A sexualidade, apesar de sua relevância no âmbito da promoção da saúde, é pouco abordada durante os cursos de graduação e por profissionais da saúde na prática clínica. O objetivo deste trabalho é descrever o projeto "Sexo sem Tabu", realizado por alunos do primeiro ano do curso de Medicina da Universidade de São Paulo, dentro da proposta da disciplina "Atenção Primária à Saúde I". Após delineamento do tema e revisão literária, foram executados dois dias de intervenção. Baseados em dinâmicas propostas pelo Ministério da Saúde, discutimos sexualidade e temas correlatos em saúde, com pequenos grupos de alunos de uma escola técnica na cidade de São Paulo. Dentre os alunos participantes, 115/117 (98,3%) disseram ter dúvidas solucionadas durante a discussão e 114/117 (97,4%) consideraram que as informações que foram trazidas eram relevantes para suas vidas. Os alunos da Faculdade de Medicina relataram a oportunidade de treinar várias habilidades afetivas e cognitivas como habilidades de comunicação, desenvoltura, capacidade de lidar com o imprevisto, além de reconhecer que a abordagem da sexualidade não se restringe aos aspectos relacionados às doenças sexualmente transmissíveis, mas também a questões emocionais, morais e fisiológicas. Em conclusão, esta ação comunitária, com foco em promoção da saúde dos adolescentes e abordando o tema da sexualidade, trouxe resultados positivos para os alunos do ensino médio e para a formação profissional dos estudantes de medicina.
Objectives/Hypothesis This study aimed to describe the videolaryngostroboscopic (VLS) findings in a cohort of patients with isolated paresis of laryngeal adduction and identify predictive variables that may be related to voice recovery. Study Design Chart review and VLS analysis of dysphonic patients diagnosed with isolated paresis of laryngeal adduction by laryngeal electromyography (LEMG). Methods Demographic, clinical, VLS, and LEMG findings were analyzed according to the outcome of dysphonia. Results There were 17 patients, 12 males (70.6%), mean age of 46.6 years, with median dysphonia duration of 4 months (range, 1–60 months) included in the study. In all patients, gross movement of both vocal folds were normal. Laryngoscopy showed limited adduction of the ipsilateral ventricular fold, contralateral interarytenoid region deviation, and vocal fold atrophy in 100%, 94.1%, and 76.5% of patients, respectively. VLS findings included: impairment of glottic closure (94.1%), phase asymmetry (94.1%), and reduced mucosal wave on the affected side (76.5%). Predictors of good voice outcome were sudden onset (P = .012), duration of dysphonia on presentation shorter than 5 months (P = .005), and absence of polyphasic potentials on LEMG (P = .041). Conclusions Findings on VLS as described suggest isolated paresis of laryngeal adduction and should warrant indication of LEMG for definite diagnosis. Voice improvement may be related to clinical and LEMG findings. Level of Evidence 4 Laryngoscope, 129:919–925, 2019
An otherwise healthy 28-year-old male presented with a 10-year history of bolus sensation after eating and occasional regurgitation of undigested food. Symptoms were getting worse in the last two years. The episodes occurred right after eating, especially with solid boluses, when he leaned forward or contracted the pharyngeal muscles, a maneuver that he learned useful to clear the food bolus that was not properly swallowed. He also presented occasional episodes suggestive of aspiration, evidenced by cough while eating and one episode of choking but no past history of bronchitis or pneumonia. He denied chronic throat clearing, nocturnal coughing, pain, dyspnea, or weight loss. Findings on physical examination were within normal limits. Fiberoptic laryngoscopy showed slightly enlarged lingual tonsils hampering the visualization of the valleculae, but was otherwise unremarkable. There was no evident pooling, penetration, or aspiration of saliva (Fig. 1). CT scan of the neck suggested bilateral mixed (internal and external) laryngoceles with slight increase with Valsalva maneuver (Fig. 2a, b), but the diagnosis was inconsistent with clinical symptoms and laryngoscopic findings.
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