Τετάρτη 17 Νοεμβρίου 2021

Effect of swallowing rehabilitation using traditional therapy, kinesiology taping and neuromuscular electrical stimulation on dysphagia in post-stroke patients: A randomized clinical trial

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Clin Neurol Neurosurg. 2021 Nov 6;211:107020. doi: 10.1016/j.clineuro.2021.107020. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to evaluate the functional recovery of stroke patients with orophyaryngeal dysphagia after treatment with traditional swallowing therapy (TST), neuromuscular electrical stimulation (NMES), and kinesiology taping (KT), by using clinical swallowing assessments and objective fiberoptic endoscopic evaluation of swallowing (FEES).

METHODS: A total of 37 patients were randomized in three groups: those who received TST and NMES as Group 1 (n:12), those who received both TST and KT as Group 2 (n:13), and those who received TST, NMES, and KT together as Group 3 (n:12). Patients were evaluated before treatment, after treatment, and three months after treatment onset with bedside water-swallow test, Eating Assessment Tool (EAT-10), Functional Oral Intake Scale (FOIS), penetration-aspiration scale (PAS), and Nationa l Institute of Health-Swallow Safety Scale (NIH-SSS). FOIS, PAS, and NIS-SSS were completed according to results of fiberoptic endoscopic evaluation of swallowing (FEES).

RESULTS: A statistically significant decrease was observed in bedside water-swallow test, EAT-10, PAS, and NIH-SSS scores in all treatment groups 5 weeks and 3 months after treatment onset compared to pre-treatment scores (p < 0.05). There was a statistically significant increase in FOIS scores 5 weeks and 3 months after treatment compared to pretreatment scores in all treatment groups (p < 0.05). When the pre-treatment, 3-week, and 5-month swallow scale scores of all groups were compared, there was no significant different difference in terms of bedside water-swallow test, EAT-10, FOIS, PAS, or NIH-SSS scores (p > 0.05).

CONCLUSION: According to the results of our study, KT is a new option in the treatment of stroke-related dysphagia, is an effective treatment approach and its efficacy is main tained throughout long-term follow-up.

PMID:34781221 | DOI:10.1016/j.clineuro.2021.107020

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Applied anatomy of the medial orbital wall

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Vestn Otorinolaringol. 2021;86(5):119-123. doi: 10.17116/otorino202186051119.

ABSTRACT

The article provides an overview of foreign and domestic studies on the anatomy of the medial wall of the orbit. Possible structural variants of the osseus structures of the medial wall and their applied clinical significance are indicated, including those having individual occurrence: additional lacrimal bone, morphological features of the structure of the fossa of the lacrimal sac, location, shape and size of the cells of the ethmoid bone, Onody cells, Haller infraorbital cell, the relative position of the anterior and posterior ethmoid foramina, the presence of additional ethmoid foramina, dysgenesis of the lacrimal bone and the orbital plate of the ethmoid bone. The anatomical prerequisites for the occurrence of intraoperative complications with surgical access to the medial wall of the orbit are described.

PMID:34783485 | DOI:10.17116/otorino202186051119

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The significance of microanatomy of the round window in terms of cochlear implantation

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Vestn Otorinolaringol. 2021;86(5):42-47. doi: 10.17116/otorino20218605142.

ABSTRACT

Sensoneural hearing loss is a polyetiological disease, which is often a secondary reflection of systemic pathology and is associated with damage of the cochlea and auditory nerve receptors. An important point in the surgical stage of cochlear implantation is the introduction of an implant active electrode into the cochleostomy spiral channel through the cochleostoma or round window. However, the issue of intra-cochlear structures surgical trauma in such surgical intervention seems to be very important, as it may reduce the success of subsequent rehabilitation. Therefore, the study of the anatomy of the round window and adjuscent areas was the objective of this work.

PMID:34783472 | DOI:10.17116/otorino20218605142

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Primary Middle Ear Meningioma with Intact Tympanic Membrane: A Case Report and Literature Review

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Ear Nose Throat J. 2021 Nov 17:1455613211058100. doi: 10.1177/01455613211058100. Online ahead of print.

ABSTRACT

Primary ectopic meningioma of the middle ear is relatively rare in clinical practice. It is often difficult to distinguish it from chronic otitis media or otitis media with effusion due to its similar and atypical clinical symptoms. We report a case of epithelial tympanic ectopic meningioma with the main complaints of otalgia, aural fullness, and hearing loss. It was accidentally discovered during tympanotomy due to the symptoms of recurring refractory secretory otitis media. This article briefly reviews the relevant literature in recent years, summarizes the characteristics of primary ectopic tympanic meningioma with intact tympanic membrane, and emphasizes the diagnosis and treatment strategy of the middle ear mass.

PMID:34784773 | DOI:10.1177/01455613211058100

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The risk factors for Graves' ophthalmopathy

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Graefes Arch Clin Exp Ophthalmol. 2021 Nov 17. doi: 10.1007/s00417-021-05456-x. Online ahead of print.

ABSTRACT

PURPOSE: This review aimed to provide an overview of current research into the risk factors for Graves' ophthalmopathy (GO).

METHODS: To find information about the risk factors for GO, the research database PubMed was searched and relevant articles were obtained to extract information about risk factors.

RESULTS: Smoking has been widely accepted as an importan t risk factor and cigarette smoking cessation has been shown to improve the outcome and decrease the onset of GO. Radioactive iodine on the thyroid may induce hyperthyroidism and increase the occurrence of GO. Selenium deficiency is a risk factor for GO and the supplementation of selenium has been an adjuvant therapy. Decreasing stressful life events (SLE) may help improve GO. Imbalance in intestinal flora is essential to GO, with Yersinia enterocolitica and Escherichia coli both increased in the digestive tract of the individual with GO. In addition, controlling serum cholesterol may help improve GO since adipogenesis is an important pathological change in its pathogenesis. Considering the correlation between Graves' disease and GO, maintaining normal thyroid function hormone level is the first-line therapeutic strategy to prevent progression of GO. An increase in antibodies such as TSHR and IGF-1R is the main predictor of GO. Besides, gender and gene polymorphism are also risk fac tors towards GO.

CONCLUSIONS: Risk factors for GO arise from five sources: physical and chemical environment, social-psychological environment, biological environment, the human organism, and genetic codes. Risk factors within these categories may interact with each other and their mechanisms in promoting the development of GO are complex. Research into risk factors for GO may promote emerging fields related to GO such as control of autoantibodies and intestinal microbiota.

PMID:34787691 | DOI:10.1007/s00417-021-05456-x

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Vorinostat, a histone deacetylase inhibitor, as a potential novel treatment for psoriasis

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Abstract

Background

Psoriasis is characterized by aberrant activation of several pro-inflammatory circuits as well as abnormal hyperproliferation and dysregulated apoptosis of keratinocytes (KCs). Most currently available therapeutic options primarily target psoriasis-associated immunological defects rather than epidermal abnormalities.

Objective

To investigate the efficacy of the histone deacetylase (HDAC) inhibitor, Vorinostat, in targeting hyperproliferation and impaired apoptosis in psoriatic skin.

Methods

Vorinostat effect was investigated in primary KCs cell cultures using cell cycle analysis by flow cytometry, apoptosis assays (Annexin V-FICH and caspase – 3/7) and antibody arrays, qRT-PCR and immunohistochemistry. Vorinostat impact on clinical manifestations of psoriasis was investigated in a chimeric mouse model.

Results

Vorinostat was found to inhibit KCs proliferation and to induce their differentiation and apoptosis. Using a chimeric mouse model, vorinostat was found to result in marked attenuation of a psoriasiform phenotype with a significant decrease in epidermal thickness and inhibition of epidermal proliferation.

Conclusions

Our results support the notion that vorinostat, a prototypic HDAC inhibitor, may be of potential use in the treatment of psoriasis and other hyperproliferative skin disorders.

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