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Search Results: 1 - 10 of 7499 matches for " Deborah Salle Levy2 "
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Cryostimulation improves recovery from oropharyngeal dysphagia after stroke
Patrícia Zart1, ,, ,,Deborah Salle Levy2,Geovana de Paula Bolzan3,Renata Mancopes4
International Archives of Otorhinolaryngology , 2013,
Abstract: Introduction: Stroke is considered one of the most frequent neurological causes of oropharyngeal dysphagia. Aim: To determine the effect of cryostimulation on oropharyngeal sensitivity and, subsequently, on the swallowing reaction and premature escape of food in patients with neurogenic dysphagia after stroke. Methods: Clinical and experimental study. The study enrolled 7 adult subjects, 6 men and 1 woman ranging from 28 to 64 years of age, with a diagnosis of stroke and current oropharyngeal dysphagia without any other underlying disease. The selected subjects underwent speech-language pathology evaluation and videofluoroscopic assessment of the dysphagia. The subjects were then treated with cryostimulation consisting of 10 applications to each structure (anterior faucial pillar, posterior oropharyngeal wall, soft palate, and back tongue) 3 times a day (for a total of 30 daily applications per structure) for 4 consecutive days. The patients were then re-evaluated based on the same criteria. The pre- and post-cryostimulation results of the clinical and videofluoroscopic evaluations were analyzed descriptively and statistically using Student's t-test and Fisher's exact test. Results: Cryostimulation had beneficial effects on oropharyngeal sensitivity in 6 of the 7 subjects. There was also a significant improvement in swallowing and in the premature escape in six subjects. Conclusion: Cryostimulation increased sensitivity and subsequently improved the swallowing reaction and premature escape of food in patients with neurogenic dysphagia after stroke. These effects were evident by both speech-language pathology and videofluoroscopic evaluation.
Cryostimulation improves recovery from oropharyngeal dysphagia after stroke
Zart, Patrícia;Levy, Deborah Salle;Bolzan, Geovana de Paula;Mancopes, Renata;Silva, Ana Maria Toniolo da;
International Archives of Otorhinolaryngology , 2013, DOI: 10.7162/S1809-97772013000100006
Abstract: introduction: stroke is considered one of the most frequent neurological causes of oropharyngeal dysphagia. aim: to determine the effect of cryostimulation on oropharyngeal sensitivity and, subsequently, on the swallowing reaction and premature escape of food in patients with neurogenic dysphagia after stroke. methods: clinical and experimental study. the study enrolled 7 adult subjects, 6 men and 1 woman ranging from 28 to 64 years of age, with a diagnosis of stroke and current oropharyngeal dysphagia without any other underlying disease. the selected subjects underwent speech-language pathology evaluation and videofluoroscopic assessment of the dysphagia. the subjects were then treated with cryostimulation consisting of 10 applications to each structure (anterior faucial pillar, posterior oropharyngeal wall, soft palate, and back tongue) 3 times a day (for a total of 30 daily applications per structure) for 4 consecutive days. the patients were then re-evaluated based on the same criteria. the pre- and post-cryostimulation results of the clinical and videofluoroscopic evaluations were analyzed descriptively and statistically using student's t-test and fisher's exact test. results: cryostimulation had beneficial effects on oropharyngeal sensitivity in 6 of the 7 subjects. there was also a significant improvement in swallowing and in the premature escape in six subjects. conclusion: cryostimulation increased sensitivity and subsequently improved the swallowing reaction and premature escape of food in patients with neurogenic dysphagia after stroke. these effects were evident by both speech-language pathology and videofluoroscopic evaluation.
Nonsteroidal Anti-Inflammatory Drugs: A survey of practices and concerns of pediatric medical and surgical specialists and a summary of available safety data
Deborah M Levy, Lisa F Imundo
Pediatric Rheumatology , 2010, DOI: 10.1186/1546-0096-8-7
Abstract: A sample of 1289 pediatricians, pediatric rheumatologists, sports medicine physicians, pediatric surgeons and pediatric orthopedic surgeons in the United States and Canada were sent an email link to a 22-question web-based survey.338 surveys (28%) were completed, 84 were undeliverable. Of all respondents, 164 (50%) had never prescribed a selective cyclooxygenase-2 (COX-2) NSAID. The most common reasons for ever prescribing an NSAID were musculoskeletal pain, soft-tissue injury, fever, arthritis, fracture, and headache. Compared to traditional NSAIDs, selective COX-2 NSAIDs were believed to be as safe (42%) or safer (24%); have equal (52%) to greater efficacy (20%) for pain; have equal (59%) to greater efficacy (15%) for inflammation; and have equal (39%) to improved (44%) tolerability. Pediatric rheumatologists reported significantly more frequent abdominal pain (81% vs. 23%), epistaxis (13% vs. 2%), easy bruising (64% vs. 8%), headaches (21% vs. 1%) and fatigue (12% vs. 1%) for traditional NSAIDs than for selective COX-2 NSAIDs. Prescribing habits of NSAIDs have changed since the voluntary withdrawal of rofecoxib and valdecoxib; 3% of pediatric rheumatologists reported giving fewer traditional NSAID prescriptions, and while 57% reported giving fewer selective COX-2 NSAIDs, 26% reported that they no longer prescribed these medications.Traditional and selective COX-2 NSAIDs were perceived as safe by pediatric specialists. The data were compared to the published pediatric safety literature.Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for the symptomatic relief of pain and fever in children, and their anti-inflammatory effects are useful for juvenile arthritis and musculoskeletal (MSK) disorders. Traditional NSAIDs are non-selective cyclooxygenase (COX) inhibitors that inhibit both COX-1 and COX-2 enzymes. Inhibition of COX-1 dependent prostanoids disrupts cytoprotection of the stomach and platelet aggregation; therefore, blocking the COX-1 en
Comportamento motor oral e global de recém-nascidos de m es usuárias de crack e/ou cocaína Oral and general motor behavior of newborns from crack and/or cocaine using mothers
Marisa Gasparin,Josiele Larger Silveira,Letícia Wolff Garcez,Beatriz Salle Levy
Revista da Sociedade Brasileira de Fonoaudiologia , 2012, DOI: 10.1590/s1516-80342012000400016
Abstract: OBJETIVO: Analisar o comportamento motor oral e global de recém-nascidos de m es que fizeram uso de crack e/ou cocaína durante a gesta o e verificar se há rela o entre o desenvolvimento dos sistemas sensório motor oral (SSMO) e motor global. MéTODOS: Estudo transversal, em que foram avaliados 25 recém-nascidos prematuros e a termo de m es usuárias de crack e/ou cocaína, pareados com outro grupo de 25 recém-nascidos sem o fator em estudo. As avalia es do SSMO e motor global foram realizadas por meio do Instrumento de Avalia o da Prontid o do Prematuro para Início da Alimenta o Oral e do Test of Infant Motor Performance (TIMP), respectivamente. Os resultados compararam os escores encontrados nas duas escalas e a rela o destes com o uso materno do crack e/ou cocaína durante a gesta o. RESULTADOS: No TIMP n o foi constatada diferen a na compara o entre os escores de recém-nascidos de m es usuárias de crack e/ou cocaína e os de m es n o usuárias. No Instrumento de Avalia o da Prontid o do Prematuro para Início da Alimenta o Oral, os resultados apresentaram diferen a. Foi observada associa o entre os resultados de bebês que apresentaram atraso no TIMP com menor escore no Instrumento de Avalia o da Prontid o do Prematuro para Início da Alimenta o Oral. CONCLUS O: O baixo desempenho observado no Instrumento de Avalia o da Prontid o do Prematuro para Início da Alimenta o Oral sugere que as respostas motoras orais est o alteradas pelo uso materno das drogas. A correla o entre os dois instrumentos mostra que o desenvolvimento do SSMO pode estar relacionado ao desenvolvimento motor global. PURPOSE: analyzing the oral and general motor behavior of newborns from women who used crack and/or cocaine during pregnancy, and verifying if there is a relation between the development of the oral and general sensory motor system. METHODS: Cross-sectional study with 25 premature and full-term newborns from women who were crack and/or cocaine users were compared with another group composed of 25 newborns without the studied factor. The evaluations of the oral and general sensory motor system were carried out by the Instrument to Assess the Readiness of Preterm Infants for Oral Feeding and by the Test of Infant Motor Performance (TIMP). The results compared the scores obtained in both scales and their relation to the use of crack and/or cocaine during pregnancy. RESULTS: No significant difference was found by the TIMP when comparing the newborns from crack and/or cocaine-using mothers to the ones from non-using mothers. The results from the Instrument to Assess th
A STUDY ON CONDUCT OF TEAMS IN AN IT AND A BPO COMPANY
S. NIRMALA#1, S. DEBORAH SHARON *2
International Journal of Computer Trends and Technology , 2011,
Abstract: Teamwork is the ability to work together toward a common vision. And a leader is a person who guides and has the ability to direct individual accomplishments toward organizational objectives. It is the fuel that allows common people to attain uncommon results. With this in mind the role of a leader is indispensable in the team. This article deals with the conduct of leaders and team members in the aspect of People and Task Management Skills.
Using and interpreting cost-effectiveness acceptability curves: an example using data from a trial of management strategies for atrial fibrillation
Elisabeth Fenwick, Deborah A Marshall, Adrian R Levy, Graham Nichol
BMC Health Services Research , 2006, DOI: 10.1186/1472-6963-6-52
Abstract: A retrospective cost-effectiveness analysis of the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) randomized controlled trial with 4060 patients followed for 3.5 years. The target population was patients with atrial fibrillation who were 65 years of age or had other risk factors for stroke or death similar to those enrolled in AFFIRM. The intervention involved the management of patients with atrial fibrillation with antiarrhythmic drugs (rhythm-control) compared with drugs that control heart rate (rate-control). Measurements of mean survival, mean costs and incremental cost-effectiveness were made. The uncertainty surrounding the estimates of cost-effectiveness was illustrated through a cost-effectiveness acceptability curve.The base case point estimate for the difference in effects and costs between rate and rhythm-control is 0.08 years (95% CI: -0.1 years to 0.24 years) and -US$5,077 (95% CI: -$1,100 to -$11,006). The CEAC shows that the decision uncertainty surrounding the adoption of rate-control strategies is less than 1.7% regardless of the maximum acceptable ceiling ratio. Thus, there is very little uncertainty surrounding the decision to adopt rate-control compared to rhythm-control for patients with atrial fibrillation from a resource point of view.The CEAC is straightforward to calculate, construct and interpret. The CEAC is useful to a decision maker faced with the choice of whether or not to adopt a technology because it provides a measure of the decision uncertainty surrounding the choice.Health care decision-makers need to choose whether or not to reimburse health technologies, and cost-effectiveness is increasingly one of the criteria used to guide that choice. Estimates of cost-effectiveness are inevitably associated with some degree of uncertainty, generated jointly from the estimate of effectiveness and costs. In addition to the point estimate for cost-effectiveness, a confidence interval around the estimate provides the
Random pharmacokinetic profiles of EC-MPS in children with autoimmune disease
Guido Filler, Ajay Sharma, Deborah M Levy, Abeer Yasin
Pediatric Rheumatology , 2010, DOI: 10.1186/1546-0096-8-1
Abstract: We therefore performed a pilot study on 6 patients, who were treated with EC-MPS. All patients underwent 1-2 full 10-point pharmacokinetic (PK) profiles over a 12-hour dosing interval. We compared the results with that of 22 similar patients on MMF therapy.Median EC-MPS dose was 724 mg/m2 (range 179-933 mg/m2). The MPA Area-Under-The-(Time-Concentration)-Curves (AUCs) on MMF and EC-MPS were comparable (54.4 mg × h/L on MMF and 44.0 mg × h/L on EC-MPS, n.s., Mann Whitney). After correcting for bioequivalence, the dose-normalized AUCs were also similar on both the formulations. However, PK profiles on EC-MPS were quite random, and time to maximum concentration varied from 30 minutes to 720 minutes. The concentration at six-hour correlated best with the AUC. This was different from a homogenous PK-profile on MPA.EC-MPS has a different PK profile from MMF. The data suggest that patients on EC-MPS must undergo a complete PK profile to assess adequate exposure. The 6-hour concentration provides an estimate of the exposure and should be targeted between 3-4 mg/L.Mycophenolate mofetil (MMF) is an immunosuppressive drug that reversibly inhibits the inosin monophosphate dehydrogenase (IMPDH), thereby providing selective inhibition of the proliferation of B and T-cells as they require de-novo synthesis of purines [1]. MMF has become a valuable treatment option for adults and children with autoimmune diseases. A recent randomized controlled clinical trial suggests equal efficacy when compared to cyclophosphamide for the initial treatment of lupus nephritis [2]. There are few publications on the dosing of MMF. Based on pharmacokinetic studies in children with autoimmune disease, an initial dosing of MMF at 900 mg/m2 in two divided doses is recommended [3]. This dose is lower than that recommended for pediatric renal transplant recipients, where the starting dose should be between 1200 and 2400 mg/m2, depending on the concomitant calcineurin inhibitor. The reasons for different d
Quality of life in adolescents with recently diagnosed childhood-onset systemic lupus erythematosus
Tuck Sarah,Williams Tricia,Silverman Earl D,Levy Deborah M
Pediatric Rheumatology , 2012, DOI: 10.1186/1546-0096-10-s1-a19
Abstract:
Descriptive analysis of herpes zoster in childhood-onset systemic lupus erythematosus
Isgro Josephine,Levy Deborah M,LaRussa Philip,Imundo Lisa F
Pediatric Rheumatology , 2012, DOI: 10.1186/1546-0096-10-s1-a25
Abstract:
Prolonged Fever, Hepatosplenomegaly, and Pancytopenia in a 46-Year-Old Woman
Liran Levy ,Abedelmajeed Nasereddin,Moshe Rav-Acha,Meirav Kedmi,Deborah Rund,Moshe E. Gatt
PLOS Medicine , 2009, DOI: 10.1371/journal.pmed.1000053
Abstract:
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