Effects of a tongue training program in Parkinson's disease: Analysis of electrical activity and strength of suprahyoid muscles

xlomafota13 shared this article with you from Inoreader Effects of a tongue training program in Parkinson's disease: Analysis of electrical activity and strength of suprahyoid muscles Via swallowing exercises J Electromyogr Kinesiol. 2022 Feb 12;63:102642. doi: 10.1016/j.jelekin.2022.102642. Online ahead of print. ABSTRACT OBJECTIVE: To assess the electrical activity of the suprahyoid muscle and the tongue pressure in a two-wing program of tongue strengthening in individuals with Parkinson's disease (PD). METHODS: A pre-post-detraining design study included sixty PD patients assigned to two groups randomly. The experimental group (EG) performed tongue isometric pressure exercises using the Iowa Oral Performance Instrument with an increasing scheme of 5% load weekly and traditional tongue therapy for 8 weeks. The control group (CG) performed only traditional therapy. The electrical activity of suprahyoids was measured using surface electromyography (sEMG) during tongue-to-palate pressure. Four selected domains of the Swallowing Quality of Life Questionnaire (SWAL-QOL) mostly related to tongue strength were considered. RESULTS: The experimental group showed increased sEMG values of suprahyoid muscles reaching statistically significant difference at the fourth week of tongue training, while the control did it at the eighth week. Experimental group showed significant improvements in tongue strength (d = 2.128; p = 0.000). Only controls showed detraining effect. Statistically significant difference within groups were found in one and three dimensions of the SWAL-QOL in the CG and EG, respectively. CONCLUSION: Analysis of electrical activity on suprahy oids muscles provided a better understanding of the changes underlying the outcomes of tongue strength gains obtained through a combined tongue strengthening exercises protocol in PD. Such protocol led not only to increased tongue strength but also to a better perceived swallowing function in PD subjects. PMID:35189571 | DOI:10.1016/j.jelekin.2022.102642 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outcomes After Oral Cavity and Oropharyngeal Salvage Surgery

xlomafota13 shared this article with you from Inoreader Outcomes After Oral Cavity and Oropharyngeal Salvage Surgery Via The Laryngoscope Objectives Investigate outcomes following oral cavity and oropharyngeal salvage surgery. Methods Adult patients who underwent salvage surgery for recurrent squamous cell carcinoma of the oral cavity and oropharynx from 1996 to 2018 were analyzed using multivariable Cox proportional hazards regression. Disease-free survival (DFS), overall survival (OS), associated factors, and basic quality measures were analyzed. Results One hundred and eight patients (72% oral cavity, 28% oropharynx) were followed for a median of 17.9 months. Median DFS and OS were 9.9 and 21 months, respectively. Surgery with adjuvant chemoradiotherapy compared to surgery alone (hazard ratio [HR] = 0.15, 95% confidence interval [CI]: 0.03–0.78) and negative margins (HR = 0.36, 95% CI: 0.14–0.90) were associated with better DFS, while lymphovascular space invasion (LVSI) (HR = 2.66, 95% CI: 1.14–6.19) and higher stage (III vs. I–II, HR = 3.94, 95% CI: 1.22–12.71) were associated with worse DFS. Higher stage was associated with worse OS (HR = 3.79, 95% CI: 1.09–13.19). Patients were hospitalized for a median of 8 days with 24% readmitted within 30 days. A total of 72% and 38% of patients, respectively, underwent placement of a feeding tube or tracheostomy. Conclusions After oral cavity and oropharyngeal salvage surgery, adjuvant chemoradiotherapy, negative margins, negative LVSI, and lower stage were associated with a lower risk of recurrence. Only lower-stage disease was associated with improved survival. The majority of patients had feeding tubes, half underwent free tissue transfer, a third required tracheostomy, and a quarter was readmitted. Level of Evidence 3 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A randomized trial of topical mitomycin-C in the immediate post-operative period for the short and long-term prevention of granulation tissue in mastoid cavities

xlomafota13 shared this article with you from Inoreader A randomized trial of topical mitomycin-C in the immediate post-operative period for the short and long-term prevention of granulation tissue in mastoid cavities Via American Journal of Otolaryngology Publication date: Available online 22 February 2022 Source: American Journal of Otolaryngology Author(s): Abolfazl Ghobadi, Mehraveh Sadeghi Ivraghi, Zohreh Yazdi, Sanaz Keshavarz Shahbaz View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effect of extra safety measures on incidence of surgical site infection after alloplastic breast reconstruction

xlomafota13 shared this article with you from Inoreader The effect of extra safety measures on incidence of surgical site infection after alloplastic breast reconstruction Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Jan 22:S1748-6815(22)00038-9. doi: 10.1016/j.bjps.2022.01.021. Online ahead of print. ABSTRACT BACKGROUND: This study aimed to evaluate whether the implementation of extra perioperative safety measures and precautions through adopted standard operating procedures (SOPs) to ensure optimal anti-microbial conditions has led to less surgical site infections (SSI) after alloplastic breast reconstruction (BR). METHODS: This retrospective study compared two Cohorts of patients treated before and after the implementation of new SOPs (2009-2014: Cohort 1 versus 2014-2019: Cohort 2). Multivariate logistic regression analyses, adjusting for patient confounders, were implemented to compare SSI incidence between both Cohorts. RESULTS: Overall, SSI incidence was equal in both groups (10%, p = 0.545). The incidence of deep SSI was 9% for Cohort 1 and 5% for Cohort 2 (p = 0.074). Incidence of SSI-related explantation was 8% and 5%, respectively (p = 0.136). After adjusting for patient confounders, no statistically significant difference was seen between both Cohorts in overall SSI, deep SSI incidence, and explantation due to SSI (ORadjusted: -0.31, p = 0.452, ORadjusted: 0.16, p = 0.747 and ORadjusted: 0.18, p = 0.712). Higher BMI, smoking, one-stage BR, and immediate BR were associated with the risk for SSI (p<0.001, p = 0.036, p<0.001, and p = 0.022, respectively). CONCLUSION: Extra safety measures to assure optimal anti-microbial conditions did not contribute to lower SSI incidence or SSI-related explantation after alloplastic BR. Confounders such as BMI, smoking, immediate BR, and one-stage BR were correlated to an increased risk for overall SSI, deep SSI, and SSI-related explantation of TE/implants. PMID:35190280 | DOI:10.1016/j.bjps.2022.01.021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-Term Voice Outcomes After Type I, Type II, or Type V Cordectomy

xlomafota13 shared this article with you from Inoreader Long-Term Voice Outcomes After Type I, Type II, or Type V Cordectomy Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Feb 21:34894221081259. doi: 10.1177/00034894221081259. Online ahead of print. ABSTRACT INTRODUCTION: We compare long-term voice outcomes in patients treated with European Laryngeal Society (ELS) classification Type I, Type II, or Type V cordectomy. The aim is to understand the impact of Type V cordectomy on voice outcomes in relation to Type I and Type II cordectomy. METHODS: A retrospective review of patients treated with Type I, Type II , or Type V cordectomy by a single surgeon over a 20-year period was performed. Voice Handicap Index-10 (VHI-10) scores, Cepstral Spectral Index of Dysphonia (CSID) measures from CAPE-V sentences, and two-rater GRBAS scores were analyzed. RESULTS: Sixty-two patients were identified with a mean follow-up of 52 months. Of these, there were 43 Type I and 19 Type II cordectomies, including 8 in each group with Type V resections. Significant differences in all parameters were noted between the Type I (VHI 5.7, CSID 20.6, Grade 1.3) and the Type II cohorts (VHI 12.6, CSID 36.3, Grade 1.8) who did not undergo Type V cordectomy. Patients undergoing Type V cordectomy demonstrated voice outcomes (VHI 9.4, CSID 35.6, Grade 1.7) which fell between those of Type I and Type II cordectomies. CONCLUSIONS: Better long-term subjective, objective, and computer-analyzed voice outcomes are noted for patients undergoing Type I rather than Type II cordectomy. When Type V cordectomy is performe d, voice outcomes are comparable to those of both Type I and Type II cordectomy, a surprising finding given the expectation of worsened dysphonia in longer resections. Further work is needed to explain this finding and define voice outcomes after Type V cordectomy. PMID:35189725 | DOI:10.1177/00034894221081259 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Case report of unusual insertion of the fibularis brevis muscle

xlomafota13 shared this article with you from Inoreader Case report of unusual insertion of the fibularis brevis muscle Via radiol anat Surg Radiol Anat. 2022 Feb 22. doi: 10.1007/s00276-022-02894-y. Online ahead of print. ABSTRACT The fibularis brevis and fibularis longus muscles belong to the lateral compartment of the leg. The fibularis brevis is morphologically variable, especially in the number of tendons and place of insertion. Its type of insertion is correlated with the presence of a fibularis digiti quinti, which is also anatomically variable. We present a case study based on dissection of a seventy -three-year-old female cadaver with an unusual insertion of the fibularis brevis muscle. The tendon had three bands inserting into the fifth metatarsal bone. There was a coexisting fibularis digiti quinti, which was fused with the fibularis tertius muscle. Awareness of such anatomical variation could be useful during reconstructive surgery and planning rehabilitation protocols. PMID:35192041 | DOI:10.1007/s00276-022-02894-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

How to manage Graves' disease in women of childbearing potential

xlomafota13 shared this article with you from Inoreader How to manage Graves' disease in women of childbearing potential Via radioactive iodine Clin Endocrinol (Oxf). 2022 Feb 22. doi: 10.1111/cen.14705. Online ahead of print. ABSTRACT The management of Graves' Disease (GD) in women of childbearing potential has multiple specific complexities. Many factors are involved, which differ at the various stages from preconception, conception, first trimester, later pregnancy, postpartum and lactation, with both maternal and foetal considerations. The incidence and significance of the risks incurred from antithyroid drugs (ATDs) i n pregnancy have been re-evaluated recently and must be balanced against the risks of uncontrolled hyperthyroidism during childbearing years. Contraception is advised until hyperthyroidism is controlled. ATD cessation should be considered in those who are well controlled on low dose therapy before conception and in early pregnancy. Advice on iodine supplementation does not generally differ in those with GD. Radioiodine (RAI) is contraindicated from 6 months preconception until completion of breast feeding. In all women who have a history of GD, monitoring of TSH receptor antibodies (TRAb) is strongly recommended during pregnancy, and if elevated, foetal monitoring, and assessment of thyroid function in the neonate are required. Of note, RAI increases TRAb for up to a year, making this treatment option even less attractive in this patient group. A small amount of ATD is transferred into breast milk but low doses are safe during lactation. Routine periodic thyroid function testing is recommended in remission to detect postpartum GD recurrence. We present our approach to the Clinical Question 'How to manage GD in women of childbearing potential?' This article is protected by copyright. All rights reserved. PMID:35192205 | DOI:10.1111/cen.14705 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.