ABSTRACT Objective: to relate the risk of dysphagia and aspects of eating behavior to the cognitive aspects of elderly people with dementia. Methods: 35 elderly patients with Alzheimer or vascular dementia were submitted to clinical and cognitive assessments as well as to a questionnaire for assessing appetite/eating disorder and the Dysphagia Risk Evaluation Protocol (DREP). Appropriate statistical tests were applied adopting a significance level lower than 0.05. Results: mild dementia occurred in 16 cases, moderate, in 14, and severe, in 5. Complaints of choking/coughing in the medical history, and signs of dysphagia in the DREP, occurred in 9 and 25 elderly patients, respectively, with no differences regarding the type and severity of dementia. Patients presented with dysphagia and alterations in the oral and pharyngeal phases of DREP, were older. Alterations in the pharyngeal phase were associated with poorer performance in the Mini-Mental State Examination (total score, attention/calculation, language). Changes in appetite/weight/eating habits were associated with signs of dysphagia, increasing severity of dementia and functional impairment. Conclusion: choking/coughing and signs of dysphagia were high. Changes in appetite/weight/eating habits were related to the severity of dementia and presence of dysphagia, and cognitive disorders and old age were associated with dysphagia.

Resumo: Este artigo tem por objetivo analisar e comparar o uso de protocolos brasileiros e norte-americanos para videofluoroscopia da deglutição em pacientes com histórico de acidente vascular encefálico. Trata-se de uma revisão bibliográfica de artigos brasileiros e norte-americanos. Foram selecionados artigos com descrição de procedimentos para videofluoroscopia da deglutição em sujeitos que sofreram acidente vascular encefálico, publicados entre 2003 e 2013. Os procedimentos descritos para realização de videofluoroscopias foram analisados de forma quantitativa e qualitativa. Consideraram-se as variáveis: posicionamento para o exame, consistências e quantidades de oferta de bolo, tipos de utensílios e utilização de protocolos Foram encontrados 16 artigos que atenderam aos critérios supracitados, sendo nove (56,25%) norte-americanos e sete (43,75%) brasileiros. Observou-se que quatro dos estudos nacionais (57,14%) não relatam as quantidades oferecidas, enquanto todos os artigos norte-americanos detalharam as quantidades, que variaram entre 2 e 15 mL; os tipos de alimento e suas consistências foram detalhadas em todos os estudos nacionais e norte-americanos, porém os nacionais o fizeram de forma genérica, sem identificação dos alimentos. Quanto à posição do paciente durante o exame, 57,14% dos artigos nacionais não relataram e todos os artigos norte-americanos o fizeram. Os utensílios para oferta do bolo são citados em 55,55% dos artigos norte-americanos e em apenas 14,28 % dos nacionais. Quanto à utilização de protocolos para avaliação 33% dos estudos norte-americanos não os citam, comparados aos 71,42% dos nacionais. Observou-se a necessidade de padronização dos procedimentos e terminologias utilizadas na videofluoroscopia da deglutição, de modo a facilitar a intercompreensão e reprodutibilidade dos estudos.

Abstract: The aim of this study is to analyze and compare the use of Brazilian and North American protocols for videofluoroscopy in patients with stroke. A literature review of Brazilian and North American articles was conducted. Articles containing the description of procedures for videofluoroscopy of swallowing in subjects who had stroke published between 2003 and 2013 were selected. Qualitative and quantitative analysis of the procedures for videofluoroscopy was performed. The following variables were considered: positioning for the exam, consistency and quantity of the bolus, types of tools and use of protocols. Sixteen studies were included, nine (56.25%) North American and 7 (43.75%) Brazilian. It was observed that four of the national studies (57.14%) did not report the quantity offered, while all American ones detailed it between 2 and 15 mL; the types of food and their consistencies were detailed in all national and North American studies, but national studies did it generically, without identification of foods. Regarding the position of the patient during the examination, 57.14% of the national articles did not report it, while all American articles did. Equipment used to offer the bolus are mentioned in 55.55% of Americans articles and in just 14.28% of the national ones. As for the use of protocols, only 33% of American articles did not mention it, while 71.42% of national articles failed to mention it. There is a need to standardization of procedures and terminologies in videofluoroscopy, both in Brazilian as North American publications.

OBJETIVO: analisar as informações adquiridas por profissionais da voz em ações preventivas e verificar o impacto destas para a saúde vocal. MÉTODOS: participaram 100 profissionais da voz, de ambos os sexos, entre 16 e 55 anos, sendo professores, locutores, cantores, atores e operadores de tele-serviços. Os sujeitos estudados responderam a um questionário sobre cuidados com a voz, a proveniência das orientações recebidas e a aplicação das mesmas e, ainda, a qualificação destas quanto sua eficácia. RESULTADOS: as informações mais citadas, a partir das orientações recebidas foram: hidratação, apontada por 66% (N=66) dos sujeitos e o consumo de maçã citado por 32% (N=32), não sendo, no entanto, as mais apontadas como utilizadas pelo grupo estudado. Os exercícios de aquecimento vocal são utilizados por todos os sujeitos que os referiram (12%), sendo mais praticados pelos cantores. Para 66% dos sujeitos as informações e orientações foram recebidas de diversas fontes profissionais, enquanto que 34% referiram o fonoaudiólogo. Os sujeitos que referiram seguir as orientações sobre os cuidados com a voz (58%, N=58) afirmaram observar melhora na qualidade vocal. CONCLUSÃO: o relevante desconhecimento por parte dos profissionais da voz estudados em relação aos cuidados com a saúde vocal pode ser atribuído a pouca importância dada à saúde preventiva. No entanto, os sujeitos que afirmaram seguir as orientações recebidas confirmam melhoras na voz. Conclui-se que o fonoaudiólogo pode ser considerado como referência de orientação, quando comparado com os diferentes seguimentos de profissionais.

PURPOSE: to analyze the information acquired by voice professionals in preventive speech actions and check their impact in relation to vocal health. METHODS: 100 voice professionals took part in this study, men and women, between 16 and 55-year old, including teachers, announcers, singers, actors and telemarketing operators. The studied subjects answered a questionnaire on how to take care of voice, origin of received guidance and its application, and how the interviewed subjects qualify its effectiveness. RESULTS: the most cited information, considering the received guidance, was: hydration of vocal cords by 66% (N=66) of the subjects and consumption of apple by 32% (N=32) of the subjects, however, they were not the most used by them. Voice warm up exercises were used by 12% of all those that had cited them, being mostly practiced by the singers. For 66% of the subjects, the information and guidance were received from other professionals while 34% got them from the speech therapists. And 58% (N= 58) of the people who closely followed the guidance steps affirmed having noted an improvement in their voice quality. CONCLUSION: the relevant lack of knowledge on the part of the studied voice professionals in relation to the cares with the vocal health can be attributed to the little importance given to preventive speech actions. However, the subjects that affirmed following the received guidance confirmed improvements in voice quality. We may conclude that speech therapists can be considered as guidance reference when compared with different segments of professionals.