José Diniz Junior

Rhinocerebral zygomycosis in a diabetic patient

Rhinocerebral zygomycosis is the most frequent form of fungal infection caused by members of the Zygomycetes class. A fatal case of rhinocerebral zygomycosis caused by Rhizopus (oryzae) arrhizus with histopathological and mycological diagnosis is reported in a diabetic patient.

Tinnitus evaluation: relation among pitch matching and loudness, visual analog scale and tinnitus handicap inventory

INTRODUCTION Tinnitus is a subjective auditory symptom usually associated with a sound, even in the absence of external sound sources. Its diagnosis is complex, and some of the forms of measurement alone or in combination, include self-assessment questionnaires, such as the tinnitus handicap inventory, the visual analog scale and/or pitch and loudness matching. OBJECTIVE To analyze the correlation among three tinnitus measurement methods: tinnitus handicap inventory, visual analog scale and pitch and loudness matching. METHODS The study consisted of 148 patients complaining of chronic tinnitus. An otorhinolaryngological evaluation, anamnesis directed to tinnitus, audiometry (pure tone and speech), imitanciometry, tinnitus handicap inventory, visual analog scale, and pitch and loudness matching were performed. The study was registered in the Ethics Committee of the Institution with no. 0129/12. RESULTS Regarding the frequency of tinnitus handicap inventory responses, a higher occurrence of the mild degree was observed. An average of 6 points was observed on the visual analog scale. The mean loudness matching in the right ear was 20dBNS, and in the left ear was 17dBNS. As for the type of stimulus, the most found was continuous pure tone. The frequency of the pitch sensation was 6000Hz in the largest number of cases. Regarding the measures of tinnitus handicap inventory and the visual analogical scale, a significant correlation was observed, and as one value increases the other also increases. Pitch and loudness matching and the visual analogical scale results are also significant. CONCLUSION There was a significant correlation between the values measured by the tinnitus handicap inventory, visual analogical scale (annoyance) and loudness matching in the evaluation of tinnitus. The selection of any one of the three evaluative methods for tinnitus investigation provides different dimensions of the tinnitus and complements the others.

ANÁLISE DE DESEMPENHO SOBRE REDES IEEE 802.3/PM-AH (PROTOCOLO MULTICILOS PARA AUTOMAÇÃO HOSPITALAR)

Com a incorporacao de conceitos da automacao em ambientes hospitalares surge uma serie de novos requisitos pertinentes a area medica. Dentre esses requisitos, um que merece destaque e a necessidade do estabelecimento de uma rede de comunicacao segura e eficiente entre os elementos do ambiente hospitalar, visto que, os mesmos encontram-se de maneira distribuida. Nesse sentido, existe uma serie de protocolos que podem ser utilizados no estabelecimento dessa rede, dentre os quais, um que merece destaque e o PM-AH (Protocolo Multiciclos para Automacao Hospitalar) justamente por ser voltado a automatizacao de ambientes hospitalares tanto no que diz respeito ao cumprimento dos requisitos impostos nesse tipo de ambiente, como pelo fato de ser projetado para funcionar sobre a tecnologia Ethernet, padrao esse que e comumente utilizado pela rede de dados dos hospitais. Em decorrencia disso, o presente trabalho aborda uma analise de desempenho comparativa entre redes PM-AH e puramente Ethernet visando atestar a eficiencia do primeiro no que diz respeito ao cumprimento dos requisitos impostos pela automacao hospitalar.

Bilateral Multicentric Paraganglioma

.CASE REPORTN.F.S., 76, black, complained of dizziness that did not improve with medi-cation, pulsatile tinnitus and progressive hearing loss for the past 3 years in his right ear, as well as left side neck bulging for 30 years, of slow growth, painless, of fibroelastic material, non-pulsatile.On CT scan we noticed an exten-sive solid mass with ill-defined lobulated contours, occupying the carotid space in both sides, with right side temporal bone destruction by a tumor radiologically equal to the one previously described, and the patient was allergic to iodine. MRI showed hypervascularized lesions (see Figure), in the aforementioned regions, thus corrobo-rating CT findings. Angiography confirmed the diagnosis. DISCUSSIONNeck paragangliomas, because of their rare occurrence, are a difficult to diagnose and treat pathology. Among other causes of neck bulging we have: branchyal cysts, carotid aneurisms, neuro-fibromas, parotid tumors, tumor metastasis, inflammatory lymphadenopathy, amongst others. They are mostly benign; paragan-gliomas can have malignant transforma-tion in 2 to 10% of cases, accounting for 0.012% of head and neck tumors. The most frequent site is the carotid body; the less common sites are the middle ear, jugular, vagus nerve, larynx and aortic arch