Oral Muscles Are Progressively Affected in Duchenne Muscular Dystrophy: Implications for Dysphagia Treatment.

Oral muscles are progressively affected in Duchenne muscular dystrophy: implications for dysphagia treatment.

Filed under: Rehab Centers

J Neurol. 2012 Dec 23;
van den Engel-Hoek L, Erasmus CE, Hendriks JC, Geurts AC, Klein WM, Pillen S, Sie LT, de Swart BJ, de Groot IJ

Dysphagia is reported in advanced stages of Duchenne muscular dystrophy (DMD). The population of DMD is changing due to an increasing survival. We aimed to describe the dysphagia in consecutive stages and to assess the underlying mechanisms of dysphagia in DMD, in order to develop mechanism based recommendations for safe swallowing. In this cross-sectional study, participants were divided into: early and late ambulatory stage (AS, n = 6), early non-ambulatory stage (ENAS, n = 7), and late non-ambulatory stage (LNAS, n = 11). Quantitative oral muscle ultrasound was performed to quantify echo intensity. Swallowing was assessed with a video fluoroscopic swallow study, surface electromyography (sEMG) of the submental muscle group and tongue pressure. Differences in outcome parameters among the three DMD stages were tested with analysis of variance. Oral muscles related to swallowing were progressively affected, starting in the AS with the geniohyoid muscle. Tongue (pseudo) hypertrophy was found in 70 % of patients in the ENAS and LNAS. Oral phase problems and post-swallow residue were observed, mostly in the LNAS with solid food. sEMG and tongue pressure data of swallowing solid food revealed the lowest sEMG amplitude, the longest duration and lowest tongue pressure in the LNAS. In case of swallowing problems in DMD, based on the disturbed mechanisms of swallowing, it is suggested to (1) adjust meals in terms of less solid food, and (2) drink water after meals to clear the oropharyngeal area.
HubMed – rehab

 

Adhesive capsulitis: one sonographic-guided injection of 20 mg triamcinolon into the rotator interval.

Filed under: Rehab Centers

Rheumatol Int. 2012 Dec 22;
Juel NG, Oland G, Kvalheim S, Løve T, Ekeberg OM

The aim of this study was to establish a method for injecting corticosteroid into the rotator interval under sonographic guidance and to measure the effect on function, pain and range of motion after 4 and 12 weeks. This study involved a multicenter cohort trial and carried out at outpatient clinics of the physical medicine and rehabilitation departments in Oslo and Porsgrunn, Norway. 39 patients with adhesive capsulitis lasting between 3 and 12 months. Sonographic-guided corticosteroid and lidocaine injection into the rotator interval medial to the biceps tendon using 20 mg triamcinolon hexacetat and 3 ml 20 mg/ml xylocain. Change in the shoulder pain and disability index score (SPADI) after 12 weeks. The change in SPADI was 42 points (95 % confidence interval, 33-51). Changes in the secondary outcomes shoved highly statistically significant increase in active and passive range of motion. One ultrasound-guided corticosteroid injection into the rotator interval seems to give significant improvement in SPADI and active range of motion after 12 weeks. The protocol was evaluated by the research faculty at Oslo university hospital, dept of physical medicine. The study was regarded as regular clinical procedure as injections with triamcinolon already is standard treatment. No trial registration was obtained but the protocol presented the local ethics committee without comments.
HubMed – rehab

 

Comparative study on the microbial adhesion to preveneered and stainless steel crowns.

Filed under: Rehab Centers

J Indian Soc Pedod Prev Dent. 2012 Jul; 30(3): 206-11
Bin Alshaibah WM, El-Shehaby FA, El-Dokky NA, Reda AR

Context: The extensive plaque formation on dental restorations may contribute to secondary caries or periodontal inflammation. Therefore, it is important to know how different types of dental restorations may prevent or promote the accumulation of microorganisms. Aims: The aim of this in vivo study was to evaluate the adhesion of Streptococcus mutans to preveneered and stainless steel crowns (SSCs) and to evaluate the effects of these restorations on the gingival health and oral hygiene. Materials and Methods: Twenty patients (age 3-5 years) were selected from the outpatient clinic of the pedodontics department, Faculty of Oral and Dental Medicine, Cairo University. The selected patients had (dmf) index for primary dentition ?4, including lower right and left first primary molars. Each tooth was pulpotomy-treated and restored with either type of crowns (split-mouth technique). Then, ten swabs from the buccal mucosa, preveneered crown, and SSC surfaces were taken from each patient. Also, the gingival index (GI) and oral hygiene index (OHI-S) were measured at different times during the study. Mitis Salivarius Bacitracin agar (MSBA) was used as a selective medium for S. mutans growth. MSBA plates were taken in candle jar and incubated aerobically in 37°C for 48 h. Finally, bacteria were counted and expressed in colony forming unit (CFU). Results: After 1, 2, and 4 weeks, mucosa and crown swabs of preveneered crown showed statistically significant higher mean CFU counts than SSC. Through the whole study period, the two restorations revealed a statistically significant decrease in mean CFU counts. Also, there was a statistically significant positive (direct) correlation between OHI-S, GI, and S. mutans counts on both restorations. Conclusions: The adhesion of S. mutans to preveneered crowns was higher than to SSC. Full mouth rehabilitation led to significant decrease in S. mutans count in the short term. An increase in S. mutans counts is associated with an increase in OHI-S and GI.
HubMed – rehab

 

The broad street pump: epidemiology is more than skin deep.

Filed under: Rehab Centers

Adv Skin Wound Care. 2013 Jan; 26(1): 7
Salcido RS

HubMed – rehab

 


 

Altegnam zare 02 – please rate subscribe comment we will be adding more Ethiopian videos

 

More Rehab Centers Information…