Impaired Tongue Function as an Indicator of Laryngeal Aspiration in Adults with Acquired Oropharyngeal Dysphagia: A Systematic Review
AbstractTongue function assessment typically forms part of a clinical bedside swallowing evaluation (CBSE). The predictive value of lingual function for calculating aspiration risk in isolation is not known. The aim of this systematic review was to collate current evidence on the utility of assessing lingual deficits for predicting aspiration. Health databases Medline, CINAHL, Cochrane Library, SpeechBITE, AMED and Embase were searched from inception to November 2016. Studies were included if there was a comparison between a clinical lingual assessment (index test) and aspiration on instrumental assessments (reference test) in adults who had been diagnosed with oropharyngeal dysphagia. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess the quality of the studies. Sensitivity, specificity, predictive values, likelihood ratios and odds ratios were extracted or calculated where possible. A best evidence synthesis and receiver operator curve (ROC) analysis for sensitivity and specificity were conducted. Twelve studies were included, of which only one had a low risk of bias. The ROC curve, predictive values and likelihood ratios did not show a relationship between lingual function and aspiration. Best evidence synthesis showed moderate evidence that when motility and strength are jointly assessed, they are not associated with aspiration. Other lingual assessment variables indicated either limited or conflicting evidence of an association. Ther...
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ConclusionThe similarity between osteotomy planes predicted using theSignature system and osteotomy planes actually achieved was excellent for the tibia although some discrepancies were seen for the femur. The use of 3D system techniques in TKA surgery can provide accurate intraoperative guidance, especially for patients with deformed bone, tailored to individual patients and ensure better placement of the implant.
This study attempts to quantify the effect of sequential needle puncturing of the medial collateral ligament (MCL) using a pressure sensor insert (Verasense by OrthoSensor) and gap measurement under tension.MethodsCruciate-retaining arthroplasties were placed in 14 cadaveric knees. The MCL was elongated by step-wise perforation, in five sets of five perforations, with the use of an 18-gauge needle, followed by valgus stress. Following the fifth set of needle perforations, blade perforation was performed on the remaining tense fibers of the MCL. Following each step-wise perforation, corresponding medial compartment pressure...
ConclusionBCS TKA has a wide acceptable range of posterior tibial slope for avoiding knee instability if the posterior tibial slope is less than 10 °. Surgeons should prioritize avoiding adverse effects over trying to achieve positive effects such as decreasing patellofemoral contact force and quadriceps force by increasing posterior tibial slope. Our study helps surgeons determine the optimal posterior tibial slope during surgery with BCS TKA ; posterior tibial slope should not exceed 10° in routine clinical practice.
DEMENTIA symptoms can include difficulty performing familiar tasks, problems with language and disorientation in familiar places. Restlessness could also be a sign of the condition
In the article “No Fat, No Sugar, No Salt . . . No Problem? Prevalence of ‘Low-Content’ Nutrient Claims and Their Associations with the Nutritional Profile of Food and Beverage Purchases in the United States,” published in the September 2017 issue of the Journal of the Academy of Nutrition and Dietetics, the authors and web address listed for reference 15 (p 1373) are incorrect. Reference 15 should read as follows: Muth MK, Sweitzer M, Brown D, et al. Understanding IRI household-based and store-based scanner data.