Pharyngeal Manometry in Pediatric Dysphagia Assessment

2019 ◽  
Vol 4 (4) ◽  
pp. 656-682 ◽  
Author(s):  
Lara Ferris ◽  
Taher Omari
Keyword(s):  
Oropharyngeal Dysphagia ◽  
Image Data ◽  
Endoscopic Examination ◽  
Therapeutic Interventions ◽  
High Resolution Manometry ◽  
Swallow Study ◽  
Pharyngeal Manometry ◽  
Videofluoroscopic Swallow Study ◽  
Pediatric Dysphagia

Purpose Reliable measures to capture swallowing pathophysiology and outcomes from therapeutic interventions are needed in the pediatric setting. Therefore, this review presents the current best evidence for manometry investigation and its application in pediatric dysphagia. For oropharyngeal dysphagia assessment, videofluoroscopic swallow study is considered the gold standard, and fiberoptic endoscopic examination of swallowing is also employed in some settings. In clinical practice, both tests mostly rely on qualitative interpretation of image data and have variable reliability to detect pathophysiology. Conclusion Acknowledging that swallowing is a pressure-driven event, the role of manometry is now being considered as an objective, nonradiological technique that can be performed as an adjunct to other clinical swallow evaluations. The latest high-resolution manometry catheter technologies are miniaturized and simple to use, enhancing their potential application in pediatric clinical and research contexts.

scholarly journals Acoustic analysis of swallowing as an auxiliary method for assessing dysphagia in Parkinson's disease

2021 ◽  
Vol 10 (16) ◽  
pp. e323101623298
Author(s):  
Glauce Souza da Silva ◽  
Ana Clara Gonçalves de Figueiredo ◽  
Bianca Simone Zeigelboim ◽  
Cristiano Miranda de Araújo ◽  
José Stechmann Neto ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Predictive Value ◽  
Acoustic Analysis ◽  
Screening Method ◽  
Oropharyngeal Dysphagia ◽  
Accuracy Study ◽  
Swallow Study ◽  
Videofluoroscopic Swallow Study ◽  
Tracheal Aspiration

Objective: To measure the accuracy of DeglutiSom as an auxiliary method to assess swallowing in patients with Parkinson's disease (PD). Methodology: Accuracy study. Among 248 individuals, 91 participants met the inclusion criteria, with a mean age of 64.9 years (SD 7.7), 53.8% male and 46.2% female, with a mean disease duration of 12.6 years (SD 3.8 years). Two instrumental studies were performed: An acoustic analysis with Sonar Doppler via the DeglutiSom Software, and a videofluoroscopic swallow study. Three judges analyzed the swallowing sounds in the DeglutiSom software and the instrumental examination findings. Results: The inter-rater reliability was 90.1%, with 4.4% degree of partial agreement and 5.5% disagreement. Sensitivity resulted in 90.0% and specificity in 90.0%. A sensitivity of 97.0% and specificity of 91.0% are indicators of a high validity for the dysphagia screening method, with predictive value (+) of 97.0% and predictive value (-) of 91.0%, with an accuracy method of 96.0%. The validity indicator values for screening aspiration were also high, with a sensitivity of 90.0%, specificity of 90.0%, predictive value (+) of 82.0%, predictive value (-) of 95% , 0% and 90.0% accuracy. Conclusion: The method proposed is considered appropriate for oropharyngeal dysphagia and tracheal aspiration screening in patients with Parkinson's Disease.

Cholesterol and its Ayurvedic Complement – Depicting its role in Pathogenesis as well as Management of Diabetes

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Divya Kajaria
Keyword(s):  
Treatment Modality ◽  
Review Article ◽  
Therapeutic Interventions ◽  
Herbal Remedies ◽  
Natural Properties ◽  
Lipid Balance ◽  
Vast Area

Role of cholesterol in the pathogenesis of diabetes is the emergent are of research with full of potential; it not only open a vast area of therapeutic interventions but also can change the prevailing treatment modality. Ayurveda, the Indian system of medicine materialize the concept of lipocenteric approach for the management of diabetes even thousands of years back. According to Ayurveda, the natural properties of lipid are deranged that causes diabetes. It may prove beneficial to quest the search of herbal remedies that can harmonize the lipid balance and uproot the pathogenesis. In the presenting review article, role of cholesterol in the pathogenesis of diabetes is discussed along with detailed description of Ayurvedic concepts regarding pathogenesis and a brief description of herbal management.

The Role of Resilience in Sexual and Gender Minority Mental Health

2020 ◽  
pp. 428-442
Author(s):  
Dawn M. Szymanski ◽  
Kirsten A. Gonzalez
Keyword(s):  
Mental Health ◽  
Minority Stress ◽  
Quantitative Research ◽  
Social Stigma ◽  
Therapeutic Interventions ◽  
Future Research ◽  
Minority Mental Health ◽  
And Gender ◽  
Structural Levels

Many lesbian, gay, bisexual, transgender, and queer (LGBTQ) persons are able to persevere and flourish despite pervasive social stigma and minority stress based on their sexual orientation and gender identity. This chapter reviews the research on LGBTQ resilience that can occur at individual, interpersonal/family, community, and contextual/structural levels. The authors describe qualitative research that has examined pathways to resilience and positive LGBTQ identity. The authors also review quantitative research on LGBTQ resilience via mediator, moderator, and moderated mediation models. Variables are described that have been found to explain or buffer the links between external and internalized minority stressors and mental health outcomes. The authors review the small but growing body of research that has begun to examine the efficacy of therapeutic interventions aimed at promoting LGBTQ resilience. Limitations are discussed and directions for future research are suggested.

scholarly journals Neonatal Immune System Ontogeny: The Role of Maternal Microbiota and Associated Factors. How Might the Non-Human Primate Model Enlighten the Path?

Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 584
Author(s):  
Natalia Nunez ◽  
Louis Réot ◽  
Elisabeth Menu
Keyword(s):  
Immune System ◽  
Mode Of Delivery ◽  
Microbial Colonization ◽  
Therapeutic Interventions ◽  
Primate Model ◽  
Neonatal Immune System ◽  
Gastrointestinal Colonization ◽  
The Impact ◽  
Human Primate

Interactions between the immune system and the microbiome play a crucial role on the human health. These interactions start in the prenatal period and are critical for the maturation of the immune system in newborns and infants. Several factors influence the composition of the infant’s microbiota and subsequently the development of the immune system. They include maternal infection, antibiotic treatment, environmental exposure, mode of delivery, breastfeeding, and food introduction. In this review, we focus on the ontogeny of the immune system and its association to microbial colonization from conception to food diversification. In this context, we give an overview of the mother–fetus interactions during pregnancy, the impact of the time of birth and the mode of delivery, the neonate gastrointestinal colonization and the role of breastfeeding, weaning, and food diversification. We further review the impact of the vaccination on the infant’s microbiota and the reciprocal case. Finally, we discuss several potential therapeutic interventions that might help to improve the newborn and infant’s health and their responses to vaccination. Throughout the review, we underline the main scientific questions that are left to be answered and how the non-human primate model could help enlighten the path.

scholarly journals B Cells and Antibodies as Targets of Therapeutic Intervention in Neuromyelitis Optica Spectrum Disorders

2021 ◽  
Vol 14 (1) ◽  
pp. 37
Author(s):  
Jan Traub ◽  
Leila Husseini ◽  
Martin S. Weber
Keyword(s):  
B Cells ◽  
Neuromyelitis Optica ◽  
Plasma Cells ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Therapeutic Interventions ◽  
Complement Factor ◽  
Major Subset ◽  
Spectrum Disorders

The first description of neuromyelitis optica by Eugène Devic and Fernand Gault dates back to the 19th century, but only the discovery of aquaporin-4 autoantibodies in a major subset of affected patients in 2004 led to a fundamentally revised disease concept: Neuromyelits optica spectrum disorders (NMOSD) are now considered autoantibody-mediated autoimmune diseases, bringing the pivotal pathogenetic role of B cells and plasma cells into focus. Not long ago, there was no approved medication for this deleterious disease and off-label therapies were the only treatment options for affected patients. Within the last years, there has been a tremendous development of novel therapies with diverse treatment strategies: immunosuppression, B cell depletion, complement factor antagonism and interleukin-6 receptor blockage were shown to be effective and promising therapeutic interventions. This has led to the long-expected official approval of eculizumab in 2019 and inebilizumab in 2020. In this article, we review current pathogenetic concepts in NMOSD with a focus on the role of B cells and autoantibodies as major contributors to the propagation of these diseases. Lastly, by highlighting promising experimental and future treatment options, we aim to round up the current state of knowledge on the therapeutic arsenal in NMOSD.

Jewish Women's Psychological Well-Being: The Role of Attachment, Separation, and Jewish Identity

2005 ◽  
Vol 29 (2) ◽  
pp. 197-206 ◽  
Author(s):  
Julie L. Goldberg ◽  
Karen M. O'Brien
Keyword(s):  
Jewish Identity ◽  
Psychological Functioning ◽  
Well Being ◽  
Therapeutic Interventions ◽  
Jewish Women ◽  
Late Adolescent ◽  
Psychological Well Being ◽  
Separation From Parents ◽  
Anxiety Depression

The purpose of this study was to examine the contributions of attachment, separation, and Jewish identity to psychological well-being in a sample of 115 late adolescent Jewish women. Results from multiple regression analyses demonstrated that attachment to parents, separation from parents, and Jewish identity collectively accounted for variance in psychological distress, as measured by anxiety, depression, self-esteem problems, and interpersonal problems. Thus, late adolescent Jewish women's psychological functioning may be fostered by therapeutic interventions addressing their relationships with parents and Jewish identity.

scholarly journals Distinguishing Levels of Suicide Risk in Depressed Male Veterans: The Role of Internalizing and Externalizing Psychopathology as Measured by the MMPI-2-RF

Assessment ◽  
2017 ◽  
Vol 26 (1) ◽  
pp. 85-98 ◽  
Author(s):  
Stephanie N. Miller ◽  
Melanie L. Bozzay ◽  
Yossef S. Ben-Porath ◽  
Paul A. Arbisi
Keyword(s):  
Suicide Risk ◽  
Minnesota Multiphasic Personality Inventory ◽  
Therapeutic Interventions ◽  
Externalizing Psychopathology ◽  
Hierarchical Logistic Regression ◽  
Male Veterans ◽  
Scale Scores ◽  
Suicidal Death ◽  
Psychiatrically Hospitalized

Suicide occurs at high rates among veterans, underscoring a need for improved identification of veterans at risk of engaging in suicidal behavior. Considering dimensions of psychopathology in the context of an ideation-to-action framework, the present study examined the utility of the Minnesota Multiphasic Personality Inventory–2–Restructured Form in distinguishing depressed, psychiatrically hospitalized male veterans ( N = 430) at varying levels of suicide risk. Analysis of variance and hierarchical logistic regression analyses indicated that internalizing scales differentiated depressed ideators ( n = 147) and depressed controls ( n = 143); and in line with expectations, both broad and narrowly focused externalizing scales provided incremental validity in distinguishing depressed attempters ( n = 140) from depressed ideators. Interactions between Suicidal/Death Ideation and externalizing scale scores were found to differentiate only depressed ideators from depressed controls. Clinical implications in the areas of suicide risk assessment and therapeutic interventions with suicidal veterans are discussed.

scholarly journals The ketogenic diet increases Neuregulin 1 expression via elevating histone acetylation and its anti-seizure effect requires ErbB4 kinase activity

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jin Wang ◽  
Jie Huang ◽  
Shan Yao ◽  
Jia-Hui Wu ◽  
Hui-Bin Li ◽  
...  
Keyword(s):  
Histone Acetylation ◽  
Ketogenic Diet ◽  
Chromatin Immunoprecipitation ◽  
Kinase Activity ◽  
Control Diet ◽  
Synaptic Activity ◽  
Therapeutic Interventions ◽  
Type I ◽  
Neuregulin 1

Abstract Background The ketogenic diet (KD)has been considered an effective treatment for epilepsy, whereas its underlying mechanisms remain obscure. We have previously reported that the KD feeding increased Neuregulin 1 (NRG1) expression in the hippocampus; disruption of NRG1 signaling by genetically deleting its receptor-ErbB4 abolished KD’s effects on inhibitory synaptic activity and seizures. However, it is still unclear about the mechanisms underlying the effect of KD on NRG1 expression and whether the effects of KD require ErbB4 kinase activity. Methods The effects of the KD on NRG1 expression were assessed via western blotting and real-time PCR. Acetylation level at the Nrg1 promoter locus was examined using the chromatin immunoprecipitation technique. Kainic acid (KA)-induced acute seizure model was utilized to examine the effects of KD and histone deacetylase inhibitor-TSA on seizures. Synaptic activities in the hippocampus were recorded with the technique of electrophysiology. The obligatory role of ErbB4 kinase activity in KD’s effects on seizures and inhibitory synaptic activity was evaluated by using ErbB kinase antagonist and transgenic mouse-T796G. Results We report that KD specifically increases Type I NRG1 expression in the hippocampus. Using the chromatin immunoprecipitation technique, we observe increased acetylated-histone occupancy at the Nrg1 promoter locus of KD-fed mice. Treatment of TSA dramatically elevates NRG1 expression and diminishes the difference between the effects of the control diet (CD) and KD. These data indicate that KD increases NRG1 expression via up-regulating histone acetylation. Moreover, both pharmacological and genetic inhibitions of ErbB4 kinase activity significantly block the KD’s effects on inhibitory synaptic activity and seizure, suggesting an essential role of ErbB4 kinase activity. Conclusion These results strengthen our understanding of the role of NRG1/ErbB4 signaling in KD and shed light on novel therapeutic interventions for epilepsy.

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