Lucia Mourão - Academia.edu (original) (raw)

Papers by Lucia Mourão

Saude E Sociedade, 2009

Among workers, the largest category that makes professional use of the voice is that of teachers.... more Among workers, the largest category that makes professional use of the voice is that of teachers. This article aims to discuss, from the teacher's perspective, the use of the voice in the teaching practice and the prevention of vocal problems. It is a qualitative-descriptive case study carried out with 25 teachers. Based on a semi-structured script, interviews were conducted to ascertain the subjects' relationship with their voice and with the teaching work, and also to receive suggestions for preventive actions. Results indicated that the voice alteration was perceived, but the teachers usually gave more importance to making sure they were being understood and to exerting control over the students. The teachers who had not had vocal problems yet knew colleagues who had; they knew the risk to which they were exposed and, apparently, they regarded it as a natural and expected consequence of the teaching practice. They believed that interventions with the students, the employer's support, the presence of specialists in the school and the work with the specific needs they face in the classroom could help them preserve their voices.

Arquivos De Neuro-psiquiatria, 2005

Long-term complications in levodopa treated Parkinson's disease (PD) patients caused a resurgence... more Long-term complications in levodopa treated Parkinson's disease (PD) patients caused a resurgence of interest in pallidotomy as an option of treatment. However, postoperative complications such as speech disorders can occur. PURPOSE: The aim of this study is to evaluate the acoustic voice in PD patients, before and after posteroventral pallidotomy. METHOD: Twelve patients with PD were submitted to neurological and voice assessments during the off and on phases, in the pre-operative, 1st and 3rd post-operative months. The patients were evaluated with the UPDRS and the vocal acoustic parameters - f0, NHR, jitter, PPQ, Shimmer, APQ (using the software MultiSpeech - Kay Elemetrics - 3700). RESULTS: The off phase UPDRS scores revealed a tendency to improvement at the 1st month and the off phase worsened. The shimmer and APQ improved. CONCLUSION: This study shows that pallidotomy has little improvement on functional use of communication of PD patients.

Acta Neurologica Scandinavica, 2009

Voice and speech disorders are common in Parkinson's disease patients and may lead to social isol... more Voice and speech disorders are common in Parkinson's disease patients and may lead to social isolation. We employed routine clinical voice therapy measures to evaluate the effect of voice rehabilitation. Twenty patients with a stable drug regimen participated in this study. The patients were assessed before and after a program of voice rehabilitation consisting of 13 group therapy sessions during 1 month, with emphasis on the increase in laryngeal sphincteric activity. Voice rehabilitation produced an increase in maximal phonation times, decrease in the values of s/z ratio and air flow, increase in vocal intensity, decrease in the complaints of weak and strained-strangled voice and monotonous and unintelligible speech and elimination of complaints of swallowing alterations. These data indicate a greater glottic efficiency after voice rehabilitation reflecting a more functional oral communication.

Arquivos De Neuro-psiquiatria, 2008

Objective: To establish correlations between nutritional, functional and respiratory indices of p... more Objective: To establish correlations between nutritional, functional and respiratory indices of patients with amyotrophic lateral sclerosis (ALS). Method: Twenty patients (13 appendicular -GA and 7 bulbar -GB) were included in the multidisciplinary study at the Neurological Clinic Ambulatory of the University of Campinas Hospital. Results: Among the GA type significant correlation was observed between maximal inspiratory (MIP) and expiratory (MEP) pressure (r= -0.76), MEP and pulse oxymetry (r=0.58), MIP and percent weight loss (%WL; r=0.59), and between MIP, total and subscale respiratory scores (ALSFRS-R) with %WL. With regard to the GB, correlation was found between MEP and body mass index (BMI) (r=0.97). In both GA and GB correlations were noticed between the BMI and the variables mass (kg), fat (%), arm and wrist circumference (cm), and tricipital, subscapular and supra-iliac skinfolds (mm), as well as the arm muscle circumference (cm) and fatty arm muscular area (mm 2 ). Conclusion: It is suggested that the application of simple anthropometric measurements could be useful in routine monitoring of patients with ALS.

Brazilian Journal of Otorhinolaryngology (impresso), 2009

Opaciente disfágico apresenta prejuízos em diversos aspectos, sendo a atuação interdisciplinar fu... more Opaciente disfágico apresenta prejuízos em diversos aspectos, sendo a atuação interdisciplinar fundamental para definição do diagnóstico e da conduta. A atuação em conjunto na avaliação clínica e videoendoscópica é de extrema importância. OBJETIVO: Estudar a correlação entre a avaliação clínica (ACD) e videoendoscópica da deglutição (VED) por meio da classificação do grau de severidade e a análise qualitativo/descritiva dos procedimentos. FORMA DE ESTUDO: Estudo transversal, descritivo, comparativo. MATERIAL E MÉTODO: Realizado no março a dezembro de 2006 no ambulatório de Otorrinolaringologia/Disfagia de um hospital do interior de São Paulo. Foram avaliados pela ACD e VED 30 pacientes disfágicos com diferentes doenças. Os dados foram classificados por meio de escalas de severidade e análise qualitativa/descritiva. RESULTADOS: A correlação entre as escalas de severidade de ACD e VED apontou concordância baixa (KAPA = 0,4) de modo estatisticamente significante (p=0,006). A correlação entre a análise qualitativa/descritiva apontou concordância excelente (KAPA=0.962) estatisticamente significante (p<0.001) para a amostra total. CONCLUSÃO: A concordância baixa entre as escalas de severidade aponta a necessidade da realização de ambos os procedimentos, reforçando a VED como procedimento factível. A análise qualitativa descritiva apontou concordância excelente, dado que reforça a necessidade da compreensão da deglutição como um processo.

Arquivos De Gastroenterologia, 2010

OBJECTIVE: We evaluated the efficacy of oral supplementation with milk whey proteins and modified... more OBJECTIVE: We evaluated the efficacy of oral supplementation with milk whey proteins and modified starch (70%WPI:30%MS), on nutritional and functional parameters of patients with ALS. METHOD: A prospective randomized double-blind study was performed with 16 ALS patients, divided in two groups, the treatment group received (70%WPI:30%MS) and the control group received (maltodextrin). They underwent prospective nutritional and functional assessment for 4 months. RESULTS: Patients in the treatment group presented weight gain, increased body mass index (BMI), increased arm muscle area and circumference, higher albumin, white blood cell and total lymphocyte counts, and reduced creatine-kinase, aspartate aminotransferase and alanine aminotransferase. In the control group, biochemical parameters did not change, but weight and BMI declined. CONCLUSION: Our results indicate that the agglomerate 70%WPI:30%MS may be useful in the nutritional therapy of patients with ALS.

É importante ressaltar que a partir da reformulação curricular dos cursos de enfermagem (ANO) e m... more É importante ressaltar que a partir da reformulação curricular dos cursos de enfermagem (ANO) e medicina (ANO), as contribuições dos teóricos da educação, assim como por exemplo, o Programa de Reestruturação dos Hospitais Universitários Federais-REHUF, direcionaram ações que contemplassem a integração ensino-serviço em prol da formação em saúde de forma interdisciplinar e consequentemente a melhoria na assistência prestada ao usuário dos serviços de saúde de forma mais resolutiva.

Saude E Sociedade, 2009

Among workers, the largest category that makes professional use of the voice is that of teachers.... more Among workers, the largest category that makes professional use of the voice is that of teachers. This article aims to discuss, from the teacher's perspective, the use of the voice in the teaching practice and the prevention of vocal problems. It is a qualitative-descriptive case study carried out with 25 teachers. Based on a semi-structured script, interviews were conducted to ascertain the subjects' relationship with their voice and with the teaching work, and also to receive suggestions for preventive actions. Results indicated that the voice alteration was perceived, but the teachers usually gave more importance to making sure they were being understood and to exerting control over the students. The teachers who had not had vocal problems yet knew colleagues who had; they knew the risk to which they were exposed and, apparently, they regarded it as a natural and expected consequence of the teaching practice. They believed that interventions with the students, the employer's support, the presence of specialists in the school and the work with the specific needs they face in the classroom could help them preserve their voices.

Arquivos De Neuro-psiquiatria, 2005

Long-term complications in levodopa treated Parkinson's disease (PD) patients caused a resurgence... more Long-term complications in levodopa treated Parkinson's disease (PD) patients caused a resurgence of interest in pallidotomy as an option of treatment. However, postoperative complications such as speech disorders can occur. PURPOSE: The aim of this study is to evaluate the acoustic voice in PD patients, before and after posteroventral pallidotomy. METHOD: Twelve patients with PD were submitted to neurological and voice assessments during the off and on phases, in the pre-operative, 1st and 3rd post-operative months. The patients were evaluated with the UPDRS and the vocal acoustic parameters - f0, NHR, jitter, PPQ, Shimmer, APQ (using the software MultiSpeech - Kay Elemetrics - 3700). RESULTS: The off phase UPDRS scores revealed a tendency to improvement at the 1st month and the off phase worsened. The shimmer and APQ improved. CONCLUSION: This study shows that pallidotomy has little improvement on functional use of communication of PD patients.

Acta Neurologica Scandinavica, 2009

Voice and speech disorders are common in Parkinson's disease patients and may lead to social isol... more Voice and speech disorders are common in Parkinson's disease patients and may lead to social isolation. We employed routine clinical voice therapy measures to evaluate the effect of voice rehabilitation. Twenty patients with a stable drug regimen participated in this study. The patients were assessed before and after a program of voice rehabilitation consisting of 13 group therapy sessions during 1 month, with emphasis on the increase in laryngeal sphincteric activity. Voice rehabilitation produced an increase in maximal phonation times, decrease in the values of s/z ratio and air flow, increase in vocal intensity, decrease in the complaints of weak and strained-strangled voice and monotonous and unintelligible speech and elimination of complaints of swallowing alterations. These data indicate a greater glottic efficiency after voice rehabilitation reflecting a more functional oral communication.

Arquivos De Neuro-psiquiatria, 2008

Objective: To establish correlations between nutritional, functional and respiratory indices of p... more Objective: To establish correlations between nutritional, functional and respiratory indices of patients with amyotrophic lateral sclerosis (ALS). Method: Twenty patients (13 appendicular -GA and 7 bulbar -GB) were included in the multidisciplinary study at the Neurological Clinic Ambulatory of the University of Campinas Hospital. Results: Among the GA type significant correlation was observed between maximal inspiratory (MIP) and expiratory (MEP) pressure (r= -0.76), MEP and pulse oxymetry (r=0.58), MIP and percent weight loss (%WL; r=0.59), and between MIP, total and subscale respiratory scores (ALSFRS-R) with %WL. With regard to the GB, correlation was found between MEP and body mass index (BMI) (r=0.97). In both GA and GB correlations were noticed between the BMI and the variables mass (kg), fat (%), arm and wrist circumference (cm), and tricipital, subscapular and supra-iliac skinfolds (mm), as well as the arm muscle circumference (cm) and fatty arm muscular area (mm 2 ). Conclusion: It is suggested that the application of simple anthropometric measurements could be useful in routine monitoring of patients with ALS.

Brazilian Journal of Otorhinolaryngology (impresso), 2009

Opaciente disfágico apresenta prejuízos em diversos aspectos, sendo a atuação interdisciplinar fu... more Opaciente disfágico apresenta prejuízos em diversos aspectos, sendo a atuação interdisciplinar fundamental para definição do diagnóstico e da conduta. A atuação em conjunto na avaliação clínica e videoendoscópica é de extrema importância. OBJETIVO: Estudar a correlação entre a avaliação clínica (ACD) e videoendoscópica da deglutição (VED) por meio da classificação do grau de severidade e a análise qualitativo/descritiva dos procedimentos. FORMA DE ESTUDO: Estudo transversal, descritivo, comparativo. MATERIAL E MÉTODO: Realizado no março a dezembro de 2006 no ambulatório de Otorrinolaringologia/Disfagia de um hospital do interior de São Paulo. Foram avaliados pela ACD e VED 30 pacientes disfágicos com diferentes doenças. Os dados foram classificados por meio de escalas de severidade e análise qualitativa/descritiva. RESULTADOS: A correlação entre as escalas de severidade de ACD e VED apontou concordância baixa (KAPA = 0,4) de modo estatisticamente significante (p=0,006). A correlação entre a análise qualitativa/descritiva apontou concordância excelente (KAPA=0.962) estatisticamente significante (p<0.001) para a amostra total. CONCLUSÃO: A concordância baixa entre as escalas de severidade aponta a necessidade da realização de ambos os procedimentos, reforçando a VED como procedimento factível. A análise qualitativa descritiva apontou concordância excelente, dado que reforça a necessidade da compreensão da deglutição como um processo.

Arquivos De Gastroenterologia, 2010

OBJECTIVE: We evaluated the efficacy of oral supplementation with milk whey proteins and modified... more OBJECTIVE: We evaluated the efficacy of oral supplementation with milk whey proteins and modified starch (70%WPI:30%MS), on nutritional and functional parameters of patients with ALS. METHOD: A prospective randomized double-blind study was performed with 16 ALS patients, divided in two groups, the treatment group received (70%WPI:30%MS) and the control group received (maltodextrin). They underwent prospective nutritional and functional assessment for 4 months. RESULTS: Patients in the treatment group presented weight gain, increased body mass index (BMI), increased arm muscle area and circumference, higher albumin, white blood cell and total lymphocyte counts, and reduced creatine-kinase, aspartate aminotransferase and alanine aminotransferase. In the control group, biochemical parameters did not change, but weight and BMI declined. CONCLUSION: Our results indicate that the agglomerate 70%WPI:30%MS may be useful in the nutritional therapy of patients with ALS.

É importante ressaltar que a partir da reformulação curricular dos cursos de enfermagem (ANO) e m... more É importante ressaltar que a partir da reformulação curricular dos cursos de enfermagem (ANO) e medicina (ANO), as contribuições dos teóricos da educação, assim como por exemplo, o Programa de Reestruturação dos Hospitais Universitários Federais-REHUF, direcionaram ações que contemplassem a integração ensino-serviço em prol da formação em saúde de forma interdisciplinar e consequentemente a melhoria na assistência prestada ao usuário dos serviços de saúde de forma mais resolutiva.