Resumo Introdução e objetivos: Durante a pandemia COVID-19 a utilização de máscaras faciais, incluindo durante o exercício terapêutico, faz parte das medidas de segurança adotadas. Este facto originou preocupação a nível das unidades de reabilitação cardíaca, uma vez que as máscaras faciais podem promover efeitos deletérios na capacidade de exercício. Este estudo avaliou o impacto da utilização das máscaras faciais durante o treino aeróbio em passadeira. Métodos: Doze profissionais de saúde saudáveis completaram três provas em passadeira de acordo com o protocolo de Bruce: sem máscara, com máscara cirúrgica e com um respirador. A perceção de esforço e dispneia foi avaliada com a Escala de Perceção de Esforço de Borg e com a Escala de Dispneia de Borg, respetivamente. A pressão arterial, frequência cardíaca e saturação arterial de oxigénio (SpO2) foram registadas em cada estadio do protocolo. Resultados: A utilização de máscara facial resultou numa menor duração da prova e, em determinados momentos, níveis de perceção de dispneia e de esforço mais elevados. Verificou-se uma descida significativa da SpO2 no final da prova com respirador. Não se verificaram diferenças na resposta cronotrópica ou da pressão arterial entre as diferentes condições de prova. Conclusões: Os profissionais envolvidos na reabilitação cardíaca devem reconhecer os impactos cardiorrespiratórios provocados pela utilização da máscara facial. São necessários mais estudos para determinar se a exposição a estas condições de treino pode ter impacto nos resultados dos programas de reabilitação cardíaca.

This study aimed to review the recent literature about botulinum toxin type A treatment patterns, including muscle targets, doses, duration of effect, adverse effects, and clinical outcomes in patients with postparetic synkinesis. A bibliographic research of studies published in the last 10 yrs was carried out on PubMed database, using the medical subject heading terms: botulinum toxin and synkinesis. English-language cohort studies or randomized controlled trials about botulinum toxin type A treatment on patients with postparetic synkinesis were eligible for inclusion. Ten studies met the inclusion criteria, seven prospective studies, two retrospective studies, and one randomized controlled trial, involving 23-99 patients. The target facial muscles included frontalis, corrugator supercilli, orbicularis oculi, levator labii superioris, zygomaticus major, orbicularis oris, risorius, buccinator, depressor anguli oris, depressor labii inferioris, mentalis, and platysma. The dose of onabotulinumtoxinA administered per injection site ranged between 0.5 and 10 U. Adverse effects were rare and temporary. The mean duration of onabotulinumtoxinA effect ranges from 66 days to 4 mos. There was a statistically significant improvement in posttreatment evaluation, both in objective and subjective assessments. There is scientific evidence of the benefit of botulinum toxin type A treatment for postparetic synkinesis, but there is lack of standardized treatment protocols.

No abstract

No abstract

No abstract

No abstract

No abstract

CONCLUSION:The occipital fasciocutaneous rotation-advancement flap is a relatively simple means of obtaining local, vascularized, hair-bearing tissue for repair of wound breakdown following cochlear implantation. AOM Thomas Walker, MD (presenter); Simon Angeli, MD OBJECTIVE: Bacteria living in biofilms are extremely resistant to antibiotic therapy. Recurrent acute otitis media appears to be a disease process related to biofilm formation. The goal of this study is to determine if middle ear irrigations with saline or baby shampoo could significantly reduce or eradicate mucosal biofilms in an animal model of acute otitis media. METHOD: After an ABR was performed to assess baseline hearing, the middle ears of ten adult chinchillas were inoculated with 10 5 colony forming units of biofilm-forming H. influenzae. Five days after inoculation, the right middle ear was irrigated with 1% baby shampoo and the left ear with normal saline as a control. Two days following irrigations, a final ABR was obtained to assess post-intervention hearing. The animals were then euthanized and middle ear mucosa of each animal harvested. All specimens were analyzed by a blinded microscopist using scanning electron microscopy (SEM). RESULTS: Biofilm densities of middle ear mucosa are similar after 1% baby shampoo or saline irrigations. The hearing thresholds on auditory brainstem responses at frequencies 16 kHz, four kHz, one kHz and 500 Hz are unchanged two days after baby shampoo irrigations when compared to the baseline ABR. CONCLUSION: 1) Preliminary results indicate that middle ear irrigations with 1% baby shampoo in normal saline do not lead to significant decrease in biofilm density when compared to normal saline alone. 2) Baby shampoo is non-ototoxic and can be safely used in middle ears. 3) More chinchillas will be examined for a total of 28 animals to reach statistical significance. Middle Ear Irrigations on Biofilm in Chinchillas with MRI in Evaluation of Clinical Treatment of OtospongiosisAndy Vicente, MD, PhD (presenter); Helio Yamashita, MD; Oswaldo Laercio Cruz, MD, PhD; Norma Penido, MD, PhD OBJECTIVE: To evaluate the applicability of magnetic resonance imaging (MRI) as a method for monitoring the activity of otospongiotic lesions before and after clinical treatment. METHOD: A prospective, randomized, controlled, doubleblind study involving 31 patients with clinical, audiometric, and tomographic diagnosis of otosclerosis. As computed tomography (CT) demonstrated active lesions, consistently at the region anterior to the oval window, these patients underwent MRI in order to confirm the spongiotic foci activity (areas of gadolinium enhancement). The patients were then divided into three groups (A, B and C), receiving treatment with placebo, alendronate sodium, and sodium fluoride, respectively, for 6 months. After this period they were submitted to new clinical and audiometric evaluations along with a second MRI study. All MRI images were evaluated by a neuroradiologist and an otolaryngologist in a subjective (visual) and ob...