Comprehensive Rehabilitation for Epiglottis Dysfunction Due to Cut Injury of Neck with Respiratory and Swallowing Problems

Despite significant advances in the treatment and rehabilitation of stroke, level of post-stroke disability remains at a fairly high level. Recent innovative developments in the rehabilitation of these patients provide good results in terms of functional outcome. One of such developments is method of virtual reality (VR), which affects not only the speed and volume of regaining movement, as well as coordination, but also normalizes the psycho-emotional background, increasing the motivation of patients to improve the recovery process. This article provides a literature review of the use of the VR method in the rehabilitation of post-stroke patients, neurophysiological aspects of recovery of lost functions using this method are considered.

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Multi-Analytical Framework to Assess the In Vitro Swallowability of Solid Oral Dosage Forms Targeting Patient Acceptability and Adherence

Pharmaceutics ◽

10.3390/pharmaceutics13030411 ◽

2021 ◽

Vol 13 (3) ◽

pp. 411

Author(s):

Abdul Latif Ershad ◽

Ali Rajabi-Siahboomi ◽

Shahrzad Missaghi ◽

Daniel Kirby ◽

Afzal Rahman Mohammed

Keyword(s):

Hydroxypropyl Methylcellulose ◽

Analytical Framework ◽

Dosage Forms ◽

Oral Dosage ◽

Surface Erosion ◽

World Population ◽

Swallowing Problems ◽

Solid Oral Dosage Forms ◽

Oral Dosage Forms

A lack of effective intervention in addressing patient non-adherence and the acceptability of solid oral dosage forms combined with the clinical consequences of swallowing problems in an ageing world population highlight the need for developing methods to study the swallowability of tablets. Due to the absence of suitable techniques, this study developed various in vitro analytical tools to assess physical properties governing the swallowing process of tablets by mimicking static and dynamic stages of time-independent oral transitioning events. Non-anatomical models with oral mucosa-mimicking surfaces were developed to assess the swallowability of tablets; an SLA 3D printed in vitro oral apparatus derived the coefficient of sliding friction and a friction sledge for a modified tensometer measured the shear adhesion profile. Film coat hydration and in vitro wettability was evaluated using a high-speed recording camera that provided quantitative measurements of micro-thickness changes, simulating static in vivo tablet–mucosa oral processing stages with artificial saliva. In order to ascertain the discriminatory power and validate the multianalytical framework, a range of commonly available tablet coating solutions and new compositions developed in our lab were comparatively evaluated according to a quantitative swallowability index that describes the mathematical relationship between the critical physical forces governing swallowability. This study showed that the absence of a film coat significantly impeded the ease of tablet gliding properties and formed chalky residues caused by immediate tablet surface erosion. Novel gelatin- and λ-carrageenan-based film coats exhibited an enhanced lubricity, lesser resistance to tangential motion, and reduced stickiness than polyvinyl alcohol (PVA)–PEG graft copolymer, hydroxypropyl methylcellulose (HPMC), and PVA-coated tablets; however, Opadry® EZ possessed the lowest friction–adhesion profile at 1.53 a.u., with the lowest work of adhesion profile at 1.28 J/mm2. For the first time, the in vitro analytical framework in this study provides a fast, cost-effective, and repeatable swallowability ranking method to screen the in vitro swallowability of solid oral medicines in an effort to aid formulators and the pharmaceutical industry to develop easy-to-swallow formulations.

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Formulation and Optimization of Sodium Alginate Polymer Film as a Buccal Mucoadhesive Drug Delivery System Containing Cetirizine Dihydrochloride

Pharmaceutics ◽

10.3390/pharmaceutics13050619 ◽

2021 ◽

Vol 13 (5) ◽

pp. 619

Author(s):

Krisztián Pamlényi ◽

Katalin Kristó ◽

Orsolya Jójárt-Laczkovich ◽

Géza Regdon

Keyword(s):

Drug Delivery ◽

Tensile Strength ◽

Sodium Alginate ◽

Drug Delivery System ◽

Delivery System ◽

Polymer Films ◽

Hydroxypropyl Methylcellulose ◽

Chemical Properties ◽

Active Pharmaceutical Ingredient ◽

Swallowing Problems

Currently, pharmaceutical companies are working on innovative methods, processes and products. Oral mucoadhesive systems, such as tablets, gels, and polymer films, are among these possible products. Oral mucoadhesive systems possess many advantages, including the possibility to be applied in swallowing problems. The present study focused on formulating buccal mucoadhesive polymer films and investigating the physical and physical–chemical properties of films. Sodium alginate (SA) and hydroxypropyl methylcellulose (HPMC) were used as film-forming agents, glycerol (GLY) was added as a plasticizer, and cetirizine dihydrochloride (CTZ) was used as an active pharmaceutical ingredient (API). The polymer films were prepared at room temperature with the solvent casting method by mixed two-level and three-level factorial designs. The thickness, tensile strength (hardness), mucoadhesivity, surface free energy (SFE), FTIR, and Raman spectra, as well as the dissolution of the prepared films, were investigated. The investigations showed that GLY can reduce the mucoadhesivity of films, and CTZ can increase the tensile strength of films. The distribution of CTZ proved to be homogeneous in the films. The API could dissolve completely from all the films. We can conclude that polymer films with 1% and 3% GLY concentrations are appropriate to be formulated for application on the buccal mucosa as a drug delivery system.

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Effect of a newly developed pastille on the salivary flow rate in subjects with dry mouth symptoms: a randomized, controlled, monocentric clinical study

BMC Oral Health ◽

10.1186/s12903-021-01471-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

S. Bielfeldt ◽

D. Wilhelm ◽

C. Neumeister ◽

U. Schwantes ◽

K. -P. Wilhelm

Keyword(s):

Surface Tension ◽

Flow Rate ◽

Gum Arabic ◽

Salivary Flow ◽

Salivary Flow Rate ◽

Dry Mouth ◽

Main Ingredient ◽

Control Product ◽

Swallowing Problems ◽

The Mean

Abstract Background Xerostomia is associated with several diseases and is a side effect of certain drugs, resulting from reduced saliva secretion. Often, aged and sometimes younger people suffer from (idiopathic) xerostomia. Chewing gum and sucking pastilles may relieve symptoms of xerostomia by increasing the salivary flow rate due to the mechanical effect of sucking and gustatory stimulation. Swallowing problems and the urge to cough or experiencing a tickling sensation in the throat might be alleviated through a reduction in dry mouth symptoms. We investigated whether a pastille containing four polysaccharides increased the salivary flow rate and relieved the symptoms of dry mouth. Methods Participating subjects with xerostomia were randomized into two equally balanced treatment groups. Subjects received the pastille on Day 1 and a control product (Parafilm®) on Day 3, or vice versa. Unstimulated saliva was collected every 2.5 min for 0–10 min. Stimulated saliva was collected after subjects sucked the pastille or the control product. The salivary flow rate was determined gravimetrically, and, in parallel, the feeling of dry mouth was assessed using a visual analog scale. Saliva surface tension was measured in pooled saliva samples (0–5 min of sampling). Additionally, in stimulated saliva from six subjects who sucked the pastille, the presence of the main ingredient—gum arabic—was examined by Raman spectroscopy. Results Chewing the pastille significantly increased the mean salivary flow rate by 8.03 g/10 min compared to the mean changes after chewing the control product (+ 3.71 g/10 min; p < 0.0001). The mean score of dry mouth was significantly alleviated by the pastille (− 19.9 ± 17.9 mm) compared to the control product (− 3.3 ± 18.1 mm). No difference between the two products was seen regarding the saliva surface tension. Gum arabic was present in the saliva of all investigated subjects for up to 10 min after sucking the pastille. Conclusions The pastille was well tolerated and effective in increasing the salivary flow rate and reducing mouth dryness after sucking. These results were in line with the detection of the main ingredient, gum arabic, in saliva for up to 10 min after sucking the pastille. Trial registration German Register Clinical Trials (Deutsches Register Klinische Studien, DRKS) DRKS-ID: DRKS00017393, Registered 29 May 2019, https://www.drks.de/drks_web/navigate.do?navigationId=trial. HTML&TRIAL_ID = DRKS00017393.

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A comprehensive rehabilitation programme tailored to the needs of adults with muscular dystrophy

Clinical Rehabilitation ◽

10.1191/0269215506cr898oa ◽

2006 ◽

Vol 20 (2) ◽

pp. 132-141 ◽

Cited By ~ 16

Author(s):

G Ahlström ◽

B Lindvall ◽

S Wenneberg ◽

L G Gunnarsson

Keyword(s):

Muscular Dystrophy ◽

Rehabilitation Programme ◽

Comprehensive Rehabilitation

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Let "Ruin" into a "Home" — Create a Ruins Environment in the Contemporary Urban with the Model of Ecomuseum

Advanced Materials Research ◽

10.4028/www.scientific.net/amr.368-373.3659 ◽

2011 ◽

Vol 368-373 ◽

pp. 3659-3662 ◽

Cited By ~ 1

Author(s):

Xiao Min Wang ◽

Fan Li

Keyword(s):

Sustainable Development ◽

Natural Environment ◽

Rapid Development ◽

Historical Context ◽

Community Life ◽

Indoor Space ◽

Comprehensive Rehabilitation ◽

Urban Sites ◽

Organically Combine

Facing the current rapid development of economic and the constantly renewal of urban appearance, this article discusses the ideas about creating a ruins environment in the contemporary urban with the model of “Ecomuseum” from the point of sustainable development. Through the establishment of ecomuseum , the exhibition activities happen from indoor space to outdoor place; the exhibition content organically combine with the humanistic landscape and landmarks, natural environment and community life. This space mode not only focuses on ruins itself, but also tends to comprehensive rehabilitation and utilization about the ruins area environment. This mode play an important role for the Overall protection of the urban sites and continuous inheritance of historical context.

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Impact of Voice and Swallowing Problems in the Elderly

Otolaryngology ◽

10.1016/j.otohns.2008.05.162 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P50-P50

Author(s):

Richard Turley ◽

Seth M Cohen

Keyword(s):

Quality Of Life ◽

Treatment Options ◽

The Elderly ◽

T Test ◽

Barriers To Treatment ◽

Continuous Variables ◽

Spearman Correlation ◽

Cross Sectional ◽

Swallowing Problems

Objective 1) Evaluate the prevalence of and quality of life impact of voice and swallowing problems in the elderly. 2) Determine treatment trends and barriers to treatment. Methods Cross-sectional study of independent living residents in 2 retirement communities. Main outcome measures include prevalence of dysphonia and dysphagia, Voice Related Quality of Life (VRQOL), 7-point Likert scale of dysphagia severity, Center for Epidemiologic Studies Depression (CES-D) scale, and barriers to treatment. Relationship between continuous variables were analyzed with Spearman correlation and between categorical and continuous variables with a t-test. Results 248 residents responded, with a mean age of 82.4 years. 19.8% had dysphonia, 13.7% dysphagia, and 6% both. Respondents with more severe swallowing difficulty had greater impairment on the VRQOL (p = 0.04, Spearman correlation = −0.4). Respondents with both dysphonia and dysphagia had greater depression scores than those with neither symptom (mean CES-D score 15.5 versus 9.9, p = 0.008, t-test). While 75% of respondents with dysphonia were interested in treatment, only 20.4% and 2.1% had sought treatment for dysphonia and dysphagia, respectively. Being unaware of treatment options, and viewing voice and swallowing trouble as a normal part of aging, were the two most common reasons for not seeking treatment. Conclusions Voice and swallowing problems are common in the elderly but they are not realizing potential treatment benefits. Improved health care services for voice and swallowing problems in the elderly are essential.

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No. 169 Comprehensive Rehabilitation Improved Taste Sensitivity in Patients With Overweight and Obesity

PM&R ◽

10.1016/j.pmrj.2014.08.166 ◽

2014 ◽

Vol 6 (8) ◽

pp. S128

Author(s):

Kumiko Ito ◽

Satoru Ebihara ◽

Tamao Takahashi ◽

Masahiro Kohzuki

Keyword(s):

Overweight And Obesity ◽

Taste Sensitivity ◽

Comprehensive Rehabilitation

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