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Schindler A, de Fátima Lago Alvite M, Robles-Rodriguez WG, Barcons N, Clavé P. History and Science behind the Eating Assessment Tool-10 (Eat-10): Lessons Learned. J Nutr Health Aging 2023; 27:597-606. [PMID: 37702330 DOI: 10.1007/s12603-023-1950-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 03/31/2023] [Indexed: 09/14/2023]
Abstract
INTRODUCTION Oropharyngeal dysphagia (OD) is an underdiagnosed medical condition with a high prevalence in populations such as patients with frailty, neurological disease, or head and neck pathology. Potential barriers to its diagnosis include lack of (or low) awareness of the existence and severity of the condition, the hidden nature of the condition within the 'normal ageing' process, clinical limitations, and socioeconomic reasons. Consequently, an effective treatment is not systematically offered in a timely manner, and complications, such as dehydration and respiratory infections or aspiration pneumonia, can arise. To overcome this issue, the early use of screening questionnaires to identify people at risk of swallowing disorders represents the cornerstone of preventive medicine. Several screening tools have been created but few are widely used in clinical practice. The Eating Assessment Tool-10 (EAT-10) was developed as a quick, easy-to-understand, and self-administered screening tool for OD. METHODS A literature review was conducted in five databases with no restrictions on the language, date of publication, or design of the study to identify aspects of the validation, applicability, and usefulness of EAT-10. RESULTS AND CONCLUSIONS Transcultural adaptation and translation studies, as well as studies involving various types of patients with dysphagia in different settings have shown the validity and reliability of EAT-10 in relation to the gold standard and other validation tools. The use of this standardised screening tool could be used as a primary screening instrument of dysphagia in routine clinical practice across a wide range of diseases and settings and thereby increase the likelihood of early diagnosis and management of a condition that lead to serious complications and impaired quality of life.
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Affiliation(s)
- A Schindler
- William Gildardo Robles-Rodriguez FUCS: Fundacion Universitaria de Ciencias de la Salud, Colombia,
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Evert K, Kocher T, Schindler A, Müller M, Müller K, Pink C, Holtfreter B, Schmidt A, Dombrowski F, Schubert A, von Woedtke T, Rupf S, Calvisi DF, Bekeschus S, Jablonowski L. Repeated exposure of the oral mucosa over 12 months with cold plasma is not carcinogenic in mice. Sci Rep 2021; 11:20672. [PMID: 34667240 PMCID: PMC8526716 DOI: 10.1038/s41598-021-99924-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 09/28/2021] [Indexed: 01/20/2023] Open
Abstract
Peri-implantitis may result in the loss of dental implants. Cold atmospheric pressure plasma (CAP) was suggested to promote re-osseointegration, decrease antimicrobial burden, and support wound healing. However, the long-term risk assessment of CAP treatment in the oral cavity has not been addressed. Treatment with two different CAP devices was compared against UV radiation, carcinogen administration, and untreated conditions over 12 months. Histological analysis of 406 animals revealed that repeated CAP exposure did not foster non-invasive lesions or squamous cell carcinoma (SCCs). Carcinogen administration promoted non-invasive lesions and SCCs. Molecular analysis by a qPCR screening of 144 transcripts revealed distinct inflammatory profiles associated with each treatment regimen. Interestingly, CAP treatment of carcinogen-challenged mucosa did not promote but instead left unchanged or reduced the proportion of non-invasive lesions and SCC formation. In conclusion, repeated CAP exposure of murine oral mucosa was well tolerated, and carcinogenic effects did not occur, motivating CAP applications in patients for dental and implant treatments in the future.
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Affiliation(s)
- K Evert
- Institute of Pathology, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - T Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - A Schindler
- Leibniz Institute of Surface Modification (IOM Leipzig), Leipzig, Germany.,Consultants PILOTO, Ion Beam & Plasma Surface Technologies, Grimma, Germany
| | - M Müller
- Institute of Pathology, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - K Müller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - C Pink
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - B Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - A Schmidt
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Greifswald, Germany
| | - F Dombrowski
- Institute of Pathology, University Medicine Greifswald, Greifswald, Germany
| | - A Schubert
- Department of Immunology, Fraunhofer Institute for Cell Therapy and Immunology (IZI), Leipzig, Germany
| | - T von Woedtke
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Greifswald, Germany.,Department of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
| | - S Rupf
- Clinic of Operative Dentistry, Saarland University, Homburg, Germany
| | - D F Calvisi
- Institute of Pathology, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - S Bekeschus
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Greifswald, Germany
| | - L Jablonowski
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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Geneid A, Nawka T, Schindler A, Oguz H, Chrobok V, Calcinoni O, am Zehnhoff-Dinnesen A, Neumann K, Farahat M, Abou-Elsaad T, Moerman M, Chavez E, Fishman J, Yazaki R, Arnold B, Frajkova Z, Graf S, Pflug C, Drsata J, Desuter G, Samuelsson C, Tedla M, Costello D, Sjögren E, Hess M, Kinnari T, Rubin J. Union of the European Phoniatricians' position statement on the exit strategy of phoniatric and laryngological services: staying safe and getting back to normal after the peak of coronavirus disease 2019 (issued on 25th May 2020). J Laryngol Otol 2020; 134:661-664. [PMID: 32613918 PMCID: PMC7399138 DOI: 10.1017/s002221512000122x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND The following position statement from the Union of the European Phoniatricians, updated on 25th May 2020 (superseding the previous statement issued on 21st April 2020), contains a series of recommendations for phoniatricians and ENT surgeons who provide and/or run voice, swallowing, speech and language, or paediatric audiology services. OBJECTIVES This material specifically aims to inform clinical practices in countries where clinics and operating theatres are reopening for elective work. It endeavours to present a current European view in relation to common procedures, many of which fall under the aegis of aerosol generating procedures. CONCLUSION As evidence continues to build, some of the recommended practices will undoubtedly evolve, but it is hoped that the updated position statement will offer clinicians precepts on safe clinical practice.
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Affiliation(s)
- A Geneid
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Finland
| | - T Nawka
- Department of Audiology and Phoniatrics, Charité – Universitätmedizin Berlin, Germany
| | - A Schindler
- ‘L Sacco’ Department of Biomedical and Clinical Sciences, University of Milan, Italy
| | - H Oguz
- Private practice, Ankara, Turkey
| | - V Chrobok
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Czech Republic
| | - O Calcinoni
- Voice and Music Professionals’ Care Team, Milan, Italy
| | - A am Zehnhoff-Dinnesen
- Clinic of Phoniatrics and Pedaudiology, University Hospital Münster, Westphalian Wilhelm University, Germany
| | - K Neumann
- Clinic of Phoniatrics and Pedaudiology, University Hospital Münster, Westphalian Wilhelm University, Germany
| | - M Farahat
- Department of Otolaryngology, Research Chair of Voice, Swallowing, and Communication Disorders, Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - T Abou-Elsaad
- Phoniatric Unit, ORL Department, Faculty of Medicine, Mansoura University, Egypt
| | - M Moerman
- Private practice, Sint-Martens-Latem, Belgium
| | - E Chavez
- Centro de Foniatría y Audiología, Mexico City, Mexico
| | - J Fishman
- Royal National Throat, Nose and Ear Hospital, University College London Hospitals NHS Foundation Trust, UK
| | - R Yazaki
- Artistic Voice Institute, Oswaldo Cruz German Hospital, São Paulo, Brazil
| | - B Arnold
- Private practice, Munich, Germany
| | - Z Frajkova
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital and Comenius University Bratislava, Slovakia
| | - S Graf
- Otorhinolaryngology/ Phoniatrics, Klinikum rechts der Isar, Technical University Munich, Germany
| | - C Pflug
- Department of Voice, Speech and Hearing Disorders, Center for Clinical Neurosciences, University Medical Center Hamburg-Eppendorf, Germany
| | - J Drsata
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Czech Republic
| | - G Desuter
- Voice and Swallowing Clinic, ENT Head and Neck Surgery Department, Cliniques Universitaires Saint-Luc, Louvain, Brussels, Belgium
| | - C Samuelsson
- Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication, Linköping University, Sweden
| | - M Tedla
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital and Comenius University Bratislava, Slovakia
| | - D Costello
- Department of ENT, Wexham Park Hospital, Slough, UK
| | - E Sjögren
- Department of Otorhinolaryngology Head and Neck Surgery, Leiden University Medical Center, The Netherlands
| | - M Hess
- Deutsche Stimmklinik, Hamburg, Germany
| | - T Kinnari
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Finland
| | - J Rubin
- Royal National ENT and Eastman Dental Hospitals Division, University College London Hospital NHS Trust, UK
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Abstract
Our goal was determine the effects of dydrogesterone supplementation to reduce the incidence of preeclampsia (PE) in early pregnancy (from 6 to 20 weeks of gestation). A total of 406 pregnant women were involved into the study. The Study group enrolled 169 women, supplemented with dydrogesterone at a dose of 30 mg/d 6-20 weeks of gestation compared with the control group (237 subjects) - without dydrogesterone supplementation. The women were randomized by age, race, obstetrics complications, and their somatic history. The use of dydrogesterone in early pregnancy - before 20 weeks of gestation (at a dose of 30 mg/d) with high-risk factors of PE contributed to a statistically significant reduction in the frequency of this complication (13.1% and 71.4%, p < .001). It was seen, that women who took dydrogesterone developed significantly less such disorders like hypertension (3.2% and 71.2%, p < .001), proteinuria (0.0% and 66.18%, p < .001), fetal growth retardation syndrome (2.2% and 21.58%, p < .001), destroy of uteri-placenta velocity (3.2% and 21.58%, p < .001), preterm labor (8.6% and 53.95%, p < .001). Dydrogesterone supplementation in the first and second period of pregnancy (from 6 to 20 weeks of gestation) significantly reduced the incidence of PE in women with higher risk pregnancy.
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Affiliation(s)
- V Tskhay
- Perinatology, Obstetrics and Gynecology Department, Krasnoyarsk State Medical University named after Voino-Yasenetsky, Krasnoyarsk, Russia
| | - A Schindler
- Perinatology, Obstetrics and Gynecology Department, Krasnoyarsk State Medical University named after Voino-Yasenetsky, Krasnoyarsk, Russia
- Institute for Medical Research and Education, Essen, Germany
| | - M Shestakova
- Perinatology, Obstetrics and Gynecology Department, Krasnoyarsk State Medical University named after Voino-Yasenetsky, Krasnoyarsk, Russia
| | - O Klimova
- Perinatology, Obstetrics and Gynecology Department, Krasnoyarsk State Medical University named after Voino-Yasenetsky, Krasnoyarsk, Russia
| | - А Narkevich
- Perinatology, Obstetrics and Gynecology Department, Krasnoyarsk State Medical University named after Voino-Yasenetsky, Krasnoyarsk, Russia
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Schindler A, Meabon J, Baskin B, Cooper E, Yagi M, Simon B, Peskind E, Phillips P, Cook D. Non-invasive vagus nerve stimulation for the prevention/treatment of comorbid mild traumatic brain injury and PTSD. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Ricci Maccarini A, Stacchini M, Mozzanica F, Schindler A, Basile E, DE Rossi G, Woo P, Remacle M, Magnani M. Efficacy of trans-nasal fiberendoscopic injection laryngoplasty with centrifuged autologous fat in the treatment of glottic insufficiency due to unilateral vocal fold paralysis. ACTA ACUST UNITED AC 2019; 38:204-213. [PMID: 29984796 DOI: 10.14639/0392-100x-2012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 01/11/2018] [Indexed: 11/23/2022]
Abstract
SUMMARY The objective of this work is to evaluate the safety, feasibility and efficacy of trans-nasal fiberendoscopic injection laryngoplasty (IL) with centrifuged autologous fat, performed under local anaesthesia, in the treatment of glottic insufficiency due to unilateral vocal fold paralysis (UVFP). It is a within-subject study with follow-up 1 week after phonosurgery and after 6 months. A total of 22 patients with chronic dysphonia caused by glottic insufficiency due to UVFP were enrolled. Each patient underwent trans-nasal IL with centrifuged autologous fat through flexible operative endoscope under local anaesthesia and was evaluated before and twice (1 week and 6 months) after phonosurgery, using a multidimensional set of investigations. The assessment protocol included videolaryngostroboscopy, perceptual evaluation of dysphonia, maximum phonation time and patient's self-assessment on voice-related quality of life (QOL) with the Voice Handicap Index-10 and the comparative self-assessment on vocal fatigue and voice quality pre-post treatment. Trans-nasal IL with centrifuged autologous fat was performed in all 22 patients and there were no complications in any case. Significant improvements in videolaryngostroboscopic findings, perceptual evaluation of dysphonia, maximum phonation time and QoL self-assessment were reported after 1 week and were maintained at 6 months. In one patient, the result after 6 months was not satisfactory and this patient then underwent a medialization laryngoplasty (thyroplasty type I) with satisfactory long-term results. In conclusion, trans-nasal fiberendoscopic IL with centrifuged autologous fat seems to be a safe, feasible and efficacious phonosurgical procedure for treatment of glottic insufficiency due to unilateral vocal fold paralysis.
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Affiliation(s)
| | - M Stacchini
- ENT Department, M. Bufalini Hospital, Cesena, Italy
| | - F Mozzanica
- Department of Biomedical and Clinical Sciences, L. Sacco Hospital, University of Milan, Milan, Italy
| | - A Schindler
- Department of Biomedical and Clinical Sciences, L. Sacco Hospital, University of Milan, Milan, Italy
| | - E Basile
- ENT Clinic, University of Messina, Messina, Italy
| | - G DE Rossi
- Medical Center of Phoniatrics and Phonosurgery, Padua, Italy
| | - P Woo
- Clinical Professor, Department Of Otolaryngology Head and Neck Surgery, Icahn School of Medicine, New York, USA
| | - M Remacle
- Department of Otorhinolaryngology Head and Neck Surgery, Centre Hospitalier Luxemburg, Luxemburg
| | - M Magnani
- ENT Department, M. Bufalini Hospital, Cesena, Italy
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7
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Salmen T, Ermakova T, Schindler A, Ko SR, Göktas Ö, Gross M, Nawka T, Caffier PP. Efficacy of microsurgery in Reinke's oedema evaluated by traditional voice assessment integrated with the Vocal Extent Measure (VEM). ACTA ACUST UNITED AC 2019; 38:194-203. [PMID: 29984795 DOI: 10.14639/0392-100x-1544] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 07/26/2017] [Indexed: 12/15/2022]
Abstract
SUMMARY There are few data analysing to what specific extent phonomicrosurgery improves vocal function in patients suffering from Reinke's oedema (RE). The recently introduced parameter vocal extent measure (VEM) seems to be suitable to objectively quantify vocal performance. The purpose of this clinical prospective study was to investigate the outcomes of phonomicrosurgery in 60 RE patients (6 male, 54 female; 56 ± 8 years ([mean ± SD]) by analysing its effect on subjective and objective vocal parameters with particular regard to VEM. Treatment efficacy was evaluated at three months after surgery by comparing pre- and postoperative videolaryngostroboscopy (VLS), auditory-perceptual assessment (RBH-status), voice range profile (VRP), acoustic-aerodynamic analysis and patient's self-assessment using the voice handicap index (VHI-9i). Phonomicrosurgically, all RE were carefully ablated. VLS revealed removal or substantial reduction of oedema with restored periodic vocal fold vibration. All subjective and most objective acoustic and aerodynamic parameters significantly improved. The VEM increased on average from 64 ± 37 to 88 ± 25 (p #x003C; 0.001) and the dysphonia severity index (DSI) from 0.5 ± 3.4 to 2.9 ± 1.9. Both parameters correlated significantly with each other (rs = 0.70). RBH-status revealed less roughness, breathiness and overall grade of hoarseness (2.0 ± 0.7 vs 1.3 ± 0.7). The VHI-9i-score decreased from 18 ± 8 to 12 ± 9 points. The average total vocal range enlarged by 4 ± 7 semitones, and the mean speaking pitch rose by 2 ± 4 semitones. These results confirm that: (1) the use of VEM in RE patients objectifies and quantifies their vocal capacity as documented in the VRP, and (2) phonomicrosurgery is an effective, objectively and subjectively satisfactory therapy to improve voice in RE patients.
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Affiliation(s)
- T Salmen
- Department of Audiology and Phoniatrics of Charité, University Medicine Berlin, Berlin, Germany
| | - T Ermakova
- Department of Business Informatics, Social Media and Data Science, University of Potsdam, Potsdam, Germany
| | - A Schindler
- Phoniatric Unit, Department of Biomedical and Clinical Sciences "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - S-R Ko
- Department of Audiology and Phoniatrics of Charité, University Medicine Berlin, Berlin, Germany
| | - Ö Göktas
- Department of Audiology and Phoniatrics of Charité, University Medicine Berlin, Berlin, Germany
| | - M Gross
- Department of Audiology and Phoniatrics of Charité, University Medicine Berlin, Berlin, Germany
| | - T Nawka
- Department of Audiology and Phoniatrics of Charité, University Medicine Berlin, Berlin, Germany
| | - P P Caffier
- Department of Audiology and Phoniatrics of Charité, University Medicine Berlin, Berlin, Germany
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Preti A, Mozzanica F, Gera R, Gallo S, Zocchi J, Bandi F, Guidugli G, Ambrogi F, Yakirevitch A, Schindler A, Dragonetti A, Castelnuovo P, Ottaviani F. Horizontal lateral lamella as a risk factor for iatrogenic cerebrospinal fluid leak. Clinical retrospective evaluation of 24 cases. Rhinology 2019. [PMID: 29785412 DOI: 10.4193/rhin18.103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Several authors highlighted the limitations of the Keros classification system in predicting intracranial entry risk. Recently, our group proposed a new classification system based on the angle formed between the lateral lamella of the cribriform plate (LLCP) and the continuation of an horizontal plane passing through the cribriform plate (Gera classification). The aim of this study was to analyze whether the risk of iatrogenic cerebrospinal fluid leak (CSF-L) was better predicted by Keros or Gera classification. METHODOLOGY The pre-operative CT scans of 24 patients (CSF-L group) who suffered from iatrogenic CSF-L during endoscopic sinus surgery (ESS) were compared to those obtained from a group of 100 patients who underwent uneventful ESS (control group). The skull base measurements as well as the distribution of Keros and Gera classes in the 2 groups were analyzed. RESULTS No difference in the distribution of Keros classes or in the depth of the cribriform plate between CSF-L and control group were demonstrated. On the contrary, significant differences in the distribution of Gera classes and in the degree of the angle formed by the LLCP and the continuation of the horizontal plane passing through the cribriform plate were found. In particular, according to Gera classification system, 19 out of 24 patients in the CSF-L group were considered at risk for iatrogenic CSF-L. CONCLUSIONS Gera classification system might be more sensitive to anatomical variations associated with CSF-L than the Keros one, further suggesting the application of the former during the preoperative CT scan evaluation.
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Affiliation(s)
- A Preti
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - F Mozzanica
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - R Gera
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - S Gallo
- Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - J Zocchi
- Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - F Bandi
- Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - G Guidugli
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - F Ambrogi
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - A Yakirevitch
- Department of Otorhinolaryngology - Head and Neck Surgery, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Israel
| | - A Schindler
- Department of Biochemical and Clinical science Luigi Sacco, University of Milan, Milan, Italy
| | - A Dragonetti
- Department of Otolaryngology, Ospedale Niguarda, Milan, Italy
| | - P Castelnuovo
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - F Ottaviani
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
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Preti A, Mozzanica F, Gera R, Gallo S, Zocchi J, Bandi F, Guidugli G, Ambrogi F, Yakirevitch A, Schindler A, Dragonetti A, Castelnuovo P, Ottaviani F. Horizontal lateral lamella as a risk factor for iatrogenic cerebrospinal fluid leak. Clinical retrospective evaluation of 24 cases. Rhinology 2018; 56:358-363. [PMID: 29785412 DOI: 10.4193/rhin.18.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Several authors highlighted the limitations of the Keros classification system in predicting intracranial entry risk. Recently, our group proposed a new classification system based on the angle formed between the lateral lamella of the cribriform plate (LLCP) and the continuation of an horizontal plane passing through the cribriform plate (Gera classification). The aim of this study was to analyze whether the risk of iatrogenic cerebrospinal fluid leak (CSF-L) was better predicted by Keros or Gera classification. METHODOLOGY The pre-operative CT scans of 24 patients (CSF-L group) who suffered from iatrogenic CSF-L during endoscopic sinus surgery (ESS) were compared to those obtained from a group of 100 patients who underwent uneventful ESS (control group). The skull base measurements as well as the distribution of Keros and Gera classes in the 2 groups were analyzed. RESULTS No difference in the distribution of Keros classes or in the depth of the cribriform plate between CSF-L and control group were demonstrated. On the contrary, significant differences in the distribution of Gera classes and in the degree of the angle formed by the LLCP and the continuation of the horizontal plane passing through the cribriform plate were found. In particular, according to Gera classification system, 19 out of 24 patients in the CSF-L group were considered at risk for iatrogenic CSF-L. CONCLUSIONS Gera classification system might be more sensitive to anatomical variations associated with CSF-L than the Keros one, further suggesting the application of the former during the preoperative CT scan evaluation.
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Affiliation(s)
- A Preti
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - F Mozzanica
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - R Gera
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - S Gallo
- Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - J Zocchi
- Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - F Bandi
- Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - G Guidugli
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - F Ambrogi
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - A Yakirevitch
- Department of Otorhinolaryngology - Head and Neck Surgery, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Israel
| | - A Schindler
- Department of Biochemical and Clinical science Luigi Sacco, University of Milan, Milan, Italy
| | - A Dragonetti
- Department of Otolaryngology, Ospedale Niguarda, Milan, Italy
| | - P Castelnuovo
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - F Ottaviani
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
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Gera R, Mozzanica F, Karligkiotis A, Preti A, Bandi F, Gallo S, Schindler A, Bulgheroni C, Ottaviani F, Castelnuovo P. Lateral lamella of the cribriform plate, a keystone landmark: proposal for a novel classification system. Rhinology 2018; 56:65-72. [DOI: 10.4193/rhin17.067] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Mozzanica F, Scarponi L, Pedrali S, Pizzorni N, Pinotti C, Foieni F, Zuccotti G, Schindler A. Dysphagia screening in subacute care settings using the Italian version of the Royal Brisbane and Women's Hospital (I-RBWH) dysphagia screening tool. Acta Otorhinolaryngol Ital 2017; 37:25-31. [PMID: 28374867 PMCID: PMC5384306 DOI: 10.14639/0392-100x-1057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 09/21/2016] [Indexed: 11/23/2022]
Abstract
The large majority of the available dysphagia screening tools has been developed for the stroke population. Only few screening tools are suitable for heterogeneous groups of patients admitted to a subacute care unit. The Royal Brisbane and Women's Hospital (RBWH) dysphagia screening tool is a nurse-administered, evidence-based swallow screening tool for generic acute hospital use that demonstrates excellent sensitivity and specificity. No Italian version of this tool is available to date. The aim of this study was to determine the reliability and screening accuracy of the Italian version of the RBWH (I-RBWH) dysphagia screening tool. A total of 105 patients consecutively admitted to a subacute care unit were enrolled. Using the I-RBWH tool, each patient was evaluated twice by trained nurses and once by a speech and language pathologist (SLP) blind to nurses' scores. The SLP also performed standardised clinical assessment of swallowing using the Mann assessment of swallowing ability (MASA). During the first and the second administration of the I-RBWH by nurses, 28 and 27 patients, respectively, were considered at risk of dysphagia, and 27 were considered at risk after SLP assessment. Intra- and inter-rater reliability was satisfactory. Comparison between nurse I-RBWH scores and MASA examination demonstrated a sensitivity and specificity of the I-RBWH dysphagia screening tool up to 93% and 96%, respectively; the positive and negative predictive values were 90% and 97%, respectively. Thus, the current findings support the reliability and accuracy of the I-RBWH tool for dysphagia screening of patients in subacute settings. Its application in clinical practice is recommended.
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Affiliation(s)
- F Mozzanica
- Phoniatric Unit, Department of Biomedical and Clinical Science, L. Sacco Hospital University of Milan, Milan, Italy
| | - L Scarponi
- Phoniatric Unit, Department of Biomedical and Clinical Science, L. Sacco Hospital University of Milan, Milan, Italy
| | - S Pedrali
- Phoniatric Unit, Department of Biomedical and Clinical Science, L. Sacco Hospital University of Milan, Milan, Italy
| | - N Pizzorni
- Department of Rehabilitation Medicine, Casa di Cura Privata del Policlinico, Milan, Italy
| | - C Pinotti
- SubAcute Care Unit, L. Sacco Hospital, Milan, Italy
| | - F Foieni
- SubAcute Care Unit, L. Sacco Hospital, Milan, Italy
| | - G Zuccotti
- Pediatric Unit, Department of Biomedical and Clinical Science, Buzzi Hospital University of Milan, Milan, Italy
| | - A Schindler
- Phoniatric Unit, Department of Biomedical and Clinical Science, L. Sacco Hospital University of Milan, Milan, Italy
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Schindler A, Schinner R, Altaf N, Kooi M, Moody A, Poppert H, Reiser M, Auer D, Saam T. Der Einfluss von in der MRT-detektierten, eingebluteten Karotisplaques auf das erstmalige oder wiederholte Auftreten zerebrovaskulärer Ereignisse: eine Individuen-basierte Metaanalyse (Big Data). ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- A Schindler
- Klinikum der LMU München, Institut für klinische Radiologie, München
| | - R Schinner
- Klinikum der LMU München, Institut für klinische Radiologie, München
| | - N Altaf
- The University of Nottingham, Radiological Sciences, Nottingham
| | - M Kooi
- Maastricht University, Department of Radiology, Maastricht
| | - A Moody
- University of Toronto, Department of medical imaging, Toronto
| | - H Poppert
- TU München, Neurologische Klinik, München
| | - M Reiser
- Klinikum der LMU München, Institut für klinische Radiologie, München
| | - D Auer
- The University of Nottingham, Radiological Sciences, Nottingham
| | - T Saam
- Klinikum der LMU München, Institut für klinische Radiologie, München
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Cordier R, Joosten A, Clavé P, Schindler A, Bülow M, Demir N, Arslan SS, Speyer R. Evaluating the Psychometric Properties of the Eating Assessment Tool (EAT-10) Using Rasch Analysis. Dysphagia 2016. [PMID: 27873090 DOI: 10.1007/s00455-016-9754-2.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
Early and reliable screening for oropharyngeal dysphagia (OD) symptoms in at-risk populations is important and a crucial first stage in effective OD management. The Eating Assessment Tool (EAT-10) is a commonly utilized screening and outcome measure. To date, studies using classic test theory methodologies report good psychometric properties, but the EAT-10 has not been evaluated using item response theory (e.g., Rasch analysis). The aim of this multisite study was to evaluate the internal consistency and structural validity and conduct a preliminary investigation of the cross-cultural validity of the EAT-10; floor and ceiling effects were also checked. Participants involved 636 patients deemed at risk of OD, from outpatient clinics in Spain, Turkey, Sweden, and Italy. The EAT-10 and videofluoroscopic and/or fiberoptic endoscopic evaluation of swallowing were used to confirm OD diagnosis. Patients with esophageal dysphagia were excluded to ensure a homogenous sample. Rasch analysis was used to investigate person and item fit statistics, response scale, dimensionality of the scale, differential item functioning (DIF), and floor and ceiling effect. The results indicate that the EAT-10 has significant weaknesses in structural validity and internal consistency. There are both item redundancy and lack of easy and difficult items. The thresholds of the rating scale categories were disordered and gender, confirmed OD, and language, and comorbid diagnosis showed DIF on a number of items. DIF analysis of language showed preliminary evidence of problems with cross-cultural validation, and the measure showed a clear floor effect. The authors recommend redevelopment of the EAT-10 using Rasch analysis.
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Affiliation(s)
- R Cordier
- School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia. .,College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia.
| | - A Joosten
- School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia
| | - P Clavé
- Unitat d'Exploracions Funcionals Digestives, Department of Surgery, Hospital de Mataró, Universitat Autònoma de Barcelona, Mataró, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Barcelona, Spain
| | - A Schindler
- Phoniatric Unit, Department of Biomedical and Clinical Sciences "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - M Bülow
- Diagnostic Centre of Imaging and Functional Medicine, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden.,Skane University Hospital Malmö, Malmö, Sweden
| | - N Demir
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - S Serel Arslan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - R Speyer
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia.,Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
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Mozzanica F, Salvadorini R, Sai E, Pozzoli R, Maruzzi P, Scarponi L, Barillari MR, Spada E, Ambrogi F, Schindler A. Reliability, validity and normative data of the Italian version of the Bus Story test. Int J Pediatr Otorhinolaryngol 2016; 89:17-24. [PMID: 27619022 DOI: 10.1016/j.ijporl.2016.07.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 07/17/2016] [Accepted: 07/21/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Evaluation of the reliability and the validity of the Italian version of the Bus Story Test (I-BST), providing normative data in Italian children. METHODS A total of 552 normally developing children (278 males and 274 females) aged 3; 6 to 9; 0 years, were enrolled. Test-retest, intra- and inter-rater reliability were analysed on a sample of respectively 145, 178 and 178 children. Normative data were gathered from all the enrolled children and estimate centiles according to the CG-LMS method provided. The children were divided into 11 age classes of six months each; percentile scores and standard error measurement were analysed in children from age class 4; 0-4; 5 years to age class 8; 6-811 years. Age effects on I-BST were analysed. RESULTS Results showed high test-retest, intra- and inter-rater reliability scores. A significant age effect on I-BST scores emerged from the ANOVA test analysis; in particular, as age increases, so do I-BST scores. CONCLUSION The I-BST is a reliable and valid tool. The availability of normative data for Italian speaking children may help clinicians during clinical assessment.
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Affiliation(s)
- F Mozzanica
- Department of Biochemical and Clinical Science "Luigi Sacco", University of Milan, Milan, Italy.
| | | | | | - R Pozzoli
- IRCCS Medea La Nostra Famiglia, Bosisio Parini, Italy
| | - P Maruzzi
- Department of Biochemical and Clinical Science "Luigi Sacco", University of Milan, Milan, Italy
| | - L Scarponi
- Department of Biochemical and Clinical Science "Luigi Sacco", University of Milan, Milan, Italy
| | - M R Barillari
- Phoniatric Department, University of Naples, Naples, Italy
| | - E Spada
- Clinical Sciences and Community Department, University of Milan, Milan, Italy
| | - F Ambrogi
- Clinical Sciences and Community Department, University of Milan, Milan, Italy
| | - A Schindler
- Department of Biochemical and Clinical Science "Luigi Sacco", University of Milan, Milan, Italy
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Raimondi E, Zardoni M, Bruno S, Nascimbene C, Pasanisi M, Morandi L, Gianelli F, Colombo M, Schindler A, Mariani C, Osio M. 37. Dysphagia in Myotonic Dystrophy type 1: Preliminary results of an integrated neurophysiological and swallowing protocol. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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16
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Ottaviani F, Iacona E, Sykopetrites V, Schindler A, Mozzanica F. Cross-cultural adaptation and validation of the Nijmegen Cochlear Implant Questionnaire into Italian. Eur Arch Otorhinolaryngol 2015; 273:2001-7. [PMID: 26324881 DOI: 10.1007/s00405-015-3765-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 08/21/2015] [Indexed: 10/23/2022]
Abstract
The NCIQ is a quantifiable self-assessment health-related quality of life instrument specific for cochlear implant users. The aim of this study was to culturally adapt the NCIQ into Italian (I-NCIQ). A prospective instrument validation study was conducted. Cross-cultural adaptation and validation were accomplished. Cronbach α was used to test internal consistency in 51 CI users and in a control group composed by 38 post-lingual deaf adult on a waiting list for a CI. ICC test was used for test-retest reliability analysis. Kruskal-Wallis test with Mann-Whitney post hoc were used to compare the I-NCIQ scores in CI users before and after the cochlear implantation and in control patients. I-NCIQ scores obtained in CI users were compared with the results of Italian version of disyllabic testing without lip-reading and without masking. Good internal consistency and good test-retest reliability were found. I-NCIQ scores obtained in the 51 CI users after implantation were consistently higher than those obtained before implantation and in the control group. Moreover, no differences were found in the results of I-NCIQ obtained in the group of 51 CI users before implantation and in the group of control patients on post hoc Mann-Whitney analysis. Positive correlations between I-NCIQ scores and the results of disyllabic testing without lip-reading and without masking were found. The I-NCIQ is a reliable, valid, self-administered questionnaire for the measurement of QOL in CI users; its application is recommended.
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Affiliation(s)
- F Ottaviani
- Department of Clinical Sciences and Community Health, San Giuseppe Hospital, Università degli Studi di Milano, Milan, Italy
| | - E Iacona
- Department of Clinical Sciences and Community Health, San Giuseppe Hospital, Università degli Studi di Milano, Milan, Italy
| | - V Sykopetrites
- Department of Clinical Sciences and Community Health, San Giuseppe Hospital, Università degli Studi di Milano, Milan, Italy
| | - A Schindler
- Department of Biomedical and Clinical Sciences, L. Sacco Hospital, Università degli Studi di Milano, Milan, Italy
| | - F Mozzanica
- Department of Clinical Sciences and Community Health, San Giuseppe Hospital, Università degli Studi di Milano, Milan, Italy.
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Bruells CS, Schindler A, Marx G. [The role of colloids in intensive care medicine. Evidence instead of emotions]. Med Klin Intensivmed Notfmed 2015; 110:133-7. [PMID: 25764132 DOI: 10.1007/s00063-015-0005-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 02/19/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Besides albumin, which is gained from human donors, synthetic colloids have been playing a dominant role in treating patients in shock and are standard therapy in intensive care units (ICU). Since the publication of large randomized controlled trials indicating negative effects on renal function, their use has been questioned, especially for hydroxyethyl starch products. The preliminary assumption that these side effects are only existent in first or secondary generation starch fluids was proven incorrect. In fact, the use of hydroxyethyl starch products in critically ill patients is prohibited by the European Medicines Agency. CURRENT DISCUSSION AND INDICATIONS Several methodological limitations exist in each of these trials that limit the evidence value of these investigations, although they served as the basis for the negative judgment of the European Medicines Agency. In addition, a large randomized controlled trial on the efficacy of gelatin is lacking. The use of colloids in ICU patients is indicated in cases where crystalloid volume therapy is inadequate. CONCLUSION Especially during the first 6 h of sepsis, when aggressive volume therapy is decisive for patient outcome, colloids may be relevant to increase patient survival. The latest guideline on treatment with colloids has been published in the German S3 guideline "Intravascular volume therapy in adults."
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Affiliation(s)
- C S Bruells
- Klinik für operative Intensivmedizin und Intermediate Care, Universitätsklinik der RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland,
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Hu Y, Donkervoot S, Stojkovic T, Voermans N, Foley A, Leach M, Dastgir J, Bolduc V, Cullup T, Becdelièvre A, Yang L, Su H, Meilleur K, Schindler A, Kamsteeg E, Richard P, Butterfield R, Winder T, Crawford T, Weiss R, Muntoni F, Allamand V, Bönnemann C. G.P.214. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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19
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Goodman BL, Schindler A, Washington M, Bogie KM, Ho CH. Factors in rehospitalisation for severe pressure ulcer care in spinal cord injury/disorders. J Wound Care 2014; 23:165-6, 168, 170-2 passim. [PMID: 24762380 DOI: 10.12968/jowc.2014.23.4.165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Repeated hospital admissions (RHA) for ongoing pressure ulcer (PU) care remains a significant challenge in the clinical management of the spinal cord injury/disorders (SCI/D) population. The current study investigated the significance of risk factors for PU treatment and RHA. METHOD A retrospective chart review of veterans admitted to the Louis Stokes Cleveland Department of Veterans Affairs Medical Center (LSCDVAMC) Spinal Cord Injury (SCI) unit for Category III or IV PUs was carried out. A random sample of 105 individuals with SCI/D, evaluated by the Wound Care Team (WCT) from 2006 to 2009 was assessed. Multiple PU development risk factors were extracted from the electronic health record system using standardised data collection forms and entered into the Spinal Cord Injury Pressure Ulcer Database (SCIPUD). Potential associations with RHA were analysed. RESULTS Twenty variables were initially identified as potentially related to PU development. Descriptive statistics and statistically significant associations between risk factors and RHA were determined. Demographic factors showed no significant association with RHA. Duration of injury, power wheelchair use and sub-optimally managed spasticity (SMS) were significantly associated with higher RHA. Sub-optimally managed neurogenic bowel (SMNB) at admission was significantly associated with reduced RHA. CONCLUSION Factors previously found to be predictive of initial PU development may not, in fact, be predictive of RHA. Some protective trends were observed, such as polypharmacy and marital status, but these did not reach statistical significance in this preliminary study of admission characteristics, warranting further research. DECLARATION OF INTEREST There were no external sources of funding for this study. The authors have no conflicts of interests to declare.
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Affiliation(s)
- B L Goodman
- MPH, Louis Stokes Cleveland Department of Veterans Affairs Medical Center (LSCDVAMC), Cleveland, Ohio, US. Department of Epidemiology & Biostatistics, Case Western Reserve University, Cleveland, Ohio, US
| | - A Schindler
- BA, The Ohio College of Podiatric Medicine, Cleveland, Ohio, US
| | - M Washington
- RN, MS, Louis Stokes Cleveland Department of Veterans Affairs Medical Center (LSCDVAMC), Cleveland, Ohio, US
| | - K M Bogie
- PhD, Louis Stokes Cleveland Department of Veterans Affairs Medical Center (LSCDVAMC), Cleveland, Ohio, US. Department of Orthopaedics, Case Western Reserve University, Cleveland, Ohio, US
| | - C H Ho
- MD, Louis Stokes Cleveland Department of Veterans Affairs Medical Center (LSCDVAMC), Cleveland, Ohio, US. Division of Physical Medicine & Rehabilitation, University of Calgary, Calgary, Canada
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Saam T, Eberhardt K, Buchholz M, Schindler A, Bayer-Karpinska A, Dichgans M, Reiser M, Nikolaou K, Trelles M. Evaluation der Karotis-CTA als Screening Methode für die Detektion komplizierter American Heart Association Typ VI Plaques. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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21
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Mozzanica F, Ginocchio D, Borghi E, Bachmann C, Schindler A. Reliability and Validity of the Italian Version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V). Folia Phoniatr Logop 2014; 65:257-65. [DOI: 10.1159/000356479] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Schindler A, Guazzarotti L, Mameli C, Urbani E, Mozzanica F, Guerrini L, Zuccotti GV. Vomer aplasia in a patient carrying a de novo mutation of the TP63 gene (3q27). Int J Pediatr Otorhinolaryngol 2013; 77:1606-8. [PMID: 23906991 DOI: 10.1016/j.ijporl.2013.06.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 06/26/2013] [Accepted: 06/30/2013] [Indexed: 10/26/2022]
Abstract
The congenital vomer defect (CVD) is a rare and still partially unknown condition. Only few cases have been reported in the international literature and the large majority of them appeared to be isolated. We report a case of CVD detected in a 7-year-old girl affected by ectodermal dysplasia clefting syndrome caused by a mutation of the TP63 gene.
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Affiliation(s)
- A Schindler
- Phoniatric Unit, Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Milan, Italy
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Trelles M, Eberhardt KM, Buchholz M, Schindler A, Bayer-Karpinska A, Dichgans M, Reiser MF, Nikolaou K, Saam T. CTA for screening of complicated atherosclerotic carotid plaque--American Heart Association type VI lesions as defined by MRI. AJNR Am J Neuroradiol 2013; 34:2331-7. [PMID: 23868157 DOI: 10.3174/ajnr.a3607] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE High-resolution carotid MR imaging can accurately identify complicated American Heart Association lesion type VI plaques, which are characterized by thrombus, hemorrhage, or a ruptured fibrous cap. The purpose of this study is to evaluate whether CTA can be used as screening tool to predict the presence or absence of American Heart Association lesion type VI plaques as defined by high-resolution MR imaging. METHODS Fifty-one patients with suspected ischemic stroke or TIA with carotid CTA and carotid MR imaging performed within 14 days of the event/admission from April 2008 to December 2010 were reviewed. Vessels with stents or occlusion were excluded (n = 2). Each carotid artery was assigned an American Heart Association lesion type classification by MR imaging. The maximum wall thickness, maximum soft plaque component thickness, maximum calcified component thickness, and its attenuation (if the soft plaque component thickness was >2 mm) were obtained from the CTA. RESULTS The maximum soft plaque component thickness proved the best discriminating factor to predict a complicated plaque by MR imaging, with a receiver operating characteristic area under the curve of 0.89. The optimal sensitivity and specificity for detection of complicated plaque by MR imaging was achieved with a soft plaque component thickness threshold of 4.4 mm (sensitivity, 0.65; specificity, 0.94; positive predictive value, 0.75; and negative predictive value, 0.9). No complicated plaque had a soft tissue plaque thickness <2.2 mm (negative predictive value, 1) and no simple (noncomplicated) plaque had a thickness >5.6 mm (positive predictive value, 1). CONCLUSIONS Maximum soft plaque component thickness as measured by carotid CTA is a reliable indicator of a complicated plaque, with a threshold of 2.2 mm representing little to no probability of a complicated American Heart Association lesion type VI plaque.
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Affiliation(s)
- M Trelles
- Department of Radiology, University of Texas Medical Branch, Galveston, Texas
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Donkervoort S, Tesi-Rocha C, Schreiber A, Schindler A, Leach M, Zurcher V, Hu Y, Mankodi A, Friedman N, Bonnemann C. G.P.82 ‘Double Trouble’: Diagnostic challenges in DMD in patients with an additional hereditary skeletal dysplasia. Neuromuscul Disord 2012. [DOI: 10.1016/j.nmd.2012.06.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Meilleur K, Jain M, Kim E, Hynan L, Shieh C, Waite M, Duong T, Glanzman A, Main M, Rose K, McGuire M, Bendixen R, Foley R, Donkervoort S, Schindler A, Kokkinis A, Hartnett E, Leach M, Dastgir J, North K, Muntoni F, Rutkowski A, Bonnemann C. S.P.21 Clinical outcome measures in Collagen 6 (COL6) and Laminin α2(LAMA2) related congenital muscular dystrophy. Neuromuscul Disord 2012. [DOI: 10.1016/j.nmd.2012.06.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Donkervoort S, Medne L, Schindler A, Pappa M, Bonnemann C. D.P.3 Ethical, social, legal implications of clinical and research genetic testing in the neuromuscular setting: A case study approach. Neuromuscul Disord 2012. [DOI: 10.1016/j.nmd.2012.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Grimm JM, Schindler A, Schwarz F, Cyran C, Dichgans M, Freilinger T, Reiser MF, Nikolaou K, Saam T. Identifikation von symptomatischen atherosklerotischen Karotisplaques: Vergleich zwischen CT Angiographie und Black-Blood 3T MRT. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Rinaldi C, Grunseich C, Sevrioukova I, Schindler A, Ghezzi D, Zeviani M, Fischbeck K. X-Linked Recessive Axonal Neuropathy with Deafness and Cognitive Impairment (Cowchock Syndrome) Is Associated with Mutation in AIFM1 (S07.007). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Weng A, Thakur M, Schindler A, Fuchs H, Melzig MF. Liquid-chromatographic profiling of Saponinum album (Merck). Pharmazie 2011; 66:744-746. [PMID: 22026154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Saponinum album (Merck) is a complex composite of triterpene saponins. It was shown that Saponinum album (Merck) dramatically enhances the toxicity of the N-glycosylase saporin from the seeds of Saponaria officinalis L. as well as the toxicity of a saporin based anti-tumor toxin. This study was intended to chromatographically profile the saponins present in Saponinum album (Merck) in order to identify saponins that determine the cytotoxicity enhancing properties of Saponinum album (Merck) on saporin. For this purpose a liquid-chromatographic profiling (HPLC) followed by ESI-TOF-MS analysis and evaluation of cytotoxicity enhancer effects of saponins from Saponinum album (Merck) was performed. This is the first study describing a liquid-chromatographic profiling of saponins from Saponinum album (Merck). Ten different saponins were isolated. There was a lot of variation observed in the cytotoxicity enhancing properties of different isolated saponins, 8 out of 10 isolated saponins showed an enhancer effect on the toxicity of saporin. Based on these results it was concluded that the cytotoxicity enhancer effect of Saponinum album (Merck) is not attributable to a single, activity determining saponin.
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Affiliation(s)
- A Weng
- Institut für Laboratoriumsmedizin, Klinische Chemie und Pathobiochemie, Charité - Universitätsmedizin, Berlin, Germany.
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Grimm JM, Schindler A, Freilinger T, Cyran CC, Schmidt C, Dichgans M, Yuan C, Reiser MF, Nikolaou K, Saam T. Vergleich von symptomatischen und asymptomatischen atherosklerotischen Karotisplaques mittels Paralleler Bildgebung und hochauflösender 3T in vivo MRT. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Saam T, Freilinger T, Schindler A, Grimm J, Schmidt C, Bamberg F, Reiser MF, Dichgans M, Nikolaou K. Prävalenz vulnerabler Karotisplaques bei Patienten mit kryptogenem Schlaganfall: Eine in vivo MRT-Studie. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Schindler A. Allgemeine Gynäkologie. GnRH-Agonisten: Praktischer Stellenwert bei endoskopischen/hysteroskopischen Eingriffen. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0030-1250766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Bisetti MS, Segala F, Zappia F, Albera R, Ottaviani F, Schindler A. Non-invasive assessment of benign vocal folds lesions in children by means of ultrasonography. Int J Pediatr Otorhinolaryngol 2009; 73:1160-2. [PMID: 19497627 DOI: 10.1016/j.ijporl.2009.05.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Revised: 05/01/2009] [Accepted: 05/05/2009] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Flexible fiberoptic endoscopes have made pediatric laryngeal examinations an everyday practice, even though fiberoptic-flexible laryngoscopy (FFL) is not always well tolerated in young children because of limited cooperation. Laryngeal ultrasonography (LUS) has been applied to normal and pathological findings in infants and children, allowing the assessment of subglottic hemangiomas, laryngeal stenosis and paralysis. No previous study assessed benign vocal folds lesions by LUS in children. The aim of this study is to evaluate the possibility of LUS to detect benign vocal fold lesions in children by comparing the results of FFL in 16 children with those of LUS. METHODS Sixteen children (9 males and 7 females) with a mean age of 7.5+/-4.0 years were included in the study. Each child underwent FFL performed by a skilled phoniatrician and LUS performed blindly by an expert radiologist. RESULTS On FFL bilateral vocal folds nodules were found in 9 patients, vocal fold cyst in 2 other patients, while in 2 children the vocal folds appeared normal. Laryngeal papyllomatosis, vocal fold polyp and vocal fold irregularity were found in only one patient. LUS enabled the diagnosis in all the 14 patients with vocal fold lesions. Bilateral hyperechoic lesions were visible in 10 patients, while hypoechoic lesions were found in three patients. No lesion were found in two children, while one patient presented with a monolateral hyperechoic lesion. CONCLUSIONS LUS was accurate, safe, well accepted and tolerated. LUS appears to be a useful diagnostic tool for supplementing FFL in the assessment of benign vocal fold lesions in children and may represent an interesting alternative in everyday clinical practice.
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Affiliation(s)
- M Spadola Bisetti
- Department of Audiology-Phoniatrics, Università degli Studi di Torino, Italy
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Schindler A, Favero E, Nudo S, Spadola-Bisetti M, Ottaviani F, Schindler O. Voice after supracricoid laryngectomy: Subjective, objective and self-assessment data. LOGOP PHONIATR VOCO 2009; 30:114-9. [PMID: 16287650 DOI: 10.1080/14015430500256592] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Supracricoid laryngectomy (SCL) is an efficient surgical procedure for the treatment of selected laryngeal carcinoma, presently being performed not only in Europe but also in North America. The functional goals of the technique are voice and swallowing without a permanent tracheostoma. Perceptual and acoustic voice characteristics after SCL have been reported by different authors, but self-assessment data together with subjective and objective data have only been reported for a small number of subjects. Twenty male subjects, with a mean age of 71 years (range: 51-82 years) who underwent a SCL at least one year before our observation, were included in the study. Each subject underwent a flexible laryngoscopy and his voice was perceptually rated using the GRBAS scale. Objective examination included: maximum phonation time (MPT), voice spectrograms and syllable diadochokinesis on a single breath. Finally, each subject assessed his own voice using the Voice Handicap Index (VHI). The mean values of the GRBAS scale were respectively 2.4, 2.6, 2.4, 0.8, 0.5, 0.8. Mean MPT was 7.5 s, while for voice spectrograms the mean value of the Yanagihara scale was 3.7. Mean syllable diadochokinesis appeared as 3.3 syllables/s. Mean value of the VHI was 29.9. Subjective and objective data show a severely dysphonic voice after SCL; self-assessment data, on the contrary, reveal only moderate functional and emotional consequences. While perceptual, aerodynamic and acoustic data are in line with previous reports, self-assessment data were less severe in our subjects compared to what appears in the literature. It is concluded that self-assessment explores a different dimension of the patient's voice and that even if a severe dysphonia is present the consequences on everyday oral communication are only moderate.
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Affiliation(s)
- A Schindler
- Department of Otorhinolaryngology and Ophthalmology, University of Milan, Italy.
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Frost F, Fechner R, Ziberi B, Völlner J, Flamm D, Schindler A. Large area smoothing of surfaces by ion bombardment: fundamentals and applications. J Phys Condens Matter 2009; 21:224026. [PMID: 21715764 DOI: 10.1088/0953-8984/21/22/224026] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Ion beam erosion can be used as a process for achieving surface smoothing at microscopic length scales and for the preparation of ultrasmooth surfaces, as an alternative to nanostructuring of various surfaces via self-organization. This requires that in the evolution of the surface topography different relaxation mechanisms dominate over the roughening, and smoothing of initially rough surfaces can occur. This contribution focuses on the basic mechanisms as well as potential applications of surface smoothing using low energy ion beams. In the first part, the fundamentals for the smoothing of III/V semiconductors, Si and quartz glass surfaces using low energy ion beams (ion energy: ≤2000 eV) are reviewed using examples. The topography evolution of these surfaces with respect to different process parameters (ion energy, ion incidence angle, erosion time, sample rotation) has been investigated. On the basis of the time evolution of different roughness parameters, the relevant surface relaxation mechanisms responsible for surface smoothing are discussed. In this context, physical constraints as regards the effectiveness of surface smoothing by direct ion bombardment will also be addressed and furthermore ion beam assisted smoothing techniques are introduced. In the second application-orientated part, recent technological developments related to ion beam assisted smoothing of optically relevant surfaces are summarized. It will be demonstrated that smoothing by direct ion bombardment in combination with the use of sacrificial smoothing layers and the utilization of appropriate broad beam ion sources enables the polishing of various technologically important surfaces down to 0.1 nm root mean square roughness level, showing great promise for large area surface processing. Specific examples are given for ion beam smoothing of different optical surfaces, especially for substrates used for advanced optical applications (e.g., in x-ray optics and components for extreme ultraviolet lithography).
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Affiliation(s)
- F Frost
- Leibniz-Institut für Oberflächenmodifizierung e. V. (IOM), Permoserstraße 15, D-04318 Leipzig, Germany
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Barbiera F, Bosetti A, Ceravolo M, Cortinovis F, Crippa A, Facchin N, Flosi C, Gandolfo C, Juliani E, Leonardi F, Nanni P, Pallini P, Petrelli M, Raganini F, Ravera G, Raiteri U, Riso S, Rovera L, Ruoppolo G, Schindler A, Schindler O, Seneghini A, Sormani M, Sukkar S, Cupillo BT, Van Lint M, Vassallo D. ADI nutritional recommendations for dysphagia. Mediterranean Journal of Nutrition and Metabolism 2009. [DOI: 10.3233/s12349-009-0043-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- F. Barbiera
- U.O. Radiologia “Domenico Noto”, Azienda Ospedali Civili Riuniti, Sciacca (AG), Italy
| | - A. Bosetti
- Scienza dell'Alimentazione, Polo Universitario, Luigi Sacco, e Università degli Studi di Milano, Milan, Italy
| | - M.G. Ceravolo
- Medicina Fisica e Riabilitazione, Università Politecnica delle Marche e Clinica di Neuroriabilitazione, Azienda Ospedali Riuniti di Ancona, Italy
| | - F. Cortinovis
- USSD Dietologia Clinica, Azienda Ospedaliera Ospedali Riuniti, Bergamo, Italy
| | - A. Crippa
- Servizio di Dietologia e Nutrizione Clinica, ASP IMMeS e Pio Albergo Trivulzio, Milan, Italy
| | - N. Facchin
- Servizio di Dietetica e Nutrizione Clinica, Azienda Sanitaria dell'Alto Adige, Comprensorio Sanitario di Bolzano, Italy
| | - C. Flosi
- Villa Scassi, Corso di Laurea in Logopedia, Università degli Studi di Genova, Genoa, Italy
| | - C. Gandolfo
- Centro Ictus, Università degli Studi di Genova, Genoa, Italy
| | - E. Juliani
- U.O. Radiodiagnostica I, Azienda Ospedaliera S. Giovanni Battista, Turin, Italy
| | - F. Leonardi
- U.O. di Scienza dell'Alimentazione e Dietetica, Azienda Ospedaliera “Cannizzaro”, Università degli Studi di Catania, Catania, Italy
| | - P. Nanni
- Servizio di Dietetica e Nutrizione Clinica, ASUR Zona Territoriale 13, Ascoli Piceno, Italy
| | - P. Pallini
- Servizio di Dietetica e Nutrizione Clinica, U.O.C. Gastroenterologia, Azienda ULSS n. 12 Venezia, Mestre (VE), Italy
| | - M. Petrelli
- SOD Dietetica e Nutrizione Clinica, Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy
| | - F. Raganini
- UO di Neurologia, Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
| | - G. Ravera
- Dipartimento di Scienze della Salute (DISSAL), Facoltà di Medicina e Chirurgia, Università di Genova, Genoa, Italy
| | - U. Raiteri
- SC Dietetica e Nutrizione Clinica, AO “Maggiore della Carità”, Novara, e Università degli Studi di Pavia, Pavia, Italy
| | - S. Riso
- Responsabile SS Dietetica e Nutrizione Clinica, ASO Ordine Mauriziano, Turin, Italy
| | - L. Rovera
- Responsabile SS Dietetica e Nutrizione Clinica, ASO Ordine Mauriziano, Turin, Italy
| | - G. Ruoppolo
- UOC Foniatria, Policlinico Umberto I, Università degli Studi di Roma “La Sapienza”, Rome, Italy
| | - A. Schindler
- U.O. Otorinolaringoiatria, Azienda Ospedaliera - Polo Universitario “L. Sacco”, Università degli Studi di Milano, Milan, Italy
| | - O. Schindler
- S.C.D.U. Audiologia Foniatria, Università degli Studi di Torino, Turin, Italy
| | - A. Seneghini
- Centro Ictus “Luciano Garello”, UO di Neurologia, Azienda Ospedaliera S. Martino, Genoa, Italy
| | - M.P. Sormani
- Sezione di Biostatistica, Dip. di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - S.G. Sukkar
- U.O. di Dietetica e Nutrizione Clinica, Azienda Ospedaliera Universitaria S. Martino, Università degli Studi di Genova, Genoa, Italy. e-mail:
| | - B. Travalca Cupillo
- U.O.D. di Foniatria, Azienda Ospedaliera Universitaria S. Martino, Genoa, Italy
| | - M.T. Van Lint
- U.O. Ematologia, Azienda Ospedaliera Universitaria S. Martino, Genoa, Italy
| | - D. Vassallo
- S.S. di Dietetica e Nutrizione Clinica, Stroke-team S.C. Neurologia, ASO Ordine Mauriziano Umberto I, Turin, Italy
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Nawka T, Verdonck-de Leeuw I, De Bodt M, Guimaraes I, Holmberg E, Rosen C, Schindler A, Woisard V, Whurr R, Konerding U. Item Reduction of the Voice Handicap Index Based on the Original Version and on European Translations. Folia Phoniatr Logop 2009; 61:37-48. [DOI: 10.1159/000200767] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Schindler A. Endokrinologie. Bedeutung der Isoflavone für Prävention und Therapie bei der Frau. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2008-1039134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Wurster K, Zwirner M, Keller E, Schindler A, Schrode M, Heitkamp H. Discipline Specific Differences in the Responses of Pituitary, Gonadal, and Adrenal to Maximal Physical Exercise in Female Top Athletes. Int J Sports Med 2008. [DOI: 10.1055/s-2008-1026002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schindler A. Endokrinologie. Klinische Relevanz der Umwandlung von 19-Nortestosteronpräparaten in Ethinylestradiol. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2008-1038507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Schindler A, Ginocchio D, Ruoppolo G. What we don't know about dysphagia complications? Rev Laryngol Otol Rhinol (Bord) 2008; 129:75-78. [PMID: 18767323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Prevention of complications is the primary goal in patients with dysphagia. The most common complications of dysphagia are aspiration pneumonia, malnutrition and dehydration; other possible complications, such as intellectual and body development deficit in children with dysphagia, or emotional impairment and social restriction have not been studied thoroughly. Pulmonary complications of dysphagia should be viewed as an impaired balance between defence mechanisms (cough and mucociliary action, lymphatic clearance and cellular immune defences) and food and secretions aspiration. The main pulmonary complications are aspiration pneumonia, toxic aspiration syndromes, bacterial infections and pulmonary fibrosis. The risk of aspiration pneumonia is increased by poor oral status and health status, dependency for oral care and oral feeding; nonetheless, compliance with feeding recommendations of the dysphagia team, may reduce the risk of pulmonary complications. Malnutrition and dehydration are common in patients with dysphagia; however, enteral nutrition may significantly impact on both. Even though a relationship between malnutrition, dehydration and dysphagia exists, the real impact of one on the others is not known.
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Affiliation(s)
- A Schindler
- University of Milan, Department of Clinical Sciences L. Sacco Hospital, Via GB Grassi 74, 20157 Milano, Italy.
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Verdonck-de Leeuw I, Kuik D, De Bodt M, Guimaraes I, Holmberg E, Nawka T, Rosen C, Schindler A, Whurr R, Woisard V. Validation of the Voice Handicap Index by Assessing Equivalence of European Translations. Folia Phoniatr Logop 2008; 60:173-8. [DOI: 10.1159/000127836] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Schindler A, Borghi E, Tiddia C, Ginocchio D, Felisati G, Ottaviani F. Adaptation and validation of the Italian MD Anderson Dysphagia Inventory (MDADI). Rev Laryngol Otol Rhinol (Bord) 2008; 129:97-100. [PMID: 18767327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Oropharyngeal dysphagia is a common symptom in patients with head and neck tumours. The MD Anderson Dysphagia Inventory (MDADI) is a questionnaire currently used in North America for the assessment of dysphagia-related disability in patients with head and neck cancer. The aim of the study is to analyze reliability and clinical validity of the Italian MDADI. MATERIAL AND METHOD 48 persons with no history of dysphagia and 50 head and neck cancer patients with a chronic and stable dysphagia have been included in the study. Each subject completed alone the Italian MDADI twice with a week interval between the two questionnaire completion. Intra-subject reliability was analyzed through Pearson test in both groups of subjects. Clinical validity was calculated through the non parametric Mann Whitney test of the first MDADI assessment in both groups. RESULTS Internal consistency and test-retest reliability were high for each MDADI subscale in subjects without dysphagia as well as in those with dysphagia. The difference between MDADI values in subjects with and without dysphagia was significant for each subscale. DISCUSSION The Italian MDADI is reliable and clinically valid. The application of the MDADI is recommended in clinical practice as well as in descriptive, outcome and efficacy research.
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Affiliation(s)
- A Schindler
- University of Milan, Department of Clinical Sciences L. Sacco, Via GB Grassi 74, 20157 Milano, Italy.
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Schindler A. Endokrinologie. Nicht-kontrazeptive Anwendung der Hormonspirale. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-965193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Schindler A, Capaccio P, Maruzzi P, Ginocchio D, Bottero A, Otraviani F. Preliminary considerations on the application of the voice handicap index to paediatric dysphonia. Acta Otorhinolaryngol Ital 2007; 27:22-6. [PMID: 17601207 PMCID: PMC2640018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Dysphonia is a common paediatric condition. Adult voices are usually evaluated using a set of minimal basic measurements including: endoscopic examination, aerodynamics, perception, acoustics, and self-assessment by the patient. The Voice Handicap Index is the most widely used self-assessment tool, but its use in the paediatric setting has never been reported. Aim of this study was to report Voice Handicap Index ratings in a group of dysphonic children, multi-modally assessed before and after voice therapy. The study involved 28 children (16 female, 12 male, mean age 10.9 years (range 6-12)) presenting chronic hoarseness due to vocal fold nodules (18 cases), unilateral localised oedema (6 cases) or recurrent laryngeal paralysis (4 cases). All received voice therapy for 5-6 months, and underwent voice assessments based on video-endoscopy ratings (size of nodule/ oedema or glottic closure in the case of recurrent laryngeal paralysis), maximum phonation time, GIRBAS scale, spectrograms and a perturbation analysis. All patients also completed the Voice Handicap Index. Aerodynamic, acoustic, perceptual and self-assessment data, before and after voice therapy, were compared using Wilcoxon's test and Student's t test. Correlations between the Voice Handicap Index domains were measured by means of Pearson's correlation coefficient. Post-treatment measurements showed that the nodules/oedema had decreased in size in 18 children following therapy, and two subjects with recurrent laryngeal paralysis showed improved glottic closure. Mean maximum phonation time increased slightly, but the difference was not significant. There was a general reduction in perceptual severity, but this was only significant for parameters G, B and A. Spectrographic analysis showed no significant improvement and, although the mean perturbation analysis values improved, only the difference in jitter values was significant (p = 0.016). Voice Handicap Index was applicable in all cases, and showed a clear and significant improvement (p = 0.0006). The correlations between the three Voice Handicap Index factors were close; no correlation was found between the functional domain and the physical and emotional domains. The Voice Handicap Index is a useful tool in children with dysphonia, but an adapted version validated for paediatric patients is essential.
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Affiliation(s)
- A Schindler
- Department of Clinical Sciences L. Sacco, University of Milan, Italy.
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Seidel G, Cangür H, Meyer-Wiethe K, Renault G, Herment A, Schindler A, Kier C. On the ability of ultrasound parametric perfusion imaging to predict the area of infarction in acute ischemic stroke. Ultraschall Med 2006; 27:543-8. [PMID: 17146746 DOI: 10.1055/s-2006-927023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
PURPOSE Cerebral perfusion deficits in acute ischemic stroke can be detected by means of transcranial harmonic imaging after ultrasound contrast agent bolus injection. We evaluated five different parameters of the bolus kinetics as parametric images and correlated areas of disturbed perfusion with the area of definite infarction. MATERIALS AND METHODS Perfusion harmonic imaging after SonoVue bolus injection (BHI) was used to investigate 22 patients suffering from acute internal carotid artery infarction. For each subject, we calculated five different images based on the following parameters from the time-intensity curve in each pixel: pixelwise peak intensity (PPI), area under the curve (AUC), positive gradient (PG), time to peak (TTP), and a three factor image from the factor analysis of medical image sequences (FAMIS). The findings in the diencephalic imaging plane were compared with the definite area of infarction, as diagnosed by cranial CT. RESULTS In predicting the definite area of infarction in follow-up CT, we found the following sensitivities and positive predictive values (PPV): PPI (100 %/95 %), AUC (100 %/90 %), FAMIS (89 %/89 %), PG (84 %/94 %) and TTP (47 %/100 %). The areas of disturbed perfusion in all five types of parametric images correlated significantly with the area of infarction in CT. Images from the FAMIS algorithm and PPI images showed the highest Spearman rank correlation with the area of definite infarction as displayed in CT (both r = 0.76, p < 0.001). Images from the other parameters correlated as follows: PG: r = 0.62 (p = 0.003), AUC: r = 0.53 (p = 0.014), TTP: r = 0.50 (p = 0.021). CONCLUSION BHI can detect disturbed perfusion in acute hemispheric stroke. In their ability to predict the development of an infarction, intensity-based parameters and FAMIS were determined to have a high sensitivity, and TTP was found to have a high PPV and specificity.
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Affiliation(s)
- G Seidel
- Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Germany.
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Abstract
BACKGROUND Penetrating keratoplasty (PKP) is commonly referred to as the most successful transplantation procedure in medicine. This appraisal, however, is currently poorly supported by evidence. The aim of our study was to collect data on patient satisfaction with PKP as well as to analyze factors predisposing to dissatisfaction. PATIENTS AND METHODS In the years 1988-2002 a total of 3,219 PKPs were performed on 2,981 patients. These patients were sent a questionnaire. The items pertained to subjective assessment of visual quality as compared to the situation before PKP and about regretting the PKP. RESULTS The questionnaire was answered by 1,142 patients (59% of the traceable persons). The mean follow-up was 3.3+/-2.9 years. Indications for PKP were Fuchs' endothelial dystrophy (26%), keratoconus (23%), bullous keratopathy (15%), and further indications (36%). For these groups, best corrected visual acuity improved by more than two lines in 51, 80, 42, and 50%, respectively. The percentage of subjective improvement of vision was 73, 78, 47, and 63%. The percentage of regretting the PKP was 12, 4, 27, and 10%, respectively. All differences were highly statistically significant. Significant influencing factors on regretting the PKP were (inversely sorted for relevance): repeat graft failure, bullous keratopathy, contact lens wear, paresthesia, removal of running sutures, and patient age. CONCLUSIONS General satisfaction with PKP is high. An important exception is bullous keratopathy, most likely due to accompanying morbidity (e.g., cystoid macular edema).
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Affiliation(s)
- D Böhringer
- Augenklinik, Universitätsklinikum, Kilianstrasse 5, 79106, Freiburg.
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Canale A, Favero E, Lacilla M, Recchia E, Schindler A, Roggero N, Albera R. Age at diagnosis of deaf babies: a retrospective analysis highlighting the advantage of newborn hearing screening. Int J Pediatr Otorhinolaryngol 2006; 70:1283-9. [PMID: 16488484 DOI: 10.1016/j.ijporl.2006.01.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2005] [Revised: 01/14/2006] [Accepted: 01/15/2006] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Aim of the study was to assess the mean age at diagnosis of bilateral congenital hearing loss in the Audiology and Phoniatry Centre of the University of Turin, pointing out, by North-West Italy experience, the role of the newborn hearing screening in anticipating the age of diagnosis. METHODS This was a retrospective study. Forty-six congenital deaf babies were reviewed and age at diagnosis was assessed for each, taking in consideration the role of hearing loss risk factors. Eighteen babies (39%) were sent by the centres that participate to the newborn hearing screening program while 28 (61%) came for parental or pediatrician suspicion of hearing loss and for general language delay. Sixteen babies (35%) presented risk factors for hearing loss. RESULTS The mean age of identification of severe to profound hearing loss was 20.5 months (S.D.=15.3) in the whole group; considering the group of 28 babies not screened the mean age was 29.3 months (S.D.=13.4). This value decreased to 6.8 months (S.D.=3.6) in the group which underwent screening programme. This difference was statistically significant at Student's t-test (p<0.001). The average ages of diagnosis for healthy versus high risk children were significantly different only in the group of screened babies (p<0.05). CONCLUSIONS Childhood hearing impairment is one of the most common of congenital disorders, and even though there is a general trend of early identification, in reality age of diagnosis is as yet still too late even in developed countries. Our results show that newborn hearing screening could reduce the age at which infants with hearing loss are diagnosed and treated; this would improve speech, language, auditory outcome and the quality of parents and infant life.
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Affiliation(s)
- A Canale
- Department of Clinical Physiopathology, II Section of ENT, University of Turin, Turin, Italy.
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Schindler A, Schärer M, Kolyvanos Naumann U, Käser L, Vetter W. [Parvovirus B19]. Praxis (Bern 1994) 2006; 95:609-15; quiz 616. [PMID: 16681153 DOI: 10.1024/0369-8394.95.16.609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Affiliation(s)
- A Schindler
- Medizinische Poliklinik, Universitätsspital Zürich
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Meyer-Wiethe K, Schindler A, Kier C, Cangür H, Koch C, Seidel G. Transkraniell-sonographische Analyse der Wiederauffüll- und Destruktionskinetik von Ultraschallkontrastmittel im akuten Hirninfarkt. Akt Neurol 2006. [DOI: 10.1055/s-2006-953362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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