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Age 18 months
Published in Ajay Sharma, Helen Cockerill, Lucy Sanctuary, Mary Sheridan's From Birth to Five Years, 2021
Ajay Sharma, Helen Cockerill, Lucy Sanctuary
Beginning to give notice of urgent toilet needs by restlessness and vocalisation. Bowel control may be attained but very variable. May indicate wet or soiled pants.
Building the patient profile
Published in Stephanie Martin, Working with Voice Disorders, 2020
The relationship between heavy vocal demand and potential vocal misuse has been recognised for many years, especially in occupations where vocal demand is high as in teaching, telesales, health and leisure industries (Fontan et al., 2016). Many of these occupations are vocally intensive, necessitating frequent and prolonged periods of loud phonation without sufficient recovery time. Titze (2001) suggests the following critical risk factors associated with excessive vocalisation: duration of exposure, frequency of vibration and vocal loudness.
The Assessment of Pain in Children
Published in Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand, Pediatric Regional Anesthesia, 2019
One of the few studies to examine the reactions to pain in this age group was carried out by Taylor.92 She observed 20 young children aged from 18 months to 4 years recovering from herniorrhaphy. They had all received a halothane anesthetic; 13 children had morphine premedication, the other 7 received nothing. The behavior patterns considered to be indicative of pain consisted of characteristic movements and vocalizations. Movements included general restlessness, guarding or touching the operative site, and grimacing. Vocalizations included crying, whining, groaning, and verbal statements of pain. Data were collected for a 3-h period by the investigator and each movement or vocalization was recorded. Investigator and independant observer agreement of data was about 90%.
Bilateral Tapia’s syndrome secondary to cervical spine injury: a case report and literature review
Published in British Journal of Neurosurgery, 2023
Alexandros G. Brotis, Jiannis Hajiioannou, Christos Tzerefos, Christos Korais, Efthymios Dardiotis, Kostas N. Fountas, Kostantinos Paterakis
Unilateral Tapia’s syndrome (TS), initially described by the Spanish physician Antonio Garcia Tapia in 1906, presents with simultaneous apraxia of the hypoglossal and recurrent laryngeal nerves.1 It is a very rare syndrome that manifests with vocal hoarseness and impairment in swallowing and vocalization.2,3 The underlying causative mechanism is trauma, either at the tegmentum involving the vagal and the hypoglossal nerve nuclei (central TS) or at the upper cervical spine, just in front of the C1 and C2 transverse processes (peripheral TS).4 The latter usually occurs as a rare complication of strenuous airway management. In even more rare cases with bilateral involvement, the clinical manifestation is severe, with upper airway compromise, accompanied by dysphonia and feeding difficulties.3 With the current communication, we report a unique case of bilateral TS associated with cervical spine trauma and present our dilemmas in terms of diagnosis, treatment, and outcome.
Preliminary dynamic observation of wound healing after low-temperature plasma radiofrequency ablation for laryngeal leukoplakia
Published in Acta Oto-Laryngologica, 2022
Fang Hao, Liyan Yue, Xiaoyan Yin, Chunguang Shan
The vocal folds are composed of epithelium, lamina propria, and muscularis. The lamina propria is rich in extracellular matrix. The abundance and distribution of proteins and glycans in this extracellular matrix maintain the biomechanical properties of vocal folds vocalization, while injury to the extracellular matrix often affects postoperative pronunciation [17]. The arrangement and content of fibronectin and other components in the extracellular matrix of the wound after vocal fold surgery determine the formation of vocal fold lamina propria scars. Damage to the adult skin can lead to scar formation, which increases as the depth of the injury increases [18]. Although the skin and vocal folds tissue structures are different, there are similarities, and the vocal folds mucosa is a special tissue with unique repair and regeneration requirements [19]. The scars of the vocal folds are not evident after the LTPA treatment of LL wounds. Because the wound was in the mucosal layer, the lamina propria was not damaged or slightly damaged, and did not reach the muscle layer, which is consistent with the observation of postoperative wound healing in the later stage of scar formation. Similarly, Zhang et al. [20] summarized the healing of the vocal folds after treatment with LTPA in patients with early glottic laryngeal cancer and found that postoperative vocal folds scar formation was not apparent.
Examining the voice of Israeli transgender women: Acoustic measures, voice femininity and voice-related quality-of-life
Published in International Journal of Transgender Health, 2021
Vocalization is a basic manner by which people communicate and portray their identity and is considered one of the important secondary gender characteristics. Therefore, a gender-congruent voice, in which the individual's voice corresponds with the gender identity, is crucial to one's well-being and quality-of-life (Davies & Goldberg, 2006). Transgender people often show a gender non-conforming voice, as a result of a discrepancy between their gender identity and their perceived gender. Consequently, transgender women who wish for their voice to be perceived in accordance with their feminine identity could be perceived as masculine, and experience gender dysphoria. In a study that surveyed 28 transgender women, over 50% reported viewing the feminization of their communication highly important for their well-being (Neumann et al., 2002). This was further supported by other studies that have demonstrated the importance of feminine voice for transgender women, and how specific voice properties may contribute to the perception of transgender women's voices as feminine (Davies et al., 2015; Stewart, Oates, & O’Halloran, 2020).