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Journal of Personalized Medicine Sep 2022Obesity is a multifactorial chronic disease involving multiple organs, devices, and systems involving important changes in the stomatognathic system, such as in the... (Review)
Review
BACKGROUND
Obesity is a multifactorial chronic disease involving multiple organs, devices, and systems involving important changes in the stomatognathic system, such as in the orofacial muscles, temporomandibular joint, cheeks, nose, jaw, maxilla, oral cavity, lips, teeth, tongue, hard/soft palate, larynx, and pharynx. Patients with obesity indicated for bariatric surgery reportedly presented with abnormalities in the structures and function of the stomatognathic apparatus. This occurs through the accumulation of adipose tissue in the oral cavity and pharyngeal and laryngeal regions. Therefore, this systematic review aimed to elucidate the changes occurring in the stomatognathic system of patients with obesity after undergoing bariatric surgery.
METHOD
Information was searched based on the equations developed with the descriptors obtained in DECS and MESH using the PRISMA methodology. Studies published between 2010 and October 2021 in databases including PubMed, ProQuest, Scielo, Dialnet, EBSCO, and Springer Link were considered.
RESULTS
Eighty articles met the inclusion criteria after evaluating the articles, thereby allowing for the determination of the morphophysiological correlation of the stomatognathic system with the population studied. At the morphological or structural level, changes were observed in the face, nose, cheeks, maxilla, jaw, lips, oral cavity, teeth, tongue, palate, temporomandibular joint, neck, muscles, head, shoulders, larynx, and pharynx. At the morphological level, the main changes occurred in, and the most information was obtained from, the labial structures, teeth, muscles, pharynx, and larynx. Physiological changes were in breathing, phonation, chewing, and swallowing, thereby revealing the imbalance in basic and vital functions.
CONCLUSIONS
Analyzing the changes and structures of obese patients and candidates for bariatric surgery revealed that, in the preoperative period, the evidence is clear owing to the presence of a wide range of information. However, the information is more limited regarding the postoperative period; thus, further research focusing on characterization of the system postoperatively is warranted.
PubMed: 36294680
DOI: 10.3390/jpm12101541 -
Journal of Functional Morphology and... Mar 2024Teachers usually present work-related pain such as neck pain. Their posture could be the cause of these problems; indeed, it is often a sway-back posture. Furthermore,... (Review)
Review
Teachers usually present work-related pain such as neck pain. Their posture could be the cause of these problems; indeed, it is often a sway-back posture. Furthermore, teachers can also experience problems with their voice such as dysphonia, specifically muscle tension dysphonia (MTD). This scoping review aims to find the correlation between teachers' posture and MTD. It also studies how a posture-based treatment can influence this disorder. Randomized controlled trials, controlled clinical trials, prospective cohort studies, and cross-sectional studies that considered the relationship between posture and MTD and that included teachers in their sample. The search led to an initial number of 396 articles; after the screening process, a final number of eight articles were included. A total of 303 patients were analyzed and all showed altered alignment of the head around the cervical spine with hypertonus of the cricothyroid, suprahyoid, and sternocleidomastoid muscles. Although MTD is a disorder with a multifactorial etiology, the articles revealed a correlation between posture and MTD related to a forward protraction of the cervical spine with a hypertonus of the laryngeal and hyoid musculature. This study also detected that an intervention in posture could reduce vocal disorders.
PubMed: 38651418
DOI: 10.3390/jfmk9020060 -
Frontiers in Oncology 2020Gross strap muscle invasion (gSMI) in patients with differentiated thyroid cancer (DTC) was defined as high-risk recurrent group in the 2015 American Thyroid...
Gross strap muscle invasion (gSMI) in patients with differentiated thyroid cancer (DTC) was defined as high-risk recurrent group in the 2015 American Thyroid Association guidelines. However, controversy persists because several studies suggested gSMI had little effect on disease outcome. Herein, a systematic review and meta-analysis was conducted to investigate impact of gSMI on outcome of DTC. A systematic search of electronic databases (PubMed, EMBASE, Cochrane Library, and MEDLINE) for studies published until February 2020 was performed. Case-control studies and randomized controlled trials that studied the impact of gSMI on outcome of DTC were included. Six studies (all retrospective studies) involving 13,639 patients met final inclusion criteria. Compared with no extrathyroidal extension (ETE), patients with gSMI were associated with increased risk of recurrence ( = 0.0004, OR, 1.46; 95% CI: 1.18-1.80) and lymph node metastasis (LNM) ( < 0.00001, OR 4.19; 95% CI: 2.53-6.96). For mortality ( = 0.34, OR 1.47; 95% CI: 0.67-3.25), 10 year disease-specific survival ( = 0.80, OR 0.91; 95% CI: 0.44-1.88), and distant metastasis (DM) ( = 0.21, OR 2.94; 95% CI: 0.54-15.93), there was no significant difference between gSMI and no ETE group. In contrast with maximal ETE(extension of the primary tumor to the trachea, esophagus, recurrent laryngeal nerve, larynx, subcutaneous soft tissue, skin, internal jugular vein, or carotid artery), patients with gSMI were associated with decreased risk of recurrence ( < 0.0001, OR, 0.58; 95% CI: 0.44-0.76), mortality ( = 0.0003, OR 0.20; 95% CI: 0.08-0.48), LNM ( = 0.0003, OR 0.64; 95% CI: 0.50-0.81), and DM ( = 0.0009, OR 0.28; 95% CI: 0.13-0.59). DTC patients with gSMI had a higher risk of recurrence and LNM than those without ETE. However, in contrast with maximal ETE, a much better prognosis was observed in DTC patients with only gSMI.
PubMed: 33102203
DOI: 10.3389/fonc.2020.01687 -
Journal of Clinical Medicine Jul 2020(1) Background: Dysphagia is a clinical hallmark and part of the current American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) diagnostic... (Review)
Review
(1) Background: Dysphagia is a clinical hallmark and part of the current American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) diagnostic criteria for idiopathic inflammatory myopathy (IIM). However, the data on dysphagia in IIM are heterogenous and partly conflicting. The aim of this study was to conduct a systematic review on epidemiology, pathophysiology, outcome and therapy and a meta-analysis on the prevalence of dysphagia in IIM. (2) Methods: Medline was systematically searched for all relevant articles. A random effect model was chosen to estimate the pooled prevalence of dysphagia in the overall cohort of patients with IIM and in different subgroups. (3) Results: 234 studies were included in the review and 116 (10,382 subjects) in the meta-analysis. Dysphagia can occur as initial or sole symptom. The overall pooled prevalence estimate in IIM was 36% and with 56% particularly high in inclusion body myositis. The prevalence estimate was significantly higher in patients with cancer-associated myositis and with NXP2 autoantibodies. Dysphagia is caused by inflammatory involvement of the swallowing muscles, which can lead to reduced pharyngeal contractility, cricopharyngeal dysfunction, reduced laryngeal elevation and hypomotility of the esophagus. Swallowing disorders not only impair the quality of life but can lead to serious complications such as aspiration pneumonia, thus increasing mortality. Beneficial treatment approaches reported include immunomodulatory therapy, the treatment of associated malignant diseases or interventional procedures targeting the cricopharyngeal muscle such as myotomy, dilatation or botulinum toxin injections. (4) Conclusion: Dysphagia should be included as a therapeutic target, especially in the outlined high-risk groups.
PubMed: 32650400
DOI: 10.3390/jcm9072150 -
European Archives of... Mar 2024This study aims to aggregate and analyze existing clinical evidence to compare the efficacy and adverse effects of unilateral or bilateral botulinum toxin injections for... (Meta-Analysis)
Meta-Analysis
Comparison of the efficacy and adverse effects of unilateral or bilateral botulinum toxin injections for adductor spasmodic dysphonia: a systematic review and meta-analysis.
PURPOSE
This study aims to aggregate and analyze existing clinical evidence to compare the efficacy and adverse effects of unilateral or bilateral botulinum toxin injections for the treatment of adductor spasmodic dysphonia (ADSD).
METHODS
Reports from non-randomized controlled trials and cohort studies pertaining to the efficacy and adverse effects of unilateral and bilateral botulinum toxin injections for ADSD were identified and retrieved from four electronic databases from inception to July 2023. The meta-analysis employed fixed or random effects models to assess pooled relative risks (RR), mean differences (MDs), and standard mean differences (SMDs) with their corresponding 95% confidence intervals (CIs).
RESULTS
We included two non-randomized controlled trials and seven cohort studies comprising 854 total patients. Meta-analysis of the included studies showed that bilateral botulinum toxin injections associated with a longer duration of vocal improvement (MD = - 2.89, 95% CI - 3.13 to - 2.65, I = 0%, P < 0.00001). However, bilateral botulinum toxin injections associated with an increase in adverse effects, including a longer duration of breathy voice quality (SMD = - 0.51, 95% CI - 0.79 to - 0.22, I = 35%, P = 0.0005) and a higher occurrence of swallowing difficulties (RR = 0.46, 95% CI 0.35 to 0.11, I = 0%, P < 0.00001).
CONCLUSION
Bilateral botulinum toxin injections for ADSD showed a longer duration of vocal improvement, a longer breathy voice duration and a higher dysphagia occurrence and duration than unilateral injections.
Topics: Humans; Dysphonia; Botulinum Toxins, Type A; Injections; Drug-Related Side Effects and Adverse Reactions; Treatment Outcome; Laryngeal Muscles; Injections, Intramuscular; Voice Disorders
PubMed: 38095707
DOI: 10.1007/s00405-023-08366-2