Facial-muscle weakness, speech disorders and dysphagia are common in patients with classic infantile Pompe disease treated with enzyme therapy

Classic infantile Pompe disease is an inherited generalized glycogen storage disorder caused by deficiency of lysosomal acid α-glucosidase. If left untreated, patients die before one year of age. Although enzyme-replacement therapy (ERT) has significantly prolonged lifespan, it has also revealed new aspects of the disease. For up to 11 years, we investigated the frequency and consequences of facial-muscle weakness, speech disorders and dysphagia in long-term survivors. Sequential photographs were used to determine the timing and severity of facial-muscle weakness. Using standardized articulation tests and fibreoptic endoscopic evaluation of swallowing, we investigated speech and swallowing function in a subset of patients. This study included 11 patients with classic infantile Pompe disease. Median age at the start of ERT was 2.4 months (range 0.1-8.3 months), and median age at the end of the study was 4.3 years (range 7.7 months −12.2 years). All patients developed facial-muscle weakness before the age of 15 months. Speech was studied in four patients. Articulation was disordered, with hypernasal resonance and reduced speech intelligibility in all four. Swallowing function was studied in six patients, the most important findings being ineffective swallowing with residues of food (5/6), penetration or aspiration (3/6), and reduced pharyngeal and/or laryngeal sensibility (2/6). We conclude that facial-muscle weakness, speech disorders and dysphagia are common in long-term survivors receiving ERT for classic infantile Pompe disease. To improve speech and reduce the risk for aspiration, early treatment by a speech therapist and regular swallowing assessments are recommended

An Extended Model of Moral Outrage at Corporate Social Irresponsibility

The final publication is available at Springer via http://dx.doi.org/ 10.1007/s10551-014-2487-

The ANANKE Relative-Energy-Gradient (REG) Method to Automate IQA Analysis over Configurational Change

The large volumes of information that arise from telecommunications and cyberspace systems can be represented by massive digraphs. The size of these graphs are so huge that they are unable to be processed by current technologies. The graphs require new and innovative methods of processing and visualizing. Graph surfaces of hierarchical graph slices have been suggested as a way of representing massive digraphs. In this chapter an approach is presented which involves encoding Lipschitz functions into monotone k-logic functions using symmetric chain decompositions (SeD). This approach proposes to address some of the issues concerning huge graphs by providing memory minimization techniques that can be applied to storing graph surfaces