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Accuracy of a Laryngopharyngeal Endoscopic Esthesiometer (LPEER) for Evaluating Laryngopharyngeal Mechanosensitivity: A Validation Study in a Prospectively Recruited Cohort of Patients

AbstractRecent studies have shown an association between alterations in laryngopharyngeal mechanosensitivity (LPMS) and dysphagia, obstructive sleep apnea, and chronic cough hypersensitivity syndrome. A previous reliability study of a new laryngopharyngeal endoscopic esthesiometer and rangefinder (LPEER) showed high intra- and inter-rater reliability; however, its accuracy has not been tested. We performed an accuracy study of the LPEER in a prospectively and consecutively recruited cohort of 118 patients at two tertiary care university hospitals. Most of the patients were suffering from dysphagia, and all of them underwent a standard clinical evaluation and fiberoptic endoscopic evaluation of swallowing with sensory testing (FEESST) using a new sensory testing protocol. The sensory test included determinations of the laryngeal adductor reflex threshold (LART), the cough reflex threshold (CRT) and the gag reflex threshold (GRT). Abnormalities on these reflex thresholds were evaluated for associations with major alterations in swallowing safety (pharyngeal residues, penetration, and aspiration). We evaluated the discriminative capacity of the LPMS test using ROC curves and the area under the curve (AUC –ROC) and its relationship with the eight-point penetration–aspiration scale (PAS) using the Spearman’sρ correlation coefficient (SCC). We found a positive correlation between the PAS and LART (SCC 0.47;P 
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research

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Abstract Although modulation of cardiac activity may be influenced by several factors, interaction between autonomic nociceptive responses and the high-level of cortical processes is not clearly understood. Here, we studied in 26 subjects whether empathetic or unempathetic contexts could interact with autonomic pain responses. RR intervals variability was used to approach parasympathetic and sympathetic responses to painful thermal stimulations, according to contexts evoked by experimenters' comments. We observed that unempathetic context increased sympathetic reactivity to comments and to painful stimulations wit...
Source: Autonomic Neuroscience - Category: Neuroscience Authors: Tags: Auton Neurosci Source Type: research
Abstract OBJECTIVE: Arterial blood pressure (BP) increased in healthy humans in response to isometric handgrip (IHG), but the pattern of the relative contribution of cardiac output (CO) and total peripheral resistance (TPR) changes to the pressor response is different among individuals. We investigated weather patients with recurrent vasovagal syncope (VVS) have a similar pattern of individual CO, TPR and pressor responses to IHG, as healthy subjects. METHODS: 32 patients (27.5 ± 2.6 years), and 30 age-matched controls. Autonomic function was evaluated using finger-photoplethysmography to measure...
Source: Autonomic Neuroscience - Category: Neuroscience Authors: Tags: Auton Neurosci Source Type: research
Sinen O Abstract Centrally administered apelin has been shown to inhibit gastric emptying (GE) in rodents, however, the relevant mechanism has been investigated incompletely. Using male Wistar rats, we investigated the efferent pathways involved in gastroinhibitory action of central apelin. Stereotaxic intracerebroventricular (icv) cannulation, subdiaphragmatic vagotomy (VGX) and/or celiac ganglionectomy (CGX) were performed 7 days prior to the experiments. Apelin-13 was administered (30 nmol, icv) 90 min prior to GE measurement. Nitric oxide synthase inhibitor L-NAME (100 mg/kg), sympatholytic agent guane...
Source: Autonomic Neuroscience - Category: Neuroscience Authors: Tags: Auton Neurosci Source Type: research
Abstract BACKGROUND: Ventricular tachycardia (VT) and ventricular premature complexes (VPCs) originating from the right ventricular outflow tract (RVOT) are generally considered as benign arrhythmias, with ECG morphology showing LBBB pattern and inferior axis. Pathogenic mechanisms in the genesis of RVOT VT/VPC remain largely unknown. We aimed to investigate the neural mechanism in RVOT ventricular arrhythmias in canine model. METHODS: Twelve mongrel dogs (13.7 ± 1.3 kg, 5 male dogs) were studied through midline thoracotomies. High-frequency stimulation (HFS) was applied to the proximal pulmonary...
Source: Autonomic Neuroscience - Category: Neuroscience Authors: Tags: Auton Neurosci Source Type: research
Abstract Although cardiovascular responses may be altered by respiratory changes under prolonged hypoxia, the relationship between respiratory and cardiovascular changes remains unknown. The aim of the present study is to clarify cardiorespiratory changes in anesthetized rats during and after hypoxic conditions using simultaneous recordings of cardiorespiratory variables with 20-sec recording intervals. After air breathing for 20 min (pre-exposure period), rats were subjected to 10% O2 for 2 h (hypoxic exposure period) and then air for 30 min (recovery period). Minute ventilation (VE), respiratory frequency,...
Source: Autonomic Neuroscience - Category: Neuroscience Authors: Tags: Auton Neurosci Source Type: research
Conclusion: Results of this work indicate the proposed single-channel framework can emulate expert-level scoring of sleep architecture in OSA. Significance: Algorithms constructed to more accurately model physiological variability during sleep may help advance automated sleep assessment, for practical and general use in- sleep medicine.
Source: IEEE Transactions on Biomedical Engineering - Category: Biomedical Engineering Source Type: research
A 67-year-old, non-Hispanic white male underwent bilateral lung transplantation in 2016 for idiopathic pulmonary fibrosis. The patient had good graft function after transplantation, with a peak forced expiratory volume in 1 second of 2.27 liters. Surveillance bronchoscopy and biopsies done at 1, 3, and 6 months post-transplantation did not show any evidence of acute rejection or infection. He was lost to follow-up until 15 months after transplantation, when he presented with 1 week of dyspnea, cough, and fever.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Case Anecdotes, Comments and Opinions Source Type: research
Does concomitantly requested high-risk human papillomavirus reflex testing bias the cytologic interpretation of Pap tests?American Journal of Clinical Pathology
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Pathology & Lab Medicine Journal Article Source Type: news
Authors: Touhami S, Jouve L, Atia R, Georgeon C, Laroche L, Borderie V, Bouheraoua N PMID: 29778283 [PubMed - as supplied by publisher]
Source: Journal Francais d Ophtalmologie - Category: Opthalmology Tags: J Fr Ophtalmol Source Type: research
CONCLUSIONS: The propofol-remifentanil combination was associated with a higher incidence of desaturation. The dexmedetomidine-remifentanil combination was associated with inadequate sedation in one half of the patients, even though it produced less respiratory depression. Addition of remifentanil reduced the cough reflex. PMID: 25643766 [PubMed - as supplied by publisher]
Source: Sleep and Breathing - Category: Sleep Medicine Authors: Tags: Sleep Breath Source Type: research
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