RESUMEN
Objective To evaluate the effect of intensive electromyographic biofeedback ( EMGBF ) on swallowing and the velocity of hyolaryngeal excursion among stroke survivors with dysphagia. Methods Forty-two stroke survivors with dysphagia were randomly divided into a conventional rehabilitation group ( group A, n=15) , an EMGBF group (group B, n=14) and an intensive EMGBF group (group C, n=13).In addition to routine medica-tions and motor function rehabilitation training, all received 30 minutes of conventional swallowing training once a day, 5 days per week for 4 weeks. Group B additionally received 15 minutes of EMGBF once daily and group C twice daily. Videofluoroscopy was conducted to measure the superior and anterior excursion distances and the movement time of the hyoid bone when swallowing semi-liquid food, and the velocity was calculated. The swallowing dysfunction evaluation and a penetration-aspiration scale ( PAS) were also employed to evaluate the subjects'swallowing function before and after the treatment. Results There were no significant differences among the 3 groups in any of the measurements before the treatment. After the 4 weeks of treatment the average swallowing dysfunction evaluation and PAS scores of all three groups had improved significantly, as had the superior and anterior excursion velocity of the hyoid bone. Compared with group A, the average swallowing dysfunction evaluation and PAS scores of groups B and C had improved significantly more. The average swallowing dysfunction evaluation scores of groups B and C were not sig-nificantly different, but the average anterior and superior excursion velocity of the hyoid bone in group C was signifi-cantly higher than in group B. Conclusion EMGBF therapy has advantages over routine rehabilitation training in improving swallowing function after a stroke and speeding the velocity of the hyoid bone's excursions.
RESUMEN
Identificar las características de la infección por VPH en la cavidad bucal asociada a la infección por VPH genital. En el Servicio de Ginecología Maternidad "Concepción Palacios". Caracas. Se estudiaron 60 pacientes con diagnóstico histológico de VPH genital a quienes se les realizó oroscopia, citología bucal y determinación viral por reacción en cadena de polimerasa (PCR) en boca y cérvix. Se aisló el genotipo viral en la cavidad bucal en 48,33 por ciento de las pacientes (29 / 60). Hubo concordancia entre la infección genital y bucal en 44,20 por ciento de los casos. Los genotipos aislados más frecuentes fueron el 6 (71,43 por ciento) y el 11 (22,86 por ciento), solos o en combinación; solo hubo un caso con genotipo 16 (2,86 por ciento). La concordancia entre el genotipo genital y bucal fue de 10,45 por ciento (P=0,1547), sin embargo, cuando el genotipo aislado fue 6 la concordancia fue de 75,86 por ciento. La citología de la cavidad bucal tuvo una sensibilidad de 3,5 por ciento y una especificidad de 93,6 por ciento. La oroscopia tuvo una sensiblidad de 27,6 por ciento y una especificidad de 74,2 por ciento. Es frecuente la asociación entre infección por VPH genital y bucal. Tanto la citología exfoliativa de la boca como la oroscopia, son métodos diagnósticos poco sensibles y específicos.
To describe the characteristics of HPV infection in the oral cavity associated with genital HPV infection. Service of Ginecology of the Maternidad "Concepcion Palacios". Caracas. 60 patients with histological diagnosis of genital HPV were studied with oroscopy, oral cytology and viral determination with polymerase chain reaction (PCR) in the mouth and in the cervix. Viral genotype was isolated in the oral cavity in 48.33 percent of patients (29/60). There was concordance between genital and oral infection in 44.20 percent of cases. Frequently isolated genotypes were 6 (71.43 percent) and 11 (22.86 percent), alone or in combination, there was only one case with genotype 16 (2.86 percent). The concordance between genital and oral genotype was 10.45 percent (p = 0.1547), but when isolated genotype was 6, the agreement was 75.86 percent. The cytology of the oral cavity had a sensitivity of 3.5 percent and a specificity of 93.6 percent. The oroscopy sensitivity was 27.6 percent and the specificity was 74.2 percent. It is often an association between genital and oral HPV infection. Both exfoliative cytology of the mouth and the oroscopy have low sensitivity and specificity as diagnostic methods.