CoDAS最新文献

Purpose: to verify the agreement between the evaluation of orofacial myofunctional aspects and the risk of dysphagia in older people in the frailty process.

Methods: methodological study with 100 individuals from a referral center for older people, assessed using the Orofacial Myofunctional Evaluation Protocol with Scores for Older People (OMES-O) and the Oropharyngeal Dysphagia Screening in Older Adults (RaDI). Information regarding participants' chewing disorders, age, and years of education was also collected. ROC curve analysis was performed, and sensitivity, specificity, positive and negative predictive values were generated from this analysis.

Results: the OMES-O presented a median of 236.5 points. Most participants were not at risk of dysphagia. The comparison between OMES-O and RaDI indicated no difference in the score of orofacial myofunctional aspects between individuals at risk and not at risk of dysphagia. Moreover, OMES-O was not associated with chewing alterations, age, or years of education.

Conclusion: The evaluation of orofacial myofunctional aspects could not indicate the risk of oropharyngeal dysphagia in older adults in the frailty process.

Purpose: To characterize the swallowing function of patients with sepsis, describe the frequency of oropharyngeal dysphagia, examine the rehabilitation duration required, and identify clinical predictors associated with the occurrence of dysphagia in a high-complexity hospital setting.

Methods: This cross-sectional observational study included 35 patients diagnosed with sepsis, whose clinical severity was assessed using the National Early Warning Score (NEWS). Clinical and demographic data were collected from medical records. All participants underwent an initial screening with the Yale Swallow Protocol, and those identified at risk for dysphagia were further evaluated using the Dysphagia Risk Evaluation Protocol - Screening (DREP) and the Protocol for Introduction and Transition to Oral Feeding (PITOF). Swallowing functionality was classified using the Functional Oral Intake Scale (FOIS).

Results: Dysphagic patients had pulmonary infection as the primary source of sepsis, higher clinical severity, a greater prevalence of comorbidities such as neurological diseases and heart conditions, lower FOIS scores, increased need for alternative feeding routes, longer hospital stays, and a higher risk of mortality. The most frequent clinical signs included prolonged oral transit time, reduced laryngeal elevation, and aspiration indicators such as throat clearing and coughing after swallowing.

Conclusion: Oropharyngeal dysphagia in patients with sepsis is associated with worse clinical outcomes, emphasizing the importance of early diagnosis and specialized management.

Purpose: To compare the POS time in individuals diagnosed with PD in the conditions of isolated deglutition (ID) and dual-task deglutition (DD) for different consistencies and volumes.

Methods: A total of 576 swallows edited from fiberoptic endoscopic evaluation of swallowing (FEES) of 16 individuals, both sexes, at different PD stages based on the Hoehn & Yahr (H&Y) modified scale, aged 64 to 85 years (mean ± standard deviation: 72.4 ± 6). They underwent FEES with isolated deglutition (ID) and dual-task deglutition (DD) to analyze the POS time in swallowing. An otorhinolaryngologist performed the FEES, offering standardized consistencies at levels 0 - thin; 2 - mildly thick; and 4 - extremely thick, based on the International Dysphagia Diet Standardization Initiative (IDDSI). All food consistencies were dyed with blue artificial food coloring and offered 5 mL and 10 mL in disposable spoons. After adequate training, the quantitative temporal POS analysis for both deglutition conditions was performed using specific software. Data was analyzed through the Statistical Package for the Social Sciences (SPSS) with a significance level of 0.05 (5%). The Mann-Whitney test compared the ID and DD POS time.

Results: The POS time was statistically significantly different for 5 mL of consistency level 4 (ID = 912 ms and DD = 2.044 ms) (p-value = 0.007).

Conclusion: The results indicated that there was significant difference in the POS time between ID and DD only at 5 mL of consistency level 4 for individuals with PD at performing the cognitive-motor dual-task proposed.

Purpose: To verify whether there are immediate effects of photobiomodulation on maximum tongue pressure and endurance.

Methods: This was a double-blind experimental study that investigated the immediate effects of photobiomodulation on maximum tongue pressure and endurance in individuals without functional alterations of this structure. The non-probabilistic sample consisted of 60 individuals of both sexes, aged between 18 and 35 years, divided into four groups. The tested doses were 7, 9, and 11J per point, using infrared wavelength, applied to six points on the dorsal surface of the tongue (three longitudinal points in two rows) and three longitudinal points on each lateral side, totaling 12 application points. The placebo group underwent the same procedures as the others, but the device was not activated. Participants underwent an intraoral evaluation of the tongue using the MBGR protocol to determine eligibility, as well as maximum tongue pressure and endurance assessment using the IOPI, both before and after irradiation. The maximum tongue pressure and endurance were compared before and after photobiomodulation.

Results: The groups were homogeneous regarding sex, age, maximum tongue pressure, and endurance before irradiation. No differences were observed in tongue pressure or resistance between the pre and post-irradiation moments in any of the tested groups.

Conclusion: Photobiomodulation, at the tested doses, did not produce immediate effects on maximum tongue pressure or resistance in adults without structural and/or functional alterations of the tongue.

Purpose: Dyslexia is a specific learning disorder that affects reading and is associated with emotional and behavioral problems. Previous research indicates that children with dyslexia are at greater risk of developing anxiety, depression, and difficulties in executive functions, which affect their academic performance and well being.

Methods: This study explored and compared behavioral, emotional, and executive functioning profiles in children with dyslexia and in neurotypical children in a sample of 120 children aged 8 to 10, divided into a dyslexia group and a control group. The BASC-3, SENA, and ENFEN were used for assessments, and data were analyzed using t-tests, Levene's test, and mediation analyses.

Results: Children with dyslexia showed significantly higher levels of aggressiveness, anxiety, depression, and attention problems. In addition, they exhibited difficulties in executive functions such as resistance to interference and verbal fluency, highlighting the impact of dyslexia in these areas.

Conclusion: Mediation analyses suggest that dyslexia is a potential indicator of difficulties in executive functioning and behavior, as well as influencing internalized and externalized emotional problems. These findings underscore the need to implement comprehensive educational and therapeutic strategies to address the needs of this vulnerable population.

Purpose: To verify changes in phonetic, nasometric and aerodynamic aspects of speech in individuals with cleft lip and palate and the influence of occlusion on these variables, before and after orthognathic surgery (OC) for maxillary advancement.

Methods: Retrospective, observational, cross-sectional and analytical study. Fifty-one patients with previously repaired cleft lip and palate participated, 26 men and 25 women (x̅=31 years), who underwent maxillary advancement OC. The following were performed: assessment of phonetic and occlusal aspects, nasometry and aerodynamic assessment of velopharyngeal function (flow-pressure technique), before and after OC. The phonetic aspects were evaluated by 3 experienced judges.

Results: There was high intra and inter judge agreement. There was a significant improvement in phonetic production after OC: in tongue interposition ([d], [t], [l], [n], [ʎ]), distortion ([f], [v]) and anterior lisp ([s], [z], [ʃ]). In the occlusal aspects, the overjet reached, on average, the normal values after the OC and there was an occlusal improvement in the anterior crossbite, openbite and overbite. Nasalance values were within the normal range after CO for the nasal text and there was an increase in nasalance, suggestive of hypernasality, in the oral text. There was no change in velopharyngeal closure, in the production of the word "rampa", suggestive of adequate velopharyngeal closure. Occlusion did not influence nasalance and velopharyngeal closure before or after maxillary advancement OC.

Conclusion: There was a significant improvement in phonetic, occlusal and nasometric aspects after OC. However, none of the phones obtained 100% adequacy,reinforcing the importance of speech therapy after OC.

Purpose: To present the diagnostic accuracy of the clinical examination with scores, the Orofacial Myofunctional Evaluation Protocol MMBGR for Infants and Preschoolers, for the age group of six to 23 months.

Methods: Diagnostic accuracy validation using a convenience sample. Images from 76 participants were analyzed by groups of three speech-language pathologists, who individually and separately assessed the images, with agreement between two of them considered valid. An electronic form was used to assess the domains of the orofacial myofunctional evaluation, Orofacial Myofunctional Disorder (OMD), and the need for referrals. The responses of speech-language pathologists who provided opinions based on clinical experience, without using the protocol (gold standard), were compared with those provided by speech-language pathologists who used the protocol (index test). The Receiver Operating Characteristic Curve (ROC) method was employed, and cut-off points were assigned using the R Core Team (2022) software, yielding sensitivity and specificity values.

Results: For infants aged six to 11 months, diagnostic accuracy was not ideal for orofacial structures, orofacial functions, and Orofacial Myofunctional Disorder (OMD), but reasonable for tone (70%). For infants aged 12 to 23 months, accuracy was reasonable for most domains- orofacial structures, orofacial functions, tone-and ideal for OMD (88.9%). The OMD cut-off point is 9 (for ages 6 to 11 months) and 14 (for ages 12 to 23 months). Accuracy was reasonable for multidisciplinary referrals but not ideal for speech-language pathology referrals.

Conclusion: The Orofacial Myofunctional Evaluation Protocol MMBGR for Infants and Preschoolers, when analyzed through photos and videos, is accurate for assessing infants aged six to 11 months only in terms of tone; and for infants aged 12 to 23 months, it is accurate across all exam domains, being ideal for diagnosing OMD. The instrument is reasonable for determining the need for multidisciplinary referrals in infants.