Alimentação no recém-nascido com fissuras labiopalatinas* Feeding in newborn with cleft lip and palate Resumo As dificuldades alimentares não estão presentes em todos os recémnascidos (RN) e crianças portadoras de fissuras labiopalatinas (FLP). As características anatômicas desses portadores que prejudicam a alimentação são a acentuada projeção da pré-maxila, que não oferece apoio para o mamilo ou bico de mamadeira, em oposição aos movimentos linguais, e a posição de posteriorização da língua assumida pelos portadores de FLP durante a fala ou em repouso, tornando o impulso muscular sobre o mamilo ou bico não efetivo. Esta revisão tem como objetivo caracterizar a alimentação em RN portadores de FLP e os seus possíveis transtornos. As dificuldades encontradas são estabelecidas pela realização ineficiente, alterada ou não coordenada das funções de sucção, deglutição e respiração, que promovem uma sucessão de eventos que podem comprometer a saúde geral do portador de FLP.
Background. Dysphagia is a predictor of mortality in Parkinson’s disease (PD). Developing alternative methods to videofluoroscopy swallowing study (VFSS) for the evaluation of dysphagia is a public health necessity. The Swallowing Clinical Assessment Score in Parkinson’s Disease (SCAS-PD) is an alternative and low-cost tool for diagnosis of dysphagia, but had not been properly validated in comparison to the gold-standard method. The objective of this study was to assess the validity and reliability of the SCAS-PD. Methods. SCAS-PD was applied to 31 patients with PD, and VFSS was conducted concurrently. This clinical assessment uses different volumes and viscosities to identify signs of swallowing impairments. For validation purposes, the interclass correlation coefficient and the weighted kappa were calculated. The AUC of the ROC curve, sensitivity, and specificity values for detection of penetration/aspiration (PA) were assessed. Internal consistency was calculated by Cronbach’s alpha. Results. Fifty-one percent of patients were classified with dysphagia. SCAS-PD was differentiated between normal/functional deglutition and dysphagia with AUC 0.97, 95% CI 0.92–1.00, and an optimal cutoff at 19 (sensitivity 100% and specificity 87.5%). The internal consistency was α = 0.91 for the total score. The internal consistency of the SCAS-PD domains was oral phase (α = 0.73), pharyngeal phase (α = 0.86), and signs of PA (α = 0.95). The weighted kappa analysis demonstrated a high rate of concordance at 0.71 (p<0.001) between SCAS-PD and VFSS. Conclusions. SCAS-PD has been shown to have a good concordance with the VFSS. Considering this, SCAS-PD is highly applicable in clinical settings, since it is a simple and low-cost diagnostic tool for detecting dysphagia in PD patients.
Perfil dos sons da deglutição de um grupo pós-AVC fazendo uso de software de estetoscópio eletrônico Swallowing sounds profile of a post stroke group using electronic stethoscope software Perfil de los sonidos de deglutición de un grupo pós-AVC que hace uso del software del estetoscopio electrónico
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