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R A Dedivitis

Publications and source records attributed to R A Dedivitis.

6 recordsLinked to original sources
PubMed2004

Interobserver perceptual analysis of smokers voice.

The purpose of this study was to investigate variations in the voice by three experienced speech-language therapists. Forty-eight men and nine women from the Associação dos Alcoólicos Anônimos, Santos were studied. Their ages were from 28 to 81 years, with median of 49 years and everyone was a smoker for 60 to 720 months. Most of them used more than 20 cigarettes a day and all of them had stopped alcohol use for 1 to 25 months. The perceptual analysis of the voices was performed by means of the GRBAS scale. The voice sample consisted of a sustained vowel /a/ at a comfortable pitch and loudness level. The three judges were blinded to the opinion of their colleagues and a kappa test was applied. For roughness, the concordance rates were 59.6% for observers 1 and 2 (kappa = 0.234); 47.4% for 1 and 3 (kappa = 0.047) and 52.6% (kappa = 0.016) for 2 and 3. For breathiness, the concordance rates were 80.7% for observers 1 and 2 (kappa = 0.191); 57.9% for 1 and 3 (kappa = 0.147) and 57.9% (kappa = 0.156) for 2 and 3. With regard to asthenic quality, there was concordance of 100% for observers 1 and 2, so kappa could not be applied; the concordance rate was 96.5% for 1 and 3 and for 2 and 3. The evaluation for strained voice revealed concordance rates of 71.9% for observers 1 and 2 (kappa = -0.017); 59.6% for 1 and 3 (kappa = 0.095) and 70.2% (kappa = 0.039) for 2 and 3. The disagreement among the observers was worst for pathological rather than normal voices; when disagreement was present among experienced judges, it was of only one point in the scale used.

Adult↗
PubMed2000

Frontal sinus adenocarcinoma.

CONTEXT: Paranasal sinus cancer is considered rare, with an incidence of less than 1 per 100,000 per year, with the frontal sinus being the primary site in only 0.3%. We report a case of adenocarcinoma arising in the frontal sinus. DESIGN: Case report. CASE REPORT: A 59-year-old woman, secretary, came in February 1998 with a 4-month history of low intensity frontal headache. She denied contact with wood dust. On examination a non-tender swelling was noted over her right forehead next to the medial aspect of the right orbit. CT scan showed a soft-tissue mass involving frontal sinus with intracranial invasion through the posterior wall. The anterior ethmoid sinus and the medial aspect of the right orbit were also involved. MRI demonstrated dural thickening in communication with the frontal mass. She underwent an en-bloc tumor resection by craniotomy including orbital clearance. Histology revealed an adenocarcinoma. After surgery she had tumor recurrence, and chemotherapy and radiotherapy were started resulting in partial improvement.

Adenocarcinoma↗
PubMedDate not supplied

Transcutaneous fine needle aspiration biopsy of the preepiglottic space.

OBJECTIVE: To evaluate transcutaneous fine needle aspiration biopsy of the preepiglottic space for staging supraglottic squamous cell carcinoma. STUDY DESIGN: We studied 28 patients who underwent total or horizontal supraglottic laryngectomy as their main therapy modality due to supraglottic squamous cell carcinoma, followed in some cases by adjuvant radiation therapy. All the patients underwent transcutaneous fine needle aspiration. RESULTS: The cytopathologic examination of the material obtained by aspiration was compared to the histopathologic analysis of the laryngectomy specimens; the efficiency was 96.4%. The method did not cause any morbidity. CONCLUSION: Transcutaneous fine needle aspiration biopsy of the preepiglottic space is useful for preepiglottic space evaluation, with a high correlation with histopathologic results and no morbidity.

Aged↗
PubMedDate not supplied

Surgical treatment of the substernal goitre.

This report describes the surgical experience gained from 32 patients with substernal goitre, operated on during January 1995 to December 1997. The material corresponds to 15.7% of the total thyroidectomies performed. The diagnosis was clinical. In spite of 65.6% of the patients being asymptomatic, breathing problems, dysphagia and hyperthyroidism were observed. The patients underwent tests of thyroid function, simple chest radiograph and computerized tomography of mediastinum. All patients underwent surgical treatment through a transverse cervical incision. Two patients (6.25%) needed median sternotomy. Vocal cord palsy (3.12%), transient hypocalcemia (6.25%) and one death due to cardiac causes (3.12%) were the complications that occurred.

Adult↗
PubMedDate not supplied

Papillary thyroid carcinoma in thyroglossal duct cyst.

Thyroglossal duct remnants are the most common midline neck swellings, but carcinoma is found in approximately 1% of these lesions. The cysts are usually asymptomatic and the presentation of the patient with carcinoma is indistinguishable from the common cyst. Papillary adenocarcinoma comprises 75-85% of the tumors reported. A 36-year-old woman underwent Sistrunk procedure for excision of a thyroglossal cyst. No thyroid abnormality was noted pre-operatively nor during the surgical examination. The histopathological examination revealed papillary carcinoma. She has been maintained on thyroxine suppression and was doing well at 14 months' follow-up. Carcinoma of the thyroglossal duct cyst is rare. The ultrasonographic examination should be performed pre-operatively for thyroid gland study. The main question is what to do with the thyroid gland. There still is controversy about thyroid removal for a papillary carcinoma, but all the patients should receive suppressive doses of thyroid hormone. As the cure rate is 95% for the patients whose thyroid is preserved and further postoperative complications are avoided, we can consider that the optimal surgical procedure for thyroglossal duct carcinoma is the same as that for the benign cyst.

Adult↗