Abstract Introduction: The nose and throat are areas of high viral load, which could place otolaryngologists at an even higher risk for COVID-19 than other health-care workers. Objective: To investigate the prevalence of antibodies against SARS-CoV-2 in otorhinolaryngologists in southern Brazil, its relationship to demographic data, professional practice and reported symptoms of COVID-19, and compare it with official data on other health-care workers of the state and the general population in the same period. Methods: In this cross-sectional multicenter study, otolaryngologists actively practicing officially registered in Rio Grande do Sul were screened for IgM and IgG antibodies against SARS-CoV-2 from August 1 to September 15, 2020. A questionnaire was also applied. Results: We screened 358 (80.1%) of 447 actively practicing otolaryngologists (195 [54.5%] male; mean [SD] age, 47.77 [13.57] years; range, 26-84 years). Twenty-three were positive for IgM and/or IgG (6.4%). This result was significantly associated with reports of infected household contacts (19/315 negatives and 8/23 positives; p<0.001). From 23 seropositive participants, 14 were asymptomatic (60.9%; p< 0.001). There were no significant associations between seroconversion and age, sex, number of patient appointments and surgical procedures, workplace (hospital or private practice), patients with or without respiratory symptoms, or level of personal protective equipment used. The rate of COVID-19 in all health-care workers in the state was 7.69% at the end of the same period. Data from state government seroprevalence was 5.26 (risk ratio [RR]; 95% CI 3.27–8.45) and 4.66 (RR; 95% CI 2.93–7.43) times higher in otolaryngologists than in the general population in August and September, respectively. Conclusion: Otolaryngologists had a higher seroconversion rate than the general population. Using personal protective equipment, the level of occupational exposure did not result in higher rates of infection than other health-care workers, but the presence of infected household contacts was associated with higher rates of seroconversion.

RESUMO: Objetivo: verificar e correlacionar medidas vocais acústicas de fonte glótica e características laríngeas em mulheres sem afecções laríngeas e sem queixas vocais após a fonação em tubo de vidro imerso em água. Métodos: vinte e quatro mulheres, entre 18 e 40 anos de idade, foram avaliadas e distribuídas de forma igualitária no grupo de estudo e no grupo de controle. Realizaram-se coleta da vogal /a:/ e videolaringoestroboscopia antes e após a execução da técnica, no grupo estudo, e antes e após um período de silêncio no controle. Realizou-se análise vocal acústica e perceptivoauditiva e análise estatística com Wilcoxon, Qui-quadrado e Spearman (p<0,05). Resultados: grupo estudo: melhora do quociente de perturbação do pitch suavizado, índice de turbulência vocal, Shimmer percentual e Shimmer em dB; melhora da soprosidade na avaliação perceptivoauditiva; na videolaringoestroboscopia, a constrição do vestíbulo laríngeo não se alterou significantemente. Conclusão: a técnica de fonação em tubo de vidro imerso em água reduziu a aperiodicidade da vibração glótica e do ruído, com aumento da energia harmônica e consequente melhora do sinal glótico. Na videolaringoestroboscopia, a constrição do vestíbulo laríngeo não se alterou significantemente, o que sugere que a técnica não provoca hipertensão laríngea.

ABSTRACT: Purpose: to check and correlate measures of vocal acoustic of the glottal source and laryngeal characteristics of women without laryngeal disorders and without vocal complaints, after the phonation in a glass tube immersed in water. Methods: twenty-four women, between 18 and 40 years, were available and allocated in two groups, being 12 in the study group and 12 in the control group. Were performed collect the vowel /a:/ and videolaryngostroboscopy before and after the execution of technique, in the study group, and before and after a period of silence in the control. Was performed an analysis vocal acoustics and hearing perceptual and statistical analysis with Wilcoxon, Chi-square and Spearman (p<0,05). Results: SG: improvement of the smoothed pitch perturbation quotient, voice turbulence index, Shimmer percentage and Shimmer in dB; improvement of breathiness in RASATI; in the videolaryngostroboscopy, the laryngeal vestibule constriction did not change significantly. CONCLUSION: the technique phonation in a glass tube immersed in water reduced of vibration glottal aperiodicity and the noise, with increased energy harmonic and consequent improvement of the glottal signal. In videolaryngostroboscopy, the laryngeal vestibule constriction did not change significantly, this suggests that the technique does not cause laryngeal hypertension.

Introdução O uso de ventilação não invasiva sob a forma de Continuous Positive Airway Pressure (CPAP) está entre as principais opções terapêuticas no manejo de pacientes com apneia obstrutiva do sono (AOS). No entanto, os efeitos obtidos logo na primeira noite de uso do CPAP ainda são pouco relatados. Objetivo Avaliar os efeitos agudos do CPAP sobre variáveis polissonográficas em pacientes com AOS. Materiais e métodos Trata-se de uma série de casos, com um total de 31 pacientes (55,8 ± 11,4 anos; 22 homens) em fase inicial de tratamento com o CPAP no Instituto do Sono de Santa Maria (RS). Os sujeitos foram avaliados pela polissonografia sem e com CPAP (10,2 ± 3,1 cmH2O), em dias diferentes, por meio das seguintes variáveis: estágios do sono 1, 2 e 3 (N1, N2 e N3), sono REM (rapid eyes moviment), índice de apneia e hipopneia (IAH), IAH no sono REM (IAHREM) e índice de microdespertares (IMD). Resultados Houve diminuição com o uso do CPAP no N2 (p < 0,001), IAH (p < 0,001), IAHREM (p < 0,001) e IMD (p = 0,001). O N3 (p = 0,006) e o sono REM (p < 0,001) aumentaram durante a noite com o CPAP. Conclusão Este estudo demonstrou que o CPAP, logo na primeira noite de sua utilização, promove um maior equilíbrio entre as fases e melhora na qualidade do sono de pacientes com AOS. Esses resultados devem ser apresentados aos pacientes e aos seus familiares, visando estimular maior adesão na fase inicial do tratamento com o CPAP.

Introduction The use of non-invasive ventilation in the form of continuous positive airway pressure (CPAP) is among the main therapeutic options for patients with obstructive sleep apnea (OSA). Yet the effects of CPAP obtained on the first night of use are underreported. Objective To evaluate the acute effects of CPAP on polysomnographic variables in patients with OSA. Materials and methods This study is a case series with 31 patients (55.8 ± 11.4 years; 22 men) in the initial phase of CPAP treatment. The subjects were evaluated by means of polysomnography with and without CPAP (10.2 ± 3.1 cmH2O) and without CPAP, on different days, by means of the following variables: sleep stages 1, 2 and 3 (N1, N2 and N3), rapid eye movement (REM) sleep, apnea and hypopnea index (AHI), AHI in REM sleep (AHIREM) and the micro-arousal index (MAI). Results The use of CPAP resulted in a reduction of N2 (p < 0.001), AHI (p < 0.001), AHIREM (p < 0.001) and MAI (p = 0.001). There was an increase in N3 (p = 0.006) and REM sleep (p < 0.001) during the night with use of CPAP. Conclusion This study demonstrated that, from the first night of use by patients with OSA, CPAP promotes greater balance between sleep phases, and improves sleep quality. These results should be presented to patients and their families in order to encourage greater adherence in the initial phase of treatment with CPAP.