Flávio Fallopa

Coupling agents in therapeutic ultrasound: acoustic and thermal behavior.

OBJECTIVE To compare transmissivity data and thermal behavior of 4 coupling media. DESIGN Experimental. SETTING Postgraduate rehabilitation program in Brazil. SPECIMENS Four coupling media: gel, mineral oil, white petrolatum, and degassed water. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The transmission, attenuation, reflection coefficient, and acoustic impedance of gel, mineral oil, white petrolatum, and degassed water were measured with a density measurement cell. The temperature variation in the therapeutic ultrasound transducer was measured with a thermocouple. RESULTS The transmissivity data showed that the water and gel presented the highest transmission coefficient, the lowest reflection, and an attenuation coefficient and acoustic impedance close to that of the skin. The thermal data revealed the highest heating in the transducer during the insonation with white petrolatum and mineral oil, resulting from the thermal conductivity features of each medium. CONCLUSIONS Transmissivity data obtained showed that water and gel present the best acoustic features. In ultrasound therapy, with the direct contact technique using thin layers of coupling agents, any product may be used, because the effect of the attenuation coefficient does not play a significant role when layers are as thin as those used in this experiment.

Coupling agents in therapeutic ultrasound: acoustic and thermal behavior 1,2

OBJECTIVE To compare transmissivity data and thermal behavior of 4 coupling media. DESIGN Experimental. SETTING Postgraduate rehabilitation program in Brazil. SPECIMENS Four coupling media: gel, mineral oil, white petrolatum, and degassed water. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The transmission, attenuation, reflection coefficient, and acoustic impedance of gel, mineral oil, white petrolatum, and degassed water were measured with a density measurement cell. The temperature variation in the therapeutic ultrasound transducer was measured with a thermocouple. RESULTS The transmissivity data showed that the water and gel presented the highest transmission coefficient, the lowest reflection, and an attenuation coefficient and acoustic impedance close to that of the skin. The thermal data revealed the highest heating in the transducer during the insonation with white petrolatum and mineral oil, resulting from the thermal conductivity features of each medium. CONCLUSIONS Transmissivity data obtained showed that water and gel present the best acoustic features. In ultrasound therapy, with the direct contact technique using thin layers of coupling agents, any product may be used, because the effect of the attenuation coefficient does not play a significant role when layers are as thin as those used in this experiment.

Intra-individual evaluation of results between open and endoscopic release in bilateral carpal tunnel syndrome

Objective The authors performed an intra-individual comparison of surgical results between the open and endoscopic surgical techniques in patients with bilateral carpal tunnel syndrome. Each hand was submitted to surgery using one of these techniques. Methods Fifteen patients (30 hands) were evaluated by the Boston Questionnaire, visual analogue pain scale, palmar grip strength, and for tip, key, and tripod pinch strengths. These measurements were taken before surgery and at two weeks, one month, three months, and six months after the procedure. Scores for each evaluation tool in each evaluation time period were compared. Results In comparison to the group submitted to open surgery, the group submitted to endoscopic surgery had worse scores in the evaluation of the 1st and 6th postoperative months regarding the severity of the symptoms. The authors found no differences in the functional status of the hand. Regarding the intensity of pain evaluated by the visual analogue pain scale, no difference was found between the averages in all time periods evaluated. No differences in palmar grip strength and in fingertip, key (lateral), and tripod pinch strengths were found in all time periods. There were no differences between averages in the preoperative period at two weeks, one month, and three months after surgery. After six months, the group of patients submitted to open surgery presented greater tripod force than the group of patients who underwent endoscopic surgery. Conclusion No differences were observed by using the intra-individual evaluation in the results between open and endoscopic techniques for the treatment of carpal tunnel syndrome.

Translation and Cross-Cultural Adaptation of the 6-Item Carpal Tunnel Syndrome Symptoms Scale and Palmar Pain Scale Questionnaire Into Brazilian Portuguese

Background: There are several medical questionnaires to evaluate the quality of life of carpal tunnel syndrome patients. However, most measures are only available in English. We chose to translate and culturally adapt to Portuguese the Six-Item Carpal Tunnel Syndrome Symptoms Scale and Palmar Pain Scale (CTS-6) questionnaire because it provides objective assessment using a small number of questions. Methods: The translation and cultural adaptation were carried out according to the medical literature and consisted of five steps: (1) initial translation by two translators fluent in both languages, (2) association of initial translations, (3) back translation to Portuguese by two native speakers of English, (4) association of back translation and (5) comparison with the original version. Results: The Portuguese version was administered to patients with carpal tunnel syndrome and difficulties were noted concerning the comprehension and completion of the translated questionnaire. Patients had difficulty in understanding the horizontal layout of the response choices. Without altering the content, we changed the response choices to a vertical layout and re-administered the questionnaire to a new sample of patients followed up in the same ambulatory care service. We noted a substantial improvement in comprehension and completion of the questionnaire after the modifications. Conclusions: Availability of a Portuguese version of the Six-Item Carpal Tunnel Syndrome Symptoms Scale and Palmar Pain Scale (CTS-6) questionnaire will allow an objective evaluation of the treatment of a syndrome that is very prominent in medical practice.

Coupling agents in therapeutic ultrasound: acoustic and thermal behavior 1,21No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or any organization with which the authors are associated.2The therapeutic ultrasound was provided by Bioset Indústria de Tecnologia Eletrônica Ltda.

OBJECTIVE To compare transmissivity data and thermal behavior of 4 coupling media. DESIGN Experimental. SETTING Postgraduate rehabilitation program in Brazil. SPECIMENS Four coupling media: gel, mineral oil, white petrolatum, and degassed water. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The transmission, attenuation, reflection coefficient, and acoustic impedance of gel, mineral oil, white petrolatum, and degassed water were measured with a density measurement cell. The temperature variation in the therapeutic ultrasound transducer was measured with a thermocouple. RESULTS The transmissivity data showed that the water and gel presented the highest transmission coefficient, the lowest reflection, and an attenuation coefficient and acoustic impedance close to that of the skin. The thermal data revealed the highest heating in the transducer during the insonation with white petrolatum and mineral oil, resulting from the thermal conductivity features of each medium. CONCLUSIONS Transmissivity data obtained showed that water and gel present the best acoustic features. In ultrasound therapy, with the direct contact technique using thin layers of coupling agents, any product may be used, because the effect of the attenuation coefficient does not play a significant role when layers are as thin as those used in this experiment.

Brief reportCoupling agents in therapeutic ultrasound: acoustic and thermal behavior 1,2

OBJECTIVE To compare transmissivity data and thermal behavior of 4 coupling media. DESIGN Experimental. SETTING Postgraduate rehabilitation program in Brazil. SPECIMENS Four coupling media: gel, mineral oil, white petrolatum, and degassed water. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The transmission, attenuation, reflection coefficient, and acoustic impedance of gel, mineral oil, white petrolatum, and degassed water were measured with a density measurement cell. The temperature variation in the therapeutic ultrasound transducer was measured with a thermocouple. RESULTS The transmissivity data showed that the water and gel presented the highest transmission coefficient, the lowest reflection, and an attenuation coefficient and acoustic impedance close to that of the skin. The thermal data revealed the highest heating in the transducer during the insonation with white petrolatum and mineral oil, resulting from the thermal conductivity features of each medium. CONCLUSIONS Transmissivity data obtained showed that water and gel present the best acoustic features. In ultrasound therapy, with the direct contact technique using thin layers of coupling agents, any product may be used, because the effect of the attenuation coefficient does not play a significant role when layers are as thin as those used in this experiment.

Fratura do hâmulo do hamato em jogador de bocha: relato de caso

A case of fracture of the hook of the hamate in a boccie player is presented. The mechanism of the fracture, diagnostic and treatment are discussed.