The influence of sour taste and cold temperature in pharyngeal transit duration in patients with stroke

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeito do sabor azedo e da temperatura fria na fase oral da deglutição no acidente vascular encefálico

Pós-graduação em Bases Gerais da Cirurgia - FMB

O efeito do sabor azedo e da temperatura fria no tempo de trânsito faríngeo da deglutição em indivíduos após acidente vascular encefálico hemisférico isquêmico

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A influência dos estímulos azedo e frio sobre o tempo da trânsito faríngeo da deglutição no acidente vascular encefálico isquêmico

Pós-graduação em Bases Gerais da Cirurgia - FMB

Grau de comprometimento e tempo de trânsito orofaríngeo em disfagia no acidente vascular encefálico

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Taste and Temperature in Swallowing Transit Time after Stroke

Background: Oropharyngeal dysphagia is common in individuals after stroke. Taste and temperature are used in dysphagia rehabilitation. The influence of stimuli, such as taste and temperature, on swallowing biomechanics has been investigated in both healthy individuals and in individuals with neurological disease. However, some questions still remain unanswered, such as how the sequence of offered stimuli influences the pharyngeal response. The goal of the present study was to determine the influence of the sequence of stimuli, sour taste and cold temperature, on pharyngeal transit time during deglutition in individuals after stroke. Methods: The study included 60 individuals with unilateral ischemic stroke, 29 males and 31 females, aged 41–88 years (mean age: 66.2 years) examined 0–50 days after ictus (median: 6 days), with mild to moderate oropharyngeal dysphagia. Exclusion criteria were hemorrhagic stroke patients, patients with decreased level of consciousness, and clinically unstable patients, as confirmed by medical evaluation. The individuals were divided into two groups of 30 individuals each. Group 1 received a nonrandomized sequence of stimuli (i.e. natural, cold, sour, and sour-cold) and group 2 received a randomized sequence of stimuli. A videofluoroscopic swallowing study was performed to analyze the pharyngeal transit time. Four different stimuli (natural, cold, sour, and sour-cold) were offered. The images were digitalized and specific software was used to measure the pharyngeal transit time. Since the values did not present regular distribution and uniform variances, nonparametric tests were performed. Results: Individuals in group 1 presented a significantly shorter pharyngeal transit time with the sour-cold stimulus than with the other stimuli. Individuals in group 2 did not show a significant difference in pharyngeal transit time between stimuli. Conclusions: The results showed that the sequence of offered stimuli influences the pharyngeal transit time in a different way in individuals after stroke and suggest that, when the sour-cold stimulus is offered in a randomized sequence, it can influence the response to the other stimuli in stroke patients. Hence, the sour-cold stimulus could be used as a therapeutic aid in dysphagic stroke patients.

Tratamento farmacológico da epilepsia em cães

Seizure is a clinical manifestation of abnormal neuronal hyperactivity of the cerebral cortex, presentation clinical varies according to the location and extent of the brain. The classic seizure begins with an inicial period, named prodrome, followed by the aura, the ictus and finally the post-ictus phase. Seizures can be generalized or focal/partial types. Focal seizures with secondary generalization are the most common type in dogs. The seizure can be divided etiologically in intracraneal (idiopathic epilepsy; sintomatic; probably sintomatic epilepsy) and extracraneal disorders. After determining the etiology of seizures and critical analysis of the frequency, severity, and worry they cause to the owner, you should make the decision whether to launch an anticonvulsant drug therapy. Although the ideal is the elimination of seizures, the real goal should be to decrease the frequency and intensity of crises, without affecting the quality of life of patients taking the drugs used side effects acceptable. The veterinary should consider the bioavailability of the drug, contraindications, toxicity, drug interactions, the amount of daily administration, the availability of the owner and the cost of therapy. Seizures can be controlled in about 70- 80% of the dogs and in the majority of the cats when treated with Phenobarbital alone. Addition of a second drug (usually potassium bromide), decreases the number of seizures in more that 50% in about 70-80% of dogs. However, approximately 20-30% of dogs are refractory to this treatment. In these cases, it will be necessary to think in other pharmacological alternatives, like felbamate, gabapentin, levetiracetam, zonisamid, among others. It has been concluded that... (Complete abstract click eletronic access below)

Qualidade da atenção ao usuário acometido por AVC, antes e após a implantação de uma Unidade de AVC

Pós-graduação em Enfermagem - FMB

Avaliação das principais infecções ocorridas em pacientes com acidente vascular cerebral

Pós-graduação em Enfermagem - FMB