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Configura??o glótica em tocadores de instrumento de sopro
Eckley, Claudia Alessandra;
Revista Brasileira de Otorrinolaringologia , 2006, DOI: 10.1590/S0034-72992006000100008
Abstract: introduction: knowledge of occupational voice disorders has gained increased importance as more individuals rely on their voices for their work. wind instrument players are a specific group of individuals that present intensive use of the vocal tract associated with blowing their instrument. interestingly, only a small number of reports focus on the laryngeal function of such professionals. aim: the current study evaluated the laryngeal and vocal tract movement of wind instrument players. material and methods: ten adult wind instrument players were studied with flexible videolaryngoscopy while playing their instrument, in order to observe the movements of the glottis, the vocal tract and the base of the tongue. results: in all the participants it was observed that musical tones were played with adducted vocal folds and that the greater the technical difficulty reported by the player, the more it was associated with increased lateral tension in the larynx, as well as constriction in the vocal tract. conclusions: the larynx controls the airflow that will reach the mouthpiece of the instrument, directly interfering in blowing. therefore, wind instrument players should also be considered professional voice users.
Estudo da concentra??o salivar do fator de crescimento epidérmico em indivíduos com laringite cr?nica por refluxo laringofaríngeo
Eckley, Claudia A.;Costa, Henrique O.;
Revista Brasileira de Otorrinolaringologia , 2003, DOI: 10.1590/S0034-72992003000500002
Abstract: introduction: gastroesophageal reflux disease (gerd) may cause intense inflammation and symptoms in the larynx and pharynx (laryngopharyngeal reflux lpr). studies have not been able to establish a direct link between the refluxed acid and the typical laryngeal findings in lpr. the epidermal growth factor (egf) is a polypeptide produced by the salivary glands and shown to induce epithelial development, inhibit gastric acid secretion and accelerate wound healing. this factor is decreased in the saliva of patients with reflux esophagitis, but there are no reports of its behavior in lpr. aim: the objective of this study was to determine the salivary concentration of egf in adults with lpr compared to normal controls. study design: control study. material and method: the salivary egf concentration of 39 patients with lpr and 20 healthy controls was determined using a commercially available elisa kit. lpr was diagnosed based on history and typical laryngopharyngeal signs. the 39 patients with lpr were graded according to endoscopic (presence of associated esophagitis) and laryngoscopic criteria (severity of laryngitis). patients with lpr were also submitted to esophageal manometry and 24-hour double probe ph-metry. results: salivary egf concentration was significantly lower in the lpr group when compared to controls (p= 0,002). no correlation between the severity of laryngeal findings or presence/absence of esophagitis and salivary egf concentration could be determined. conclusions: this study suggests that a decreased salivary concentration of epidermal growth factor could be associated to the pathogenesis of gerd and that this same deficiency could also be related to lpr.
Estudo comparativo do pH e do volume salivar em indivíduos com laringofaringite cr?nica por doen?a do refluxo gastroesofágica antes e após o tratamento
Eckley, Claudia Alessandra;Costa, Henrique Olival;
Revista Brasileira de Otorrinolaringologia , 2006, DOI: 10.1590/S0034-72992006000100010
Abstract: introduction: gastroesophageal reflux disease (gerd) is the most prevalent digestive disease of the modern society and has been associated with abnormalities in the larynx and pharynx (lpr). nonetheless, little is known about the mechanisms involved in this atypical form of the disease. contradictory clinical data suggest a defense deficit at this segment. saliva with its organic and inorganic components is responsible for the homeostasis of the oral mucosa and the digestive tract. salivary ph and volume abnormalities have been linked to laryngopharyngeal symptoms of gerd and lpr. in a recent study we demonstrated significant salivary ph reduction in patients with lpr. another study found correlation between reduced salivary ph and volume directly related to esophageal ph-metry results. aim: to evaluate salivary ph and volume before and after clinical treatment of lpr. material and method: twenty-three adults with lpr had total fasting saliva tested before and after a 12-week course of oral proton pump inhibitor. results: a statistically significant difference was found in salivary ph before and after treatment with increase of ph values after control of the disease (p<0.001). salivary volumes of treated patients were also significantly higher than in pre-treated patients (p=0.009). discussion: these findings suggest that salivary ph and volume are influenced by the presence of gastroesophageal contents and that salivary ph monitoring can potentially become a cost-effective method for diagnosing and controlling lpr.
Correla??o do pH e volume salivares com sintomas laringofaríngeos
Costa, Henrique Olival;Eckley, Cláudia Alessandra;
Revista Brasileira de Otorrinolaringologia , 2004, DOI: 10.1590/S0034-72992004000100004
Abstract: in spite of the great enthusiasm wakened up by the progress of the concepts of the denominated syndrome of the larygopharyngeous reflux (lfr), it is still difficult for the otorrinolaringologist to establish with safety if this illness can be considered in the future as a disease similar to the gastro esophageal reflux. the inflammatory signs in the segment, found in some patient that present phmetry with ph below 4 in the proximal probe can be found in other situations aggressive to the area, not being, therefore, patognomonic of lfr. the conditions of saliva, the volume, clearence and alterations of the eletrolitic conditions can influence the capacity of protection of the regional mucous membrane. aim: to observe the relationship between the inflammatory symptoms and the ph and volume of saliva. study design: observacional cohort with transversal cut. material and method: 59 subjects were studied, with ages varying from 24 to 76 years, with average 50,5 years, being 44 women and 15 men. all the patients answered to a questionnaire on laryngopharyngeous symptoms and they had his/her saliva collected and measured its volume and ph. results: the median volume of saliva collected in the patients was 4,3 ml, with the minimum of 1,5 and a maximum of 7,5. the median ph was of 7,1, extending from 6 to 8. of the total of symptoms 31 patients presented dysphonia, 39 throat clearing, 2 dyspnea, 24 halitosis, 4 caseum, 4 recurrent tonsillitis, 6 teeth and gingival problems, 9 oral ulcers, 6 xerostomia, 12 glossodynia, 36 globus pharingeus, 2 odinophagia and 8 dysphagia. the several correlations among ph, volume to salivate and symptoms were observed showing, in some cases, strong positive or negative correlation. conclusion: the ph of saliva, in the dependence of its volume can have strong interference in the laryngopharyngeous inflammatory symptoms.
Estudo da concentra o salivar do fator de crescimento epidérmico em indivíduos com laringite cr nica por refluxo laringofaríngeo
Eckley Claudia A.,Costa Henrique O.
Revista Brasileira de Otorrinolaringologia , 2003,
Abstract: INTRODU O: A Doen a do Refluxo Gastroesofágico (DRGE), chegando até a faringe e laringe, pode cursar com intensa inflama o local e rica sintomatologia (Refluxo Laringofaríngeo RLF). Os estudos atuais n o foram capazes de provar que o ácido refluído é o causador das altera es visualizadas na laringite cr nica. O Fator de Crescimento Epidérmico (EGF) é um polipeptídeo produzido pelas glandulas salivares, sendo implicado na indu o do crescimento epitelial, na inibi o da secre o gástrica e na acelera o da cicatriza o. Deficiência salivar deste fator foi encontrada na esofagite de refluxo, mas n o há relatos sobre a concentra o salivar de EGF em indivíduos com RLF. OBJETIVO: Determinar a concentra o salivar do EGF em indivíduos com RLF. FORMA DE ESTUDO: Caso controle. CASUíSTICA E MéTODO: A concentra o salivar de EGF de 39 indivíduos com RLF e 20 controles normais foi estudada pela técnica de ELISA. O RLF foi diagnosticado por história e exame videolaringoscópico característicos. Os 39 pacientes com RLF foram estratificados de acordo com os achados de endoscopia digestiva (com ou sem esofagite associada) e de acordo com a intensidade da laringite cr nica. Foram, também, submetidos a manometria esofágica e pH-metria esofágica de 24 horas com dois canais. RESULTADOS: Constatou-se uma concentra o de EGF significativamente menor nos indivíduos com RLF quando comparados aos controles normais (p=0,002). N o houve diferen a estatisticamente significante na concentra o salivar de EGF entre os indivíduos com RLF, nem em rela o à presen a de esofagite, nem quanto à intensidade da laringite. CONCLUS ES: Este estudo sugere que uma deficiência na concentra o salivar do Fator de Crescimento Epidérmico pode estar associada à patogenia da DRGE, e que este polipeptídeo poderia ser um co-fator na gênese do RLF.
Correla o do pH e volume salivares com sintomas laringofaríngeos
Costa Henrique Olival,Eckley Cláudia Alessandra
Revista Brasileira de Otorrinolaringologia , 2004,
Abstract: Apesar do grande entusiasmo despertado pelo avan o dos conceitos definidores do conjunto sintomático denominado refluxo laringofaríngeo (RLF), ainda é muito difícil, para o otorrinolaringologista, estabelecer com seguran a se esta síndrome poderá ser considerada no futuro como uma doen a semelhante ao refluxo gastroesofágico1. A nosso ver, os sinais inflamatórios no segmento laringofaríngeo encontrados em alguns pacientes que apresentam phmetria com presen a de pH abaixo de 4 na sonda proximal podem ser mimificados por outras situa es que agridem a regi o, n o sendo, portanto, patognom nicos de RLF. As condi es de fluxo salivar, seu volume, clearence e altera es das condi es eletrolíticas da saliva podem influenciar na capacidade de prote o da mucosa regional. OBJETIVO: Este estudo teve como principal objetivo observar a rela o entre os sintomas laringofaríngeos de inflama o e o pH e volume salivares. FORMA DE ESTUDO: Observacional coorte com corte transversal. MATERIAL E MéTODO: Foram estudados 59 sujeitos com idades variando de 24 a 76 anos, com média 50,5 anos, sendo 44 mulheres e 15 homens. Todos os pacientes responderam a questionário sobre sintomas laringofaríngeos e tiveram sua saliva coletada e seu volume e pH mensurados. RESULTADOS: O volume médio de saliva coletado no total de pacientes foi 4,3 ml, com o mínimo de 1,5 e um máximo de 7,5. O pH médio foi de 7,1, se estendendo de 6 a 8. Do total de sintomas apresentados, 31 pacientes apresentaram disfonia, 39 apresentaram pigarro, 2 dispnéia, 24 halitose, 4 caseo, 4 amigdalite de repeti o, 6 problemas dento-gengivais, 9 aftas, 6 xerostomia, 12 glossodínia, 36 globus pharingeus, 2 odinofagia, 16 tosse e 8 disfagia. As diversas correla es entre pH, volume salivar e sintomas foram observadas mostrando, em alguns casos, forte correla o positiva ou negativa. CONCLUS O: O pH salivar, na dependência do volume salivar, pode ter forte interferência na sintomatologia faringolaríngea.
LS2W: Implementing the Locally Stationary 2D Wavelet Process Approach in R
Idris A. Eckley,Guy P. Nason
Journal of Statistical Software , 2011,
Abstract: Locally stationary process representations have recently been proposed and applied to both time series and image analysis applications. This article describes an implementation of the locally stationary two-dimensional wavelet process approach in R. This package permits construction of estimates of spatially localized spectra and localized autocovariance which can be used to characterize structure within images.
Optimal detection of changepoints with a linear computational cost
R. Killick,P. Fearnhead,I. A. Eckley
Quantitative Biology , 2011, DOI: 10.1080/01621459.2012.737745
Abstract: We consider the problem of detecting multiple changepoints in large data sets. Our focus is on applications where the number of changepoints will increase as we collect more data: for example in genetics as we analyse larger regions of the genome, or in finance as we observe time-series over longer periods. We consider the common approach of detecting changepoints through minimising a cost function over possible numbers and locations of changepoints. This includes several established procedures for detecting changing points, such as penalised likelihood and minimum description length. We introduce a new method for finding the minimum of such cost functions and hence the optimal number and location of changepoints that has a computational cost which, under mild conditions, is linear in the number of observations. This compares favourably with existing methods for the same problem whose computational cost can be quadratic or even cubic. In simulation studies we show that our new method can be orders of magnitude faster than these alternative exact methods. We also compare with the Binary Segmentation algorithm for identifying changepoints, showing that the exactness of our approach can lead to substantial improvements in the accuracy of the inferred segmentation of the data.
Efficient penalty search for multiple changepoint problems
Kaylea Haynes,Idris A. Eckley,Paul Fearnhead
Statistics , 2014,
Abstract: In the multiple changepoint setting, various search methods have been proposed which involve optimising either a constrained or penalised cost function over possible numbers and locations of changepoints using dynamic programming. Such methods are typically computationally intensive. Recent work in the penalised optimisation setting has focussed on developing a pruning-based approach which gives an improved computational cost that, under certain conditions, is linear in the number of data points. Such an approach naturally requires the specification of a penalty to avoid under/over-fitting. Work has been undertaken to identify the appropriate penalty choice for data generating processes with known distributional form, but in many applications the model assumed for the data is not correct and these penalty choices are not always appropriate. Consequently it is desirable to have an approach that enables us to compare segmentations for different choices of penalty. To this end we present a method to obtain optimal changepoint segmentations of data sequences for all penalty values across a continuous range. This permits an evaluation of the various segmentations to identify a suitably parsimonious penalty choice. The computational complexity of this approach can be linear in the number of data points and linear in the difference between the number of changepoints in the optimal segmentations for the smallest and largest penalty values. This can be orders of magnitude faster than alternative approaches that find optimal segmentations for a range of the number of changepoints.
Estudo comparativo da concentra??o salivar do fator de crescimento epidérmico em indivíduos com laringite cr?nica por doen?a do refluxo gastroesofágica antes e após o tratamento: resultados preliminares
Eckley, Claudia Alessandra;Rios, Lilia da Silva;Rizzo, Luiz Vicente;
Revista Brasileira de Otorrinolaringologia , 2007, DOI: 10.1590/S0034-72992007000200003
Abstract: the laryngopharyngeal reflux (lpr) physiopathology is still unknown. the epidermal growth factor (egf) is a biologically active salivary protein that aids in the rapid regeneration of the oropharyngeal and upper digestive tract mucosas. salivary deficiency of this protein in patients with lpr has been demonstrated in previous studies. aim: to compare salivary egf concentration in patients with lpr before and after treatment. materials and methods: in this prospective study twelve patients with gerd and moderate lpr were studied. whole saliva samples were collected before and after treatment and salivary egf concentration was determined using a commercially available elisa kit (quantikine ?). results: there were eleven females and one male among the patients, the mean age was 49 years. the mean pre-treatment salivary egf concentration was 2,867.6 pg/ml and the mean post treatment egf concentration was 1,588.5 pg/ml. this difference was statistically significant (p=0.015). discussion and conclusions: although salivary egf concentrations are higher before lpr treatment, the concentration is still much lower than the mean salivary egf concentration in normal individuals without lpr, which suggests a primary disorder of this defense factor in individuals with lpr.
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