Eletroestimulação neuromuscular na reabilitação da disfagia orofaríngea

A reabilitação da disfagia orofaríngea ganhou um novo instrumento terapêutico, a eletroestimulação neuromuscular (EENM), sendo que os mais renomados pesquisadores têm estudado a indicação e os resultados desta abordagem. O objetivo deste trabalho foi apresentar revisão bibliográfica sobre a aplicabilidade da EENM na reabilitação da disfagia orofaríngea. Realizou-se amplo levantamento bibliográfico em bases de dados, englobando as duas últimas décadas de pesquisa na área. Este artigo de revisão mostrou que ainda não há consenso sobre o uso da EENM na reabilitação da disfagia. Constatou-se que a maioria dos trabalhos descreveu o uso da EENM de forma isolada, não relatou as técnicas fonoaudiológicas associadas à eletroterapia e utilizou amostras heterogêneas que agrupavam disfagias orofaríngeas mecânicas e neurogênicas. Somente recentemente programas específicos têm sido delineados e testados em populações mais homogêneas.The rehabilitation of oropharyngeal dysphagia has a new therapeutic tool, the neuromuscular electrical stimulation (NMES), and the most renowned researchers have been studying the applicability and the results of this approach. The aim of this study was to present a literature review regarding the applicability of NMES in the rehabilitation of oropharyngeal dysphagia. An extensive literature review was carried out, considering the last two decades of research in the area. The review showed that there is still no consensus on the use of NMES in the rehabilitation of dysphagia. It was found that most studies described the use of NMES in isolation, did not describe the techniques associated with speech-language therapy associated to electrotherapy, and used heterogeneous samples that clustered mechanical and neurogenic oropharyngeal dysphagia. Only recently specific programs have been designed and tested in more homogeneous populations

From Asian curiosity to eruptive American pest: Megacopta cribraria (Hemiptera: Plataspidae) and prospects for its biological control

Citation: Ruberson, J. R., Takasu, K., Buntin, G. D., Eger, J. E., Gardner, W. A., Greene, J. K., ... Toews, M. D. (2013). From Asian curiosity to eruptive American pest: Megacopta cribraria (Hemiptera: Plataspidae) and prospects for its biological control. Retrieved from http://krex/ksu/eduThe kudzu bug or bean plataspid, Megacopta cribraria (Fabricius), is native to Asia where it appears to be widely distributed (although the taxonomy is not entirely clear), but is infrequently a pest of legumes. This bug appeared in 2009 in the southeastern United States, where it is closely associated with kudzu, Pueraria montana Lour. [Merr.] variety lobata [Willd.] Maesen & S. Almeida. However, the insect has become a consistent economic pest of soybeans, Glycine max (L.) Merr., and some other leguminous crops in areas where large numbers can build in kudzu, in addition to being a considerable nuisance in urban landscapes where kudzu occurs. The insect has remarkable capacity for movement, and has spread rapidly from nine Georgia counties in 2009 to seven states in 2012. Despite being a nuisance in urban areas and a crop pest, high populations of the bug also reduce the biomass of kudzu, which is itself a seriously problematic invasive weed, complicating the status of M. cribraria in its expanded range. Extant predators and a pathogen in the US have been observed attacking kudzu bugs in the laboratory and field, but no parasitism of eggs or nymphs has been observed to date. A single record of parasitism of an adult kudzu bug by a tachinid fly is known from the US, but no other adult parasitism has been observed in the US or elsewhere. Extant enemies may eventually significantly reduce the bug’s populations, but at present native enemies appear to be insufficient for the task, and exotic enemies from the kudzu bug’s native range may offer the best possibility for effective biological control in the US. Based on the available literature, the best option for an importation biological control program appears to be the platygastrid egg parasitoid Paratelenomus saccharalis (Dodd) because of its apparent host specificity, intimate biological linkages with M. cribraria, and wide geographic distribution in the Eastern Hemisphere. Other natural enemies may eventually emerge as good candidates for importation, but at present P. saccharalis appears to be most promising

Screening tools for dysphagia: a systematic review

Objetivo: Realizar a revisão sistemática dos instrumentos de rastreio em disfagia disponíveis na literatura. Estratégia de pesquisa: Para a seleção dos estudos, foram utilizados os seguintes descritores: “questionários”, “questionnaires”, “transtornos de deglutição”, “deglutition disorders”, “programas de rastreamento” e “mass screening” e foram utilizadas as bases de dados: Biblioteca Virtual em Saúde (LILACS, IBECS, MEDLINE, Biblioteca Cochrane, SciELO) e PubMed. A busca foi realizada no período entre abril e junho de 2013. Critérios de seleção: Foram selecionados artigos em Inglês, Português e Espanhol, independentemente do ano de publicação, que possuíam no título, resumo ou corpo do artigo relação com o objetivo da pesquisa. Análise dos dados: Após a leitura dos artigos na íntegra, foram extraídos dados de identificação e métodos dos artigos para posterior análise. Resultados: A pesquisa realizada a partir dos descritores propostos, nas bases de dados utilizadas, gerou o total de 1.012 artigos. Após a análise dos títulos, resumos e leitura dos artigos na íntegra, foram selecionados 20 estudos. As publicações sobre instrumentos para identificação de pacientes disfágicos iniciaram em 1999 e 50% dos artigos analisados foram desenvolvidos nos Estados Unidos. Os métodos empregados nos instrumentos foram: questionários, a observação de sinais e sintomas clínicos do paciente, a solicitação da execução de alguns movimentos orofaciais, teste de deglutição com água ou alimentos. Conclusão: Os instrumentos de rastreio em disfagia são bastante heterogêneos e foram desenvolvidos para diferentes públicos com o objetivo principal de identificar os pacientes com distúrbios de deglutição.Purpose: To perform a systematic review of screening instruments for dysphagia available in the literature. Methods: For the selection of studies, the following descriptors were used: “questionários”, “questionnaires”, “transtornos de deglutição”, “deglutition disorders”, “programas de rastreamento”, and “mass screening”. The online databases used for the research were Virtual Health Library (LILACS, IBECS, MEDLINE, Cochrane Library, SciELO) and PubMed. The research was performed from April to June 2013. Selection criteria articles in English, Portuguese, and Spanish, regardless of the year of publication, whose title, abstract, or text had any relation to the purpose of the research. After reading the articles in their entirety, identification data and method of the articles were extracted for later analysis. Results: The research carried out from the proposed descriptors produced 1,012 articles. After reviewing the titles, summaries, and fully reading the articles, 20 studies were chosen. The publications on instruments for the identification of dysphagic patients started in 1999, and 50% of the analyzed studies were carried out in the USA. The methods used on the instruments were questionnaires, observation of patient’s clinical signals and symptoms, the request for execution of some orofacial movements, and swallowing test with water or food. Conclusion: Screening instruments in dysphagia are fairly heterogeneous and have been developed for different audiences with the main objective of identifying patients with swallowing disorders