Aeroallergen immunotherapy associated with reduced risk of severe COVID-19 in 1095 allergic patients.

Introduction: Allergen immunotherapy (AIT) brings along changes in the immune system, restoring dendritic cell function, reducing T2 inflammation and augmenting the regulatory cell activation. Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, interferes with the immune system causing immune suppression during the first phase and over-activation in more advanced disease. We decided to explore the interaction of both in a real-world observational trial. Methods: We registered COVID-19 outcomes in patients with allergic disorders in Latin America, treated with and without AIT. The registry was conducted during the first 1.3 years of the pandemic, with most of the data collected before COVID-19 vaccination was concluded in most countries. Data collection was anonymous via a web-based instrument. Ten countries participated. Results: 630/1095 (57.6%) of the included patients received AIT. Compared to patients without AIT, those treated with AIT had a reduced risk ratio (RR) for COVID-19 lower respiratory symptoms (RR 0.78, 95% CI: 0.6703-0.9024; p = 0.001662) and need for oxygen therapy (RR 0.65, 95% CI: 0.4217-0.9992; p = 0.048). In adherent patients on maintenance sublingual immunotherapy/subcutaneous immunotherapy (SLIT/SCIT) the RR reduction was larger [RR = 0.6136 (95% CI 0.4623-0.8143; p < 0.001) and RR: 0.3495 (95% CI 0.1822-0.6701; p < 0.005), respectively]. SLIT was slightly more effective (NS). We excluded age, comorbidities, level of health care attendance, and type of allergic disorder as confounders, although asthma was related to a higher frequency of severe disease. When analyzing patients with allergic asthma (n = 503) the RR reduction favoring AIT was more pronounced with 30% for lower respiratory symptoms or worse (RR 0.6914, 95% CI 0.5264 to 0.9081, p = 0.0087) and 51% for need of oxygen therapy or worse (RR 0.4868, 95% CI 0.2829-0.8376, p = 0.0082). Among severe allergic patients treated with biologics (n = 24) only 2/24 needed oxygen therapy. There were no critical cases among them. Conclusion: In our registry AIT was associated with reduced COVID-19 severity.

Evaluación fonoaudiológica clínica de la alimentación y la deglución en lactantes menores con hipoplasia 0 aplasia cóndilo-mandibular: Scoping review / Clinical speech therapy evaluation of feeding and swallowing in young infants with hypoplasia or aplasia of the mandibular condyle: A scoping review

Introducción: Los síndromes craneofaciales congénitos han sido ampliamente descritos debido a su naturaleza precursora de alteraciones en el sistema cráneo-cérvico-mandibular; específicamente las malformaciones a nivel cóndilo-mandibular, como la hipoplasia o aplasia de estas estructuras, comprometen una de las funciones vitales para el ser humano: la alimentación. Con el objetivo de establecer una guía de práctica clínica, se proponen lineamientos que promuevan la práctica fonoaudiológica basada en la evidencia. Pacientes y métodos: Se realiza una revisión sistemática de tipo scoping review en las principales bases de datos biomédicas, en búsqueda de artículos científicos dirigidos a la evaluación de la alimentación y deglución en lactantes menores con hipoplasia y aplasia cóndilo-mandibular asociadas a síndromes craneofaciales. Resultados:Se seleccionaron 37 artículos de tipo ensayo clínico aleatorizado, estudio de casos, estudio ecológico, metaanálisis y revisión sistemática, cuyo contenido es presentado y organizado dentro de un formato de evaluación que busca la obtención de información anatomofuncional de los lactantes menores para el desarrollo de su evaluación clínica. Conclusiones: Se resalta una reducida cantidad y difusión de evidencia fonoaudiológica al aplicar los parámetros de búsqueda, encontrando que los criterios de evaluación específicos ante esta patología no difieren en gran medida a los de la población pediátrica en general.(AU)

Introduction: Congenital craniofacial syndromes have been widely described due to their precursor nature of alterations in the cranio-cervico-mandibular system; specifically, condyle-mandibular malformations such as hypoplasia or aplasia of these structures, compromise one of the vital functions for humans, nutrition. In order to establish a clinical practice guide, guidelines that promote evidence-based speech therapy practice are proposed. Patients and methods: A scoping review is carried out in the main biomedical databases, in search of scientific articles aimed at evaluating feeding and swallowing in newborn and young infants with condyle-mandibular hypoplasia and aplasia associated with craniofacial syndromes. Results: Thirty-seven articles of a randomized clinical trial, case study, ecological study, meta-analysis, and systematic review were selected, this content is presented and organized using an evaluation format that seeks to obtain anatomical and functional information on newborn and young infants for the development of a clinical assessment. Conclusions: A reduced amount and dissemination of speech therapy evidence is highlighted when applying the search parameters, finding that the specific evaluation criteria for this pathology do not differ greatly from those of the pediatric population in general.(AU)

Fonoaudiologia y lactancia humana / Speech-language pathology and breastfeeding

Resumen Introducción. Las interrelaciones entre el desarrollo de la lactancia humana y la fonoaudiologia se dan a partir de acciones profesionales en marco de procesos comunicativos, el desarrollo de habilidades oromotoras y la construcción del lenguaje como medio transversal en la atención del binomio madre-hijo durante los primeros 6 meses de vida. Objetivo. Establecer acciones profesionales en fonoaudiología desarrolladas en consejería y apoyo en lactancia humana, desarrollo oromotor y desarrollo comunicativo. Materiales y métodos. Se empleó el método investigación acción participativa (IAP), dirigido a mujeres adolescentes o en condición de vulnerabilidad en su último trimestre de gestación y lactantes. Resultados. Se conformaron cinco grupos de apoyo con 53 participantes en total; se ejecutaron acciones profesionales en consejería grupal e individual, evaluación e intervención en diversos temas relacionados y en dificultades en lactancia humana y alimentación. Conclusiones. Se ratificó la acción del fonoaudiólogo como especialista en la organización desde la correlación anatómica y funcional de estructuras y órganos involucrados, tanto en la madre como en el infante, durante la lactancia. Además, se comprobó la pertinencia de la metodología IAP durante la consejería en fonoaudiología en entornos comunitarios y lactancia humana.

Abstract Introduction: The correlation between breastfeeding and Speech-Language Pathology is based on professional communicative processes, the development of oral motor skills and the construction of language as a transversal means to address the mother-child binomial during the first 6 months of life. Objective. To establish speech-language pathology actions through counseling and support to breastfeeding, and oral motor and communicative development. Materials and methods: The participatory action research (PAR) method was used, aimed at adolescent or vulnerable women in the last trimester of gestation or in lactation stage. Results: Five support groups were formed with 53 participants in total. Professional actions were implemented by means of group and individual counseling, evaluation and intervention in various related issues, and difficulties in breastfeeding and feeding. Conclusions: The action of a speech therapist as a specialist of the organization was confirmed based on the anatomical and functional correlation of structures and organs involved, both in the mother and in the infant, during lactation. In addition, the relevance of the PAR methodology was verified during speech therapy counseling in community settings and breastfeeding.

Fonoaudiología en los cuidados paliativos / Phonoaudiology in palliative care

Los cuidados paliativos (CP) se pueden aplicar desde el diagnóstico de una enfermedad potencialmente mortal, durante su progresión y al final de la vida. Para garantizarles calidad de vida al paciente con enfermedad terminal y a su familia, se provee una atención física, emocional y espiritual; así pues, los CP no se aplican únicamente cuando un tratamiento curativo no tiene un efecto favorable o cuando el paciente está en la fase de agonía. Con el objetivo de documentar, describir y caracterizar el quehacer del fonoaudiólogo en los cuidados paliativos, se realizó una revisión bibliográfica narrativa. En esta, se emplearon bases de datos especializadas, libros, guías de manejo, páginas electrónicas de instituciones y organizaciones reconocidas mundialmente en cuidados paliativos, fonoaudiología, dolor cráneo-facial, cáncer, enfermedades crónicas, entre otras. Con la información obtenida, se logró contextualizar teóricamente, identificar la situación en Colombia y determinar el rol del fonoaudiólogo en las áreas de comunicación, dolor cráneo-facial y disfagia. Se concluyó que existe escasa información que determine el rol del fonoaudiólogo en los cuidados paliativos, a pesar del reporte de la importancia de su quehacer profesional en esta área. Además, todas sus actividades profesionales están alineadas con los disposiciones establecidas por la Organización Mundial de la Salud (OMS) al buscar un cuidado que garantice buena vida en los últimos días.

Palliative care (PC) can be applied since the moment a potentially life-threatening illness is diagnosed, during its progression and in the final stages of life. To ensure quality of life for a terminally ill patient and their family, physical, emotional and spiritual care are provided; hence, it can be deduced that the PC are not only applied when a curative treatment has an unfavorable effect and/or in the agony stage of the patient. With the purpose of documenting, describing, and characterizing the role of the speech-language pathologist in PC, a narrative literature review was conducted by means of specialized databases, books, management guidelines, and websites of institutions and organizations worldwide recognized in PC, speech-language therapy, craniofacial pain, cancer, and chronic illnesses, among others. With the information obtained, it was possible to make a theoretical contextualization, identify the situation in Colombia and determine the role of the speech therapist in communication, craniofacial pain and dysphagia. It was concluded that there is little information that would determine the role of the speech-language pathologist in PC, despite the report on the importance of their professional work in this area. Furthermore, all of their professional activities are aligned with the guidelines established by the World Health Organization (WHO) in the quest for care that guarantees a good life during the final days.

Description of oral-motor development from birth to six years of age / Descripción del desarrollo de los patrones oromotores desde el nacimiento hasta los seis años de edad

This document seeks to present bibliometric research into characterizing the behaviors of each of the stomatognathic functions of a child based on developmental age and expected development until the age of six. The investigation collected the information provided in scientific literature regarding the development of oral-motor postural patterns, environmental influences, sensitivity, tone, muscle strength, use of feeding tools, anatomy, physiology, and the neurology of the anatomical structures of the stomatognathic system. As a result, the major milestones of oromotor development from birth to the age of six are described in this document. Also, a more detailed manual was written to be used by Speech-Language Pathologists. The research concludes that oral motor patterns emerge according to the maturation and function of the different stomatognathic structures. It is of prime importance for Speech-Language Pathologists to be experts in normal oromotor development in order to provide the best professional services when treating children in need of feeding, sucking and dysphagia therapy.

El presente documento expone una investigación bibliométrica referente al desarrollo de las funciones estomatognáticas de respiración, succión, deglución, masticación y habla desde el nacimiento hasta los seis años. La investigación se planteó a través de la recopilación de información dispuesta en la literatura científica en torno al desarrollo de patrones oromotores y su interrelación con factores ambientales y posturales. Se trata de los patrones de sensibilidad, tono y resistencia muscular, uso de instrumentos de alimentación y, finalmente, la anatomía, fisiología y neurología propias de las estructuras del sistema estomatognático. Lo anterior se analizó con el fin de caracterizar cada una de las funciones estomatognáticas. Como resultado, se describen los principales hitos del desarrollo oromotor de cero a seis años de edad. Se concluye que los patrones oromotores surgen de acuerdo con la maduración de las diferentes estructuras y funciones del sistema estomatognático y se destaca la importancia de conocer el proceso normal de desarrollo oromotor dentro del rol fonoaudiológico, a fin de garantizar una adecuada práctica profesional.

"Like a Mexican wedding": psychosocial intervention needs of predominately Hispanic low-income female co-survivors of cancer.

Although recent work has recognized that the influence and consequences of cancer extend beyond the individual receiving the diagnosis, no studies have focused on the specific psychosocial intervention needs of female co-survivors in low-income populations. In this qualitative study, the co-survivors, 16 women, representing 10 low-income families and predominately Hispanic, were interviewed about their experience of having someone in their family diagnosed with cancer. Several themes emerged from the data, including family stress, lack of skill in coping with the effects of cancer (e.g., depression of their loved one), a need for financial help, a willingness to share with others, and reliance on faith to see them through the cancer experience. Whereas no agreement existed as to where and how to provide an intervention, participants reported that tailoring an intervention to family needs and delivering it in a way that was accessible to them was important.