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La disfagia es la incapacidad de mover alimentos o líquidos desde la boca, a través de la faringe y el esófago, hacia el estómago de manera segura y eficiente. Algunas estimaciones consideran que el 80-90% de los niños con discapacidades del desarrollo, presentan algún trastorno en la deglución y se resume la evolución sensorial y motora del bebé. El propósito de este artículo es la revisión de la etiología, el diagnóstico y el tratamiento de la disfagia en el paciente pediátrico, comprendiendo algunas de las técnicas más aceptadas para el estudio de la deglución y la disfagia, algunas terapias propuestas para su tratamiento incluyendo el uso de equipos de alimentación específicos, así como la clasificación de la textura del bolo alimenticio y su modificación con agentes espesantes. Se describen algunas técnicas sencillas para determinar la textura del alimento

Dysphagia is the inability to move food or liquid from the mouth, through the pharynx and esophagus, into the stomach, safely and efficiently. Some estimations consider that 80-90% of children with developmental disabilities have a swallowing disorder. The sensory and motor evolution of the infant are summarized, as well as baby's sensory and motor evolution. The aim of this paper is to revise the etiology, diagnosis and treatment of dysphagia in pediatric patients are reviewed, including some of the most accepted techniques for the study of swallowing and dysphagia. Some therapies proposed for its treatment, including the use of specific feeding equipment, are also reviewed. The classification of the texture of the food bolus and its modification with thickening agents is presented. Some simple techniques are described to determine the texture of food

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OBJECTIVE: To investigate, in vitro, the influence of at-home bleaching with 16% carbamide peroxide (CP) gels containing different thickeners on the color, gloss, roughness, and microhardness of a composite resin with bisphenol A (BPA) and without bisphenol A (BPA-free). MATERIAL AND METHODS: Cylindrical samples (7 × 2 mm) of a composite resin with BPA (Filtek Z350 XT®; 3M/ESPE) and composite resin BPA-free (Vittra APS®; FGM) were subdivided into six subgroups (n = 12), according to the bleaching gel used: no bleaching (control), commercial gel with 16% CP and carbopol, experimental gel with 16% CP and carbopol, experimental gel with 16% CP and natrosol, experimental gel with carbopol and experimental gel with natrosol. At the end of the experimental phase, the specimens were analyzed for color (ΔE*ab and ΔE00 ), surface roughness (Ra), gloss (GU), and surface microhardness (SMH). The data for all analyzes were submitted to Levene's test, Shapiro-Wilk's test and ANOVA. RESULTS: For ΔE*ab and ΔE00 no statistically significant differences were found between all groups evaluated. Bleaching with experimental 16% CP gel with carbopol resulted in the lowest GU values for both composite resins evaluated. 16% CP experimental gel with natrosol resulted in higher Ra for the BPA composite resin and the bleaching with natrosol resulted in higher Ra for BPA-free. About 16% CP experimental gel with carbopol and 16% CP experimental gel with natrosol resulted in the lowest final SMH for composite resin with BPA. For the BPA-free composite resin, no differences were found between the groups in SMH for the same resin, however they presented the lowest values compared with all others groups. CONCLUSION: The effects on physical properties are dependent on the composition of the composite resin and the thickener/bleaching gel used. The BPA-free composite resin showed less changes after exposure to bleaching agent, although its initial physical properties were worse compared to a bleached BPA. CLINICAL RELEVANCE: The hydrogen peroxide and thickener of the at-home bleaching gel does impact the properties of composites with BPA or BPA-free such as gloss, roughness and surface microhardness, extremely important factors for maintaining an aesthetically and physically satisfactory restoration. BPA-free composite resins have inferior properties after at-home bleaching with different thickeners.

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Abstract Bleaching gel thickeners induce important changes in tooth enamel and these changes are reversed by saliva. Objective This in situ study aimed to evaluate the effect of bleaching gels with different thickeners on tooth enamel under normal and hyposalivation conditions. Methodology Of 28 participants, 14 had normal salivary flow and 14 had low salivary flow. For each salivary flow, four types of treatment were performed with different thickeners: no bleaching (negative control), bleaching with a commercial 10% carbamide peroxide (CP) gel with carbopol (positive control) and bleaching with experimental 10% CP gels with natrosol and aristoflex. Participants used a palatal appliance containing bovine enamel/dentin specimens for 15 days. From day 2 to day 15, specimens were bleached extraorally. The bleaching gel was applied according to the groups for four hours. When the bleaching gel was removed, the palatal appliance was inserted again in the participants' mouth until the next day for another bleaching application. This procedure was repeated for 14 days and on day 15, surface microhardness (SMH), color (ΔE*ab and ΔE00), surface roughness (Ra), scanning electron microscopy (SEM), and energy-dispersive X-ray spectrometry (EDS) analyses were performed and data were subjected to statistical analysis. Results Neither salivary flow nor thickeners influenced ΔE*ab and ΔE00 results. Carbopol had the lowest SMH, the highest Ra, and the lowest Ca% among all groups. For normal flow, natrosol and aristoflex had higher SMH. For low flow, aristoflex had higher SMH and natrosol and aristoflex had lower Ra. Aristoflex had higher Ca% and Ca/P and differed from carbopol for normal flow. Conclusion For normal flow, 10% CP gels with natrosol and aristoflex caused fewer surface changes, and for low flow, only the 10% CP gel with aristoflex.

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Dysphagia is a swallowing disorder that mainly affects elderly but can be minimized by thickening of liquid foods. Flaxseed gum (FG) was studied as a potential alternative thickener for dysphagia patients in comparison to commercial thickeners based on xanthan gum (XG) and modified starch (MS). Rheological and tribological responses of biopolymer-based thickening solutions (0.75-3% w/w) incorporated in different food matrices (water, orange-flavoured soy juice and skim milk) were recorded and correlated. In general, the increase in gums concentration led to increases in viscosity, viscoelastic properties and lubricating capacity. An opposite behavior was observed for the MS-based products, since an increase in concentration led to a lower increase in viscosity and viscoelastic properties but caused a decrease in the lubricating capacity. These results indicated that associating tribology to rheology is crucial to further define formulations with pleasant swallowing characteristics.

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INTRODUCTION: Oral feeding safety is necessary to provide nutrition, hydration, and eating pleasure for patients with dysphagia. Commercial thickeners are prescribed for these patients to change food viscosity and may alter the proper preparation of modified food. OBJECTIVE: Analyze composition, employed terminology, preparation instructions, recommended amount and weight of provided measuring spoons, nutritional information, and viscosity of 7 commercial thickeners. METHODS: The sample comprised all thickeners from different brands available in Brazil, named A to G. Products were submitted to viscosity analysis using viscometer and the International Dysphagia Diet Standardization Initiative (IDDSI) test. Samples were prepared with mineral water (25°C) and with the amount of thickener recommended to obtain intermediate viscosity (level 2) according to the manufacturer's instructions. RESULTS: Products B, C, and E presented similar composition. Manufacturer's information about the amount and preparation procedure, time, temperature, and base liquid was incomplete. Viscosity tests revealed that thickener C was basically solid while D displayed results out of the desired viscosity level. CONCLUSIONS: The study showed differences in components and viscosity, beyond the lack of label details. There was no established correlation between viscosity classifications provided by National Dysphagia Diet and IDDSI.

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ABSTRACT Purpose: to evaluate the effects of a thickening agent on the osmolality of human milk and on an infant formula, with respect to concentration and time. Methods: six trials were performed to evaluate the osmolality of a natural and thickened infant formula, raw human milk, and pasteurized human milk. Rice cereal was used as a thickening agent (at concentrations of 2%, 3%, 5%, and 7%). Osmolality was measured using the Advanced Micro Osmometer Model 3300 after sample preparation periods of 0-60 minutes. Statistical evaluations were performed using ANOVA. Results: pasteurized human milk exhibited time- and concentration-dependent variation in osmolality. The osmolality of raw human milk differed among time points and between the samples with 5% and 7%, when compared to the non-thickened milk. The infant formula did not show differences in osmolality with respect to time. At time zero, there were differences in osmolality between the infant formula samples with 2%, 3%, and 5% thickener. At other time points, there were differences in osmolality between the sample with a 5% thickener and the non-thickened formula. Conclusion: the osmolality of diets varied over time and according to the concentration of thickener in human milk and the infant formula. However, the observed variation remained within the recommended parameters, indicating that rice cereal is a safe thickener for the feeding of infants presented with mild or moderate oropharyngeal dysphagia.

RESUMO Objetivo: avaliar o efeito do agente espessante na osmolalidade do leite humano e da fórmula infantil em relação às concentrações e ao efeito do tempo. Métodos: foram realizados 6 ensaios para avaliar a osmolalidade, ao natural e com espessamento, da fórmula infantil, leite humano ordenhado cru e pasteurizado. O cereal de arroz foi usado como agente espessante (nas concentrações de 2%, 3%, 5% e 7%). A osmolalidade foi aferida pelo The Advanced TM Micro Osmometer Model 3300 após a preparação das amostras por um período de 0-60 minutos. As diferenças significantes foram avaliadas por meio de Anova. Resultados: observou-se variação da osmolalidade no leite humano pasteurizado nos tempos observados e nas concentrações. O leite humano cru apresentou variação nos tempos e nas concentrações 5 e 7%, quando comparado ao leite não espessado. A fórmula infantil não mostrou diferenças na osmolalidade com relação ao tempo. No tempo zero, apresentou variações entre as concentrações de 2, 3 e 5%. Nos demais tempos, houve diferença na osmolalidade entre as amostras com concentração de 5% e a fórmula não espessada. Conclusão: a osmolalidade das dietas analisadas variou conforme o tempo e as concentrações para o leite humano e a formula infantil. No entanto, estas variações se mantiveram dentro dos parâmetros preconizados, indicando que o cereal de arroz é um espessante seguro para a alimentação de lactentes com disfagia orofaríngea leve ou moderada.

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ABSTRACT Purpose: to analyze the modification of the viscosity of human milk and infant formula. Methods: three studies were performed to assess the viscosity and effect of time on infant formula with a thickener, at concentrations of 2, 3, and 5%, as well as raw and pasteurized human milk at concentrations of 2, 3, 5, and 7% at 37ºC, for 60 minutes. Rice cereal was used as a thickening agent. The viscosity was evaluated using a Ford Cup-type viscometer, and the samples were analyzed at 20-minute intervals. Significant differences were assessed using the ANOVA test. Results: no significant differences in viscosity were observed over time in concentrations of 2, 3, and 5%. There was a difference in the viscosity between human milk and infant formula, in concentrations of 2% and 5%, 2% and 7%, 3% and 5%, and 3% and 7%, independently of the time intervals evaluated. Conclusion: the findings of this study demonstrate the need for different concentrations of the thickening agent for human milk and infant formula. Rice cereal is a suitable therapeutic option for newborns presented with dysphagia in concentrations of 2, 3, 5, and 7%, due to its effect on the viscosity and flow reduction, provided that the feeding time is considered.

RESUMO Objetivo: analisar o leite humano e a fórmula láctea infantil com a viscosidade modificada. Métodos: foram realizados três estudos considerando a viscosidade e efeito do tempo na fórmula nas concentrações 2, 3 e 5% e no leite humano cru e pasteurizado nas concentrações 2, 3, 5 e 7% na temperatura de 37ºC pelo tempo de 60 minutos. O cereal de arroz foi utilizado como agente espessante. A viscosidade foi avaliada pelo viscosímetro do tipo Copo Ford e as amostras analisadas em quatro intervalos de tempo. Diferenças significativas foram avaliadas por meio do teste da Anova. Resultados: não foram observadas diferenças significativas da viscosidade em relação ao tempo para as concentrações de 2, 3 e 5%. Observou-se diferença na viscosidade entre leite humano e fórmula nas concentrações de 2% e 5%, 2% e 7%, 3% e 5%, e 3% e 7%, independente dos intervalos de tempo considerados. Conclusão: o estudo aponta para a necessidade de diferentes concentrações para leite humano e formula. O cereal de arroz apresenta-se como opção terapêutica adequada para os recém-nascidos com disfagia nas concentrações de 2, 3, 5 e 7% pelo seu efeito na viscosidade e redução do fluxo, desde que se observe o tempo de mamada.

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Microbial biosurfactants with high ability to reduce surface and interfacial surface tension and conferring important properties such as emulsification, detergency, solubilization, lubrication and phase dispersion have a wide range of potential applications in many industries. Significant interest in these compounds has been demonstrated by environmental, bioremediation, oil, petroleum, food, beverage, cosmetic and pharmaceutical industries attracted by their low toxicity, biodegradability and sustainable production technologies. Despite having significant potentials associated with emulsion formation, stabilization, antiadhesive and antimicrobial activities, significantly less output and applications have been reported in food industry. This has been exacerbated by uneconomical or uncompetitive costing issues for their production when compared to plant or chemical counterparts. In this review, biosurfactants properties, present uses and potential future applications as food additives acting as thickening, emulsifying, dispersing or stabilising agents in addition to the use of sustainable economic processes utilising agro-industrial wastes as alternative substrates for their production are discussed.

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Produtos cosméticos para a higiene capilar promovem a remoção de gordura, suor, poeira, células mortas, micro-organismos e resíduos de outros cosméticos do couro cabeludo e do cabelo. Com esta finalidade, foi proposto o desenvolvimento e avaliação da estabilidade de formulações contendo tensoativos primários não sulfatados associados separadamente com diferentes agentes de consistência (Myrj® 6000, NovethixTM L-10 e Carbopol® Ultrez 20). Dentre os seis tensoativos "não sulfatados" avaliados, dois foram selecionados (Plantapon® LGC Sorb e Sensactive® C30) conforme critérios de avaliação da viscosidade e da formação de espuma. Seis formulações foram desenvolvidas, com combinações distintas entre os tensoativos selecionados e os diferentes agentes de consistência (sem a adição intencional de cloreto de sódio), com posterior estudo de estabilidade em variadas condições de armazenamento. Durante os estudos de estabilidade acelerada, as formulações contendo os agentes de consistência Myrj® 6000 ou NovethixTM L-10 não apresentaram estabilidade adequada. Ao final do estudo de estabilidade normal, as formulações remanescentes, contendo Carbopol® Ultrez 20, mantiveram as características organolépticas e desempenho adequado quanto à viscosidade, comprovando a eficiência deste polímero, mesmo em formulações com grandes quantidades de tensoativos "não sulfatados" e eletrólitos.

Cosmetic products for hair cleansing promote the removal of grease, sweat, dirt, dead cells, microorganisms and residues of other cosmetics from the skin, scalp and hair. In this context, it was decided to develop and assess the stability of formulations containing various non-sulfate primary surfactants, combined separately with three different consistency agents (Myrj® 6000, NovethixTM L-10 and Carbopol® Ultrez 20). Among the six non-sulfate surfactants tested, two were selected (Plantapon® LGC Sorb and Sensactive® C30) by viscosity and foam formation criteria. Thus, 6 formulations were developed, with distinct combinations of the 2 selected surfactants and 3 consistency agents (without the intentional addition of sodium chloride), and subsequently their stability under various storage conditions was studied. In the short-term stability study, formulations containing the consistency agents Myrj® 6000 or NovethixTM L-10 did not show adequate stability. At the end of the full-length stability study, the remaining formulations, containing Carbopol® Ultrez 20, maintained their organoleptic characteristics and good viscosity, proving the efficiency of this polymer, even in formulations with large amounts of non-sulfate surfactants and electrolytes.

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