The Influence of Surface Electromyography Visual and Clinician Verbal Feedback on Swallow Effort Ratio at Different Bolus Volumes in a Healthy Population

pa.ythelady61 shared this article with you from Inoreader The Influence of Surface Electromyography Visual and Clinician Verbal Feedback on Swallow Effort Ratio at Different Bolus Volumes in a Healthy Population Via Folia Phoniatrica et Logopaedica Background/Aims: The effortful swallow is a common treatment intervention requiring increased intensity to facilitate adaptations and modify swallow kinematics. The type of feedback and bolus volume provided may influence the intensity of the effortful swallow. To determine the increased effortful swallow intensity, a clinician can collect the peak amplitude of an effortful swallow and a typical swallow and compute a "swallow effort ratio" (SER). Dividing the effortful swall ow surface electromyography (sEMG) peak amplitude by the typical swallow sEMG peak amplitude derives the SER. A higher SER suggests increased intensity. An increase in the SER may have clinical relevance in swallowing therapy as a threshold of intensity is required to elicit neuroplastic change. The purpose of this investigation was to determine whether sEMG visual and clinician verbal feedback increases the SER. Additionally, the investigation examined whether the SER is influenced by different liquid bolus volumes. Methods: Eighty-two nondysphagic, healthy adults were assigned at random to 2 groups. One group received no feedback, and the other received verbal and visual feedback while performing typical and effortful swallows at 3 liquid volumes. Results: An analysis of covariance compared the typical and effortful peak swallow amplitudes among 3 volumes in the 2 feedback groups. There was a significant effect on the peak amplitude values by feedback g roup F(2, 79) = 22.82, p #x3c; 0.001. There were no differences in peak amplitude by volume regardless of feedback F(2, 78) = 0.413, p = 0.663. Conclusion: It appears that sEMG visual and clinician verbal feedback increases the SER, which may be a surrogate for intensity. An increased SER may have a positive effect on swallow intervention as intensity is known to influence outcomes of exercise and elicit neuroplastic change. Folia Phoniatr Logop View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Perdida de peso involuntaria: causas

pa.ythelady61 shared this article with you from Inoreader Perdida de peso involuntaria: causas Via Cuida tu tiroides La pérdida de peso involuntaria y que no se explica por un cambio de hábitos es una preocupación que puede tener causas diferentes. Entre ellas están las alteraciones en el funcionamiento de la glándula tiroides.  La pérdida de peso involuntaria puede deberse a causas diversas: Efectos secundarios de algunos medicamentos (algunos de los que se emplean para tratar condiciones de la tiroides) Alteraciones de la salud mental o el estado de ánimo Alcoholismo Anorexia nerviosa Dificultad para tragar (un síntoma de diferentes enfermedades) Alteraciones de la salud bucodental Alteraciones cognitivas Problemas intestinales Cáncer  Hipertiroidismo, hipotiroidismo, hiperparatiroidismo, hipoadrenalismo Pérdida de peso y problemas de tiroides Los científicos han comprobado hace tiempo que la relación entre las enfermedades de la tiroides, el peso corporal y el metabolismo es estrecha, pero no necesariamente sencilla. Aunque las hormonas de la glándula tiroides son importantísimas para el peso corporal, no son ni mucho menos el único elemento que determina una posible pérdida de peso involuntaria. Hay otras hormonas, proteínas y procesos del organismo que pueden explicar por qué una persona pierde peso. Las hormonas tiroideas regulan el metabolismo. Si la medida del metabolismo se obtiene en reposo, el resultado se denomina tasa metabólica basal (TMB, o BMR por sus siglas en inglés).  Los expertos en endocrinología han investigado la relación entre TMB y han llegado a las siguientes conclusiones: La TMB en valores bajos está asociada con niveles bajos de hormonas tiroideas en el organismo La TMB en valores altos está asociada con niveles elevados de hormonas tiroideas (hipertiroidismo), una de las posibles causas de pérdida de peso involuntaria La TMB ya casi no se emplea debido a la complejidad de la prueba y a que hay más factores que causan pérdida de peso, pero su relación con la tiroides está establecida.  En cuanto a la relación entre TMB y condiciones de la tiroides, se ha documentado que los valores elevados en esta prueba en personas con hipertiroidismo llevan asociados en muchas ocasiones pérdida de peso involuntaria. Además, la pérdida de peso es mayor si el hipertiroidismo es severo. Por ejemplo, si la tiroides está extremadamente hiperactiva -produciendo hormonas en cantidades sustancialmente excesivas- la TMB del paciente se incrementa. Eso hace que el cuerpo necesite más calorías para mantener su actividad normal. Es una de las causas de pérdida de peso relacionada con la actividad de la tiroides. Puesto que el hipertiroidismo es un estado alterado del organismo, puede predecirse que la pérdida de peso se corregirá cuando la tiroides recupere la normalidad. De todas formas, los especialistas suelen recordar que los factores que controlan nuestro apetito, metabolismo y actividad son extremadamente complejos. Las hormonas de la glándula tiroides son únicamente uno de esos factores. Si sospechas que puedes padecer alguna enfermedad de la glándula tiroides debes hablar con tu médico. En el siguiente test te damos algunas pistas.   FUENTES American Thyroid Association. Thyroid and Weight FAQs. Torlinska B et al 2019 Patients treated for hyperthyroidism are at increased risk of becoming obese: findings from a large prospective secondary care cohort. Thyroid 29:1380–1389. PMID: 31375059. Gang L, et al. Abstract 11438: Thyroid Hormones and Changes in Body Weight and Metabolic Parameters in Response to Weight-Loss Diets: The POUNDS LOST Trial. Circulation. 2016;134:A11438 La entrada Perdida de peso involuntaria: causas se publicó primero en Cuida tu tiroides. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rhinologic disease and its impact on sleep: a systematic review

pa.ythelady61 shared this article with you from Inoreader Rhinologic disease and its impact on sleep: a systematic review Via International Forum of Allergy & Rhinology Background Rhinologic disease can be responsible for systemic symptoms affecting mood, cognition, and sleep. It is unclear whether sleep disturbance in specific rhinologic disorders (chronic rhinosinusitis [CRS], rhinitis, and nasal septal deviation [NSD]) is an obstructive phenomenon or due to other mechanisms. In this review we examine the impact of CRS, rhinitis, and NSD on objective and subjective sleep outcome metrics and draw comparisons to normal controls and patients with known obstructive sleep apnea (OSA). Methods A systematic review of 4 databases (PubMed, Scopus, Cochrane Library, and Web of Science) was performed. Studies reporting on objective (apnea‐hypopnea index [AHI], respiratory disturbance index [RDI], oxygen nadir) and subjective (Epworth Sleepiness Scale [EpSS], Pittsburgh Sleep Quality Index [PSQI], Fatigue Severity Scale [FSS]) sleep parameters and disease‐specific patient‐reported outcome measures (PROMs; 22‐item Sino‐Nasal Outcome Test [SNOT‐22], Rhinoconjunctivitis Quality of Life Questionnaire [RQLQ], Nasal Obstruction Symptom Evaluation [NOSE]) were included. Results The database search yielded 1414 unique articles, of which 103 were included for analysis. Baseline PROMs were at the high end of normal to abnormal for all 3 conditions: EpSS: CRS (9.8 ± 4.0), rhinitis (9.7 ± 4.3), and NSD (8.9 ± 4.6); and PSQI: CRS (11.0 ± 4.5), rhinitis (6.1 ± 3.7), and NSD (8.6 ± 3.5). Objective measures demonstrated a mild to moderate OSA in the studied diseases: AHI: CRS (10.4 ± 11.5), rhinitis (8.6 ± 8.8), and NSD (13.0 ± 6.9). There were significant differences when compared with reported norms in all measured outcomes (p < 0.001). Conclusion Sleep quality is impacted by rhinologic (CRS, rhinitis, NSD) disease. There is likely a mild obstructive component contributing to poor sleep, but other contributing factors may be involved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Risk factors for subsequent recurrence after surgical treatment of recurrent pleomorphic adenoma of the parotid gland

pa.ythelady61 shared this article with you from Inoreader Risk factors for subsequent recurrence after surgical treatment of recurrent pleomorphic adenoma of the parotid gland Via Head & Neck Abstract Background Recurrent pleomorphic adenoma (PA) can be a lifelong disease, and rates of subsequent recurrence are high. Methods Patients between 2000 and 2015 were identified. Primary outcome was subsequent recurrence after surgical salvage. Results Twenty‐seven of 84 patients developed a subsequent recurrence. Risk factors for subsequent recurrence included a higher number of previous recurrences (P < .01), worse preoperative facial nerve function (P < .01), and deep parotid lesion(s) (P < .01). Interval since last surgery was protective (P < .01), specifically >10 years since last surgery (P < .01). For patients with a >10‐year interval since their last surgery, the subsequent recurrence‐free rate at 10 years follow‐up was 80.2% vs 31.8%. Conclusions For patients presenting with a >10‐year interval since their last surgery, subsequent recurrence rates are low, which may allow for as needed surveillance recommendations. For patients presenting with recurrent PA and ≤10 years since their last surgery, a closer surveillance is warranted. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Smart needle to diagnose metastatic lymph node using electrical impedance spectroscopy

pa.ythelady61 shared this article with you from Inoreader Smart needle to diagnose metastatic lymph node using electrical impedance spectroscopy Via Auris Nasus Larynx The cause of cervical lymphadenopathy varies from inflammation to malignancy. Accurate and prompt diagnosis is crucial as delayed detection of malignant lymph node can lead to a worse prognosis. To improve the diagnostic accuracy of metastatic lymph node, electrical spectroscopy was employed to study human normal and metastatic lymph nodes using a hypodermic needle with fine interdigitated electrodes on its tip (EoN). View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endonasal endoscopic surgery for sinonasal squamous cell carcinoma from an oncological perspective

pa.ythelady61 shared this article with you from Inoreader Endonasal endoscopic surgery for sinonasal squamous cell carcinoma from an oncological perspective Via Auris Nasus Larynx Endonasal endoscopic surgery (EES) has been applied to the management of sinonasal (SN) tumors based on recent advances in endoscopic surgical techniques and technologies over the past three decades. EES has been mainly indicated for benign tumors and less aggressive malignant tumors. Notwithstanding this, EES has been gradually adopted for squamous cell carcinoma (SCC), which is the most common histology among SN malignancies. However, an analysis of the outcomes of EES for patients with SCC is difficult because most articles included SCC a wide range of different tumor histologies. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Epicutaneous Immunotherapy for Treatment of Peanut Allergy: Follow-up from the Consortium for Food Allergy Research

pa.ythelady61 shared this article with you from Inoreader Epicutaneous Immunotherapy for Treatment of Peanut Allergy: Follow-up from the Consortium for Food Allergy Research Via Journal of Allergy and Clinical Immunology Capsule Summary: With extended Viaskin peanut 250 mcg treatment for 130 weeks, persistent desensitization and immunomodulatory changes were observed, associated with favorable safety, tolerability, and adherence profiles. Treatment success was observed predominantly in younger participants. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Relationship between cognitive impairment and olfactory function among older adults with olfactory impairment

pa.ythelady61 shared this article with you from Inoreader Relationship between cognitive impairment and olfactory function among older adults with olfactory impairment Via Auris Nasus Larynx Understanding the relationships among aging, cognitive function, and olfaction may be useful for diagnosing olfactory decline in older adults. Olfactory function declines in the early stage of neurodegenerative diseases, including Alzheimer's and Parkinson's diseases. Aging and cognitive impairment are associated with olfactory decline. Moreover, the assessment of hyposmia and anosmia is paramount to the diagnosis of neurodegenerative diseases. We aimed to assess the relationships among aging, cognitive function, and olfaction in patients with olfactory impairment. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Idiopathic Sudden Sensorineural Hearing Loss: Speech Intelligibility Deficits Following Threshold Recovery

pa.ythelady61 shared this article with you from Inoreader Idiopathic Sudden Sensorineural Hearing Loss: Speech Intelligibility Deficits Following Threshold Recovery Via Ear and Hearing - Published Ahead-of-Print Objectives: This retrospective study tests the hypothesis that patients who have recovered from idiopathic sudden sensorineural hearing loss (SSNHL) show deficits in word recognition tasks that cannot be entirely explained by a loss in audibility. Design: We reviewed the audiologic profile of 166 patients presenting with a unilateral SSNHL. Hearing loss severity, degree of threshold recovery, residual hearing loss, and word recognition performance were considered as outcome variables. Age, route of treatment, delay between SSNHL onset and treatment, and audiogram configuration were considered as predictor variables. Results: Severity, residual hearing loss, and recovery were highly variable across patients. While age and onset-treatment delay could not account for the severity, residual hearing loss and recovery in thresholds, configuration of the SSNHL and overall inner ear status as measured by thresholds on the contralateral ear were predictive of threshold recovery. Speech recognition performance was significantly poorer than predicted by the speech intelligibility curve derived from the patient's audiogram. Conclusions: SSNHL is associated with (1) changes in thresholds that are consistent with ischemia and (2) speech intelligibility deficits that cannot be entirely explained by a change in hearing sensitivity. ACKNOWLEDGMENTS: The authors are grateful to William Goedicke and Piotr Marciniak for their technical help and logistic support. This work was supported by the National Institutes of Health—National Institute on Deafness and Other Communication Disorders P50 DC015857 (S.F.M., Project principal investigator). S.F.M. conceived and designed research; M.O. collected the data, A.P. developed software for data acquisition and analysis, M.O. and S.F.M. performed data analysis, and S.F.M., D.B.W., and M.C.L. wrote, edited and revised the article. The authors have no conflicts of interest to disclose. Received June 8, 2020; accepted October 1, 2020 Address for correspondence: Stéphane F. Maison, Eaton-Peabody Laboratories, Massachusetts Eye & Ear, 243 Charles Street, Boston, MA 02114-3096, USA. E-mail: stephane_maison@meei.harvard.edu Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficient Detection of Cortical Auditory Evoked Potentials in Adults Using Bootstrapped Methods

pa.ythelady61 shared this article with you from Inoreader Efficient Detection of Cortical Auditory Evoked Potentials in Adults Using Bootstrapped Methods Via Ear and Hearing - Published Ahead-of-Print Background: Statistical detection methods are useful tools for assisting clinicians with cortical auditory evoked potential (CAEP) detection, and can help improve the overall efficiency and reliability of the test. However, many of these detection methods rely on parametric distributions when evaluating test significance, and thus make various assumptions regarding the electroencephalogram (EEG) data. When these assumptions are violated, reduced test sensitivities and/or increased or decreased false-positive rates can be expected. As an alternative to the parametric approach, test significance can be evaluated using a bootstrap, which does not require some of the aforementioned assumptions. Bootstrapping also permits a large amount of freedom when choosing or designing the statistical test for response detection, as the distributions underlying the test statistic no longer need to be known prior to the test. Objectives: To improve the reliability and efficiency of CAEP-related applications by improving the specificity and sensitivity of objective CAEP detection methods. Design: The methods included in the assessment were Hotelling's T2 test, the Fmp, four modified q-sample statistics, and various template-based detection methods (calculated between the ensemble coherent average and some predefined template), including the correlation coefficient, covariance, and dynamic time-warping (DTW). The assessment was carried out using both simulations and a CAEP threshold series collected from 23 adults with normal hearing. Results: The most sensitive method was DTW, evaluated using the bootstrap, with maximum increases in test sensitivity (relative to the conventional Hotelling's T2 test) of up to 30%. An important factor underlying the performance of DTW is that the template adopted for the analysis correlates well with the subjects' CAEP. Conclusion: When subjects' CAEP morphology is approximately known before the test, then the DTW algorithm provides a highly sensitive method for CAEP detection. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and text of this article on the journal's Web site (www.ear-hearing.com). ACKNOWLEDGMENTS: The authors would also like to thank Jo Brooks and Sara Al-Hanbali for data collection. This article presents independent research funded by the Oticon Fonden and by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0214-33009). K.J.M. was supported by the NIHR Manchester Biomedial Research Centre. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. M.A.C. and D.M.S. contributed toward algorithm design and data analysis, S.L.B., K.J.M., A.V., M.A.S., J.M.H., and L.B.S. contributed toward project conception and/or experiment design and/or data acquisition and interpretation. All authors contributed toward the drafting and critical revision of the manuscript. The authors declare no conflicts of interest to disclose. Received September 27, 2019; accepted August 12, 2020. Address for correspondence: Michael Alexander Chesnaye, Institute of Sound and Vibration Research, Faculty of Engineering and the Environment, University of Southampton, United Kingdom. E-mail: mac1r19@soton.ac.uk Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Internal Consistency and Convergent Validity of the Inventory of Hyperacusis Symptoms

pa.ythelady61 shared this article with you from Inoreader Internal Consistency and Convergent Validity of the Inventory of Hyperacusis Symptoms Via Ear and Hearing - Published Ahead-of-Print Objectives: The aim was to assess the internal consistency and convergent and discriminant validity of a new questionnaire for hyperacusis, the Inventory of Hyperacusis Symptoms (IHS; Greenberg & Carlos 2018), using a clinical population. Design: This was a retrospective study. Data were gathered from the records of 100 consecutive patients who sought help for tinnitus and/or hyperacusis from an audiology clinic in the United Kingdom. The average age of the patients was 55 years (SD = 13 years). Audiological measures were the pure-tone average threshold (PTA) and uncomfortable loudness levels (ULL). Questionnaires administered were: IHS, Tinnitus Handicap Inventory (THI), Hyperacusis Questionnaire (HQ), Insomnia Severity Index, Generalized Anxiety Disorder, and Patient Health Questionnaire-9. Results: Cronbach's alpha for the 25-item IHS questionnaire was 0.96. Neither the total IHS score nor scores for any of its five subscales were correlated with the PTA of the better or worse ear. This supports the discriminant validity of the IHS, as hyperacusis is thought to be independent of the PTA. There were moderately strong correlations between IHS total scores and scores for the HQ, Tinnitus Handicap Inventory, Generalized Anxiety Disorder, and Patient Health Questionnaire-9, with r = 0.58, 0.58, 0.61, 0.54, respectively. Thus, although IHS scores may reflect hyperacusis itself, they may also reflect the coexistence of tinnitus, anxiety, and depression. The total score on the IHS was significantly different between patients with and without hyperacusis (as diagnosed based on ULLs or HQ scores). Using the HQ score as a reference, the area under the receiver operating characteristic for the IHS was 0.80 (95% confidence interval = 0.71 to 0.89) and the cutoff point of the IHS with high est overall accuracy was 56/100. The corresponding sensitivity and specificity were 74% and 82%. Conclusions: The IHS has good internal consistency and reasonably high convergent validity, as indicated by the relationship of IHS scores to HQ scores and ULLs, but IHS scores may also partly reflect the co-occurrence of tinnitus, anxiety, and depression. We propose an IHS cutoff score of 56 instead of 69 for diagnosing hyperacusis. ACKNOWLEDGMENTS: We thank the members of the THTSC at RSCH (Viveka Owen, Jemma Hatton, Jennifer Whiffin, Jenni Stevens, and Judith Ballinger) for their help in data collection. The authors have no conflicts of interest to disclose. Received October 20, 2019; accepted October 3, 2020 Address for correspondence: Hashir Aazh, Tinnitus & Hyperacusis Therapy Specialist Clinic, Audiology Department, Royal Surrey NHS Foundation Trust, Egerton Road, Guildford, GU2 7XX, United Kingdom. E-mail: info@hashirtinnitusclinic.com Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.