RESUMO
PURPOSE: Ambulatory voice biofeedback (AVB) has the potential to significantly improve voice therapy effectiveness by targeting one of the most challenging aspects of rehabilitation: carryover of desired behaviors outside of the therapy session. Although initial evidence indicates that AVB can alter vocal behavior in daily life, retention of the new behavior after biofeedback has not been demonstrated. Motor learning studies repeatedly have shown retention-related benefits when reducing feedback frequency or providing summary statistics. Therefore, novel AVB settings that are based on these concepts are developed and implemented. METHOD: The underlying theoretical framework and resultant implementation of innovative AVB settings on a smartphone-based voice monitor are described. A clinical case study demonstrates the functionality of the new relative frequency feedback capabilities. RESULTS: With new technical capabilities, 2 aspects of feedback are directly modifiable for AVB: relative frequency and summary feedback. Although reduced-frequency AVB was associated with improved carryover of a therapeutic vocal behavior (i.e., reduced vocal intensity) in a patient post-excision of vocal fold nodules, causation cannot be assumed. CONCLUSIONS: Timing and frequency of AVB schedules can be manipulated to empirically assess generalization of motor learning principles to vocal behavior modification and test the clinical effectiveness of AVB with various feedback schedules.
Assuntos
Assistência Ambulatorial , Biorretroalimentação Psicológica/instrumentação , Disfonia/terapia , Doenças da Laringe/terapia , Aplicativos Móveis , Pólipos/terapia , Smartphone , Terapia Assistida por Computador/instrumentação , Treinamento da Voz , Acelerometria/instrumentação , Adulto , Desenho de Equipamento , Feminino , Humanos , Espectrografia do Som , Interface Usuário-Computador , Qualidade da VozRESUMO
Gardner syndrome (GS) is an autosomal dominant disease characterized by the presence of colonic polyposis, osteoma and soft tissue tumors. It is regarded as a clinical subgroup of familial adenomatous polyposis (FAP) and may present at any age from 2 mo to 70 years with a variety of symptoms, either colonic or extracolonic. We present a case of a 23-year-old female patient with GS who presented with gastric polyposis and was successively treated with restorative proctocolectomy in combination with ileal pouch anal anastomosis (RPC/ IPAA), ileostomy, ileostomy closure operation, snare polypectomy during 8 mo. After operation, the patient took oral traditional Chinese medicine pills made of Fructus mume and Bombyx batryticatu for about 6 mo. The innutrition and anaemia of this patient were gradually improved. Gastroscopy showed that the remnant gastric polypi gradually decreased and finally disappeared 19 mo after the first operation. The patient had 2-3 times of solid stool per day at the time we wrote this paper.
Assuntos
Síndrome de Gardner/diagnóstico , Pólipos/diagnóstico , Gastropatias/diagnóstico , Adulto , Animais , Bombyx/metabolismo , Endoscopia , Feminino , Síndrome de Gardner/complicações , Síndrome de Gardner/terapia , Humanos , Medicina Tradicional Chinesa , Extratos Vegetais/uso terapêutico , Pólipos/complicações , Pólipos/terapia , Proctocolectomia Restauradora/métodos , Gastropatias/complicações , Gastropatias/terapia , Fatores de Tempo , Resultado do TratamentoRESUMO
In this communication, we report for the first time, that immunization of cancer patients with autologous soluble tumor-associated antigens (sTAA) isolated from their own serum prevents the toxic side effects of chemotherapy, improves the patients' clinical status, and has therapeutic effects without chemotherapy. In 2001 and 2002, two cancer patients were treated, during chemotherapy, with autologous sTAA. Another benign tumor-bearing patient was treated with a medicinal herb and autologous sTAA. Doses for subcutaneous injections varied between 2.5 and 3 mg of sTAA in 0.5 ml of sterile distilled water. Injections were performed twice a week or at weekly intervals. In each case, the clinical status of the patient became more stable and healthier. Toxic side effects caused by chemotherapy decreased or even disappeared. No additional toxic side effects were observed after vaccination with sTAA. In the studied cases, a polyp disappeared and a metastatic brain tumor began to encapsulate. No metastases were seen in the case with colon adenocarcinoma. We concluded that vaccination of patients with autologous sTAA prevents the toxic side effects of chemotherapy in cancer patients and improves their clinical status. In the case with the benign tumor, this vaccination activated the host's immune system, prevented progress of the disease and even promoted tumor disappearance. We suggest that immunotherapy with autologous sTAA provides significant clinical benefits in cancer patients and appears to be an important new adjuvant treatment of cancer.
Assuntos
Adjuvantes Farmacêuticos/uso terapêutico , Antígenos de Neoplasias/biossíntese , Antineoplásicos/farmacologia , Vacinas Anticâncer , Imunoterapia Ativa/métodos , Neoplasias/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/efeitos adversos , Neoplasias Encefálicas/secundário , Neoplasias Encefálicas/terapia , Colo Sigmoide/cirurgia , Doenças do Colo/terapia , Feminino , Humanos , Masculino , Melanoma/patologia , Melanoma/cirurgia , Pessoa de Meia-Idade , Pólipos/terapia , Doenças Vaginais/terapiaAssuntos
Pólipos do Colo/terapia , Terapia por Estimulação Elétrica/métodos , Endoscopia do Sistema Digestório/métodos , Cálculos Biliares/terapia , Marca-Passo Artificial , Idoso , Pólipos do Colo/complicações , Pólipos do Colo/cirurgia , Terapia Combinada , Terapia por Estimulação Elétrica/instrumentação , Eletrodos Implantados , Feminino , Cálculos Biliares/complicações , Cardiopatias/complicações , Cardiopatias/fisiopatologia , Humanos , Litotripsia , Masculino , Pessoa de Meia-Idade , Pólipos/complicações , Pólipos/cirurgia , Pólipos/terapia , Neoplasias Gástricas/complicações , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/terapiaRESUMO
The efficacy of ultrasonic ethmoidectomy combined with magnetic therapy was investigated in 90 patients. Ultrasonic ethmoidectomy was applied with the help of a LORA system consisting of a generator and an acoustic unit connected to a waveguide with a spoon-shaped end (44 Hz frequency and 35-40 microns amplitude). Under visual control the ultrasonic spoon was inserted into the meatus nasi medius, and the injured medial, superior and some anterior cells of the ethmoidal bone were opened. Bone trabecules of the cells were removed together with the polypous mucous membrane and polyps, by moving the concave surface forwards and keeping the long axis of the bent portion of the spoon in the vertical position. Follow-up of the treated patients during 6 months to 4 years revealed the absence of polyps in 79.7%. Repeated application of this treatment in the case of severe recurrent forms of polypous ethmoiditis improved the therapeutic efficacy.