Effects of Therapy in Oropharyngeal Dysphagia by Speech and Language Therapists: A Systematic Review

Medical and paramedical treatments should be evaluated according to current standards of evidence-based medicine. Evaluation of therapy in oropharyngeal dysphagia fits into this growing interest. A systematic review is given of the literature on the effects of therapy in oropharyngeal dysphagia carried out by speech therapists. Thus, the review excludes reports of surgical or pharmacological treatments. The literature search was performed using the electronic databases PubMed and Embase. All available inclusion dates up to November 2008 were used. The search was limited to English, German, French, Spanish, and Dutch publications. MESH terms were supplemented by using free-text words (for the period after January 2005). Fifty-nine studies were included. In general, statistically significant positive therapy effects were found. However, the number of papers was rather small. Moreover, diverse methodological problems were found in many of these studies. For most studies, the conclusions could not be generalized; comparison was hindered by the range of diagnoses, types of therapies, and evaluation techniques. Many questions remain about the effects of therapy in oropharyngeal dysphagia as performed by speech and language therapists. Although some positive significant outcome studies have been published, further research based on randomized controlled trials is needed

Comportamento alimentar durante o confinamento por COVID-19 (CoV-Eat Project): protocolo de um estudo transversal em países de língua espanhola

In December 2019, cases of pneumonia of unknown etiology emerged, which were later classified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). On March 11st, the pandemic by COVID-19 disease was declared, and since then it has been used transmission containment measures such as social distancing and confinement, measures with known effects as stressors that can influence eating behavior. Therefore, the aim of this research protocol is to identify eating behavior through dietary restriction, emotional feeding, and uncontrolled intake and to explore the factors associated with these adult behaviors during the COVID-19 pandemic in Spanish-speaking countries.En diciembre de 2019 surgieron casos de neumonía de etiología desconocida, que más tarde fueron clasificados como coronavirus del síndrome respiratorio agudo grave de tipo 2 (SARS-CoV-2). El 11 de marzo se declaró la pandemia por la enfermedad respiratoria coronavirus disease 2019 (COVID-19), por lo que se recurrió a medidas de contención de la transmisión, como el distanciamiento social y confinamiento, medidas con conocidos efectos estresores que pueden influir en la conducta alimentaria. Por ello, el objetivo de esta investigación es identificar la conducta alimentaria a través de la restricción dietética, alimentación emocional e ingesta incontrolada, y explorar los factores asociados con estas conductas en adultos durante el confinamiento por COVID-19 en países hispanohablantes.Em dezembro de 2019 surgiram casos de pneumonia de etiologia desconhecida, posteriormente classificados como coronavírus de síndrome respiratória aguda grave do tipo 2 (SARS-CoV-2). No dia 11 de março, foi declarada a pandemia pela doença respiratória coronavirus disease 2019 (COVID-19), por isto foram utilizadas medidas de contenção da transmissão, como o distanciamento social e o confinamento, medidas com conhecidos efeitos estressantes que podem influenciar o comportamento alimentar. Portanto, o objetivo desta pesquisa é identificar o comportamento alimentar por meio da restrição dietética, a alimentação emocional e a ingestão descontrolada, e explorar os fatores associados a esses comportamentos em adultos durante o confinamento por COVID-19 em países de língua espanhola

Autologous microsurgical breast reconstruction and coronary artery bypass grafting: an anatomical study and clinical implications

OBJECTIVE: To identify possible avenues of sparing the internal mammary artery (IMA) for coronary artery bypass grafting (CABG) in women undergoing autologous breast reconstruction with deep inferior epigastric artery perforator (DIEP) flaps. BACKGROUND: Optimal autologous reconstruction of the breast and coronary artery bypass grafting (CABG) are often mutually exclusive as they both require utilisation of the IMA as the preferred arterial conduit. Given the prevalence of both breast cancer and coronary artery disease, this is an important issue for women's health as women with DIEP flap reconstructions and women at increased risk of developing coronary artery disease are potentially restricted from receiving this reconstructive option should the other condition arise. METHODS: The largest clinical and cadaveric anatomical study (n=315) to date was performed, investigating four solutions to this predicament by correlating the precise requirements of breast reconstruction and CABG against the anatomical features of the in situ IMAs. This information was supplemented by a thorough literature review. RESULTS: Minimum lengths of the left and right IMA needed for grafting to the left-anterior descending artery are 160.08 and 177.80 mm, respectively. Based on anatomical findings, the suitable options for anastomosis to each intercostals space are offered. In addition, 87-91% of patients have IMA perforator vessels to which DIEP flaps can be anastomosed in the first- and second-intercostal spaces. CONCLUSION: We outline five methods of preserving the IMA for future CABG: (1) lowering the level of DIEP flaps to the fourth- and fifth-intercostals spaces, (2) using the DIEP pedicle as an intermediary for CABG, (3) using IMA perforators to spare the IMA proper, (4) using and end-to-side anastomosis between the DIEP pedicle and IMA and (5) anastomosis of DIEP flaps using retrograde flow from the distal IMA. With careful patient selection, we hypothesize using the IMA for autologous breast reconstruction need not be an absolute contraindication for future CABG

Layer-by-layer assemblies in nanoporous templates : nano-organized design and applications of soft nanotechnology

The synergistic combination of layer-by-layer (LbL) assembly and nanoporous membrane templating has greatly facilitated the creation of complex and functional nanotubular structures. The approach takes advantage of both the new properties conferred by assembling diverse LbL building blocks and the tight dimensional control offered by nanotemplating to enable new functionalities that arise from the highly anisotropic "one-dimensional'' LbL-nanotube format. In this review, we aim to convey the key developments and provide a current snap-shot of such templated LbL nanoarchitectures. We survey recent developments that have enabled the assembly of polymers, biomolecules and inorganic nanoparticles "a la carte'', via electrostatic, covalent and specific (bio)recognition interactions. We also discuss the emerging mechanistic understanding of the LbL assembly process within the nanopore environment. Finally, we present a diverse range of LbL nanotube "devices'' to illustrate the versatility of the nanotemplated LbL toolbox for generating functional soft nanotechnology