An overview of dysphagia rehabilitation for stroke patients

ABSTRACT Background: Dysphagia is characterized by difficulty in the swallowing pattern at any stage of this neuromuscular process. It is a frequent symptom after stroke. Objective: This study aimed to investigate the most commonly used phonoaudiological interventions as therapy for the treatment of swallowing disorders in patients with dysphagia after stroke. Methods: We performed a review of studies indexed in MEDLINE-PubMed, LILACS, Cochrane, and Clinical trials.gov focusing on speech-language interventions for adult dysphagic patients after stroke between January 2008 and January 2021. Results: Thirty-six articles of clinical trials were selected. Eleven different types of therapies have been studied. Studies on the efficacy of therapeutic interventions for the rehabilitation of adult patients with dysphagia after stroke are still scarce. Most techniques are combined with conventional therapy, so the effectiveness of the other techniques alone cannot be assessed. Conclusions: Therapeutic interventions should be selected in accordance with the possibilities and limitations of the patients, and especially with the findings of the clinical evaluation and with its objective.

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Controversies in endodontic access cavity design: A literature review

Dental Update ◽

10.12968/denu.2020.47.9.747 ◽

2020 ◽

Vol 47 (9) ◽

pp. 747-754

Author(s):

Manahil Maqbool ◽

Tahir Yusuf Noorani ◽

Jawaad Ahmed Asif ◽

Saleem D Makandar ◽

Nafij Bin Jamayet

Keyword(s):

Clinical Trials ◽

Literature Review ◽

Root Canal ◽

The Other ◽

Root Canal Treatment ◽

Tooth Structure ◽

Different Types ◽

Cavity Design ◽

Compare And Contrast

The purpose of this article is to compare and contrast the different types of endodontic access cavity designs based on the current available evidence. Four types of access cavity designs, namely, traditional endodontic access cavity design (TEC), contracted/conservative endodontic access cavity design (CEC), ultra-conservative or ninja endodontic access cavity design (NEC) and truss endodontic access cavity design (TREC) have been suggested, and the latter three are currently in the limelight. Studies in vitro have been performed comparing the TECs, CECs, TRECs and NECs; except for the TECs, the other three types have not undergone clinical trials on patients. The choice of endodontic access cavity design affects fracture strength of the tooth, but remnants of pulpal tissue, due to ineffective instrumentation, can cause root canal treatment failure. CPD/Clinical Relevance: Root canal treatment with new access cavity designs has been proposed. However, there is lack of evidence to support such practices. It is important to consider the potential deleterious effects of such access cavity designs rather than emphasizing the preservation of tooth structure alone.

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STROKE

The Professional Medical Journal ◽

10.29309/tpmj/2006.13.04.4951 ◽

2006 ◽

Vol 13 (04) ◽

pp. 680-686

Author(s):

UMAIR MASOOD ◽

ANJUM ANWAR QADRI ◽

MUHAMMAD ANSAR MAQSOOD

Keyword(s):

Significant Variation ◽

The Other ◽

Military Hospital ◽

Stroke Patients ◽

Chi Square ◽

Different Types ◽

Different Seasons ◽

One Year ◽

June July ◽

Peak Summer

Objective: To document seasonal variations invarious types of stroke and to identify possible precipitating/aggravating factors. Design: Analytical. Place andDuration of Study: Military Hospital Rawalpindi and Combined Military Hospital Rawalpindi, for one year, from IstOctober 2001 to 30th September 2002. Patients and Methods: 116 adult stroke patients diagnosed on the basis ofhistory, clinical examination and CT Scan and admitted during this period were included in the study. The findings weredocumented and analyzed using SPSS and frequency of stroke in relation to seasons was calculated. Chi square testwas used to determine significance of differences in frequency of different types of stroke in the winter and summer.Results: The age of the patients ranged from 20-87 years.83 were males while 33 were females. Sixty-nine out of 116cases presented in summer and the rest 47 in winter. In summer out of 69 subjects, 48(69.56%) had ischaemic strokesand 21(30.44%) had hemorrhagic strokes, of which 19 had Intra Cerebral Hemorrhage (ICH) and 2 subarachnoidhemorrhage (SAH). In winter, out of 47 subjects, 28(59.57%) had ischaemic strokes and 19(40.43%) had haemorrhagicstrokes (all ICH). Two definite seasonal peaks one in extreme summer (June, July) and the other in extreme winter(December, January) were seen. Conclusions: There is a significant variation in frequency of stroke and its differenttypes in different seasons of the year with higher occurrence in peak summer (June, July) and extreme winter(December, January).

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Accelerating Coronavirus Disease 2019 Therapeutic Interventions and Vaccines—Selecting Compounds for Clinical Evaluation in Coronavirus Disease 2019 Clinical Trials

Critical Care Medicine ◽

10.1097/ccm.0000000000005295 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Timothy G. Buchman ◽

Ruxandra Draghia-Akli ◽

Stacey J. Adam ◽

Neil R. Aggarwal ◽

Joshua P. Fessel ◽

...

Keyword(s):

Clinical Trials ◽

Clinical Evaluation ◽

Therapeutic Interventions

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Circulating Anticoagulant (Antifactor VIII) Treated with Immunosuppressive Drugs

Thrombosis and Haemostasis ◽

10.1055/s-0038-1653534 ◽

1969 ◽

Vol 21 (02) ◽

pp. 249-258 ◽

Cited By ~ 17

Author(s):

L. A Sherman ◽

M. A Goldstein ◽

H. S Sise

Keyword(s):

Factor Viii ◽

Conventional Therapy ◽

Immunosuppressive Drugs ◽

The Other ◽

Not Given ◽

Factor Viii Concentrates ◽

Short Courses

SummaryThree cases have been presented who had a circulating antifactor VIII anticoagulant developing spontaneously in non-hemophilic subjects. Following two short courses of azathioprine in one case there were transient incomplete remissions of a degree not seen in the previous 4 months of observation. In the other two cases complete remissions were observed within three weeks of beginning administration of 6-mercaptopurine. In one of these, a brief relapse was retreated successfully. In 4 other cases not given these drugs and in cases reported in the literature, such a rapid remission was not seen to occur spontaneously and happened only infrequently in cases given corticosteroids. On the basis of this experience, we suggest that in the treatment of antifactor VIII, if the disorder shows no improvement with conventional therapy (blood, factor VIII concentrates, and corticosteroids), a trial with immunosuppressive drugs is warranted.

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Ingredients, Functionality, and Safety of the Japanese Traditional Sweet Drink Amazake

Journal of Fungi ◽

10.3390/jof7060469 ◽

2021 ◽

Vol 7 (6) ◽

pp. 469

Author(s):

Atsushi Kurahashi

Keyword(s):

Clinical Trials ◽

Blood Glucose ◽

Bowel Movement ◽

Skin Barrier ◽

Fermented Food ◽

The Other ◽

Added Sugar ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Main Components

The sweet drink amazake is a fermented food made from Aspergillus oryzae and related koji molds in Japan. There are two types of drinks called amazake, one made from koji (koji amazake) and the other made from sake lees, a by-product of sake (sakekasu amazake). The sweetness of koji amazake is from glucose, derived from starch broken down by A. oryzae amylase. The other, sakekasu amazake, depends on added sugar. The main components are glucose and sucrose, but they also contain more than 300 other ingredients. Koji amazake contains oligosaccharides and ergothioneine, and sakekasu amazake has a resistant protein and α-ethyl glucoside, which are characteristic ingredients of each amazake. However, there are also common ingredients such as glycosylceramide. Functionality is known to include anti-fatigue, bowel movement, skin barrier, and other effects on human health. In particular, the bowel movement-improving effects have been well studied for both amazakes. These functions result from ingesting approximately 100 mL per day, but human clinical trials have clarified that this amount has no effect on blood glucose levels and weight gain. In the future, the identification of substances associated with each function is required.

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Validity and reliability of the Mandarin version of the Treatment Burden Questionnaire among stroke patients in Mainland China

Family Practice ◽

10.1093/fampra/cmab004 ◽

2021 ◽

Author(s):

Qi Zhang ◽

Ke Zhang ◽

Miao Li ◽

Jiaxin Gu ◽

Xintong Li ◽

...

Keyword(s):

Internal Consistency ◽

Convergent Validity ◽

Intraclass Correlation ◽

Reliability And Validity ◽

Therapeutic Interventions ◽

Treatment Burden ◽

Validity And Reliability ◽

Stroke Patients ◽

Retest Reliability ◽

Test Retest Reliability

Abstract Objectives To examine the validity and reliability of the Mandarin version of the Treatment Burden Questionnaire (TBQ) among stroke patients. Background Stroke patients need long-term management of symptoms and life situation, and treatment burden has recently emerged as a new concept that can influence the health outcomes during the rehabilitation process. Methods The convenience sampling method was used to recruit 187 cases of stroke patients in a tertiary grade hospital in Tianjin for a formal investigation. Item analysis, reliability and validity tests were carried out. The reliability test included internal consistency and test–retest reliability. And as well as content, structure and convergent validity were performed for the validity test. Results Of the 187 completed questionnaires, only 180 (96.3%) were suitable for analysis. According to the experts’ evaluation, the I-CVI of each item was from 0.833 to 1.000, and the S-CVI was 0.967. The exploratory factor analysis yielded three-factor components with a cumulative variation of 53.054%. Convergent validity was demonstrated using measures of Morisky’s Medication Adherence Scale 8 (r = –0.450, P < 0.01). All correlations between items and global scores ranged from 0.403 to 0.638. Internal consistency reliability and test–retest reliability were found to be acceptable, as indicated by a Cronbach’s α of 0.824 and an intraclass correlation coefficient of 0.846, respectively. Conclusions The Mandarin TBQ had acceptable validity and reliability. The use of TBQ in the assessment of treatment burden of stroke survivor may benefit health resources allocation and provide tailor therapeutic interventions to construct minimally disruptive care.

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Melatonin in Cancer Treatment: Current Knowledge and Future Opportunities

Molecules ◽

10.3390/molecules26092506 ◽

2021 ◽

Vol 26 (9) ◽

pp. 2506

Author(s):

Wamidh H. Talib ◽

Ahmad Riyad Alsayed ◽

Alaa Abuawad ◽

Safa Daoud ◽

Asma Ismail Mahmod

Keyword(s):

Clinical Trials ◽

Current Knowledge ◽

Biological Activities ◽

Experimental Studies ◽

Therapeutic Effects ◽

Cell Proliferation Inhibition ◽

Different Types ◽

Solid Foundation

Melatonin is a pleotropic molecule with numerous biological activities. Epidemiological and experimental studies have documented that melatonin could inhibit different types of cancer in vitro and in vivo. Results showed the involvement of melatonin in different anticancer mechanisms including apoptosis induction, cell proliferation inhibition, reduction in tumor growth and metastases, reduction in the side effects associated with chemotherapy and radiotherapy, decreasing drug resistance in cancer therapy, and augmentation of the therapeutic effects of conventional anticancer therapies. Clinical trials revealed that melatonin is an effective adjuvant drug to all conventional therapies. This review summarized melatonin biosynthesis, availability from natural sources, metabolism, bioavailability, anticancer mechanisms of melatonin, its use in clinical trials, and pharmaceutical formulation. Studies discussed in this review will provide a solid foundation for researchers and physicians to design and develop new therapies to treat and prevent cancer using melatonin.

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Comparative Surface Imaging Study of Multifocal Diffractive Intraocular Lenses

Klinische Monatsblätter für Augenheilkunde ◽

10.1055/a-1328-2550 ◽

2021 ◽

Author(s):

Hyeck Soo Son ◽

Jung Min Lee ◽

Ramin Khoramnia ◽

Chul Young Choi

Keyword(s):

Imaging Study ◽

The Other ◽

Intraocular Lenses ◽

Optical Surface ◽

Diffractive Optic ◽

Atomic Force ◽

Acceptable Range ◽

Different Types ◽

Concentric Pattern

Abstract Purpose To analyse and compare the surface topography and roughness of three different types of diffractive multifocal IOLs. Methods Using scanning electron microscope (SEM, Inspect F, 5.0 KV, maximum magnification up to 20,000) and atomic force microscope (AFM, Park Systems, XE-100, non-contact, area profile comparison, 10 × 10 µm, 40 × 40 µm), the surface quality of the following diffractive IOLs was studied: the AcrySof IQ PanOptix (Alcon, USA), the AT LARA 829MP (Carl Zeiss Meditec, Germany), and Tecnis Symfony (Johnson&Johnson Vision, USA). The measurements were made over three representative areas (central non-diffractive optic, central diffractive optic, and diffractive step) of each IOL. Roughness profile in terms of mean arithmetic roughness (Ra) and root-mean-squared roughness (Rq) values were obtained and compared statistically. Results In SEM examination, all IOLs showed a smooth optical surface without any irregularities at low magnification. At higher magnification, Tecnis Symfony showed unique highly regular, concentric, and lineate structures in the diffractive optic area which could not be seen in the other studied diffractive IOLs. The differences in the measured Ra and Rq values of the Tecnis Symfony were statistically significant compared to the other models (p < 0.05). Conclusion Various different topographical traits were observed in three diffractive multifocal IOLs. The Ra values of all studied IOLs were within an acceptable range. Tecnis Symfony showed statistically significant higher surface Ra values at both central diffractive optic and diffractive step areas. Furthermore, compared to its counterparts, Tecnis Symfony demonstrated highly ordered, concentric pattern in its diffractive surfaces.

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RADIATION EXPOSURE TO THE BACK WITH DIFFERENT TYPES OF APRONS

Radiation Protection Dosimetry ◽

10.1093/rpd/ncab044 ◽

2021 ◽

Author(s):

Seung Wan Hong ◽

Tae Won Kim ◽

Jae Hun Kim

Keyword(s):

Radiation Exposure ◽

Effective Dose ◽

Exposure Time ◽

The Other ◽

Lead Apron ◽

Type Group ◽

Air Kerma ◽

Different Types ◽

The Relationship

Abstract Physicians and nurses stand with their back towards the C-arm fluoroscope when using the computer, taking things out of closets and preparing drugs for injection or instruments for intervention. This study was conducted to investigate the relationship between the type of lead apron and radiation exposure to the backs of physicians and nurses while using C-arm fluoroscopy. We compared radiation exposure to the back in the three groups: no lead apron (group C), front coverage type (group F) and wrap-around type (group W). The other wrap-around type apron was put on the bed instead of on a patient. We ran C-arm fluoroscopy 40 times for each measurement. We collected the air kerma (AK), exposure time (ET) and effective dose (ED) of the bedside table, upper part and lower part of apron. We measured these variables 30 times for each location. In group F, ED of the upper part was the highest (p < 0.001). ED of the lower part in group C and F was higher than that in group W (p = 0.012). The radiation exposure with a front coverage type apron is higher than that of the wrap-around type and even no apron at the neck or thyroid. For reducing radiation exposure to the back of physician or nurse, the wrap-around type apron is recommended. This type of apron can reduce radiation to the back when the physician turns away from the patient or C-arm fluoroscopy.

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MITOTIC CROSSING OVER AND NONDISJUNCTION IN TRANSLOCATION HETEROZYGOTES OF ASPERGILLUS

Genetics ◽

10.1093/genetics/82.4.605 ◽

1976 ◽

Vol 82 (4) ◽

pp. 605-627

Author(s):

Etta Käfer

Keyword(s):

Selective Advantage ◽

The Other ◽

Translocation Chromosome ◽

Crossing Over ◽

Selective Marker ◽

Reciprocal Translocations ◽

Poor Growth ◽

Different Types ◽

Diploid Genotype ◽

One Step

ABSTRACT To analyze mitotic recombination in translocation heterozygotes of A. nidulans two sets of well-marked diploids were constructed, homo- or heterozygous for the reciprocal translocations T1(IL;VIIR) or T2(IL;VIIIR) and heterozygous for selective markers on IL. It was found that from all translocation heterozygotes some of the expected mitotic crossover types could be selected. Such crossovers are monosomic for one translocated segment and trisomic for the other and recovery depends on the relative viabilities of these unbalanced types. The obtained segregants show characteristically reduced growth rates and conidiation dependent on sizes and types of mono- and trisomic segments, and all spontaneously produce normal diploid sectors. Such secondary diploid types either arose in one step of compensating crossing over in the other involved arm, or—more conspicuously—in two steps of nondisjunction via a trisomic intermediate.—In both of the analyzed translocations the segments translocated to IL were extremely long, while those translocated from IL were relatively short. The break in I for T1(I;VII) was located distal to the main selective marker in IL, while that of T2(I;VIII) had been mapped proximal but closely linked to it. Therefore, as expected, the selected primary crossover from the two diploids with T2(I;VIII) in coupling or in repulsion to the selective marker, showed the same chromosomal imbalance and poor growth. These could however be distinguished visually because they spontaneously produced different trisomic intermediates in the next step, in accordance with the different arrangement of the aneuploid segments. On the other hand, from diploids heterozygous for T1(I;VII) mitotic crossovers could only be selected when the selective markers were in coupling with the translocation; these crossovers were relatively well-growing and produced frequent secondary segregants of the expected trisomic, 2n+VII, type. For both translocations it was impossible to recover the reciprocal crossover types (which would be trisomic for the distal segments of I and monosomic for most of groups VII or VIII) presumably because these were too inviable to form conidia.—In addition to the selected segregants of expected types a variety of unexpected ones were isolated. The conditions of selection used favour visual detection of aneuploid types, even if these produce only a few conidial heads and are not at a selective advantage. For T2(I;VIII) these "non-selected" unbalanced segregants were mainly "reciprocal" crossovers of the same phenotype and imbalance as the selected ones. For T1(I;VII) two quite different types were obtained, both possibly originating with loss of the small VII-Itranslocation chromosome. One was isolated when the selective marker in repulsion to T1(I;VII) was used and, without being homo- or hemizygous for the selective marker, it produced stable sectors homozygous for this marker. The other was obtained from both coupling and repulsion diploids and showed a near-diploid genotype; it produced practically only haploid stable sectors of the type expected from monosomics, 2n-1 for the short translocation chromosome.

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