A systematic review and meta-analysis of the effects of intraoral treatments for neurogenic oropharyngeal dysphagia

xlomafota13 shared this article with you from Inoreader A systematic review and meta-analysis of the effects of intraoral treatments for neurogenic oropharyngeal dysphagia Via swallowing exercises J Oral Rehabil. 2021 Nov 20. doi: 10.1111/joor.13274. Online ahead of print. ABSTRACT BACKGROUND: Rehabilitative treatments for oropharyngeal dysphagia, including oromotor exercises and sensory stimulation, have been widely adopted in clinical practice. However, the effects of these treatments are mainly supported by exploratory studies. As such, their clinical efficacy remains uncertain. OBJECTIVE: Our systematic review and meta-analysis aimed to evaluate the efficacy of int raoral treatments for neurogenic oropharyngeal dysphagia based on evidence from randomised controlled trials (RCTs). METHODS: Six electronic databases were systematically searched between January 1970 and July 2021. Data were extracted and analysed by two independent reviewers. The outcome measure was change in (any) relevant clinical swallowing-related characteristic. RESULTS: Data from 285 dysphagic patients were collected from 8 RCT studies across a range of intraoral dysphagia treatments. The pooled effect size of all intraoral dysphagia treatments was non-significant compared to control comparators (SMD [95%CI] = 0.23 [-0.22, 0.69], p=0.31; I2 =73%). Subgroup analysis revealed that the pooled effect sizes were also non-significant for oromotor exercises (device-facilitated lip resistance exercises and tongue exercises) (SMD [95%CI] = 0.11 [-0.76, 0.97]; p=0.81; I2 =88%) and sensory stimulation (thermal-tactile, thermo-chemical and electrical st imulation) (SMD [95%CI] = 0.35 [-0.03, 0.72]; p=0.07; I2 =0%). CONCLUSIONS: Our results showed that overall, intraoral dysphagia treatments, including oromotor exercises and sensory stimulation, do not show beneficial effects for neurogenic oropharyngeal dysphagia. The evidence for these treatments remains weak and currently inadequate to support clinical use. Large scale, multi-centre randomised controlled trials are warranted to fully explore their clinical efficacy. PMID:34800341 | DOI:10.1111/joor.13274 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Role and mechanism of Glut-1 and H+/K+-ATPase expression in pepsin-induced development of vocal cord leukoplakia

xlomafota13 shared this article with you from Inoreader Role and mechanism of Glut-1 and H+/K+-ATPase expression in pepsin-induced development of vocal cord leukoplakia Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Nov 20. doi: 10.1007/s00405-021-07172-y. Online ahead of print. ABSTRACT PURPOSE: We investigated the role of Glut-1 and H+/K+-ATPase expression in pepsin-induced development of human vocal cord leukoplakia cells (HVCLCs). Next, we analyzed the relationship between Glut-1 and H+/K+-ATPase expression with the clinicopathological features of laryngeal carcinoma. METHODS: Glut-1 and H+/K+-ATPase expression levels in HVCLCs were determined after treatment with artificial gastric juice containing pepsin and laryngeal carcinoma tissues. RESULTS: Exposure to pepsin-containing artificial gastric juice significantly enhanced the migration and proliferation of VSCLCs in a time-dependent manner. The apoptotic rate of VSCLCs decreased over time after exposure to pepsin and reached a nadir on day 7 (p < 0.01). With increasing duration of exposure to pepsin, the proportion of VSCLCs in G0/G1 phase decreased and the proportions in the S and G2/M phases significantly increased (p < 0.05). After treatment with pepsin-containing artificial gastric juice, RT-PCR and Western blotting showed that the expression of Glut-1 and H+/K+-ATPase α, β significantly increased in HVCLCs compared to in the absence of pepsin (p < 0.05). The expression of Glut-1 and H+/K+-ATPase α, β gradually increased from vocal cord leukoplakia (VLC) to laryngeal carcinoma (p < 0.05). Lentivirus-mediated inhibition of Glut-1 expression in VCL significantly inhibited the cells' migration and proliferation (p < 0.05) but enhanced their apoptosis (p < 0.05). Also, inhibition of Glut-1 expression resulted in an increased proportion of cells in G0/G1 phase and a significantly decreased proportion in G2/M phase (p < 0.05). CONCLUSIONS: Elevated Glut-1 expression may promote the develop ment of VCL by upregulating laryngeal H+/K+-ATPase expression to reactivate absorbed pepsin, thus damaging the laryngeal mucosa. PMID:34800155 | DOI:10.1007/s00405-021-07172-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Right vertebral artery arising from the right common carotid artery without association with an aberrant right subclavian artery and entering the C3 transverse foramen

xlomafota13 shared this article with you from Inoreader Right vertebral artery arising from the right common carotid artery without association with an aberrant right subclavian artery and entering the C3 transverse foramen Via radiol anat Surg Radiol Anat. 2021 Nov 20. doi: 10.1007/s00276-021-02861-z. Online ahead of print. ABSTRACT The right vertebral artery (VA) rarely arises from the right common carotid artery (CCA); however, the majority of anomalous right VAs are seen in combination with an aberrant right subclavian artery (SA). Independent (or isolated) right VA of the right CCA origin is extremely rare, with only a few cases reported previously. We herein report an additional case diagnosed incidental ly using computed tomography angiography. This patient had a left VA arising from the aortic arch between the origins of the left CCA and left SA. The bilateral VAs took an anterior course and entered the C3 transverse foramina, at an extremely high level. PMID:34800153 | DOI:10.1007/s00276-021-02861-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anatomical variants of the medioplantar oblique ligament and inferoplantar longitudinal ligament: an MRI study

xlomafota13 shared this article with you from Inoreader Anatomical variants of the medioplantar oblique ligament and inferoplantar longitudinal ligament: an MRI study Via radiol anat Surg Radiol Anat. 2021 Nov 20. doi: 10.1007/s00276-021-02860-0. Online ahead of print. ABSTRACT PURPOSE: The spring ligament complex (SL) is the chief static stabilizer of the medial longitudinal foot arch. The occurrence of normal anatomical variants may influence radiological diagnostics and surgical treatment. The aim of this study was to evaluate anatomical variants of the part of SL located inferior to the talar head (i-SL), medioplantar oblique ligament (MPO) and infer oplantar longitudinal ligament (IPL). METHODS: We included 220 MRI examinations of the ankle performed on a 3.0 T engine. Only patients with a normal SL were included. Two musculoskeletal radiologists assessed the examinations and Cohen's kappa was used to assess agreement. Differences between groups were assessed using the chi-squared test; p < 0.05 was considered as significant. The final decision was made by consensus. RESULTS: Most commonly, i-SL was composed of the two ligaments IPL and MPO n = 167 (75.9%); in this group, bifid ligaments occurred in 19.2%, most commonly in the MPO. A branch to the os cuboideum was seen in n = 17 (10.2%). Three ligaments were seen in n = 52 (23.6%). In this group, bifid ligaments occurred in 13.5%; most commonly, the IPL was bifid and a branch to the os cuboideum was noted in n = 6 (11.5%). In one case, n = 1 (0.04%), we identified MPO, IPL and two accessory ligaments. No significant relationship was noted between the number of li gaments, the presence of bifid ligaments and side or gender (p > 0.05). CONCLUSION: More than two aligaments were seen in 24.1% of examined cases, the most common variant was the presence of MPO, IPL and one accessory ligament. PMID:34800154 | DOI:10.1007/s00276-021-02860-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Postoperative depth of sedation and associated outcomes in free flap transfers to the head and neck

xlomafota13 shared this article with you from Inoreader Postoperative depth of sedation and associated outcomes in free flap transfers to the head and neck Via Head & Neck Abstract Background To evaluate the impact of postoperative depth of sedation in free flap transfers to the head and neck. Methods A single center, retrospective cohort of 92 patients were stratified by depth of sedation, light sedation (RASS −1 or greater) or deep sedation (RASS less than −1), and analyzed for postoperative flap and medical complications. Results Of the 92 patients 45 were included in the light sedation and 47 in the deep sedation group. Flap complication requiring return to the operating room occurred in 8 (22.2%) patients in light sedation compared to 12 (27.7%) (p = 0.450) patients in deep sedation. A composite outcome of flap and medical complications occurred less frequently in the light sedation group 14 (31.8%) compared to deep sedation 32 (69.6%) (p < 0.001). Conclusion There was no difference in return to the operating room between the two groups. Light sedation had reduced incidence of medical complications compared to deep. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Circadian clock and cell cycle: Cancer and chronotherapy

xlomafota13 shared this article with you from Inoreader Circadian clock and cell cycle: Cancer and chronotherapy Via histochem Acta Histochem. 2021 Nov 17;123(8):151816. doi: 10.1016/j.acthis.2021.151816. Online ahead of print. ABSTRACT The circadian clock is an endogenous timing system that ensures that various physiological processes have nearly 24 h circadian rhythms, including cell metabolism, division, apoptosis, and tumor production. In addition, results from animal models and molecular studies underscore emerging links between the cell cycle and the circadian clock. Mutations in the core gene s of the circadian clock' can disrupt the cell cycle, which in turn increases the possibility of tumors. At present, tumor chronotherapy, which relies on a circadian clock mechanism, is developing rapidly for optimizing the time of drug administration in tumor treatment to improve drug efficacy and safety. However, the relationship between the circadian clock and the cell cycle is extremely complicated. This review summarizes the possible connection between the circadian clock and the cell cycle. In addition, the review provides evidence of the influence of the circadian clock on senescence and cancer. PMID:34800857 | DOI:10.1016/j.acthis.2021.151816 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cross-population coupling of neural activity based on Gaussian process current source densities

xlomafota13 shared this article with you from Inoreader Cross-population coupling of neural activity based on Gaussian process current source densities Via cortical auditory PLoS Comput Biol. 2021 Nov 17;17(11):e1009601. doi: 10.1371/journal.pcbi.1009601. Online ahead of print. ABSTRACT Because local field potentials (LFPs) arise from multiple sources in different spatial locations, they do not easily reveal coordinated activity across neural populations on a trial-to-trial basis. As we show here, however, once disparate source signals are decoupled, their trial-to-trial fluctuations become more accessible, and cross-population correlations become more apparent. To decouple sources we introduce a general framework for estimation of current source densities (CSDs). In this framework, the set of LFPs result from noise being added to the transform of the CSD by a biophysical forward model, while the CSD is considered to be the sum of a zero-mean, stationary, spatiotemporal Gaussian process, having fast and slow components, and a mean function, which is the sum of multiple time-varying functions distributed across sp ace, each varying across trials. We derived biophysical forward models relevant to the data we analyzed. In simulation studies this approach improved identification of source signals compared to existing CSD estimation methods. Using data recorded from primate auditory cortex, we analyzed trial-to-trial fluctuations in both steady-state and task-evoked signals. We found cortical layer-specific phase coupling between two probes and showed that the same analysis applied directly to LFPs did not recover these patterns. We also found task-evoked CSDs to be correlated across probes, at specific cortical depths. Using data from Neuropixels probes in mouse visual areas, we again found evidence for depth-specific phase coupling of primary visual cortex and lateromedial area based on the CSDs. PMID:34788286 | DOI:10.1371/journal.pcbi.1009601 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.