Vanessa Veis Ribeiro

Purpose: The purpose of this study was to identify and describe extrapulmonary cough receptors located in healthy individuals' larynges and pharynges and the types of stimuli to which they are sensitive. Method: This scoping review was registered in the Open Science Framework. The review followed the Joanna Briggs Institute methodology and was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. The search was performed electronically in the LILACS, Scopus, manually in gray literature (Google Scholar, MedRxiv, and ProQuest), and by mapping citations and consulting experts. The search was initiated in August 2024. The review included primary studies describing laryngeal and/or pharyngeal cough receptors in healthy human individuals. The data were analyzed descriptively. Results: The search found 12 studies on extrapulmonary cough receptors, all describing laryngeal and seven of them also pharyngeal ones. Only rapidly adapting receptors (RARs) with myelinated fibers were reported in both regions, responding predominantly to mechanical stimuli. The locations of the receptors, when described, are not uniform, with epithelium and mucosa being possible sites. Conclusions: Data on the location of extrapulmonary cough receptors in healthy individuals are heterogeneous. RARs that respond mainly to mechanical stimuli predominate in these regions and conduct stimuli to the nerve centers through myelinated fibers to trigger cough. However, the small number of included studies and variability in anatomical descriptions limit definitive conclusions.

RESUMO Objetivo Realizar a validação transcultural do Teste de Autoavaliação da Competência na Comunicação (TACCom) para a língua italiana. Método O procedimento de validação transcultural seguiu as recomendações e diretrizes do COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) e constou de cinco etapas: 1) Tradução do TACCom do português brasileiro (PB) para o italiano, por três fonoaudiólogos bilíngues; 2) Elaboração da versão por consenso; 3) Retrotradução do italiano para o PB por um quarto fonoaudiólogo bilíngue; 4) Comparação da retrotradução com o instrumento original e elaboração da versão final em italiano, denominada Test di Autovalutazione della Competenza nella Comunicazione (TACCom-IT); e 5) Aplicação do pré-teste do TACCom-IT em 101 indivíduos nativos italianos, que usam a voz e a comunicação oral como principal instrumento de trabalho. Nesta etapa, a opção “não aplicável” foi acrescentada na chave de respostas. Resultados Na tradução, houve escolhas lexicais diferentes em relação ao título, às instruções e a sete itens. Na retrotradução, houve discordâncias conceituais no título e nas instruções, e lexicais em cinco itens. O comitê de especialistas realizou mudanças no título, nas instruções e em três itens. Na fase pré-teste, uma proporção significativamente maior de participantes respondeu com opções da chave de resposta habitual do instrumento para todos os itens. Conclusão A versão adaptada do TACCom para o italiano, intitulada Test di Autovalutazione della Competenza nella Comunicazione (TACCom-IT), apresenta equivalência cultural e linguística satisfatória em relação ao instrumento original, sendo considerada válida transculturalmente.

Purpose To carry out the cross-cultural validation of the Self-Assessment of Competence in Communication – SACCom to Italian. Methods The cross-cultural validation procedure followed the recommendations and guidelines of the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and consisted of five stages: 1) Translation of the SACCom from Brazilian Portuguese (BP) into Italian by three bilingual speech-language-hearing pathologists; 2) Preparation of a consensus version; 3) Back-translation from Italian into BP by a fourth bilingual speech-language-hearing pathologist; 4) Comparison of the back-translation with the original instrument and preparation of the final version in Italian called Test di Autovalutazione della Competenza nella Comunicazione (TACCom-IT); and, 5) Application of the TACCom-IT pre-test to 101 native Italians whose voice and communication are essential to their profession. At this stage, the option “not applicable” was added to the answer key. Results In the translation, there were different lexical choices regarding the title, instructions, and seven items. In the back-translation, there were conceptual disagreements in the title and instructions, and lexical disagreements in five items. The expert committee made changes to the title, instructions, and three items. In the pre-test phase, a significantly higher proportion of participants responded with options from the instrument's usual answer key for all items. Conclusion The Italian adapted version of SACCom, entitled Test di Autovalutazione della Competenza nella Comunicazione (TACCom-IT), shows satisfactory cultural and linguistic equivalence in relation to the original instrument and is considered cross-culturally valid.

Purpose To establish cutoff points and evaluate the discriminative accuracy of the self-perception instruments Cough Severity Index (CSI-Br) and Newcastle Laryngeal Hypersensitivity Questionnaire (LHQ-Br) in identifying symptoms related to chronic refractory cough (CRC) in adults. Methods This is a cross-sectional, observational, quantitative study with a sample of 157 participants (111 females and 46 males), with a mean age of 44.92 years. They were divided into two groups based on the presence or absence of CRC: Group with CRC (CRC-G) with 110 participants (31 males and 79 females), with a mean age of 48.67 (SD: 16.04) years; The study included a healthy control group (CG) with 47 participants (15 males and 32 females), with a mean age of 36.34 (SD: 14.31) years. Data were collected in person at the outpatient clinics of the participating hospitals and online via Google Forms. Participants answered the CSI-Br and LHQ-Br. Analysis was performed using SPSS 29.0 software, employing ROC curves to determine cutoffs and performance metrics. Results For the LHQ-Br, the area under the curve (AUC) was 0.753, with a cutoff of 5.8, sensitivity of 70%, and specificity of 73.4%. The CSI-Br had an AUC of 0.894 in the total score, with a cutoff of 4.5, sensitivity of 84.9%, and specificity of 83%. Conclusion Based on the established cutoffs, both questionnaires proved to be sensitive and specific, with greater robustness for CSI-Br.

Purpose To define cut-off values for acoustic measures extracted from the sustained vowel [a] task to discriminate between the presence and absence of vocal disorders in Brazilian Portuguese speakers. Methods The sample consisted of 376 participants, 288 female and 88 male, with a mean age of 41.20 ± 14.04 years. All individuals underwent a laryngological evaluation and a voice recording session, during which a sustained vowel [a] sample was collected. Subsequently both auditory-perceptual and acoustic analyses of the voice were performed. Among the participants 277 were classified as having a vocal disorder and 99 as having no vocal disorder. A total of 44 acoustic measures were extracted and analyzed using ROC curves to determine the cut-off value for each measure, along with their performance metrics (sensitivity, specificity and AUC). Results Cut-off values were established for 23 of the 44 extracted acoustic measures. Six measures showed robust and clinically relevant performance in discriminating between voices with and without vocal disorders in Brazilian Portuguese speakers. The measures with AUC values greater than 0.70 and balanced sensitivity and specificity above 70% were: Amplitude Variability Index (AVI) (≤0,91), Glottal-to-noise excitation (GNE)2000Hz (>0,92), Spectral Noise Level (SNL)100-2600Hz (≤7,71), SNL100-3000Hz (≤3,38), SNL100-8000Hz (≤10,95) and SNL5100-8000Hz (≤–1,84). Conclusion Six acoustic measures demonstrated satisfactory performance in identifying the presence of vocal disorders in Brazilian Portuguese speakers. Ten measures showed good performance for voice screening purposes and seven for diagnostic confirmation of vocal disorders.