S134 PRESENTATIONS

SS duration did not show any significant variations between the 2 groups(mean¼615 ms vs. Mean¼658 ms p-value¼0.55). Conclusion: In thisstudy we were able to obtain significant differences on the SS signal areasthat could be used to evaluate the presence of residue at the pyriform sinusfrom the SS recorded externally at the neck.

No. 203 Eficacia De La Toxina Botulínica Tipo A Aplicada EnEl Palmaris Longus En Pacientes Con Síndrome Del Túnel DelCarpo Idiopático.Trujillo Millán A.; Díaz Jaimes E.; Rosas Barrita A.;Ocaña Martínez Cl.

Introducción: Es ampliamente conocido el efecto de la toxina botulínicatipo A (TBA) en el músculo y controvertida su utilidad en el manejo dedolor. Por otro lado se ha demostrado la influencia del palmaris longus en elaumento de la presión intracarpal.Objetivo: Evaluar el efecto clínico de latba aplicada en el palmaris longus en pacientes con síndrome del túnel decarpo idiopático (STCI). Material y Métodos: Se realizó un estudioprospectivo longitudinal comparativo y experimental. Se incluyeron 11pacientes con diagnóstico de STCI 7 bilaterales y 4 unilaterales (18 manosafectadas). Se dividieron en 2 grupos aleatoriamente al grupo experimentalse le aplicó 25 UI de TBA. Los cambios se evaluaron en base al cuestionarioBoston para túnel del carpo y el cuestionario Michigan. Resultados: En elgrupo experimental se observó una diferencia � 0.8 puntos en relación a laseveridad de los síntomas a las 16 semanas (p<0.0001) lo que representóuna mejoría en 7 de 10 manos afectadas en contraste con el grupo control enel que no hubo mejoría significativa (p¼0.04). En relación al estado fun-cional en el grupo experimental la diferencia fue estadísticamente signi-ficativa con una (p¼0.001) sin embargo la diferencia � 0.8 a las 16 semanassólo se observó en 3 de 10 pacientes del grupo de experimental y ningúnpaciente en el grupo placebo (p¼0.0147). Consideraciones finales: Laaplicación de toxina botulínica tipo A en el palmaris longus disminuye lossíntomas clínicos en pacientes con STCI.

No. 204 Treatment and Rehabilitation Costs of Moderateand Severe Injuries Caused By Traffic Accidents.Deisy A. Vélez, MD; Luz H. Lugo, MD Msc; Blanca C. Cano;Paula A. Castro.

Disclosure: None. Objective: To know the direct and indirect costsgenerated from the treatment and rehabilitation of patients with mod-erate or severe injuries caused by traffic accident in the world.Design: Systematic review. Setting: Studies published in 12 countries.Participants: Studies that evaluated costs of attention in traffic accidentvictims over 16 years old published between 2008 and 2013 in Spanish orEnglish. Interventions: None. Main Outcome Measures: Directcosts, indirect costs, burden of disease, disability and rehabilitationrelated costs. Results: 14 studies were included 6 of good quality. Wefound studies up to 567,000 patients and 10 years lasting. Direct costswere up to 22,831 USD and indirect costs of 22,889 USD per patient; thedirect costs were exceeded by the indirect costs. The burden of diseaseshowed high variability among the different countries. One study found1.305.714 delays generated by traffic accidents. Three studies evaulateddisability: in one study 60% of the patients with severe TBI and 20% withmoderate TBI had short term disability. In other study 29.1% of theinjured patients had residual disability, and in a third study 4.6% of thepatients sustained a long term disability. In one study 11.2% from themedical costs were generated by rehabilitation, in other study it was 29%thus representing the second most important medical expense. Inpatientrehabilitation represented 2% of the costs. We found great heterogenicityin the evaluated parameters cost’s components time horizon, andoutcomes presentation. Conclusions: The indirect costs incurred intraffic accidents are greater than direct costs. The costs of disability andrehabilitation are poorly evaluated. There is great heterogenicity in thecosts studies in traffic accident victims. There is neither consensus in the

quality characteristics of costs studies in traffic accident nor criticalreading guides.

No. 206 Dysphagia Assessed by the 10-Item EatingAssessment Tool Is Associated With Malnutrition in FrailElderly.Hidetaka Wakabayashi; Hironobu Sashika.

Objective: The 10-item eating assessment tool (EAT-10) is a self-administered questionnaire for dysphagia screening with each item scoredfrom 0 to 4. An EAT-10 score above 3 is abnormal and indicates dysphagia.The objective of the study was to assess the association between the EAT-10and malnutrition in frail elderly. Design: Cross-sectional study. Set-ting: Geriatric health services facilities, acute hospitals, and community-dwelling. Participants: 237 frail elderly aged 65 years and older withdysphagia or suspected dysphagia. Interventions: Not applicable. MainOutcome Measures: Mini nutritional assessment short form (MNA-SF). Scores between 12-14, 8-11, and 0-7 indicate normal nutritional statusat risk of malnutrition and malnourished respectively. Level of Evi-dence: Level 1. Results: There were 90 males and 147 females. Meanage was 82 years. Eighty-nine elderly were in geriatric health servicesfacilities, 28 were in acute hospitals, and 120 were community-dwelling.Median Barthel index score was 55. Median EAT-10 score was 1 (inter-quartile range: 0-9) and 101 respondents were more than 3. Age, gender,dwelling and the Barthel index score differed significantly between twogroups classified by the EAT-10 scores (0-2 and 3-40). The MNA-SFrevealed that 81 elderly were malnourished, 117 were at risk of malnutri-tion, and 39 had a normal nutritional status. The EAT-10 score wassignificantly correlated with the MNA-SF score (the Spearman rank corre-lation coefficient: r¼-0.305 p<0.001). The sensitivity and specificity of theEAT-10 with a score 3 or above for malnutrition were 0.652 and 0.598,respectively. The EAT-10 score, age, gender, dwelling, and the Barthel indexscore were included in logistic regression analysis of the MNA-SF(malnourished or not). The EAT-10 score (p ¼ 0.005 odds ratio: 0.944 95%CI: 0.907-0.983), dwelling, and the Barthel index score were independentlyassociated with the MNA-SF. Conclusions: Dysphagia assessed by theEAT-10 is associated with malnutrition in frail elderly.

No. 209 Effectiveness of Feeding and Swallowing Therapy inPatients With Dysphagia.Shinya Yura; Aki Nakanami; Yasutaka Takagi; Kenji Kagechika.

Objective: To clarify the effectiveness of feeding and swallowing therapyin patients with dysphagia we report the factors related to the effectivenessof the therapy. Design: Retrospective study with multivariable analysis.Setting: All patients were unable to eat orally. Participants: 45 patientswith dysphagia. Interventions: In patients with slight dysphagia evidenton screening such as repetitive saliva swallowing test or modified waterswallow test, the direct swallowing therapy was performed carefully. Videofluoroscopic examination of swallowing or video endoscopic examination ofswallowing was performed in patients with severe dysphagia. In the severecases the safety adequate indirect and direct swallowing therapy weredrafted based on the findings of the examinations. Main OutcomeMeasures: To study the factors related to the effectiveness of therapy, thepatients were examined with respect to sex, age, period from onset tobeginning of the therapy, therapy period, and physical conditions. Logisticregression analysis was used for analysis of the correlation between thetherapeutic effectiveness and these items. Results: In 45 dysphagiacases no improvement of swallowing function was found in 12 cases(26.7%), moderate improvement in 21 cases (46.7%), and good improve-ment in 12 cases (26.7%). The only factor related to the effectiveness ofthe therapy was level of dry swallowing (p¼0.005 odds ratio¼6.445).Conclusions: These results indicate that feeding and swallowing therapybefore dry swallowing is lost is effective for improvement of swallowingfunction in patients with dysphagia.