Comparative Bioinformatic Analysis of the Proteomes of Rabbit and Human Sex Chromosomes.

Studying proteins associated with sex chromosomes can provide insights into sex-specific proteins. Membrane proteins accessible through the cell surface may serve as excellent targets for diagnostic, therapeutic, or even technological purposes, such as sperm sexing technologies. In this context, proteins encoded by sex chromosomes have the potential to become targets for X- or Y-chromosome-bearing spermatozoa. Due to the limited availability of proteomic studies on rabbit spermatozoa and poorly annotated databases for rabbits compared to humans, a bioinformatic analysis of the available rabbit X chromosome proteome (RX), as well as the human X (HX) and Y (HY) chromosomes proteome, was conducted to identify potential targets that could be accessible from the cell surface and predict which of the potential targets identified in humans might also exist in rabbits. We identified 100, 211, and 3 proteins associated with the plasma membrane or cell surface for RX, HX, and HY, respectively, of which 61, 132, and 3 proteins exhibit potential as targets as they were predicted to be accessible from the cell surface. Cross-referencing the potential HX targets with the rabbit proteome revealed an additional 60 proteins with the potential to be RX targets, resulting in a total of 121 potential RX targets. In addition, at least 53 possible common HX and RX targets have been previously identified in human spermatozoa, emphasizing their potential as targets of X-chromosome-bearing spermatozoa. Further proteomic studies on rabbit sperm will be essential to identify and validate the usefulness of these proteins for application in rabbit sperm sorting techniques as targets of X-chromosome-bearing spermatozoa.

Sustainable animal production: exploring the benefits of sperm sexing technologies in addressing critical industry challenges.

The sex of the animals is of paramount importance in many animal production systems. This is particularly evident in the production of milk or in breeding programs focused on the production of female animals. In some cases, slaughter or euthanasia of animals of the unwanted sex becomes the only solution, highlighting ethical and economic concerns. As global demand for food continues to rise, the importance of addressing these issues becomes more evident. Reproductive technologies, such as sperm sexing techniques, may hold the key to addressing both animal welfare and the sustainability of animal production. The use of semen enriched with sperm capable of producing offspring of the desired sex can serve as a valuable tool for producers to exert greater control over production outcomes, not only helping to mitigate welfare issues related to the unnecessary premature death of unwanted offspring but also providing a possible ally in the face of stricter animal welfare guidelines. In addition, sexed semen can also contribute to financial gains and reduce greenhouse gas emissions and food waste associated with the less profitable part of the herd. This paper explores the positive impacts that sperm sexing can have on animal welfare, economy, and environment. It also discusses currently available options and strategies for more successful implementation of sexed semen. Partnerships between companies and scientists will be essential to find innovative ways to adapt current production systems and develop sperm sexing technologies that apply to most livestock industries.

Pregnancy Complications and Feto-Maternal Monitoring in Rabbits.

Rabbit production holds significant relevance in modern agriculture due to its potential as a sustainable source of high-quality protein and efficient feed conversion, contributing to food security and economic diversification. Nevertheless, studies incorporating feto-maternal monitoring in this species are uncommon. This review gathers research on the monitoring and evaluation of factors affecting rabbit gestation, providing a better understanding of the causes of prenatal development abnormalities. These include studies regarding how chronic maternal hypertension, gestational diabetes, maternal stress, ectopic gestation, maternal uterine ischemia and fetal hypoxia, intrauterine growth restriction, superfetation, maternal age, maternal nutritional status, maternal physical condition, maternal and embryonic genotype, and the intrauterine location of rabbit fetuses can potentially impact rabbits' reproduction and maternal and fetal health. Among other monitoring techniques, ultrasonography, considered one of the best tools for diagnosing pregnancy and conducting follow-up, is also reviewed. Details on measurable fetal-development parameters in rabbits and precautions to be considered before and during the examination are also provided. Additional studies are required to understand why some events occur and their consequences throughout gestation, allowing the determination of new biomarkers or cut-offs that can be helpful for early diagnosis and improve reproductive efficiency.

The History and Prospects of Rabbit Sperm Sexing.

Sperm sex selection is a longstanding challenge in the field of animal reproduction. The cuniculture industry, in particular producers of males or females for breeding purposes, would greatly benefit from the pre-selection of the offspring's sex. This review article overviews the current and future developments in rabbit sperm sexing technologies, as well as the implications of implementing these methodologies in cuniculture. The first attempts of sperm sexing were performed in rabbits; however, a both efficient and cost-effective methodology was not yet developed for this species. Those included sperm sexing according to differences in sperm density, surface electric charge, pH susceptibility, antisera reaction, and flow cytometry. Separation by flow cytometry has proven to be efficient in rabbits, yielding fractions with approximately 81% and 86% purity for X- and Y-sperm, respectively. However, it is not cost-effective for cuniculture and decreases sperm quality. The advantages, limitations, and practical considerations of each method are presented, highlighting their applicability and efficiency. Furthermore, herein we explore the potential of immunological-based techniques that overcome some of the limitations of earlier methods, as well as recent advancements in sperm sexing technologies in other animal models, which could be applied to rabbits. Finally, the challenges associated with the development and widespread implementation of rabbit sperm sexing technologies are addressed. By understanding the advantages and limitations of existing and emerging methods, researchers can direct their efforts towards the most promising directions, ultimately contributing to a more efficient, profitable, and sustainable cuniculture.

The drivers and impacts of Amazon forest degradation.

Approximately 2.5 × 106 square kilometers of the Amazon forest are currently degraded by fire, edge effects, timber extraction, and/or extreme drought, representing 38% of all remaining forests in the region. Carbon emissions from this degradation total up to 0.2 petagrams of carbon per year (Pg C year-1), which is equivalent to, if not greater than, the emissions from Amazon deforestation (0.06 to 0.21 Pg C year-1). Amazon forest degradation can reduce dry-season evapotranspiration by up to 34% and cause as much biodiversity loss as deforestation in human-modified landscapes, generating uneven socioeconomic burdens, mainly to forest dwellers. Projections indicate that degradation will remain a dominant source of carbon emissions independent of deforestation rates. Policies to tackle degradation should be integrated with efforts to curb deforestation and complemented with innovative measures addressing the disturbances that degrade the Amazon forest.

Entrega em adoção e demanda de reencontro à justiça: motivações da genitora / Voluntary relinquishment and request to justice for reunion: birth mother's motivations / Entrega en adopción y solicitud de reencuentro a la justicia: motivaciones de la madre biológica

Mudanças legislativas em relação à adoção vêm trazendo importantes repercussões para a compreensão do instituto. Neste artigo, temos como objetivo discutir especificidades da entrega voluntária de uma criança para adoção, no contexto da Justiça, e as motivações de demanda posterior da genitora para a viabilização de um reencontro. Problematizamos a amplitude do direito de acesso às origens, assegurado em lei aos adotados, a partir do entrelaçamento das temáticas entrega e reencontro, procurando compreender essas experiências pela perspectiva da genitora. Este trabalho parte de um caso paradigmático, atendido em uma Vara da Infância, Juventude e Idoso no estado do Rio de Janeiro, que culminou com o contato, mediado pelo Poder Judiciário, entre a adotada e sua genitora, por iniciativa desta. Trata-se de um estudo qualitativo, no qual foi realizada uma entrevista semiestruturada com a genitora, quatro anos após o acolhimento de seu pedido à Justiça. Os dados obtidos na entrevista foram analisados por meio do método de análise de conteúdo, em sua vertente categorial, resultando em duas categorias: entrega em adoção e segredos; reencontro: motivações e trajetórias. Constatamos a ausência de publicações brasileiras sobre a temática do reencontro, apontando que o assunto ainda é um tabu. Identificamos que, após o reencontro com a filha, foi possível à genitora uma transformação de si mesma, favorecendo o rompimento do segredo da entrega e de parte de sua história. Assinalamos a necessidade de mais pesquisas, incluindo-se a possibilidade da inserção do Judiciário na mediação dessas demandas.(AU)

Legislative changes related to adoption have brought important repercussions for understanding its regulations. In this article, we aim to discuss the peculiarities of a voluntary relinquishment of a child for adoption, in the context of justice, and the motivations of subsequent demand from the birth mother to set a reunion. We problematize the dimension of the right to access origins, guaranteed by law to adoptees, based on the intertwining of the themes voluntary relinquishment and reunion, seeking to understand these experiences from the perspective of the biological mother. This work is based on a paradigmatic case, attended at a Juvenile Court in the State of Rio de Janeiro, that culminated on the reunion of the adopted and her birth mother, at the initiative of the latter, mediated by the Judiciary. This is a qualitative study, in which we interviewed the biological mother, four years after her legal requirement. The data obtained in the interview were analyzed using the content analysis method, in its categorical aspect, resulting in two categories: voluntary relinquishment in adoption and secrets; reunion: motivations and trajectories. We concluded the absence of Brazilian studies about the theme of reunion, pointing out that the subject still as a taboo. We identified that, after the reunion with the daughter, it was possible for the biological mother to modify herself, favoring the breaking of the secret about the relinquishment and of part of her story. We point out the need of more research, including the possibility of inserting the Judiciary as a mediator for such demands.(AU)

Los cambios legislativos respecto a la adopción han tenido importantes repercusiones en la comprensión de la materia. Este artículo pretende discutir los detalles de la entrega espontánea de un niño para adopción, en el contexto de la Justicia, y las motivaciones de la posterior demanda de la madre biológica para hacer factible un reencuentro. Se problematiza la amplitud del derecho de acceso a los orígenes, garantizado por la ley a los adoptados, a partir del entrelazamiento de los temas entrega y reencuentro, analizando estas experiencias desde la perspectiva de la madre biológica. Este trabajo parte de un caso paradigmático que se llevó a cabo en un Juzgado de la Infancia, Juventud y Persona Mayor del Estado de Río de Janeiro y que culminó en el contacto entre la adoptada y su madre, por iniciativa de esta última, mediado por el Poder Judicial. Este estudio cualitativo realizó una entrevista semiestructurada con la madre biológica cuatro años después de su solicitud a la Justicia. A los datos obtenidos en la entrevista se aplicaron el método de análisis de contenido en su vertiente categórica, en el cual surgieron dos categorías: entrega en adopción y secretos; reencuentro: motivaciones y trayectorias. Se encontró que la falta de estudios brasileños sobre reencuentro apunta a que el concepto del sujeto todavía es un tabú. Se constató que luego del encuentro la madre biológica pasó por una autotransformación, lo que favoreció la ruptura del secreto sobre la entrega y parte de su historia. Es necesario realizar más investigaciones sobre el tema, incluida la posibilidad de insertar al Poder Judicial como mediador de tales demandas.(AU)

TLR7 and TLR8 evolution in lagomorphs: different patterns in the different lineages.

Toll-like receptors (TLRs) are one of the most ancient and widely studied innate immune receptors responsible for host defense against invading pathogens. Among the known TLRs, TLR7 and TLR8 sense and recognize single-stranded (ss) RNAs with a dynamic evolutionary history. While TLR8 was lost in birds and duplicated in turtles and crocodiles, TLR7 is duplicated in some birds, but in other tetrapods, there is only one copy. In mammals, with the exception of lagomorphs, TLR7 and TLR8 are highly conserved. Here, we aim to study the evolution of TLR7 and TLR8 in mammals, with a special focus in the order Lagomorpha. By searching public sequence databases, conducting evolutionary analysis, and evaluating gene expression, we were able to confirm that TLR8 is absent in hares but widely expressed in the European rabbit. In contrast, TLR7 is absent in the European rabbit and quite divergent in hares. Our results suggest that, in lagomorphs, more in particular in leporids, TLR7 and TLR8 genes have evolved faster than in any other mammalian group. The long history of interaction with viruses and their location in highly dynamic telomeric regions might explain the pattern observed.

Sperm DNA damage and seminal antioxidant activity in subfertile men.

Supraphysiological ROS levels can lead to apoptosis, lipid peroxidation, and DNA and protein damage. This pilot study aimed to investigate the sperm oxidative damage in subfertile men, to describe the relationship between the antioxidant system and ROS. Sixty-four semen samples were categorised according to the evaluated routine parameters (WHO, WHO laboratory manual for the examination and processing of human semen, 2010). Results were cross-referenced with the DNA damage [Comet (n = 53) and TUNEL (n = 49) assays], antioxidant enzyme activity [SOD (n = 51), CAT (n = 48) and GST (n = 48)], and content of total thiols (n = 36), lipid hydroperoxides (n = 35) and MDA (n = 31). Compared to pathospermic samples, normozoospermic presented 40%-45% fewer spermatozoa with fragmented DNA, 19% fewer hydroperoxides, and slightly higher total thiols and MDA levels. Asthenozoospermic/asthenoteratozoospermic samples had the lowest GST activity. SOD and CAT showed a similar trend. Our results evidenced significant positive correlations between DNA damage and immotile spermatozoa; SOD and CAT, GST and total thiols; CAT and GST; total thiols and sperm concentration; and MDA levels and head/midpiece abnormalities and hydroperoxides. This work contributes to the existing body of knowledge by showing that the oxidative status correlates with the classic sperm analysis parameters. Oxidative stress and DNA damage evaluation might be a valuable diagnostic and prognostic tool in cases of idiopathic male subfertility.

Oropharyngeal Swallowing Dynamic Findings in People with Asthma.

Airflow obstruction in people with asthma, similar to COPD, may interfere with swallowing, increasing the risk of food or liquid entrance into the lower airways, and favoring the uncontrolled disease. To describe the complaints and findings of the oropharyngeal swallowing mechanisms in patients with mild and severe asthma, a cross-sectional study was performed. A total of 135 participants with asthma were studied, of whom 97 had severe asthma and 38 had mild asthma. All subjects answered a questionnaire with demographic information, disease exacerbations, Asthma Control Questionnaire 6 (ACQ6-Juniper 1999), GastroEsophageal Reflux Disease Symptoms Questionnaire (GERD-SQ-Fornari et al. 2004), and Eating Assessment Tool 10 (EAT-10-Gonçalves et al., 2013). The oral and pharyngeal swallowing assessment occurred via videofluoroscopic swallowing evaluation. The age range of the participants was from 19 to 80 years, with a predominance of females (78.6%). Uncontrolled asthma was observed in 50 (52%) of the patients with severe asthma and in 11 (29%) of the patients with mild asthma (ACQ6 > 1.5). The GERD-SQ and EAT-10 scores were similar in both groups. In the bivariate analysis, the group with severe asthma presented with more changes when compared to the group with mild asthma in the following events: atypical lingual movement during the swallowing of liquid in the volumes of 5 ml (p = 0.003) and 10 ml (p = 0.001), and solid (p = 0.009); oral transit time increased in swallowing of liquid in the volumes of 5 ml (p = 0.003) and 20 ml (p = 0.026); beginning of the pharyngeal swallowing phase below the mandibular ramus (p = 0.003); pharyngeal residue (p = 0.017) of solid consistency; laryngeal penetration of 5 ml (p = 0.050) and 20 ml (p = 0.032) of liquid; increased transition time between the oral and pharyngeal swallowing phases (p = 0.035) and increased pharyngeal transit time (p = 0.045) of solid consistency. Tracheal aspiration was observed only in the group with severe asthma. After the multivariate analysis, atypical tongue movement maintained a statistically significant difference between the two groups. Oropharyngeal swallowing alternations were frequent in the studied sample and more markedly present in patients with severe asthma. Multivariate regression revealed atypical lingual movement, which was greater in patients with severe asthma. The clinical significance of these findings should be further investigated.

Association of lifestyle factors with semen quality: A pilot study conducted in men from the Portuguese Trás-os-Montes and Alto Douro region followed in fertility support consultations.

A cross-sectional pilot study was conducted in men followed in fertility consultations, from the portuguese Trás-os-Montes and Alto Douro region, in order to associate several lifestyle factors with the spermatic parameters. Of a total of 522 men, 373 were compared based on the occupational exposure to harmful factors, smoking habits and practice of physical exercise per week, and the other 149 men according to their body mass index (normal weight vs. overweight vs. obesity). In the absence of harmful occupational factors, physical exercise seems to be associated with sperm quality improvement, whether individuals smoke or not. When exposed to harmful environments, non-smokers that practice physical exercise more than two times per week tended to present the best vitality, normal morphology and sperm concentration (p > .05). However, if they smoke, physical exercise seems not enough to enhance the spermatic parameters. The BMI correlated negatively with the spermatic quality, especially with sperm concentration (p < .05). Concerning men that did not present lifestyle risks associated, the motility, midpiece and tail abnormalities, and teratozoospermia index were significantly worse on obese individuals comparing to overweight men (p < .05). Thus, patients should also be recommended to control their weight and to have a BMI under 30 kg/m2 .

Limiting the high impacts of Amazon forest dieback with no-regrets science and policy action.

Large uncertainties still dominate the hypothesis of an abrupt large-scale shift of the Amazon forest caused by climate change [Amazonian forest dieback (AFD)] even though observational evidence shows the forest and regional climate changing. Here, we assess whether mitigation or adaptation action should be taken now, later, or not at all in light of such uncertainties. No action/later action would result in major social impacts that may influence migration to large Amazonian cities through a causal chain of climate change and forest degradation leading to lower river-water levels that affect transportation, food security, and health. Net-present value socioeconomic damage over a 30-year period after AFD is estimated between US dollar (USD) $957 billion (×109) and $3,589 billion (compared with Gross Brazilian Amazon Product of USD $150 billion per year), arising primarily from changes in the provision of ecosystem services. Costs of acting now would be one to two orders of magnitude lower than economic damages. However, while AFD mitigation alternatives-e.g., curbing deforestation-are attainable (USD $64 billion), their efficacy in achieving a forest resilience that prevents AFD is uncertain. Concurrently, a proposed set of 20 adaptation measures is also attainable (USD $122 billion) and could bring benefits even if AFD never occurs. An interdisciplinary research agenda to fill lingering knowledge gaps and constrain the risk of AFD should focus on developing sound experimental and modeling evidence regarding its likelihood, integrated with socioeconomic assessments to anticipate its impacts and evaluate the feasibility and efficacy of mitigation/adaptation options.

Impact of levodopa treatment in the voice pattern of Parkinson's disease patients: a systematic review and meta-analysis.

PURPOSE: Investigate the association between levodopa therapy and vocal characteristics in Parkinson's disease patients. SEARCH STRATEGY: Studies published at MEDLINE, LILACS, and SciELO, from 1960 to December 2016. A systematic review and meta-analysis was performed using the following keywords: Parkinson's disease; levodopa; L-dopa; voice; speech disorders; dysphonia; dysarthria. After analyzing titles and abstracts, two independent reviewers selected all clinical trials that met the eligibility criteria and selected the articles and the data recorded in a previously standardized table. SELECTION CRITERIA: Trials published in English between 1960 and December 2016 individuals with clinical diagnosis of Parkinson's disease; use of levodopa therapy in stable doses; acoustic analysis combined or not with auditory-perceptual analysis to evaluate the vocal parameters under investigation. DATA ANALYSIS: The following vocal parameters were analyzed: fundamental frequency (F 0), jitter, and vocal intensity. Standardized mean differences (SMD) were calculated using the Comprehensive Meta-analysis V2 software. RESULTS: Nine articles met the eligibility criteria and were selected, with a total of 119 individuals. From these, six articles with 83 individuals were included in the meta-analysis. During the levodopa therapy "on" state, modifications in F 0 (SMD=0.39; 95% CI - 0.21-0.57) and jitter (SMD=0.23; 95% CI - 0.02-0.45) were observed. Vocal intensity was not affected (SMD=0.09; 95% CI - 0.22-0.39) by levodopa ingestion. Data of the included studies were controversial in the auditory-perceptual analysis of voice. CONCLUSION: Levodopa therapy modifies F0 and jitter. No changes in vocal intensity were observed in either the "on" or "off" states of levodopa therapy.

Genetics of personalized medicine: cancer and rare diseases.

The 21st annual meeting of the Portuguese Society of Human Genetics (SPGH), organized by Luísa Romão, Ana Sousa and Rosário Pinto Leite, was held in Caparica, Portugal, from the 16th to the 18th of November 2017. Having entered an era in which personalized medicine is emerging as a paradigm for disease diagnosis, treatment and prevention, the program of this meeting intended to include lectures by leading national and international scientists presenting exceptional findings on the genetics of personalized medicine. Various topics were discussed, including cancer genetics, transcriptome dynamics and novel therapeutics for cancers and rare disorders that are designed to specifically target molecular alterations in individual patients. Several panel discussions were held to emphasize (ethical) issues associated with personalized medicine, including genetic cancer counseling.

Impact of levodopa treatment in the voice pattern of Parkinson's disease patients: a systematic review and meta-analysis / O impacto do tratamento com levodopa na voz de pacientes com doença de Parkinson: revisão sistemática e meta-análise

Abstract Purpose Investigate the association between levodopa therapy and vocal characteristics in Parkinson's disease patients. Search strategy Studies published at MEDLINE, LILACS, and SciELO, from 1960 to December 2016. A systematic review and meta-analysis was performed using the following keywords: Parkinson's disease; levodopa; L-dopa; voice; speech disorders; dysphonia; dysarthria. After analyzing titles and abstracts, two independent reviewers selected all clinical trials that met the eligibility criteria and selected the articles and the data recorded in a previously standardized table. Selection criteria Trials published in English between 1960 and December 2016 individuals with clinical diagnosis of Parkinson's disease; use of levodopa therapy in stable doses; acoustic analysis combined or not with auditory-perceptual analysis to evaluate the vocal parameters under investigation. Data analysis The following vocal parameters were analyzed: fundamental frequency (F 0), jitter, and vocal intensity. Standardized mean differences (SMD) were calculated using the Comprehensive Meta-analysis V2 software. Results Nine articles met the eligibility criteria and were selected, with a total of 119 individuals. From these, six articles with 83 individuals were included in the meta-analysis. During the levodopa therapy "on" state, modifications in F 0 (SMD=0.39; 95% CI - 0.21-0.57) and jitter (SMD=0.23; 95% CI - 0.02-0.45) were observed. Vocal intensity was not affected (SMD=0.09; 95% CI - 0.22-0.39) by levodopa ingestion. Data of the included studies were controversial in the auditory-perceptual analysis of voice. Conclusion Levodopa therapy modifies F0 and jitter. No changes in vocal intensity were observed in either the "on" or "off" states of levodopa therapy.

RESUMO Objetivo investigar a associação entre o uso da levodopa e as características vocais em pacientes com doença de Parkinson. Estratégia de pesquisa estudos publicados nas bases MEDLINE, LILACS e SciELO, de 1960 a dezembro de 2016. Uso dos descritores: doença de Parkinson; levodopa; L-dopa; voz; distúrbios do discurso; disfonia e disartria. Depois de analisar os títulos e os resumos, dois revisores independentes selecionaram todos os ensaios clínicos que atendiam aos critérios de seleção, selecionaram os artigos e registraram os dados em uma tabela padronizada anteriormente. Critérios de seleção ensaios publicados em inglês entre 1960 e dezembro de 2016 assuntos com diagnóstico clínico de doença de Parkinson; uso de terapia com levodopa em doses estáveis; análise acústica combinada ou não com a análise auditiva-perceptiva para avaliar os parâmetros vocais sob investigação. Análise dos dados os parâmetros vocais analisados ​​foram: frequência fundamental (F0), Jitter e intensidade vocal. As diferenças de médias padronizadas (SMD) foram calculadas com o software Metanálise Abrangente V2. Resultados 9 artigos preencheram os critérios de elegibilidade e foram selecionados, com um total de 119 indivíduos. Desses 9 artigos, 6, com 83 indivíduos, foram incluídos na metanálise. Durante a fase "on", houve uma modificação no F0 (SMD = 0,39; IC 95% 0,21-0,57) e Jitter (SMD = 0,23; IC 95% 0,02-0,45). A intensidade vocal não foi afetada (SMD = 0,09; IC 95% -0,22-0,39) pela ingestão da levodopa. Ao considerar a análise auditiva-perceptiva, os dados foram controversos entre os estudos incluídos. Conclusão a terapia com levodopa modifica F0 e Jitter. Não houve alteração na intensidade vocal nas fases "on" e "off" da terapia com levodopa.

Videofluoroscopic Predictors of Penetration-Aspiration in Parkinson's Disease Patients.

Parkinson's disease (PD) patients show a high prevalence of swallowing disorders and tracheal aspiration of food. The videofluoroscopic study of swallowing (VFSS) allows clinicians to visualize the visuoperceptual and temporal parameters associated with swallowing disorders in an attempt to predict aspiration risk. However, this subject remains understudied in PD populations. Our aim was to identify the predictors of penetration-aspiration in PD patients using the VFSS. Consecutive patients were evaluated using VFSS with different consistencies and volumes of food. A speech-language pathologist measured the type of intra-oral bolus organization, loss of bolus control, bolus location at the initiation of the pharyngeal swallow, the presence of multiple swallows, piecemeal deglutition, bolus residue in the pharyngeal recesses and temporal measures. Scores ≥3 on the penetration-aspiration scale (PAS) indicated the occurrence of penetration-aspiration. Using logistic marginal regression, we found that residue in the vallecula, residue in the upper esophageal sphincter and piecemeal deglutition were associated with penetration-aspiration (odds ratio (OR) = 4.09, 2.87 and 3.83; P = 0.0040, 0.0071 and 0.0009, respectively). Penetration/aspiration occurred only with fluids (both of thin and thick consistency), and no significant differences were observed between fluid types or food volumes. The mechanisms underlying dysphagia and penetration/aspiration in PD patients and indications for further studies are discussed.

Swallowing disorders in Parkinson's disease: impact of lingual pumping.

BACKGROUND: Lingual pumping (LP) is a repetitive, involuntary, anteroposterior movement of the tongue on the soft palate that is executed prior to transferring the food bolus to the pharynx, but we also observed LP when multiple swallows were taken. LP may be associated with rigidity and bradykinesia in patients with Parkinson's disease (PD). This phenomenon tends to be more prevalent in dysphagic PD patients, and its impact on swallowing dynamics remains poorly understood. OBJECTIVE: To evaluate how LP interferes with the oral and pharyngeal phases of the swallowing of foods of different consistencies and volumes. METHODS: We used videofluoroscopy to study the swallowing of 69 PD patients performing 10 swallows of barium mixed with foods of different consistencies and volumes. RESULTS: LP was associated with the unstable intra-oral organization of the bolus, the loss of bolus control, the pharyngeal retention of food and food entering the airway. This abnormal movement was also associated with a shorter oral transit time and was found to be more prevalent with food of thicker consistencies. CONCLUSIONS: LP is associated with swallowing incoordination and with food entering the airway. Preventive measures to minimise the pulmonary or nutritional consequences of this behaviour are necessary.

Swallowing impairment and pulmonary dysfunction in Parkinson's disease: the silent threats.

INTRODUCTION: Swallowing disorders and respiratory impairment are frequent in Parkinson's disease (PD) patients, and aspiration pneumonia remains the leading cause of death among these subjects. OBJECTIVE: The objective of this study was to investigate whether there is an association between pulmonary impairment and swallowing dysfunction in PD patients. METHODS: A cross-sectional study with a comparison group was conducted with PD patients. Subjects were submitted to demographic questionnaires and underwent spirometric and videofluorographic assessments. Significance level was considered at 95% (p<0.05). RESULTS: Among 35 PD patients, 40% presented with swallowing complaints. However, 22% of the clinically asymptomatic patients presented airway food penetration when submitted to videofluoroscopy. In 20% of PD patients material entered the airways and there was contact with the vocal folds in 7%. However, there was an efficient cleaning with residue deglutition in almost all patients. No penetration/aspiration was detected among the controls. Respiratory parameters were below the normal predicted values in PD patients when compared to the healthy controls. CONCLUSION: These data suggest an association between pulmonary dysfunction and swallowing impairment in PD patients; even in patients without swallowing complaints, impaired pulmonary function can be detected.

Do swallowing exercises improve swallowing dynamic and quality of life in Parkinson's disease?

OBJECTIVE: To investigate the effect of motor swallowing exercises on swallowing dynamic, quality of life and swallowing complaints in Parkinson's disease (PD). DESIGN: A before-after trial. SETTING: University Medical Center. PARTICIPANTS: Parkinson's disease patients with dysphagia complaints. INTERVENTIONS: Motor swallowing exercises designed to increase the strength and range of motion of the mouth, larynx and pharyngeal structures, coordination between breathing and swallowing, and airway protection. Patients should perform the exercises twice a day, five days a week, for five weeks. MAIN OUTCOME MEASURE(S): The primary outcome was the difference before and after the intervention in number of swallowing videofluoroscopic events (Swallowing Score). The secondary outcomes were quality of life (QOL) and swallowing complaints. RESULTS: Fifteen patients concluded the study (10 man/5 woman; mean age 59.2 ± 9.17). The videofluoroscopic events with greater improvement were loss of bolus control (P < 0.03), piecemeal swallow (P = 0.05) and residue on the tongue (P < 0.01), valleculae (P = 0.01) and pyriform sinuses (P = 0.05). Lingual pumping and dental absence were interfering factors associated with treatment failure (beta standardized coefficient = -16.6, 26.2; P = 0.02, 0.002, respectively). The domains with greater improvements in QOL were fear (P = 0.02) and symptom frequency (P = 0.05). Regarding swallowing complaints, patients reported to have reduced mainly their difficulty in moving food in the mouth when chewing (P = 0.02). Reduction in swallowing disorders was not related with QOL improvement (cor = 0.13, [95% CI, 0.6-0.4], P = 0.63). CONCLUSIONS: Motor swallowing exercises may reduce swallowing disorders in PD patients without lingual pumping and dental absence and impact positively QOL and swallowing complaints in individuals with PD.