Abstract Objectives: Vestibular migraine is a neurological disorder characterized by the association of vertigo and headache, affecting up to 1% of the population. Among its differential diagnoses is endolymphatic hydrops. The aim of this study was to investigate the role of cervical vestibularevoked myogenic potential and electrocochleography in the diagnosis of vestibular migraine. Method: Thirteen women with clinical diagnosis of vestibular migraine (mean age 44 years) and 13 healthy volunteers without auditory and/or vestibular complaints matched for sex and age were evaluated by performing hydrops examinations of cervical vestibular-evoked myogenic potential and electrocochleography. Results: The presence of vertigo and headache was reported by all members of the group with vestibular migraine, associated with symptoms such as nausea, photophobia, and phonophobia. Tinnitus was the most frequent auditory complaint. A significant increase in P1 and N1 latencies was observed in the test group. There was no significant difference in the occurrence of asymmetry and decreased amplitude of the cervical vestibular-evoked myogenic potential. Electrocochleography showed an increase in amplitude of the summation potential. The altered SP/AP ratio was double in the group with vestibular migration, without statistical significance. Conclusions: Changes in latency increase of cervical vestibular-evoked myogenic potential suggests a central lesion. Patients with vestibular migraine may present electrocochleography compatible with endolymphatic hydrops. Level of evidence: Level 4. Objectives 1 population Method mean 4 years andor or evoked Results nausea photophobia phonophobia complaint P N SPAP SP AP migration significance Conclusions lesion evidence

RESUMO Os eventos fenológicos, em particular, a fenologia da floração e os aspectos da biologia floral ajudam a compreender a relação das plantas com seus polinizares. Assim, essa pesquisa buscou estimar, em condição semiárida, a relação entres diferentes genótipos de abóbora (Cucurbita moschata Duch.) e o ambiente, sob os aspectos da biologia reprodutiva. Quatro cultivares foram avaliados em três ciclos produtivo, mensurando as variáveis emissão diária de flores, receptividade do estigma, o tempo de antese e a morfometria das flores pistiladas e estaminadas. A emissão de flores masculinas foi superior as flores femininas com maior proporção no terceiro ciclo produtivo caracterizado por maior temperatura do ar e menor umidade relativa. Entre cultivares o ´Jacarezinho` e ´Sergipe` apresentaram a maior e a menor emissão, respectivamente. As flores femininas permanecem abertas em maior tempo em relação as flores masculinas e os estigmas permaneceram receptivos até o fechamento das flores. Considerando os dados morfométricos, há associação positiva entre o cumprimento da pétala e o diâmetro da corola e entre o acesso ao néctar e o tamanho da antera, com diferença entre os cultivares e as condições de cultivo.

ABSTRACT Phenological events, in particular, flowering phenology and aspects of floral biology help to understand the relationship of plants with their pollinators. Thus, this study sought to estimate, under semi-arid conditions, the relationship between different genotypes of pumpkin or winter squash (Cucurbita moschata Duch.) and the environment, under the aspects of reproductive biology. Four cultivars were evaluated in three productive cycles, measuring the variables daily flower emergence, stigma receptivity, anthesis time and the morphometry of pistil and staminate flowers. The production of male flowers was higher than female flowers with a higher proportion in the third production cycle characterized by higher air temperature and lower relative humidity. Among cultivars, ‘Jacarezinho’ and ‘Sergipe’ presented the highest and the lowest values of flower production, respectively. Female flowers remain open longer than male flowers and stigmas remain receptive until the flowers close. Considering the morphometric data, there is positive association between the petal length and the corolla diameter, and between access to the nectar and the anther size, with a difference between cultivars and cultivation conditions.

Abstract Introduction The China Health Authority alerted the World Health Organization (WHO) of several cases of pneumonia, and the WHO has declared the novel coronavirus (COVID-19) a global pandemic. Mastoidectomy is a high-risk aerosol generating procedure with the potential to expose the surgeon to infectious particles. Objective Aim to develop a low-cost prototype for a barrier device that can be used during mastoidectomy. Methods Describe the steps involved during otological emergency, requiring immediate surgical procedure, in untested patients. The Otorhinolaryngology Surgical Team of Walter Cantídio Hospital developed the barrier for particle dispersion presented here. Results During surgery, the prototype did not compromise visualization of the surgical field and instrumentation. Microscope repositioning was not compromised or limited by tent Instrumentation and instrument pouch under the Microscope-Tent (MT) performed surgery. After surgery, the plastic sheet was removed simply, without requiring strength. Bone dust and irrigation droplets were collected on the tent. Conclusion Our team developed and practiced, in an otologic emergency, a low-cost and reproducible barrier device that can be used in mastoidectomy in COVID-19 patients. Further tests on efficacy may be necessary.

Abstract Purpose: To evaluate the ability of dexamethasone to protect against cisplatin (CDDP)-induced ototoxicity. Methods: Male Wistar rats were divided into the following three groups: 1) Control (C): 6 animals received intraperitoneal (IP) saline solution, 8 ml/kg/day for four days; 2) C + CDDP: 11 animals received 8 ml/kg/day of IP saline and, 90 min after saline administration, 8 mg/kg/day of IP CDDP for four days; and 3) DEXA15 + CDDP: 11 animals received IP dexamethasone 15 mg/kg/day and, 90 min after dexamethasone administration, received 8 mg/kg/day of IP CDDP for four days. Results: It was found that dexamethasone did not protect against weight loss in CDDP-exposed animals. The mortality rate was comparable with that previously reported in the literature. The auditory threshold of animals in the DEXA15 + CDDP group was not significantly altered after exposure to CDDP. The stria vascularis of animals in the DEXA15 + CDDP group was partially preserved after CDDP exposure. Conclusions: Dexamethasone at the dose of 15 mg/kg/day partially protected against CDDP-induced ototoxicity, based on functional evaluation by brainstem evoked response audiontry (BERA) and morphological evaluation by optical microscopy. However, dexamethasone did not protect against systemic toxicity.

Abstract Purpose: To investigate the participation of cysteinyl leukotrienes in the pathophysiology of oral mucositis. Methods: Oral mucositis was induced in hamsters using 5-fluorouracil (5-FU; 60 and 40 mg/kg; i.p., on days 1 and 2, respectively, and with excoriations in jugal mucosa on day 4). Montelukast (10, 20, or 40 mg/kg/d; gavage), MK886 (3 mg/kg/d, i.p.), or saline or celecoxib (7.5 mg/kg/d; i.p.) was administered 1 h prior to 5-FU and daily, until the fourth (MK886) or tenth day, when the animals were euthanized and their jugal mucosa was collected for macroscopic, histopathological, and immunohistochemical evaluation. Results: Neither montelukast nor MK-886 prevented the oral mucositis induced by 5-FU, as observed by histopathological evaluation. In addition, we did not find significant differences in the expression of inducible nitric oxide synthase-2, cyclooxygenase-2, or interleukin (IL)-1β between the experimental and control groups. However, we did observe a significant decrease in tumor necrosis factor (TNF)-α expression for all doses of montelukast; we also observed a significant decrease in IL-10 with 40 mg/kg/d and MK 886. Conclusions: Cysteinyl leukotrienes do not play an important role in experimental oral mucositis induced by 5-FU. There is a modulating action specifically on TNF-α.

A fibrose cística (FC) resulta de mutação no gene regulador da condutância transmembrana, responsável pelo controle dos processos secretores. As vias aéreas superiores (VAS) geralmente são comprometidas na forma de pansinusite crônica. OBJETIVO: Avaliar as alterações das VAS nos pacientes com FC e determinar a correlação entre os achados tomográficos e endoscópicos nasossinusais e a gravidade da doença. MÉTODO: Estudo transversal, prospectivo com 20 pacientes maiores de 5 anos com diagnóstico de FC avaliando escore de Shwachman-Kulczycki (S-K), tomografia de seios paranasais (TC) (escore de Lund-Mackay) e videonasofibroscopia (escore de Meltzer). RESULTADOS: Alterações tomográficas foram observadas em 94% dos casos. Alterações endoscópicas nas VAS foram encontradas em dez pacientes. Pólipo nasal ocorreu em três pacientes (15%). Observou-se correlação entre a intensidade das alterações da TC e o escore S-K (p = 0,0097) e entre os achados endoscópicos e o escore S-K (p = 0,0318). Observou-se relação positiva entre a presença de colonização crônica e os achados endoscópicos (p = 0,0325), o que não foi observado com os achados tomográficos (p = 0,2941). CONCLUSÃO: Há correlação inversa entre o escore clínico de S-K e os achados de TC e nasofibroscopia. Portanto, os pacientes clinicamente mais graves de acordo com o escore de S-K apresentam maior comprometimento de VAS.

Cystic Fibrosis (CF) results from mutation in the transmembrane conductance regulator gene, responsible for controlling secretory processes. The upper airways (UA) are usually involved in the form of chronic pansinusitis. OBJECTIVE: To evaluate UA changes in patients with CF and to establish the correlations between sinonasal CT and endoscopic endonasal findings and disease severity. METHOD: Cross-sectional and prospective study with 20 patients older than 5 years with CF, assessing the Shwachman-Kulczycki (S-K) score, paranasal sinus tomography (CT) (Lund-Mackay score) and nasal endoscopy (Meltzer score). RESULTS: CT scan alterations were observed in 94% of cases. Endoscopic alterations findings in the upper airways were found in 10 patients. Nasal polyps were found in 3 patients (15%). There was a correlation between the intensity of changes on the CT and S-K score (p = 0.0097), and between endoscopic findings and S-K score (p = 0.0318). There was a positive correlation between the presence of chronic colonization and endoscopic findings (p = 0.0325), which was not observed on the CT (p = 0.2941). CONCLUSION: There is an inverse correlation between the S-K clinical score and nasal endoscopy and CT findings. Therefore, patients who are clinically more severe according to the S-K score have greater UA involvement.

Acromegalia é uma doença endócrina rara. Poucos estudos avaliaram sua associação com deficiência auditiva (DA) e os resultados são conflitantes. OBJETIVOS: Avaliar a prevalência e características da DA em um grupo de pacientes com acromegalia em tratamento. Analisar a transmissão auditiva central e periférica. MATERIAL E MÉTODOS: Estudo transversal. Um grupo de 34 pacientes com acromegalia submeteu-se à avaliação metabólica, audiometria tonal e potenciais evocados auditivos de tronco encefálico (PEATE). Considerou-se DA quando a média dos tons puros foi > 25 DBNA para baixas frequências (250, 500, 1000 e 2000 Hz) ou altas frequências (3000, 4000, 6000 e 8000 Hz). Os pacientes foram divididos em grupo A (com DA) e B (sem DA). RESULTADOS: Doze pacientes (35,3%) mostraram DA sensorioneural (grupo A), sendo oito bilateral e quatro unilateral. Nenhum apresentou DA mista ou condutiva. A prevalência de diabetes/intolerância à glicose de jejum foi similar entre os grupos. As frequências de 3000, 4000, 6000 e 8000 Hz foram as mais afetadas e com padrão similar em ambos os lados. CONCLUSÃO: DA sensorioneural esteve presente em 35,3% dos casos. Não foram notadas diferenças clínicas ou metabólicas significativas entre os grupos, bem como na transmissão neural auditiva periférica e central.

Acromegaly is a rare endocrine disease. Few studies have evaluated its association with hearing loss (HL) and the results are conflicting. AIM: To evaluate the prevalence and features of HL in a group of patients being treated for acromegaly. To analyze peripheral and central auditory transmission. METHODS: Cross-sectional study. A group of 34 patients with acromegaly were submitted to metabolic evaluation, tonal audiometry and brainstem auditory evoked potentials. HL was considered when pure tone average was > 25 DBHL for low frequencies (250, 500, 1000 and 2000 Hz) or high frequencies (3000, 4000, 6000 and 8000 Hz). The patients were divided in group A (with HL) and B (without HL). RESULTS: Twelve patients (35.3%) had sensorineural HL (Group A), being 8 bilateral and 4 unilateral. No one had mixed or conductive HL. The prevalence of diabetes/impaired glucose tolerance was similar between the groups. The frequencies 3000, 4000, 6000 and 8000 Hz were the most affected and with a similar pattern in both ears. CONCLUSION: sensorineural HL was found in 38.9% of cases. Neither clinical nor metabolic differences were noted between the groups, as well as in regards to peripheral and central auditory transmission.

INTRODUÇÃO: A meninge temporal rebaixada e o/ou seio sigmoide anteriorizado são condições que podem determinar dificuldades cirúrgicas na realização da mastoidectomia. OBJETIVO: Correlacionar a medida do prolapso do seio sigmoide e da meninge temporal na tomografia com a dificuldade cirúrgica na mastoidectomia. MÉTODO: As medidas tomográficas de prolapso sigmóideo e da meninge temporal foram correlacionadas com presença ou não de dificuldade cirúrgica observados durante o procedimento mastoidectomia de pacientes com otomastoidite crônica (n=30). FORMA DE ESTUDO: Coorte contemporânea com corte transversa. RESULTADOS: Em 10 pacientes, observou-se dificuldade cirúrgica assim distribuída: devido ao prolapso do seio sigmoide (n = 2) ou prolapso da meninge temporal (n = 7) ou ambos (n = 1). Nos pacientes cuja dificuldade cirúrgica foi devido ao prolapso do seio sigmoide, a distância na tomografia da borda anterior do seio sigmoide à parede posterior do canal auditivo externo foi menor que 9 mm. Nos pacientes cuja dificuldade cirúrgica foi devido ao prolapso da meninge temporal, a distância tomográfica desta ao plano superior do osso petroso foi 7 mm. CONCLUSÃO: A distância na tomografia computadorizada entre a meninge temporal e o plano superior do osso petroso 7 mm e uma distância do bordo anterior do seio sigmoide à parede posterior do canal auditivo externo inferior a 9 mm são preditivos de dificuldades cirúrgicas durante a mastoidectomia.

INTRODUCTION: The lowered temporal meninges and/ or anterior sigmoid sinus are contiditions that can determine surgical difficulties in performing mastoidectomy. OBJECTIVE: To correlate in the tomography the extent of the prolapse of the sigmoid sinus and of temporal meninges with the surgical difficulty in the mastoidectomy. METHOD: The tomographic measurements of prolapse sigmoid and of temporal meninges were correlated with the presence or non-presence of the surgical difficulty observed during the mastoidectomy procedure in patients with ostomatoiditis chronic (n=30). FORM OF STUDY: Contemporary cohort transverse. RESULTS: In 10 patients were observed surgical difficulty distributed as: due to prolapse of the sigmoid sinus (n = 2) or temporal meninges prolapse (n = 7) or both (n = 1). In patients in which the surgical difficulty was due to sigmoid sinus prolapse, the tomography distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm. In patients in which surgical difficulty was due to temporal meninges prolapse, the tomographic distance to the upper plane of the petrous bone was 7 mm. CONCLUSION: The computerized tomography distance between the temporal meninges and the upper plane of the petrous bone 7 mm and the distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm are predictive to the surgical difficulties to perform mastoidectomy.

Cisplatina é um agente quimioterápico frequentemente usado para o tratamento de várias linhagens de neoplasias. A ototoxicidade é um dos efeitos colaterais causadores de significativa morbidade e que limita sua utilização. Este estudo teve por objetivo avaliar o papel da apoptose na ototoxicidade por cisplatina. DESENHO DO ESTUDO: Estudo experimental. MATERIAL E MÉTODO: Ratos Wistar machos foram tratados com cisplatina, via intraperitoneal, nas doses de 24 e 16 mg/kg. Os animais foram avaliados através de emissões otoacústicas evocadas produtos de distorção (EOAPD) ou potenciais auditivos evocados de tronco encefálico (PAETE) no terceiro (D3) e quarto (D4) dias após o início da infusão das drogas. Em seguida suas cócleas foram removidas para estudo de imunoistoquímica para apoptose, método TUNEL. RESULTADOS: O grupo tratado com 24 mg/kg mostrou diminuição significativa da amplitude das EOAPD, fato não observado com a dose de 16 mg/kg. Ambas as doses promoveram aumento do limiar eletrofisiológico pelo PAETE no D3 e D4. A apoptose foi o mecanismo de lesão responsável pela ototoxicidade da cisplatina, dose de 16 mg/kg, quando os animais foram avaliados no D3. CONCLUSÃO: Apoptose pode estar envolvida no mecanismo de ototoxicidade pela cisplatina, na dependência da dose e tempo de avaliação da lesão.

Cisplatin is a chemotherapy agent frequently used to treat different types of neoplasia. Ototoxicity is one of the side-effects which cause significant morbidity and limits its use. This study aimed at assessing the role of apoptosis in cisplatin-induced ototoxicity. DESIGN: experimental study. MATERIALS AND METHODS: male Wistar rats were treated with intraperitoneal cisplatin, in the doses of 24 and 16 mg/kg. The animals were assessed by means of distortion product evoked otoacoustic emissions (DPEOAE) or brainstem evoked auditory potentials (BEAP) in the third (D3) and fourth (D4) days after drug infusion onset. Following that, their cochleas were removed for immunohistochemical studies of apoptosis - TUNEL method. RESULTS: the group treated with 24 mg/kg showed a significant reduction in DPEOAE amplitude, and such fact was not seen with the 16 mg/kg. Both doses caused an increase in BEAP electrophysiological threshold in D3 and D4. Apoptosis was the injury mechanism responsible for the cisplatin-induced ototoxicity - 16 mg/kg dose, when the animals were assessed on D3. CONCLUSION: apoptosis may be involved in the cisplatin-induced ototoxicity, depending on the dose and time of injury assessment.

Cisplatina (cisdiaminodicloroplatinum) é um agente quimioterápico usado para o tratamento de várias linhagens de neoplasias, mormente as de cabeça e pescoço. Sua ototoxicidade permanece sendo um dos efeitos colaterais causadores de significativa morbidade e limita sua utilização. OBJETIVO: Avaliar a sensibilidade das emissões otoacústicas evocadas produtos de distorção (EOAPD) e potenciais auditivos evocados de tronco encefálico (PAETE) na detecção da ototoxicidade secundária a diferentes doses e formas de administração de cisplatina em ratos. FORMA DE ESTUDO: Experimental. MATERIAL E MÉTODO: Ratos Wistar machos, administrou-se cisplatina por via intraperitoneal (IP) nas doses de 24 mg/kg, fracionada em três doses diárias ou 16 mg/kg em infusão única. Avaliaram-se os animais através de EOAPD ou PAETE no terceiro (D3) e quarto (D4) dias após o início da infusão das drogas. RESULTADOS: O grupo tratado com 24 mg/kg mostrou diminuição significativa da amplitude das EOAPD e aumento do limiar eletrofisiológico pelo PAETE. A dose de 16 mg/kg não foi capaz de promover redução significativa da amplitude das EOAPD, mas elevou o limiar auditivo dos animais, detectado através de PAETE. CONCLUSÃO: Em ratos, os PAETE foram mais sensíveis que as OEAPD na detecção da ototoxicidade por cisplatina para diferentes doses e formas de administração.

Cisplatin (cis-diamminedicloroplatinum) is an antineoplastic drug used in the treatment of a variety of cancers, especially head-and-neck cancer. Its ototoxicity, however, has been noted as a common side-effect which limits its use and causes significant morbidity. AIM: to assess distortion-product otoacoustic emissions (DPOAE) and brainstem evoked response audiometry (BERA) sensitivity to detect secondary ototoxicity caused by different doses and means of administration of cisplatin in rats. STUDY DESIGN: Experimental. MATERIAL AND METHODS: Male Wistar rats were intraperitoneally (i.p.) injected with 24 mg/kg cisplatin, divided into three equal doses (8mg/kg) or a single i.p. injection of 16 mg/kg. The animals were evaluated by distortion product otoacoustic emission (DPOAE) or brainstem evoked response audiometry (BERA) on the 3rd and 4th days after the cisplatin injection. RESULTS: Treatment with cisplatin 24 mg/kg resulted in significant DPOAE decrease and it raised the BERA electrophysiological threshold. The 16mg/kg dose could not significantly reduce the DPOAE amplitude, but it raised the animals' hearing thresholds - detected by the BERA. CONCLUSION: In rats, BERA was more sensitivity than DPOAE at detecting cisplatin-induced ototoxicity in rats considering different doses and means of administration.

Os Distúrbios Obstrutivos do Sono (DOS) afetam significativamente a população pediátrica. Neste grupo, sua principal etiologia é a hiperplasia adenotonsilar, sendo adenoidectomia ou adenotonsilectomia indicadas para tratamento, reversão de seqüelas e melhora na qualidade de vida. OBJETIVO: Avaliar qualidade de vida de crianças com DOS após adenoidectomia/adenotonsilectomia. CASUÍSTICA E MÉTODO: Realizou-se estudo tipo prospectivo com 48 crianças, entre 2 e 11 anos, apresentando DOS e hiperplasia adenotonsilar obstrutiva com indicação cirúrgica. Aplicou-se o questionário OSA18 sobre qualidade de vida aos cuidadores destas crianças antes da cirurgia, cerca de trinta dias e com pelo menos onze meses após o procedimento. Pontuações elevadas no escore significam pior qualidade de vida. RESULTADOS: No pré-operatório, o escore OSA18 médio foi 82,83 (DP=12,57), com nota global média para a qualidade de vida de 6,04 (DP=1,66). Na avaliação pós-operatória inicial, obteve-se escore OSA18 de 34,3(DP=9,95) e nota global de 9,6 (DP=0,81), ambos tendo redução significativa (p<0,001). Na avaliação pós-operatória tardia, entre 11 e 30 meses (média=16,85,DP=5,16), trinta e quatro (70,83%) crianças foram reavaliadas, obtendo-se escore OSA18 de 35,44(DP=19,95) e nota global de 9,28 (DP=1,78). Não houve diferença significativa entre as avaliações pós-operatórias. CONCLUSÃO: A cirurgia promoveu melhora na qualidade de vida das crianças com DOS, mantendo-se esta em longo prazo.

Obstructive Sleep Disorders (OSD) affect mostly the pediatric population. Within this group, its main etiology is adenotonsillar hyperplasia, being adenoidectomy or adenotonsillectomy the best treatment option for quality of life improvement. AIM: To asses quality of life of children with OSD after adenoidectomy/adenotonsillectomy. METHOD: A prospective study was carried out with 48 children, between 2 and 11 years, with clinical manifestations of OSD and obstructive adenotonsillar hyperplasia. The OSA18 questionnaire was answered by the parents to evaluate their children's quality of life before surgery; at about thirty days and at least eleven months after the procedure. A higher score meant a worse quality of life. RESULTS: Before surgery, the average OSA18 score was 82.83(SD=12.57), with an average global score for quality of life of 6.04(SD=1.66). Within thirty days after surgery, the average OSA18 score was 34.3 (SD=9.95) with an average global score of 9.6(SD=0.81), both showing significant reduction (p< 0.001). Thirty-four children (70.83%) were re-evaluated between 11 and 30 months (average=16.85; SD=5.16). The average OSA18 score was 35.44 (SD=19.95) with an average global score of 9.28 (SD=1.78). The postoperative evaluations weren't significantly different. CONCLUSION: surgery improves the quality of life of children with OSD, and such improvement maintains for the long run.