Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis

Manual therapy (MT) and exercise have been extensively used to treat people with musculoskeletal conditions such as temporomandibular disorders (TMD). The evidence regarding their effectiveness provided by early systematic reviews is outdated

Nebulization through tracheostomy cannula from bench to bed

Drug delivery to the lung has mainly been studied in spontaneously breathing patients and in patients who are mechanically ventilated through endotracheal tubes. Nebulization through tracheostomy in spontaneously breathing tracheostomized patients has been poorly studied. The main aim of this thesis was to increase the knowledge in nebulization through tracheostomy tube. Our first objective was to select the most appropriate configuration of a jet nebulizer to administrate the larger amount or nebulized drug through a tracheostomy cannula. Therefore, in vitro measurements were realized by laser diffraction and residual gravimetric method. Lung deposition was investigated by imagery techniques and pharmacokinetic study. The second objective was to determine the influence of cannula diameter on drug delivery. We also wanted to examine whether the inner cannula should be removed during nebulization in spontaneously breathing patients. The third objective was to compare, in a clinical study, the drug delivered to the lung by a nebulizer through the mouth of through the tracheostomy cannula. Unvented jet nebulizer with a corrugated piece of tubing was delivering a higher amount of drug compared to unvented jet nebulizer alone or open vent jet nebulizer. Those results were observed in spontaneously breathing healthy subjects, in baboons and in vitro measurements through different inner diameter sizes of tracheostomy cannulas. We showed that the inner cannula should be removed before the nebulization in order to increase the amount of drug delivered in patient’s lung. Finally, we showed that drug delivery into the lung is as efficient when delivered through a tracheostomy as when delivered to the normal mouth breathing route. Our work therefore clarifies the influence of various jet nebulizer configurations on the amount of inhaled drug and provides new informations for the treatment of tracheostomized spontaneously breathing patients. Further studies are needed to further improve our understanding of nebulization through tracheostomy tubes.(READ 3) -- UCL, 201

Formation interprofessionnelle en première ligne de soins

La pratique de la médecine générale est plurielle et interdisciplinaire. De nombreux acteurs de première ligne se croisent au quotidien pour l’accompagnement en santé des patients. La formation des futurs médecins généralistes passent par la rencontre de ces différentes professions. [...

Troubles de la déglutition et leur rééducation

Troubles de la deglutition et leur reeducatio

Hip abductor, trunk extensor and ankle plantar flexor endurance in females with and without patellofemoral pain.

BACKGROUND: Previous studies have reported strength deficit in hip abduction, extension and external rotation in females with patellofemoral pain (PFP) when compared with healthy control; however, there is conflicting evidence for a decrease in hip muscle endurance. Therefore, it seems important to evaluate hip muscle endurance in females with PFP.Moreover, trunk extensor and ankle plantar flexor endurance have not yet been evaluate in females with PFP. OBJECTIVE: To compare hip abductor, trunk extensor and ankle plantar flexor endurance between females with and without PFP. METHODS: Twenty females with PFP (mean age, 21.1 years) and 76 healthy females (mean age, 20.5 years) were recruited. Subject performed three endurance clinical tests: (1) The hip abductor isometric endurance test, (2) The Sorensen test and (3) The heel rise test. Group differences were assessed using an independent t tests, or Mann-Whitney U tests for non-normally distributed data. RESULTS: Subjects with PFP exhibited significantly lower hip abductor, trunk extensor and ankle plantar flexor endurance than healthy controls. On average, subjects with PFP had deficits of 16% in hip abduction, 14% in trunk extension and 26% in ankle plantar flexion. CONCLUSION: Females with PFP exhibited diminished hip abductor, trunk extensor and ankle plantar flexor endurance compared to healthy controls.SCOPUS: ar.jinfo:eu-repo/semantics/publishe