A criança disfônica: diagnóstico, tratamento e evolução clínica

Os nódulos vocais são causas freqüentes de disfonias infantis, porém, através das vídeoendoscopias, outras lesões têm sido diagnosticadas na laringe infantil, como os cistos, sulcos, pontes e micromembranas, denominadas de lesões estruturais mínimas. OBJETIVO: Avaliar, em 71 crianças com disfonia agendadas nos ambulatórios de Foniatria da Faculdade de Medicina de Botucatu (Unesp) nos últimos cinco anos: sexo, idade, diagnósticos, tratamentos e evolução clínica. FORMA DE ESTUDO: Clínico retrospectivo. CASUÍSTICA E MÉTODO: Realizou-se estudo retrospectivo das avaliações otorrinolaringológicas e endoscópicas de 71 crianças com queixas de disfonia e idade entre 3 a 13 anos (45 meninos e 26 meninas). As crianças haviam sido submetidas a exame endoscópico com telescópio rígido ou nasofibroscópio flexível. Foram excluídas as crianças com disfonias funcionais ou com queixas de obstrução respiratória. RESULTADOS: Os principais diagnósticos foram: nódulo vocal (47 casos; 66,2%), cisto epidérmico (7 casos; 9,9%), cisto aberto fistulizado (6 casos; 8,4%), sulco vocal (5 casos; 7,1%), ponte + cisto (2 casos; 2,8%), micromembrana anterior (2 casos; 2,8%) e pólipo vocal (2 casos; 2,8%). As disfonias foram mais freqüentes entre os meninos (63,3%). A fonoterapia isolada foi o tratamento de escolha nos casos de nódulo vocal (evolução favorável), sulco vocal (evolução desfavorável) e micro-membrana (evolução desfavorável). Nas demais lesões (cistos, pontes e pólipos) o tratamento de escolha foi a cirurgia associada à fonoterapia, com resultados satisfatórios, exceto nos casos que recusaram a cirurgia. CONCLUSÃO: Os nódulos vocais são as principais causas de disfonias em crianças, porém as lesões estruturais mínimas mostraram-se também freqüentes, exigindo exame minucioso para o diagnóstico.

Effect of acid-ethanol treatment followed by ball milling on structural and physicochemical characteristics of cassava starch

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Treatment of traumatized primary teeth: A conservative approach

This retrospective study examined some different types of treatment to primary teeth. The aim of this study was to assess the treatment of traumatized primary teeth and the importance of a long-term follow up. Brazilian children in the age group of 1-4 years from a baby clinic took part in the study. Three hundred and fifteen patients suffered some type of traumatic injury, a total of 338 affected teeth. Data were registered in specific records and submitted to statistic analysis. The most prevalent type of treatment was monitor only (85%) followed by tooth extraction and endodontic procedure. Invasive treatments were performed in case of severe traumas, usually 6 months after the injury. We verified that a careful follow up might be the preferential choice to the treatment of traumatic primary teeth even in some severe cases.

THE INFLUENCE OF THE ELECTROCHEMICAL TREATMENT ON CU-AL-AG ALLOYS IN DEAERATED 0.5M NAOH

The effect of consecutive cyclic polarization in de-aerated 0.5 M NaOH solutions on the surface microstructure of mechanically polished Cu-Al-Ag alloys of different compositions and heat treatments has been studied using optical microscopy, SEM and EDS. The current peaks of the cyclic polarization curves do not depend on the alloy composition in the composition range studied. The repetitive potential scans between H2 and O2 evolution in alkaline media lead to preferential dissolution of aluminium, the roughness and phase composition of the surface of the alloys changing significantly. The quasistationary I-E curves of the different Cu-Al-Ag alloys studied consist in the superposition of the quasistationary I-E curves of high-purity Cu and Ag, the EDS microanalysis showing that aluminium is not present on the surface of the alloy in these conditions.

Influence of heat treatment on LiNbO3 thin films prepared on Si(111) by the polymeric precursor method

The effects of heat-treatment temperature on LiNbO3 thin films prepared by the polymeric precursor method were investigated. The precursor solution was deposited on Si(111) substrates by dip coating. X-ray diffraction and thermal analyses revealed that the crystallization process occurred at a low temperature (420 °C) and led to films with no preferential orientation. High-temperature treatments promoted formation of the LiNb3O8 phase. Scanning electron microscopy, coupled with energy dispersive spectroscopy analyses, showed that the treatment temperature also affected the film microstructure. The surface texture - homogeneous, smooth, and pore-free at low temperature - turned into an `islandlike' microstructure for high-temperature treatments.

Effect of thermal treatment on the morphology of PLZT thin films prepared from polymeric precursor method

Lead lanthanum zirconate titanate (PLZT) thin films with (9/65/35) stoichiometry were prepared by dip coating from polymeric precursor method. The films deposited on silicon (100) substrates, were thermally treated from 450° to 700°C for 6 hours in order to study the influence of thermal treatment on the crystallinity, microstructure, grain size and roughness of the final film. X-ray diffraction results showed that PLZT phase crystallizes at low temperature (500°C) and present preferential orientation. It was observed by scanning electron microscopy (SEM) that it is possible to obtain dense thin films at temperatures around 650°C. The atomic force microscopy (AFM) studies showed that the grain size and roughness are strongly influenced by the annealing temperature.

Effects of thermal treatment on phase transitions and on the mechanical relaxation in poly(vinylidene fluoride)

This work reports on the effects from thermal treatment in poly(vinylidene fluoride), PVDF, obtained with differential scanning calorimetry (DSC) and dynamic thermal analysis (DMA) measurements. It is shown that in successive DMA measurements performed with one sample the α relaxation peak almost disappears while the γ′ peak appears. The α relaxation peak, at ∼100°C in DMA measurements, is attributed to the preferential orientation of chains in the amorphous phase while the γ′ relaxation peak, at ∼50°C, is related to the thermal treatment to which the sample was submitted.

A comparison between diuretics and angiotensin-receptor blocker agents in patients with stage I hypertension (PREVER-treatment trial): Study protocol for a randomized double-blind controlled trial

Background: Cardiovascular disease is the leading cause of death in Brazil, and hypertension is its major risk factor. The benefit of its drug treatment to prevent major cardiovascular events was consistently demonstrated. Angiotensin-receptor blockers (ARB) have been the preferential drugs in the management of hypertension worldwide, despite the absence of any consistent evidence of advantage over older agents, and the concern that they may be associated with lower renal protection and risk for cancer. Diuretics are as efficacious as other agents, are well tolerated, have longer duration of action and low cost, but have been scarcely compared with ARBs. A study comparing diuretic and ARB is therefore warranted.Methods/design: This is a randomized, double-blind, clinical trial, comparing the association of chlorthalidone and amiloride with losartan as first drug option in patients aged 30 to 70 years, with stage I hypertension. The primary outcomes will be variation of blood pressure by time, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new subclinical atherosclerosis and sudden death. The study will last 18 months. The sample size will be of 1200 participants for group in order to confer enough power to test for all primary outcomes. The project was approved by the Ethics committee of each participating institution.Discussion: The putative pleiotropic effects of ARB agents, particularly renal protection, have been disputed, and they have been scarcely compared with diuretics in large clinical trials, despite that they have been at least as efficacious as newer agents in managing hypertension. Even if the null hypothesis is not rejected, the information will be useful for health care policy to treat hypertension in Brazil. Clinical trials registration number: ClinicalTrials.gov: NCT00971165. © 2011 Fuchs et al; licensee BioMed Central Ltd.

Evaluation of area contaminated by wood treatment activities: genetic markers in the environment and in the child population

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effects of nitric oxide synthesis inhibitor or fluoxetine treatment on depression-like state and cardiovascular changes induced by chronic variable stress in rats

Comorbidity between mood disorders and cardiovascular disease has been described extensively. However, available antidepressants can have cardiovascular side effects. Treatment with selective inhibitors of neuronal nitric oxide synthase (nNOS) induces antidepressant effects, but whether the antidepressant-like effects of these drugs are followed by cardiovascular changes has not been previously investigated. Here, we tested in male rats exposed to chronic variable stress (CVS) the hypothesis that nNOS blockers are advantageous compared with conventional antidepressants in terms of cardiovascular side effects. We compared the effects of chronic treatment with the preferential nNOS inhibitor 7-nitroindazole (7-NI) with those evoked by the conventional antidepressant fluoxetine on alterations that are considered as markers of depression (immobility in the forced swimming test, FST, decreased body weight gain and increased plasma corticosterone concentration) and cardiovascular changes caused by CVS. Rats were exposed to a 14-day CVS protocol, while being concurrently treated daily with either 7-NI (30 mg/kg) or fluoxetine (10 mg/kg). Fluoxetine and 7-NI prevented the increase in immobility in the FST induced by CVS and reduced plasma corticosterone concentration in stressed rats. Both these treatments also prevented the CVS-evoked reduction of the depressor response to vasodilator agents and baroreflex changes. Fluoxetine and 7-NI-induced cardiovascular changes independent of stress exposure, including cardiac autonomic imbalance, increased intrinsic heart rate and vascular sympathetic modulation, a reduction of the pressor response to vasoconstrictor agents, and impairment of baroreflex activity. Altogether, these findings provide evidence that fluoxetine and 7-NI have similar effects on the depression-like state induced by CVS and on cardiovascular function.