Tratamento médico e fonoaudiológico da disfonia espasmódica: uma revisão bibliográfica

A disfonia espasmódica (DE) é um distúrbio vocal caracterizado por voz tensa-estrangulada, com quebras de sonoridade e que compromete a comunicação do indivíduo. O objetivo deste estudo é apresentar uma revisão bibliográfica dos tratamentos médico e fonoaudiológico proposto para a DE no período entre 2006 e 2010. Os tratamentos descritos foram: injeção de toxina botulínica (TB), miectomia, neurectomia, denervação e reinervação laríngea seletiva adutora, tireoplastia, miotermia tiroaritenóidea com radiofrequência, injeção de lidocaína, homeopatia e tratamento fonoaudiológico (fonoterapia). O uso de injeção de TB mostrou resultados que indicaram a satisfação dos pacientes tratados, embora alguns dos artigos apontassem a necessidade de reaplicação da toxina frequentemente, como desvantagem. Os procedimentos cirúrgicos foram considerados duradouros e indicados para os pacientes que não quiseram se submeter às aplicações de TB. Tais estudos, no entanto, apresentaram contingência de pacientes restrita e os resultados foram baseados, na maioria das investigações, no julgamento dos próprios pacientes sobre a sua qualidade vocal. Os tratamentos, com uso de lidocaína e homeopatia, mostraram resultados positivos em relação à qualidade vocal dos pacientes e foram sugeridos como uma opção, também, para aqueles que não gostariam de ser submetidos ao tratamento cirúrgico ou à aplicação de TB. Os poucos estudos que reportam fonoterapia assinalaram bons resultados quando a mesma foi associada à injeção de TB, mostrando a escassez de informações nesta área. Futuras pesquisas envolvendo a fonoterapia no tratamento da DE são necessárias.

Telefones celulares: influência nos sistemas auditivo e vestibular

Os sistemas de telecomunicações emitem radiofreqüência, uma radiação eletromagnética invisível. Telefones celulares transmitem microondas (450900 MHz no sistema analógico e 1,82,2 GHz no sistema digital), muito próximo à orelha do usuário. Esta energia é absorvida pela pele, orelha interna, nervo vestibulococlear e superfície do lobo temporal. OBJETIVO: Revisar a literatura sobre influência dos telefones celulares na audição e equilíbrio. FORMA DE ESTUDO: Revisão sistemática. METODOLOGIA: Foram pesquisados artigos nas bases Lilacs e Medline sobre a influência dos telefones celulares nos sistemas auditivo e vestibular, publicados de 2000 a 2005, e também materiais veiculados na Internet. RESULTADOS: Os estudos sobre radiação do telefone celular e risco de neurinoma do acústico apresentam resultados contraditórios. Alguns autores não encontram maior probabilidade de aparecimento do tumor nos usuários de celulares, enquanto outros relatam que a utilização de telefones analógicos por 10 anos ou mais aumenta o risco para o tumor. A exposição aguda às microondas emitidas pelo celular não influencia a atividade das células ciliadas externas da cóclea, in vivo e in vitro, a condução elétrica no nervo coclear, nem a fisiologia do sistema vestibular em humanos. As próteses auditivas analógicas são mais suscetíveis à interferência eletromagnética dos telefones celulares digitais. CONCLUSÃO: Não há comprovação de lesão cocleovestibular pelos telefones celulares.

Espectroscopia de impedância no laboratório de ensino

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

Effect of the fluorination of DLC film on the corrosion protection of aluminum alloy (AA 5052)

It is presented a study conducted on the physical and electrochemical properties of fluorinated a-C:H films deposited onto a commercial aluminum alloy (AA 5052). The coatings were deposited from mixtures of 91% of acetylene and 9% of argon by plasma immersion ion implantation and deposition technique, PIIID. Total gas pressure was 44 Pa and deposition time (t(dep)) was varied from 300 to 1200 s. The depositing plasmas were generated by the application of radiofrequency power (13.56 MHz, 100W) to the upper electrode and high voltage negative pulses (2400 V. 300 Hz) to the sample holder. Fluorine was incorporated in a post-deposition plasma treatment (13.56 MHz, 70W, 13 Pa) generated from sulfur hexafluoride atmosphere. Chemical structure and composition of the films were investigated using infrared reflectance/absorbance spectroscopy and X-ray photoelectron spectroscopy. The corrosion resistance of the layers was determined by electrochemical impedance spectroscopy (EIS) in a 3.5% NaCl solution, at room temperature. Films presented good adhesion to the substrates and are classified as hydrogenated amorphous carbon (a-C:H) with oxygen traces. Fluorine was detected in all the samples after the post-deposition treatment being its proportion independent on the deposition time. Film thickness presented different tendencies with t(dep), revealing the variation of the deposition rate as a function of the deposition time. Such fluorinated a-C:H films improved the corrosion resistance of the aluminum surface. In a general way the corrosion resistance was higher for films prepared with lower deposition times. The variation of sample temperature with t(dep) was found to be decisive for the concentration of defects in the films and, consequently, for the performance of the samples in electrochemical tests. Results are interpreted in terms of the energy delivered to the growing layer by ionic bombardment. (C) 2010 Elsevier B.V. All rights reserved.

Lubricating coating prepared by PIIID on a forming tool

In this work, the performance of a-C: H films produced by the hybrid Plasma Immersion Ion Implantation and Deposition technique as lubricating layers for a steel forming tool has been investigated. Hardened steel (AISI M2, 64 HRC) plates coated with a commercial TiN layer were used as substrates and the films were deposited in a vacuum chamber fitted with two parallel-plate electrodes. The discharges were generated in atmospheres composed of 91% C2H2 and 9% Ar by the application of radiofrequency power (13.56 MHz, 100 W) to the upper electrode while the lower one, also used as the sample holder, was biased with high voltage negative pulses (3.6 kV, 30 mu s, 300 Hz). A deposition time of 840 s was used. The effects of the gas pressure, p, on thickness, molecular structure, wettability, surface morphology and topography, hardness and friction coefficient of the films lwere investigated. Film thickness increased from 0.3 to 0.5 mu m when p was increased from 2.7 to 16.5 Pa. Generally, the films were slightly hydrophilic, with contact angles of around 84 degrees, and the deposition decreased the roughness of the steel. A polymer-like structure was detected in high pressure depositions and an amorphous carbon structure derived from the low pressure procedures. Hardness decreased from 8.2 to 7.0 GPa with increasing p. Improvement in tribological performance was indicated by the fall in the friction coefficient from 0.5 to 0.2 as the deposition pressure was reduced. Operating at the latter value (of mu) would lead to a significant reduction in wear and hence to significant economy in diverse industrial applications.

Diverse Amorphous Carbonaceous Thin Films Obtained by Plasma Enhanced Chemical Vapor Deposition and Plasma Immersion Ion Implantation and Deposition

Diverse amorphous hydrogenated carbon and similar films containing additional elements were produced by Plasma Enhanced Chemical Vapor Deposition (PECVD) and by Plasma Immersion Ion Implantation and Deposition (PIIID). Thus a-C:H, a-C:H:F, a-C:H:N, a-C:H:Cl and a-C:H:O:Si were obtained, starting from the same feed gases, using both techniques. The same deposition system supplied with radiofrequency (RF) power was used to produce all the films. A cylindrical stainless steel chamber equipped with circular electrodes mounted horizontally was employed. RF power was fed to the upper electrode; substrates were placed on the lower electrode. For PIIID negative high tension pulses were also applied to the lower electrode. Raman spectroscopy confirmed that all the films are amorphous. Chemical characterization of each pair of films was undertaken using Infrared Reflection Absorption Spectroscopy and X-ray Photoelectron Spectroscopy. The former revealed the presence of specific structures, such as C-H, C-O, O-H. The latter allowed calculation of the ratio of hetero-atoms to carbon atoms in the films, e. g. F:C, N:C, and Si:C. Only relatively small differences in elemental composition were detected between films produced by the two methods. The deposition rate in PIIID is generally reduced in relation to that of PECVD; for a-C:H:Cl films the reduction factor is almost four.

HMDSO plasma polymerization and thin film optical properties

Thin films were deposited from hexamethyldisiloxane (HMDSO) in a glow discharge supplied with radiofrequency (rf) power. Actino-metric optical emission spectroscopy was used to follow trends in the plasma concentrations of the species SiH (414.2 nm), CH (431.4 nm), CO (520.0 nm), and H (656.3 nm) as a function of the applied rf power (range 5 to 35 W). Transmission infrared spectroscopy (IRS) was employed to characterize the molecular structure of the polymer, showing the presence of Si-H, Si-O-Si, Si-O-C and C-H groups. The deposition rate, determined by optical interferometry, ranged from 60 to 130 nm/min. Optical properties were determined from transmission ultra violet-visible spectroscopy (UVS) data. The absorption coefficient α, the refractive index n, and the optical gap E04 of the polymer films were calculated as a function of the applied power. The refractive index at a photon energy of 1 eV varied from 1.45 to 1.55, depending on the rf power used for the deposition. The absorption coefficient showed an absorption edge similar to other non-crystalline materials, amorphous hydrogenated carbon, and semiconductors. For our samples, we define as an optical gap, the photon energy E04 corresponding to the energy at an absorption of 104 cm-1. The values of E04 decreased from 5.3 to 4.6 as the rf power was increased from 5 to 35 W. © 1995.

Evaluation of blood compatibility of plasma deposited heparin-like films and SF6 plasma treated surfaces

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Review of the efficacy and safety of cryoablation for the treatment of small renal masses

Purpose: Small renal masses are increasingly being discovered incidentally on imaging for another reason. The standard of care of these masses involves excision by open or laparoscopic techniques. Recently, ablative techniques, such as radiofrequency ablation (RFA) and cryoablation, have taken a more prominent role in the treatment algorithm of these masses. We evaluate the effectiveness and safety of cryoablation to treat renal tumours. Methods: A review of the literature was conducted. There was no language restriction. Studies were obtained from the following sources: the Cochrane Library, PUBMED, EMBASE and LILACS. Results: There was no clinical trial identified in the literature. Thus, we described the results from 23 case series and retrospective studies with a reasonable sample size (number of reported patients in each study ≥30), with a total of 2104 analyzed tumours from 2038 patients. There was wide variability in the outcomes reported, but success rates were generally good. Follow-up was generally short, but some series reported outcomes at 5 years. The most common complications reported were hemorrhage (some of the patients requiring transfusion), perinephric hematoma and urine leaks. Conclusion: Cryoablation presents a feasible treatment for patients with small renal masses. Only short-term data are available and, as such, meaningful conclusions regarding long-term cancer control cannot be made. More rigorous studies are needed. © 2013 Canadian Urological Association.

Forámenes emisarios del cráneo humano: Características anatómicas y sus relaciones con la neurocirugía clínica

The recognition of emissary foramens is important not only for understanding the regional neurovascular anatomy, but also to distinguish normal from potentially abnormal structures. Thus, the aim of this study was to review the literature on anatomical and clinical aspects of the mastoid, parietal and sphenoid emissary foramens. It was found that the emissary foramen presents importance in clinical practice because it acts as a route of spread of extracranial infection to the intracranial structures and also possible complications in neurosurgery, due to its influence in the performance of techniques such as radiofrequency rhizotomy for treatment of trigeminal neuralgia. The anatomical knowledge of the emissary foramens is important due to variability in their incidence in the human skull and its relation to the dura mater sinuses.

Preparation of films from aluminum acetylacetonate by plasma sputtering

Aluminum acetylacetonate has been reported as a precursor for the deposition of alumina films using different approaches. In this work, alumina-containing films were prepared by plasma sputtering this compound, spread directly on the powered lowermost electrode of a reactor, while grounding the substrates mounted on the topmost electrode. Radiofrequency power (13.56 MHz) was used to excite the plasma from argon atmosphere at a working pressure of 11 Pa. The effect of the plasma excitation power on the properties of the resulting films was studied. Film thickness and hardness were measured by profilometry and nanoindentation, respectively. The molecular structure and chemical composition of the layers were analyzed by Fourier transform infrared spectroscopy and energy dispersive spectroscopy. Surface micrographs, obtained by scanning electron microscopy, allowed the determination of the sample morphology. Grazing incidence X-ray diffraction was employed to determine the structure of the films. Amorphous organic layers were deposited with thicknesses of up to 7 μm and hardness of around 1.0 GPa. The films were composed by aluminum, carbon, oxygen and hydrogen, their proportions being strongly dependent on the power used to excite the plasma. A uniform surface was obtained for low-power depositions, but particulates and cracks appeared in the high-power prepared materials. The presence of different proportions of aluminum oxide in the coatings is ascribed to the different activations promoted in the metalorganic molecule once in the plasma phase. Copyright © 2013 John Wiley & Sons, Ltd. Copyright © 2013 John Wiley & Sons, Ltd.

Mechanical and tribological properties of a-C:H:F Thin Films

a-C:H films were grown by plasma-enhanced chemical vapor deposition in atmospheres composed by 30 % of acetylene and 70 % of argon. Radiofrequency signal (RF) was supplied to the sample holder to generate the depositing plasmas. Deposition time and pressure were chosen 300 s and 9.5 Pa, respectively, while the excitation power changed from 5 to 125 W. The films were exposed to a post-deposition treatment during 300 s in RF-plasmas (13.56 MHz, 70 W) excited from 13.33 Pa of SF6. Raman and X-ray photoelectron spectroscopy were used to evaluate the microstructure and chemical composition of the films. The thickness was measured by perfilometry. Hardness and friction coefficient were determined from nanoindentation and risk tests, respectively. With increasing power, the film thickness reduced, but a further shrinkage occurred upon the fluorination process. After that, the molecular structure was observed to vary with deposition power. Fluorine was detected in all samples replacing H atoms. Consistently with the elevation in the proportion of C atoms with sp3 hybridization, hardness increased from 2 to 18 GPa. Friction coefficient also increased with power due to the generation of dangling bonds during the fluorination process. © 2012 Springer Science+Business Media, LLC.

Optical, mechanical and surface properties of amorphous carbonaceous thin films obtained by plasma enhanced chemical vapor deposition and plasma immersion ion implantation and deposition

Diverse amorphous hydrogenated carbon-based films (a-C:H, a-C:H:F, a-C:H:N, a-C:H:Cl and a-C:H:Si:O) were obtained by radiofrequency plasma enhanced chemical vapor deposition (PECVD) and plasma immersion ion implantation and deposition (PIIID). The same precursors were used in the production of each pair of each type of film, such as a-C:H, using both PECVD and PIIID. Optical properties, namely the refractive index, n, absorption coefficient, α, and optical gap, ETauc, of these films were obtained via transmission spectra in the ultraviolet-visible near-infrared range (wavelengths from 300 to 3300 nm). Film hardness, elastic modulus and stiffness were obtained as a function of depth using nano-indentation. Surface energy values were calculated from liquid drop contact angle data. Film roughness and morphology were assessed using atomic force microscopy (AFM). The PIIID films were usually thinner and possessed higher refractive indices than the PECVD films. Determined refractive indices are consistent with literature values for similar types of films. Values of ETauc were increased in the PIIID films compared to the PECVD films. An exception was the a-C:H:Si:O films, for which that obtained by PIIID was thicker and exhibited a decreased ETauc. The mechanical properties - hardness, elastic modulus and stiffness - of films produced by PECVD and PIIID generally present small differences. An interesting effect is the increase in the hardness of a-C:H:Cl films from 1.0 to 3.0 GPa when ion implantation is employed. Surface energy correlates well with surface roughness. The implanted films are usually smoother than those obtained by PECVD. ©2013 Elsevier B.V. All rights reserved.

Ablação por cateter versus tratamento farmacológico para pacientes com síndrome de Wolf-Parkinson-White: revisão sistemática

Pós-graduação em Bases Gerais da Cirurgia - FMB

Propriedades mecânicas e tribológicas de filmes sintetizados mediante técnica de deposição e implantação iônica por imersão em plasma

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)