndrome represents a process of attrition and neuronal metabolic exhaustion due to a continuous process of denervation reinnervation which begins after the initial acute. OBJECTIVE: Review the clinical characteristics and pathophysiological of PPS,as well as present the approach in cases with pharyngolaryngeal manifestations. CASE REPORT: We present the clinical case of a male patient with 48 years old, with main complaints of dysphonia, dysphagia and previous history of polio. The patient underwent a diagnostic investigation, in which the voice psychoacoustic findings are described. Laringoscopic, electromyographic and the videoendoscopy of swallowing compatible with PPS. The treatment consisted in phonotherapy in a total of 11 weekly sessions and guidelines for swallowing, with satisfactory improvement of the symptoms. FINAL COMMENTS: The pharyngolaryngeal manifestations of PPS are susceptible to treatment, obtaining satisfactory results, with improvement of life quality of the patients.

To identify and characterize the presence of body pains in popular singers, to observe the differences in the reported pains according to gender, and to relate with data regarding vocal behavior and usage in this population.A self-explanatory questionnaire was applied to 100 popular singers (50 men and 50 women), in order to collect information about personal identification, voice use and presence of pains. Pains were divided into two groups: proximal pains (TMA, tongue, throat, nape, shoulders, neck, and pain during speech), and distal pains (arms, back/column, chest, hands, ear, and headache).The mean value of pain presence referred by popular singers was 2.9. There was no difference in reported pain according to gender. Predominant pains were on the throat (66%), during speech (41%) and on the neck (35%), all classified as proximal to the larynx. The least predominant pains were in arms, hands and chest (4%), all classified as distal pains.Popular singers reported presence of body pains mainly proximal to the larynx. There is no difference in reported pain according to gender. The presence of body pain is related to the presence of voice disorders, the need to stop singing, the absence of vocal training, and search for professional advice (otolaryngologists and speech-language pathologist) due to vocal problems. These data justify the investigation and attention to body pain symptoms by the professionals responsible for the treatment of this population.