Accuracy of endoscopic and videofluoroscopic evaluations of swallowing for oropharyngeal dysphagia.

OBJECTIVES: A systematic review and meta-analysis of the literature was conducted to compare the accuracy with which flexible endoscopic evaluation of swallowing (FEES) and videofluoroscopic swallowing study (VFSS) assessed oropharyngeal dysphagia in adults. DATA SOURCES: PubMed, Embase, and the Latin American and Caribbean Health Sciences Literature (LILACS) database. METHODS: A review of published studies was conducted in parallel by two groups of researchers. We evaluated the methodological quality, homogeneity, threshold effect, and publication bias. The results are presented as originally published, then with each test compared against the other as a reference and both compared against a composite reference standard, and then pooled using a random effects model. Software use consisted of Meta-DiSc and SPSS. RESULTS: The search yielded 5,697 articles. Fifty-two articles were reviewed in full text, and six articles were included in the meta-analysis. FEES showed greater sensitivity than VFSS for aspiration (0.88 vs. 0.77; P = .03), penetration (0.97 vs. 0.83; P = .0002), and laryngopharyngeal residues (0.97 vs. 0.80; P < .0001). Sensitivity to detect pharyngeal premature spillage was similar for both tests (VFSS: 0.80; FEES: 0.69; P = .28). The specificities of both tests were similar (range, 0.93-0.98). In the sensitivity analysis there were statistically significant differences between the tests regarding residues but only marginally significant differences regarding aspiration and penetration. CONCLUSIONS: FEES had a slight advantage over VFSS to detect aspiration, penetration, and residues. Prospective studies comparing both tests against an appropriate reference standard are needed to define which test has greater accuracy. LEVEL OF EVIDENCE: 2a Laryngoscope, 127:2002-2010, 2017.

Síntesis in situ de nanopartículas de plata sobre fibras de fique / In situ synthesis of silver nanoparticles on fique fibers / Síntese in situ de nanopartículas de prata em fibras de fique

Se realizó la síntesis de un material nanocompuesto mediante la deposiciónin situ de nanopartículas (NPs) de plata sobre fibras de Fique. La influencia de parámetros experimentales, como concentración del precursor, concentración del agente reductor y tiempos de inmersión de las fibras en la solución del precursor y del agente reductor, se evaluó en términos de recubrimiento, tamaño y dispersión del nanomaterial sobre la superficie. Los nanocompositos fueron caracterizados mediante espectroscopia de reflectancia difusa UV-Vis (RD), microscopía electrónica (FESEM) y difracción de rayos X (DRX). El control de los parámetros experimentales mencionados permitió obtener un material que exhibe recubrimiento uniforme y completo de NPs sobre la superficie y tamaños promedio de NPs de 40 nm.

A nanocomposite material was synthesized by silver nanoparticles (NPs) in situ deposition on Fique fibers. The influence of experimental conditions such as precursor concentration, reducing agent concentration and immersion times of fibers in precursor and reducing agent solutions was evaluated in terms of nanomaterial coating, size and dispersion on the fibers surface. The nanocomposites were characterized by UV-Vis diffuse reflectance spectroscopy (DR), electron microscopy (FESEM) and X-ray diffraction (XRD). By carefully controlling experimental conditions we were able to produce a material with uniforme and complete coating of NPs on the surface of the fiber, and average sizes of 40 nm.

Nanocompósito foi sintetizado através de deposição in situ de nanopartículas (NPs) de prata sobre as fibras de Fique. A influência dos parâmetrosexperimentais, tais como a concentração do sal metálico, a concentração do agente de redução e os tempos de imersão das fibras na solução do sal metálico e o agente de redução, foram avaliadas em termos do revestimento, tamanho e a dispersãona superfície do nanomaterial. Os nanocompósitosforam caracterizados por espectroscopia de refletância difusa no UV-Vis (RD), microscopia eletrônica (FESEM) e difração de raios X (XRD). O controle dos parâmetrosexperimentais mecionados originaram um material que exibe um revestimento uniforme e completo das NPs sobre a superfície das fibras e tamanhos médios de 40 nm.

Pharmacological activation of 5-HT7 receptors reduces nerve injury-induced mechanical and thermal hypersensitivity.

The involvement of the 5-HT(7) receptor in nociception and pain, particularly chronic pain (i.e., neuropathic pain), has been poorly investigated. In the present study, we examined whether the 5-HT(7) receptor participates in some modulatory control of nerve injury-evoked mechanical hypersensitivity and thermal (heat) hyperalgesia in mice. Activation of 5-HT(7) receptors by systemic administration of the selective 5-HT(7) receptor agonist AS-19 (1 and 10mg/kg) exerted a clear-cut reduction of mechanical and thermal hypersensitivities that were reversed by co-administering the selective 5-HT(7) receptor antagonist SB-258719. Interestingly, blocking of 5-HT(7) receptors with SB-258719 (2.5 and 10mg/kg) enhanced mechanical (but not thermal) hypersensitivity in nerve-injured mice and induced mechanical hypersensitivity in sham-operated mice. Effectiveness of the treatment with a 5-HT(7) receptor agonist was maintained after repeated systemic administration: no tolerance to the antiallodynic and antihyperalgesic effects was developed following treatment with the selective 5-HT(7) receptor agonist E-57431 (10mg/kg) twice daily for 11 days. The 5-HT(7) receptor co-localized with GABAergic cells in the dorsal horn of the spinal cord, suggesting that the activation of spinal inhibitory GABAergic interneurons could contribute to the analgesic effects of 5-HT(7) receptor agonists. In addition, a significant increase of 5-HT(7) receptors was found by immunohistochemistry in the ipsilateral dorsal horn of the spinal cord after nerve injury, suggesting a "pain"-triggered regulation of receptor expression. These results support the idea that the 5-HT(7) receptor subtype is involved in the control of pain and point to a new potential use of 5-HT(7) receptor agonists for the treatment of neuropathic pain.

Sigma-1 receptors regulate activity-induced spinal sensitization and neuropathic pain after peripheral nerve injury.

Sigma-1 receptor (sigma(1)R) is expressed in key CNS areas involved in nociceptive processing but only limited information is available about its functional role. In the present study we investigated the relevance of sigma(1)R in modulating nerve injury-evoked pain. For this purpose, wild-type mice and mice lacking the sigma(1)R gene were exposed to partial sciatic nerve ligation and neuropathic pain-related behaviors were investigated. To explore underlying mechanisms, spinal processing of repetitive nociceptive stimulation and expression of extracellular signal-regulated kinase (ERK) were also investigated. Sensitivity to noxious heat of homozygous sigma(1)R knockout mice did not differ from wild-type mice. Baseline values obtained in sigma(1)R knockout mice before nerve injury in the plantar, cold-plate and von Frey tests were also indistinguishable from those obtained in wild-type mice. However, cold and mechanical allodynia did not develop in sigma(1)R null mice exposed to partial sciatic nerve injury. Using isolated spinal cords we found that mice lacking sigma(1)R showed reduced wind-up responses respect to wild-type mice, as evidenced by a reduced number of action potentials induced by trains of C-fiber intensity stimuli. In addition, in contrast to wild-type mice, sigma(1)R knockout mice did not show increased phosphorylation of ERK in the spinal cord after sciatic nerve injury. Both wind-up and ERK activation have been related to mechanisms of spinal cord sensitization. Our findings identify sigma(1)R as a constituent of the mechanisms modulating activity-induced sensitization in pain pathways and point to sigma(1)R as a new potential target for drugs designed to alleviate neuropathic pain.

Immunohistochemical localization of the sigma1-receptor in oligodendrocytes in the rat central nervous system.

By using a new polyclonal antibody raised against a 21-amino acid peptide sequence corresponding to the fragment 138-157 of the cloned rat sigma(1)-receptor, we demonstrated by immunoperoxidase and double immunofluorescence techniques, that rat oligodendrocytes express the sigma(1)-receptor. Experiments in vivo and in vitro showed that sigma(1)-receptor colocalized with specific markers of progenitor (A2B5) and mature oligodendrocytes (GalC, RIP). These results suggest that sigma(1)-receptor in oligodendrocytes might be involved in myelination by direct implication in cholesterol biosynthesis or by interaction with endogenous ligands such as neurosteroids.

Effect of the novel sigma1 receptor ligand and putative atypical antipsychotic E-5842 on BDNF mRNA expression in the rat brain.

Changes in the expression of brain-derived neurotrophic factor (BDNF) have been implicated in some neuropsychiatric disorders. Several antipsychotic drugs affect the expression of BDNF mRNA in different areas of the rat brain. We examined the effect of single or repeated administration of 4-[4-fluorophenyl]-1,2,3,6-tetra-hydo-1-[4-[1,-2,4-triazol-1-il]butyl]pyridine citrate) (E-5842), a sigma1 receptor ligand and putative atypical antipsychotic drug on the expression of BDNF mRNA in rats. Acute treatment with E-5842 induced a down-regulation of BDNF mRNA levels in the frontal cortex and hippocampus, while a chronic treatment had no effect. Levels of another neurotrophin, nerve growth factor (NGF), remained unaltered after either acute or chronic treatment. The effects suggest that any therapeutic properties of E-5842 are not mediated by stimulation of BDNF or NGF, whereas the regulation of these trophic factors may be part of the mechanism of action of sigma1 receptor ligands.