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Art and science: impact of semioccluded vocal tract exercises and choral singing on quality of life in subjects with congenital GH deficiency
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Andrade, Bruna M. R. de
; Valença, Eugenia H. O.
; Salvatori, Roberto
; Oliveira Neto, Luiz A.
; Souza, Anita H. O.
; Oliveira, Alaíde H. A.
; Oliveira, Mario C.P.
; Melo, Enaldo V.
; Carvalho, Susana de
; Sales, Neuza J
; Monteiro, Gisane C.
; Lima, José Marcel de
; Annunziato, Marcos Felipe Harder
; Mannis, Guilherme Daniel Breternitz
; Souza, Lucas E. de A.
; Goes, Yasmin D.
; Carvalho, Thayza S.
; Farias, Celiane de
; Santos, Michela P. dos
; Cardoso, Gabriela P. F.
; Sousa, Carla S. Pereira
; Santana, Julia Rodrigues
; Sales, Ester Almeida
; d’Avila, Jeferson Sampaio
; Aguiar-Oliveira, Manuel H.
.
ABSTRACT Objectives: Currently, not much is known about the interactions between voice and growth hormone (GH). We have described large kindred with isolated GH deficiency (IGHD) due to a GHRH receptor mutation, resulting in severe short stature and high-pitched voice. These IGHD individuals have little interest in GH treatment, as they consider themselves “short long-lived people”, rather than patients. Interestingly, they report normal general quality of life, but they rate their Voice-Related Quality of Life (V-RQOL) as low. Here, we assessed the social and auditory-perceptual impacts of artistic-intervention voice therapy with semioccluded vocal tract exercises (SOVTE) and choral singing, on their voices. Material and methods: Seventeen GH-naïve adult IGHD individuals were enrolled in a single-arm interventional pre-post study with 13 weekly sessions of choir singing over 90 days. Outcome measures were V-RQOL scores, self-assessment of voice, and auditory-perceptual analysis (GRBAS scale, G: grade of the severity of dysphonia; R: roughness; B: breathiness; A: asthenia; and S: strain). Results: Marked improvements in total (p = 0.0001), physical (p = 0.0002), and socioemotional (p = 0.0001) V-RQOL scores and in self-assessment of voice (p = 0.004) were found. The general grades of vocal deviation (p = 0.0001), roughness (p = 0.0001), breathiness (p = 0.0001) and strain (p = 0.0001) exhibited accentuated reductions. Conclusions: Voice therapy with semioccluded vocal tract exercises and choral training improved social impact and perceptual voice assessments in IGHD subjects and markedly improved their voice-related quality of life. This is particularly important in a setting where GH replacement therapy is not widely accepted.
2.
Growing knowledge: an overview of Seed Plant diversity in Brazil
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Zappi, Daniela C.
; Filardi, Fabiana L. Ranzato
; Leitman, Paula
; Souza, Vinícius C.
; Walter, Bruno M.T.
; Pirani, José R.
; Morim, Marli P.
; Queiroz, Luciano P.
; Cavalcanti, Taciana B.
; Mansano, Vidal F.
; Forzza, Rafaela C.
; Abreu, Maria C.
; Acevedo-Rodríguez, Pedro
; Agra, Maria F.
; Almeida Jr., Eduardo B.
; Almeida, Gracineide S.S.
; Almeida, Rafael F.
; Alves, Flávio M.
; Alves, Marccus
; Alves-Araujo, Anderson
; Amaral, Maria C.E.
; Amorim, André M.
; Amorim, Bruno
; Andrade, Ivanilza M.
; Andreata, Regina H.P.
; Andrino, Caroline O.
; Anunciação, Elisete A.
; Aona, Lidyanne Y.S.
; Aranguren, Yani
; Aranha Filho, João L.M.
; Araújo, Andrea O.
; Araújo, Ariclenes A.M.
; Araújo, Diogo
; Arbo, María M.
; Assis, Leandro
; Assis, Marta C.
; Assunção, Vivian A.
; Athiê-Souza, Sarah M.
; Azevedo, Cecilia O.
; Baitello, João B.
; Barberena, Felipe F.V.A.
; Barbosa, Maria R.V.
; Barros, Fábio
; Barros, Lucas A.V.
; Barros, Michel J.F.
; Baumgratz, José F.A.
; Bernacci, Luis C.
; Berry, Paul E.
; Bigio, Narcísio C.
; Biral, Leonardo
; Bittrich, Volker
; Borges, Rafael A.X.
; Bortoluzzi, Roseli L.C.
; Bove, Cláudia P.
; Bovini, Massimo G.
; Braga, João M.A.
; Braz, Denise M.
; Bringel Jr., João B.A.
; Bruniera, Carla P.
; Buturi, Camila V.
; Cabral, Elza
; Cabral, Fernanda N.
; Caddah, Mayara K.
; Caires, Claudenir S.
; Calazans, Luana S.B.
; Calió, Maria F.
; Camargo, Rodrigo A.
; Campbell, Lisa
; Canto-Dorow, Thais S.
; Carauta, Jorge P.P.
; Cardiel, José M.
; Cardoso, Domingos B.O.S.
; Cardoso, Leandro J.T.
; Carneiro, Camila R.
; Carneiro, Cláudia E.
; Carneiro-Torres, Daniela S.
; Carrijo, Tatiana T.
; Caruzo, Maria B.R.
; Carvalho, Maria L.S.
; Carvalho-Silva, Micheline
; Castello, Ana C.D.
; Cavalheiro, Larissa
; Cervi, Armando C.
; Chacon, Roberta G.
; Chautems, Alain
; Chiavegatto, Berenice
; Chukr, Nádia S.
; Coelho, Alexa A.O.P.
; Coelho, Marcus A.N.
; Coelho, Rubens L.G.
; Cordeiro, Inês
; Cordula, Elizabeth
; Cornejo, Xavier
; Côrtes, Ana L.A.
; Costa, Andrea F.
; Costa, Fabiane N.
; Costa, Jorge A.S.
; Costa, Leila C.
; Costa-e-Silva, Maria B.
; Costa-Lima, James L.
; Cota, Maria R.C.
; Couto, Ricardo S.
; Daly, Douglas C.
; De Stefano, Rodrigo D.
; De Toni, Karen
; Dematteis, Massimiliano
; Dettke, Greta A.
; Di Maio, Fernando R.
; Dórea, Marcos C.
; Duarte, Marília C.
; Dutilh, Julie H.A.
; Dutra, Valquíria F.
; Echternacht, Lívia
; Eggers, Lilian
; Esteves, Gerleni
; Ezcurra, Cecilia
; Falcão Junior, Marcus J.A.
; Feres, Fabíola
; Fernandes, José M.
; Ferreira, D.M.C.
; Ferreira, Fabrício M.
; Ferreira, Gabriel E.
; Ferreira, Priscila P.A.
; Ferreira, Silvana C.
; Ferrucci, Maria S.
; Fiaschi, Pedro
; Filgueiras, Tarciso S.
; Firens, Marcela
; Flores, Andreia S.
; Forero, Enrique
; Forster, Wellington
; Fortuna-Perez, Ana P.
; Fortunato, Reneé H.
; Fraga, Cléudio N.
; França, Flávio
; Francener, Augusto
; Freitas, Joelcio
; Freitas, Maria F.
; Fritsch, Peter W.
; Furtado, Samyra G.
; Gaglioti, André L.
; Garcia, Flávia C.P.
; Germano Filho, Pedro
; Giacomin, Leandro
; Gil, André S.B.
; Giulietti, Ana M.
; A.P.Godoy, Silvana
; Goldenberg, Renato
; Gomes da Costa, Géssica A.
; Gomes, Mário
; Gomes-Klein, Vera L.
; Gonçalves, Eduardo Gomes
; Graham, Shirley
; Groppo, Milton
; Guedes, Juliana S.
; Guimarães, Leonardo R.S.
; Guimarães, Paulo J.F.
; Guimarães, Elsie F.
; Gutierrez, Raul
; Harley, Raymond
; Hassemer, Gustavo
; Hattori, Eric K.O.
; Hefler, Sonia M.
; Heiden, Gustavo
; Henderson, Andrew
; Hensold, Nancy
; Hiepko, Paul
; Holanda, Ana S.S.
; Iganci, João R.V.
; Imig, Daniela C.
; Indriunas, Alexandre
; Jacques, Eliane L.
; Jardim, Jomar G.
; Kamer, Hiltje M.
; Kameyama, Cíntia
; Kinoshita, Luiza S.
; Kirizawa, Mizué
; Klitgaard, Bente B.
; Koch, Ingrid
; Koschnitzke, Cristiana
; Krauss, Nathália P.
; Kriebel, Ricardo
; Kuntz, Juliana
; Larocca, João
; Leal, Eduardo S.
; Lewis, Gwilym P.
; Lima, Carla T.
; Lima, Haroldo C.
; Lima, Itamar B.
; Lima, Laíce F.G.
; Lima, Laura C.P.
; Lima, Leticia R.
; Lima, Luís F.P.
; Lima, Rita B.
; Lírio, Elton J.
; Liro, Renata M.
; Lleras, Eduardo
; Lobão, Adriana
; Loeuille, Benoit
; Lohmann, Lúcia G.
; Loiola, Maria I.B.
; Lombardi, Julio A.
; Longhi-Wagner, Hilda M.
; Lopes, Rosana C.
; Lorencini, Tiago S.
; Louzada, Rafael B.
; Lovo, Juliana
; Lozano, Eduardo D.
; Lucas, Eve
; Ludtke, Raquel
; Luz, Christian L.
; Maas, Paul
; Machado, Anderson F.P.
; Macias, Leila
; Maciel, Jefferson R.
; Magenta, Mara A.G.
; Mamede, Maria C.H.
; Manoel, Evelin A.
; Marchioretto, Maria S.
; Marques, Juliana S.
; Marquete, Nilda
; Marquete, Ronaldo
; Martinelli, Gustavo
; Martins da Silva, Regina C.V.
; Martins, Ângela B.
; Martins, Erika R.
; Martins, Márcio L.L.
; Martins, Milena V.
; Martins, Renata C.
; Matias, Ligia Q.
; Maya-L., Carlos A.
; Mayo, Simon
; Mazine, Fiorella
; Medeiros, Debora
; Medeiros, Erika S.
; Medeiros, Herison
; Medeiros, João D.
; Meireles, José E.
; Mello-Silva, Renato
; Melo, Aline
; Melo, André L.
; Melo, Efigênia
; Melo, José I.M.
; Menezes, Cristine G.
; Menini Neto, Luiz
; Mentz, Lilian A.
; Mezzonato, A.C.
; Michelangeli, Fabián A.
; Milward-de-Azevedo, Michaele A.
; Miotto, Silvia T.S.
; Miranda, Vitor F.O.
; Mondin, Cláudio A.
; Monge, Marcelo
; Monteiro, Daniele
; Monteiro, Raquel F.
; Moraes, Marta D.
; Moraes, Pedro L.R.
; Mori, Scott A.
; Mota, Aline C.
; Mota, Nara F.O.
; Moura, Tania M.
; Mulgura, Maria
; Nakajima, Jimi N.
; Nardy, Camila
; Nascimento Júnior, José E.
; Noblick, Larry
; Nunes, Teonildes S.
; O'Leary, Nataly
; Oliveira, Arline S.
; Oliveira, Caetano T.
; Oliveira, Juliana A.
; Oliveira, Luciana S.D.
; Oliveira, Maria L.A.A.
; Oliveira, Regina C.
; Oliveira, Renata S.
; Oliveira, Reyjane P.
; Paixão-Souza, Bruno
; Parra, Lara R.
; Pasini, Eduardo
; Pastore, José F.B.
; Pastore, Mayara
; Paula-Souza, Juliana
; Pederneiras, Leandro C.
; Peixoto, Ariane L.
; Pelissari, Gisela
; Pellegrini, Marco O.O.
; Pennington, Toby
; Perdiz, Ricardo O.
; Pereira, Anna C.M.
; Pereira, Maria S.
; Pereira, Rodrigo A.S.
; Pessoa, Clenia
; Pessoa, Edlley M.
; Pessoa, Maria C.R.
; Pinto, Luiz J.S.
; Pinto, Rafael B.
; Pontes, Tiago A.
; Prance, Ghillean T.
; Proença, Carolyn
; Profice, Sheila R.
; Pscheidt, Allan C.
; Queiroz, George A.
; Queiroz, Rubens T.
; Quinet, Alexandre
; Rainer, Heimo
; Ramos, Eliana
; Rando, Juliana G.
; Rapini, Alessandro
; Reginato, Marcelo
; Reis, Ilka P.
; Reis, Priscila A.
; Ribeiro, André R.O.
; Ribeiro, José E.L.S.
; Riina, Ricarda
; Ritter, Mara R.
; Rivadavia, Fernando
; Rocha, Antônio E.S.
; Rocha, Maria J.R.
; Rodrigues, Izabella M.C.
; Rodrigues, Karina F.
; Rodrigues, Rodrigo S.
; Rodrigues, Rodrigo S.
; Rodrigues, Vinícius T.
; Rodrigues, William
; Romaniuc Neto, Sérgio
; Romão, Gerson O.
; Romero, Rosana
; Roque, Nádia
; Rosa, Patrícia
; Rossi, Lúcia
; Sá, Cyl F.C.
; Saavedra, Mariana M.
; Saka, Mariana
; Sakuragui, Cássia M.
; Salas, Roberto M.
; Sales, Margareth F.
; Salimena, Fatima R.G.
; Sampaio, Daniela
; Sancho, Gisela
; Sano, Paulo T.
; Santos, Alessandra
; Santos, Élide P.
; Santos, Juliana S.
; Santos, Marianna R.
; Santos-Gonçalves, Ana P.
; Santos-Silva, Fernanda
; São-Mateus, Wallace
; Saraiva, Deisy P.
; Saridakis, Dennis P.
; Sartori, Ângela L.B.
; Scalon, Viviane R.
; Schneider, Ângelo
; Sebastiani, Renata
; Secco, Ricardo S.
; Senna, Luisa
; Senna-Valle, Luci
; Shirasuna, Regina T.
; Silva Filho, Pedro J.S.
; Silva, Anádria S.
; Silva, Christian
; Silva, Genilson A.R.
; Silva, Gisele O.
; Silva, Márcia C.R.
; Silva, Marcos J.
; Silva, Marcos J.
; Silva, Otávio L.M.
; Silva, Rafaela A.P.
; Silva, Saura R.
; Silva, Tania R.S.
; Silva-Gonçalves, Kelly C.
; Silva-Luz, Cíntia L.
; Simão-Bianchini, Rosângela
; Simões, André O.
; Simpson, Beryl
; Siniscalchi, Carolina M.
; Siqueira Filho, José A.
; Siqueira, Carlos E.
; Siqueira, Josafá C.
; Smith, Nathan P.
; Snak, Cristiane
; Soares Neto, Raimundo L.
; Soares, Kelen P.
; Soares, Marcos V.B.
; Soares, Maria L.
; Soares, Polyana N.
; Sobral, Marcos
; Sodré, Rodolfo C.
; Somner, Genise V.
; Sothers, Cynthia A.
; Sousa, Danilo J.L.
; Souza, Elnatan B.
; Souza, Élvia R.
; Souza, Marcelo
; Souza, Maria L.D.R.
; Souza-Buturi, Fátima O.
; Spina, Andréa P.
; Stapf, María N.S.
; Stefano, Marina V.
; Stehmann, João R.
; Steinmann, Victor
; Takeuchi, Cátia
; Taylor, Charlotte M.
; Taylor, Nigel P.
; Teles, Aristônio M.
; Temponi, Lívia G.
; Terra-Araujo, Mário H.
; Thode, Veronica
; Thomas, W.Wayt
; Tissot-Squalli, Mara L.
; Torke, Benjamin M.
; Torres, Roseli B.
; Tozzi, Ana M.G.A.
; Trad, Rafaela J.
; Trevisan, Rafael
; Trovó, Marcelo
; Valls, José F.M.
; Vaz, Angela M.S.F.
; Versieux, Leonardo
; Viana, Pedro L.
; Vianna Filho, Marcelo D.M.
; Vieira, Ana O.S.
; Vieira, Diego D.
; Vignoli-Silva, Márcia
; Vilar, Thaisa
; Vinhos, Franklin
; Wallnöfer, Bruno
; Wanderley, Maria G.L.
; Wasshausen, Dieter
; Watanabe, Maurício T.C.
; Weigend, Maximilian
; Welker, Cassiano A.D.
; Woodgyer, Elizabeth
; Xifreda, Cecilia C.
; Yamamoto, Kikyo
; Zanin, Ana
; Zenni, Rafael D.
; Zickel, Carmem S
.
Resumo Um levantamento atualizado das plantas com sementes e análises relevantes acerca desta biodiversidade são apresentados. Este trabalho se iniciou em 2010 com a publicação do Catálogo de Plantas e Fungos e, desde então vem sendo atualizado por mais de 430 especialistas trabalhando online. O Brasil abriga atualmente 32.086 espécies nativas de Angiospermas e 23 espécies nativas de Gimnospermas e estes novos dados mostram um aumento de 3% da riqueza em relação a 2010. A Amazônia é o Domínio Fitogeográfico com o maior número de espécies de Gimnospermas, enquanto que a Floresta Atlântica possui a maior riqueza de Angiospermas. Houve um crescimento considerável no número de espécies e nas taxas de endemismo para a maioria dos Domínios (Caatinga, Cerrado, Floresta Atlântica, Pampa e Pantanal), com exceção da Amazônia que apresentou uma diminuição de 2,5% de endemicidade. Entretanto, a maior parte das plantas com sementes que ocorrem no Brasil (57,4%) é endêmica deste território. A proporção de formas de vida varia de acordo com os diferentes Domínios: árvores são mais expressivas na Amazônia e Floresta Atlântica do que nos outros biomas, ervas são dominantes no Pampa e as lianas apresentam riqueza expressiva na Amazônia, Floresta Atlântica e Pantanal. Este trabalho não só quantifica a biodiversidade brasileira, mas também indica as lacunas de conhecimento e o desafio a ser enfrentado para a conservação desta flora.
Abstract An updated inventory of Brazilian seed plants is presented and offers important insights into the country's biodiversity. This work started in 2010, with the publication of the Plants and Fungi Catalogue, and has been updated since by more than 430 specialists working online. Brazil is home to 32,086 native Angiosperms and 23 native Gymnosperms, showing an increase of 3% in its species richness in relation to 2010. The Amazon Rainforest is the richest Brazilian biome for Gymnosperms, while the Atlantic Rainforest is the richest one for Angiosperms. There was a considerable increment in the number of species and endemism rates for biomes, except for the Amazon that showed a decrease of 2.5% of recorded endemics. However, well over half of Brazillian seed plant species (57.4%) is endemic to this territory. The proportion of life-forms varies among different biomes: trees are more expressive in the Amazon and Atlantic Rainforest biomes while herbs predominate in the Pampa, and lianas are more expressive in the Amazon, Atlantic Rainforest, and Pantanal. This compilation serves not only to quantify Brazilian biodiversity, but also to highlight areas where there information is lacking and to provide a framework for the challenge faced in conserving Brazil's unique and diverse flora.
https://doi.org/10.1590/2175-7860201566411
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