Froggy mouth: a new myofunctional approach to atypical swallowing.

INTRODUCTION: Atypical swallowing has a high incidence in adult and child populations. The treatment of the latter is generally achieved by the adoption of orthodontic appliances in conjunction with speech therapy. The aim of this article is to describe the clinical protocol of Froggy Mouth, an innovative myofunctional appliance designed to correct the atypical swallowing. MATERIALS AND METHODS: The Froggy Mouth appliance has been tested by the authors Di Vecchio at the Orthognatodontics department of Fatebenefratelli San Pietro Hospital in Rome, Italy, and by Manzini at the Orthodontics department of Carlo Poma Hospital in Mantova, Italy. This article will illustrate the clinical protocol of the appliance with therapeutic indications, clinical phases, instruction and patients and parents motivation and follow-up results. RESULTS: Froggy Mouth has proven effective in the correction of atypical swallowing, from both the clinical and the functional standpoints. The fastest and most predictable results were obtained in patients during their physiological developmental age. This appliance, compared to the traditional logopaedic therapy, requires less commitment in terms of time for the patient (only 15 minutes per day), with more predictable and durable results over time. CONCLUSIONS: The clinical evidences indicate that the Froggy Mouth is effective in the myofunctional correction of the atypical swallowing mechanism, providing the clinician a new therapeutic approach for neuromuscular re-training of atypical deglutition and dysfunctional deglutition in patients during their growth phase. However, further scientific evidences are needed to support the results of this investigation.

Delirium assessment in hospitalized elderly patients: Italian translation and validation of the nursing delirium screening scale.

BACKGROUND: Delirium has a high incidence pathology associated with negative outcomes. Although highly preventable, half the cases are not recognized. One major cause of delirium misdiagnosis is the absence of a versatile instrument to measure it. AIMS: Our objective was to translate the nursing delirium screening scale (Nu-DESC) and evaluate its performance in Italian settings. METHODS: This was a methodological study conducted in two sequential phases. The first was the Italian translation of Nu-DESC through a translation and back-translation process. The second aimed to test the inter-rater reliability, the sensibility and specificity of the instrument on a convenience sample of 101 hospitalized elderly people admitted to relevant wards of the San Gerardo Hospital in Monza. To evaluate the inter-rater reliability, two examiners tested Nu-DESC on 20 patients concurrently without comparison. To measure the sensibility and specificity of Nu-DESC, the confusion assessment method was used as a gold standard measure. RESULTS: The inter-rater reliability (Cohen Kappa) was 0.87-an excellent agreement between examiners. The study of the ROC curve showed an AUC value of 0.9461 suggesting high test accuracy. Using 3 as a cut-off value, Nu-DESC showed 100 % sensibility and 76 % specificity. DISCUSSION AND CONCLUSION: Further research is needed to test Nu-DESC on a larger sample. However, based on our results, Nu-DESC can be used in research and clinical practice in Italian settings because of its very good and similar performances to previous validation studies. The value of 3 appears to be the optimal cut-off in the Italian context.

Checklist of host plants of insect galls in the state of Goiás in the Midwest Region of Brazil.

BACKGROUND: Surveys of host plants of insect galls have been performed in different regions of Brazil. The knowledge of species of host plants of insect galls is fundamental to further studies of plant-galling insect interactions. However, a list of host plant species of gall-inducing insects has not yet been compiled for the flora of the Midwest Region of Brazil. NEW INFORMATION: We provide a compilation of the plant species reported to host insect galls in the Cerrado of the state of Goiás in the Midwest Region of Brazil. Altogether we found records for 181 species of 47 families of host plants, which hosted 365 distinct gall morphotypes.

Algunas consideraciones sobre los factores potencialmente psicopatógenos del Medio / Considerations about potential psychopathogenic factors of the environment

En este trabajo se hizo alusión a los factores potencialmente psicopatógenos del Medio, los cuales fueron obtenidos y actualizados por la revisión de diferentes textos facilitados por el Centro de Información de Ciencias Médicas y otros personales, además de Medline por correo electrónico. Se realizó una breve introducción del tema, se enumeraron los "factores" más frecuentes y se explicó cada uno de ellos.[AU]