Speech and language therapy for aphasia following subacute stroke

The aim of this study was to investigate the time window, duration and intensity of optimal speech and language therapy applied to aphasic patients with subacute stroke in our hospital. The study consisted of 33 patients being hospitalized for stroke rehabilitation in our hospital with first stroke but without previous history of speech and language therapy. Sixteen sessions of impairment-based speech and language therapy were applied to the patients, 30-60 minutes per day, 2 days a week, for 8 successive weeks. Aphasia assess- ment in stroke patients was performed with Giilhane Aphasia Test-2 before and after treatment. Compared with before treatment, fluency of speech, listening comprehension, reading comprehension, oral motor evaluation, automatic speech, repetition and naming were improved after treatment. This suggests that 16 seesions of speech and language therapy, 30-60 minutes per day, 2 days a week, for 8 successive weeks, are effective in the treatment of aphasic patients with subacute stroke.

Prevalence of IgA-antiendomysial antibody in a patient cohort with idiopathic low bone mineral density

AIM:To investigate the frequency of serum IgA-antiendomysial antibody positivity in patients with low bone mineral density and to assess the risk group for screening of celiac disease. METHODS:One hundred and thirty-five patients (14 male,121 female) with idiopathic low bone mineral density were evaluated. The median age was 57.2 years (24-81). Antiendomysial antibody was determined by the immunofluorescence method using a commercial kit (INOVA Diagnostics Inc.,CA,USA),which employs a 5 μm thin cryostat section of monkey esophagus as a substrate. RESULTS:Of the 135 patients evaluated,13 were found to have positive IgA antiendomysial antibody test (9.6%) response. None of the patients had IgA deficiency. Endoscopic appearance and histological examination were normal in all of these patients. Seropositive patients had significantly lower age (48.9 ± 4.3 vs 59.2 ± 6.2,P < 0.05),higher ratio of male gender (61.5% vs 4.9%,P < 0.01) and pre-menopausal status (8.7% vs 1.3%,P < 0.01). Lumbar spine and femoral neck z-scores,but not t-scores were significantly lower in seropositive patients. Seropositive patients had lower serum 25 (OH) vitamin D,calcium and higher serum parathormone levels than seronegative patients. CONCLUSION:The screening of celiac disease in idiopathic osteoporosis should be restricted to patients without classical risk factors (younger,pre-menopausal,male gender) for osteoporosis. Bone mineral density measurements using z-scores should be considered for identifying risk groups for celiac disease.

Pediatric dysphagia overview:best practice recommendation study by multidisciplinary experts

Background Currently,there is no comprehensive and multidisciplinary recommendation study covering all aspects of pediatric dysphagia(PD).This study aimed to generate PD management recommendations with methods that can be used in clinical practice to fill this gap in our country and in the world,from the perspective of experienced multidisciplinary experts.Methods This recommendation paper was generated by a multidisciplinary team,using the seven-step process and a three-round modified Delphi survey via e-mail.First,ten open-ended questions were created,and then detailed recommendations including management,diagnosis,treatment,and follow-up were created with the answers from these questions.Each recommendation item was voted on by the experts as overall consensus(strong recommendation),approaching consensus(weak recommendation)and divergent consensus(not recommended).Results In the 1st Delphi round,a questionnaire of 414 items was prepared based on the experts’responses to ten open-ended questions.In the 2nd Delphi round,59.2%of these items were accepted as pre-recommendation.In the 3rd Delphi round,62.6%of 246 items were accepted for inclusion in the proposals.The final version recommendations consisted of 154 items.Conclusions This study includes comprehensive and detailed answers for every problem that could be posed in clinical practice for the management of PD,and recommendations are for all pediatric patients with both oropharyngeal and esophageal dysphagia.