Validation and reliability analysis of the Questionnaire on the Emotional Impact of Vertigo-CIEV version translated to the Brazilian Portuguese language

PURPOSE

To determine the internal consistency and reliability of the "Questionário de Impacto Emocional da Vertigem (CIEV)" and to validate the instrument with respect to the Dizziness Handicap Inventory (DHI) in a sample of individuals with balance disorders.

METHODS

38 subjects participated in the study, males and females, aged from 23 to 85 years, who presented dizziness, vertigo, and/or falls complaints and attended to the Vestibular Disorders clinic at the University Hospital. Individuals with hearing complaints and/or tinnitus unrelated to dizziness, previous psychiatric comorbidities, and/or cognitive impairments were excluded. We performed an anamnesis and collected complementary data from the medical records. After that, the self-perception questionnaires, DHI, and CIEV, were applied. Statistical analysis was performed in which the Cronbach's alpha verified the internal consistency of the CIEV. Reliability and validity of the CIEV related to the DHI were calculated using Intraclass Correlation Index (ICC) and Pearson's correlation test, respectively.

RESULTS

There was a statistically significant correlation between the scores obtained, for both reliability and validation analysis (p<0.001). The mean ICC showed a moderate correlation between the total scores (0.695) and a strong correlation with the physical, emotional, and functional DHI domains (0.706 to 0.869), being the emotional aspect the highest degree (0.869). Pearson's correlation showed strong correlation between the total scores (r=0.820) and varied from moderate to strong, with strongest correlations to the DHI emotional domain (r=0.788).

CONCLUSION

The outcomes illustrate important contribution to validation parameters to consider clinical use of the CIEV in the Brazilian population, aiming to identify emotional aspects in patients with balance disorders.

Proposal of standardization of Horus® computerized posturography in adults

PURPOSE

To propose a normalization model of a posturography platform in adults without changes in body balance, through descriptive analysis by age group and sex.

METHODS

Cross-sectional observational study. Adults, with no changes in body balance and no vestibular complaints were submitted to 6 sensory conditions on the Horus® posturography platform. The following variables were analyzed: stability limit area and confidence ellipse area, trajectory length and average velocity for each condition tested. The variables were analyzed by age group and sex. The equilibrium score, the sensory integration test and the equilibrium index were calculated on the conditions.

RESULTS

Sixty-one subjects (38.3%) and 23 (37.7%) were male, 40 (65.57%) between the ages of 20 and 40 and 21 (34.43). %) between 41 and 59 years. The area of the stability limit and pressure center variables for 6 sensory conditions tested - confidence ellipse area, trajectory length, total mean velocity and confidence ellipse ratio by the area of the stability limit were described. There was a statistically significant difference in the comparison between the area of the stability limit between sexes and between age groups, being a higher value in males and in younger patients. Regarding the analysis of the variables by each condition, there was no difference of results between the sexes and age groups.

CONCLUSION

Subjects of different sexes and age groups should be considered separately only in the analysis of the stability limit.

Correlation between vascular endothelial growth factor expression and presence of lymph node metastasis in advanced squamous cell carcinoma of the larynx

INTRODUCTION

Squamous cell carcinoma is the most common neoplasm of the larynx, and its evolution depends on tumor staging. Vascular endothelial growth factor is a marker of angiogenesis, and its expression may be related to increased tumor aggressiveness, as evidenced by the presence of cervical lymphatic metastases.

OBJECTIVES

To evaluate the expression of the vascular endothelial growth factor marker in non-glottic advanced squamous cell carcinoma of the larynx (T3/T4) and correlate it with the presence of cervical lymph node metastases.

METHODS

Retrospective clinical study and immunohistochemical analysis of vascular endothelial growth factor through the German scale of immunoreactivity in products of non-glottic squamous cell carcinomas.

RESULTS

This study analyzed 15 cases of advanced non-glottic laryngeal tumors (T3/T4), four of which exhibited cervical lymphatic metastases. There was no correlation between vascular endothelial growth factor expression and the presence of cervical metastases.

CONCLUSION

Although vascular endothelial growth factor was expressed in a few cases, there was no correlation with the spread of cervical lymph metastases.

Complete gonadal dysgenesis in clinical practice: the 46,XY karyotype accounts for more than one third of cases

OBJECTIVE

To determine the frequency of XY karyotypes among females with complete gonadal dysgenesis (CGD) and to investigate the frequency of both gonadal tumors and SRY mutations.

DESIGN

Retrospective study based on data from all patients with CGD seen in our service from 1989 to 2010.

SETTING

Clinic for disorders of sex development, University Hospital, State University of Campinas.

PATIENT(S)

Thirty-two patients with hypergonadotropic hypogonadism, streak gonads, internal and external female genitalia, and normal karyotype (46,XX or 46,XY); 31 were index cases and 29 did not have a previously determined karyotype.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

None.

RESULT(S)

The percentage of XY karyotypes among patients with CGD was 34.5% (10/29). Mean age at diagnosis among XY and XX patients was 17.4 years and 19.9 years, respectively. Gonadal tumors were found in 4 of 9 XY girls, and 7 of 10 had SRY gene mutations.

CONCLUSION(S)

The previously unreported finding of an elevated frequency of 46,XY karyotype among patients with CGD and the high risk of gonadal neoplasia in such cases indicate that this diagnosis must be kept in mind by clinicians and strengthen the importance of karyotype analysis in females with primary hypogonadism. In addition, the frequency of SRY mutations in XY CGD might be higher than previously considered.