OBJETIVO: caracterizar mastigação, fase oral da deglutição e possíveis adaptações funcionais observadas nos portadores de Paralisia Facial Periférica. MÉTODO: participaram desta pesquisa 30 indivíduos com Paralisia Facial Periférica grau IV, com história de até 30 dias, sem distinção de etiologia e divididos em três grupos, os que apresentavam a paralisia em até 10 dias, de 11 a 20 e de 20 a 30 dias. As funções mastigação e fase oral da deglutição foram avaliadas tanto com alimento sólido e como com água natural. Os indivíduos responderam questões relacionadas às dificuldades imediatamente após a instalação da paralisia. Os dados foram analisados estatisticamente pelo Teste da Razão de Verossimilhança e pelo Teste Exato de Fisher. RESULTADOS: foram constatadas alterações nas funções de mastigação e fase oral da deglutição pela diminuição do tônus no músculo orbicular dos lábios e do músculo bucinador, que diminuindo a pressão intra-oral, favorece o escape de alimento e líquido. À observação da Fonoaudióloga a variável "derrama líquido enquanto bebe" apresentou dados estatisticamente significante (p=0,003) nos três grupos estudados. A variável "acúmulo de alimento entre os dentes e a gengiva no lado paralisado" foi estatisticamente significante nos grupos de 11 a 20 dias (p= 0,002). CONCLUSÃO: os indivíduos da amostra mastigam no lado paralisado com dificuldade, mediante ciclos mastigatórios lentos e inconsistentes. Ocorre um incremento nos movimentos de língua para limpeza de resíduos retidos no vestíbulo oral no lado paralisado. Este é o sintoma que mais incomoda o paciente. Apresentam dificuldade no beber de forma contínua. Desenvolvem adaptações para compensar suas dificuldades funcionais.

PURPOSE: to describe mastication, swallowing oral phase and possible functional adaptations observed in Facial Peripheral Paralysis subjects. METHOD: there were 30 subjects with grade IV Facial Peripheral Paralysis, with at the most 30 days paralysis history and no etiology differentiation. They were separated in three groups, 1 to 10 days paralysis, 11 to 20 days and 21 to 30 days. Mastication and swallowing oral phase functions were assessed with both solid food and water. Participants answered questions related to the difficulties right after the paralysis. Data were statistically analyzed using the Likelihood Ratio Test and Fisher Exact Test. RESULTS: changes were observed in mastication and swallowing oral phase due to the lowering of lips tonus, orbicular muscle and buccinator muscle that allows the escaping of food and liquid by decreasing intra-oral pressure. To the speech therapist's observation "spill liquid while drinking" presented statistically significant data (p=0,003) in the three observed groups. Variable "accumulate food between teeth and gums" was statistically significant in groups of 11 to 20 days (p= 0,002). CONCLUSION: sample subjects chew with difficulty in the paralyzed side, showing slow and inconsistent mastication cycles. There is an increased tongue movements for cleaning the residues kept in oral vestibule in the paralyzed side. This is the most annoying symptom according to the patients. They develop adaptation strategies to compensate their functional difficulties.

OBJECTIVES: To determine the frequency of medical adverse events in elderly patients admitted to an acute care geriatric unit, the predictive factors of occurrence, and the correlation between adverse events and hospital mortality rates. METHODS: This prospective study included 171 admissions of patients aged 60 years and older in the acute care geriatric unit in a teaching hospital in Brazil between 2007 and 2008. The following variables were assessed at admission: the patient age, gender, number of prescription drugs, geriatric syndromes (e.g., immobility, postural instability, dementia, depression, delirium, and incontinence), comorbidities, functional status (evaluated with the Katz Index of Independence in Activities of Daily Living), and severity of illness (evaluated with the Simplified Acute Physiology Score Il). The incidence of delirium, infection, mortality, and the prescription of potentially inappropriate medications (based on the Beers criteria) were assessed during hospitalization. An observer who was uninvolved in patient care reported the adverse events. RESULTS: The mean age of the sample was 78.12 years. A total of 187 medical adverse events occurred in 94 admissions (55%). The predictors of medical adverse events were undetermined. Compared with the patients with no adverse events, the patients with medical adverse events had a significantly longer hospital stay (21.41 ± 15.08 days versus 10.91 ± 7.21 days) and a higher mortality rate (39 deaths [41.5%] versus 17 deaths [22.1%]). Mortality was significantly predicted by the Simplified Acute Physiology Score II score (odds ratio [OR] = 1.13, confidence interval [CI] 95%, 1.07 to 1.20), the Katz score (OR=1.47, CI 95%, 1.18 to 1.83), and medical adverse events (OR = 3.59, CI 95%, 1.55 to 8.30). CONCLUSION: Medical adverse events should be monitored in every elderly hospitalized patient because there is no risk profile for susceptible patients, and the consequences of adverse events are serious, sometimes leading to longer hospital stays or even death.