Patients who require prolonged endotracheal intubation (>48 hours) are at risk of dysphagia. Speech-language pathologists should perform swallowing exercises after extubation due to the high probability of developing aspiration pneumonia. There are no studies describing the use of swallowing techniques employed in post-extubation therapy aided by surface electromyography. To evaluate the effects of swallowing function therapy in extubated patients after prolonged orotracheal intubation by means of clinical and electromyographic evaluation. A total of 15 patients were enrolled in this study (average age 48.6 ± 16.5 years). The study was carried out in three phases: (1) Clinical and electromyographic evaluation using the Dysphagia Risk Assessment Protocol following dysphagia scores criteria, and the measurement of the suprahyoid muscles amplitude (μV) expressed by root mean square (RMS), respectively; (2) swallowing rehabilitation program; and (3) reevaluation of patients after therapy. The Wilcoxon paired test assuming a significance level of 5% was used for statistical analysis. By means of the swallowing scale, it was verified that patients suffered from severe oropharyngeal dysphagia at the first evaluation (80%), but the rehabilitation therapy reduced clinical signs, persistent only in one patient (6.7%) post-therapy, thus, improving swallowing. Significant differences, pre- and post-therapy, for suprahyoid muscles during maximal voluntary isometric contractions of right (P = .0067) and left (P = .0215), saliva swallowing by right (P = .0413) and left (P = .0151), and liquid swallowing by right (P = .0479) and left (P = .0215) sides, were found, as shown by electromyography. Swallowing exercises carried out by extubated patients after prolonged orotracheal intubation increased neuromuscular recruitment of suprahyoid muscles involved with swallowing and reduced dysphagia levels.

The effects of yeast cell wall compounds (YCWs) being added to cat food on hindgut fermentation metabolites and fecal microbiota were assessed in in vivo Experiment 1 (Exp. 1) and in vitro Experiments 2 and 3 (Exp. 2 and 3). In Exp. 1, the cats’ diets were supplemented with two dietary concentrations (46.2 and 92.4 ppm) of YCWs (YCW-15 and YCW-30, respectively), and a negative control diet with no compound in three groups (six cats per group) was used to assess the fecal score, pH, digestibility, fermentation products, and microbiota. In Exp. 2, feces from the cats that were not supplemented with YCWs (control) were used as an inoculum. A blend of pectin, amino acids, and cellulose was used as a substrate, and the YCW compound was added at two levels (5 and 10 mg). In Exp. 3, feces from cats fed YCWs were used as an inoculum to test three different substrates (pectin, amino acids, and cellulose). In Exp. 2 and 3, the gas production, pH, and fermentation products (ammonia, SCFAs, and BCFAs) were assessed. YCW-30 resulted in a higher digestibility coefficient of the crude protein, organic matter (OM) (p < 0.05), and energy of the diet (p < 0.10). Regarding the fermentation products, YCW-15 showed a trend toward higher concentrations of propionate, acetate, lactate, ammonia, isobutyrate, and valerate, while YCW-30 showed a trend (p < 0.10) toward higher levels of butyrate and pH values. The bacteroidia class and the genus Prevotella were increased by using YCW-30 and the control. At the gender level, decreased (p < 0.01) Megasphaera was observed with YCW inclusion. The microbiota differed (p < 0.01) among the groups in their Shannon indexes. For beta diversity, YCW-30 showed higher indexes (p = 0.008) than the control. The microbiota metabolic profile differed in the pathway CENTFERM-PWY; it was more expressed in YCW-30 compared to the control. In Exp. 2, the YCWs showed a higher ratio (p = 0.006) of the fermentation products in the treatments with additives with a trend towards a high dose of the additive (10 mg). In Exp. 3, the effects of the substrates (p < 0.001), but not of the YCWs, on the fermentation products were observed, perhaps due to the low dietary concentrations we used. However, the marked responses of the fermentation products to the substrates validated the methodology. We could conclude that the YCWs, even at low dietary concentrations, affected fecal SCFA production, reduced the fecal pH, and modulated the fecal microbiota in the cats. These responses were more pronounced under in vitro conditions.

O objetivo deste trabalho foi avaliar o efeito do sistema de manejo que emprega práticas de conservação do solo na distribuição do sistema radicular de cafeeiros e na estrutura de dois Latossolos após seis anos de implantação da lavoura na região do Alto São Francisco, MG. Foram abertas três trincheiras aleatórias e longitudinais à linha de plantio (0,70 x 1,50 m) em um Latossolo gibbsítico e em um Latossolo caulinítico ambos sob sistema de manejo do solo que emprega práticas conservacionistas. A avaliação do sistema radicular foi feita pelo método do perfil cultural e análise digital de imagens 2D, com posterior confecção de mapas de superfície das variáveis radiculares analisadas por meio da krigagem. Amostras de solo com estrutura preservada foram coletadas para quantificar a distribuição do diâmetro de poros 3D obtida por tomografia computada de raios-X. As raízes e poros foram classificados em: 1, >1 e ≤ 3 e > 3 mm de diâmetro. O sistema radicular dos cafeeiros de ambos os solos em estudo mesmo sobre o mesmo sistema de manejo apresentaram boa ramificação na direção horizontal e vertical. A maior concentração de raízes ocorreu na profundidade de 0,20-0,34 m no Latossolo caulinítico. No Latossolo gibbsítico, a distribuição radicular foi uniformizada especialmente na direção vertical do perfil do solo atingindo maiores profundidade. A maior ocorrência de raízes finas ocorreu no Latossolo gibsítico na profundidade de 0,80-0,94 m.