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Development of Pyriform Sinus Suctioning Programs for Aspiration Pneumonia Prevention During the Acute Stroke

AbstractAspiration due to dysphagia is a factor associated with pneumonia during acute stroke. In such cases, it is likely that secretions in the pyriform sinuses enter the laryngeal inlet. The present study was based on the idea that it is possible to reduce aspiration pneumonia by periodically suctioning and removing such secretions (pyriform sinus suctioning), a study was conducted in a single facility. The incidence of pneumonia as a dependent variable was compared between before (control) and after (intervention group) intervention with pyriform sinus suctioning as an independent variable. With a view of unifying the quality and frequency of intervention, two programs to: initially confirm the safety of such suctioning; subsequently enhance/evaluate knowledge and skills related to the procedure (educational); and specify conditions for the implementation and criteria for determining its appropriateness (practical), were developed. The study involved 33 (mean age: 74.6  ± 12.4) and 30 (80.0 ± 8.8) control and intervention group members, respectively, 25 (83.3%) of the latter were treated with pyriform sinus suctioning for 5 days after a stroke. Pneumonia developed in 7 (21.2%) and 2 (6.7%) of the former and latter, respectively. As individuals with a Japan Coma Scale (JCS) score of III or a midline shift on head CT tend to develop pharyngeal dysphagia, the patients were also divided into 2 groups to compare the incidence of pneumonia...
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research

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Abstract In the absence of a vital registration and health information systems, Indonesia does not have complete, accurate, and continuous data to summarize the mortality statistics of the population, nor determine the exact cause of death. Verbal autopsies performed in a community-based mortality surveillance have been used to provide information on the cause of deaths in such context. However, physician review of verbal autopsy can be expensive, time-consuming, and give inconsistent results, raising concern about its reliability. We used the Purworejo Health and Demographic Surveillance System's (HDSS) mortality...
Source: The American Journal of Tropical Medicine and Hygiene - Category: Tropical Medicine Authors: Tags: Am J Trop Med Hyg Source Type: research
ConclusionsUES‐AD significantly decreases the number of trans‐UES reflux events and can potentially reduce the aspiration risk associated with NGT feeding. Level of Evidence4. Laryngoscope, 2017
Source: The Laryngoscope - Category: ENT & OMF Authors: Tags: Broncho ‐Esophagology Source Type: research
Abstract BACKGROUND: The surgical management of acute type A aortic dissection is evolving, and many aortic centers of excellence are reporting superior outcomes. We hypothesize that similar trends exist in a multiinstitutional regional consortium. METHODS: Records for 884 consecutive patients who underwent aortic operations (2003 to 2015) for acute type A aortic dissection were extracted from a regional The Society of Thoracic Surgeons database. Patients were stratified into three equal operative eras. Differences in outcomes and risk factors for morbidity and mortality were determined. RESULTS: Surgica...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
Authors: Choi JB, Shim SH, Yang JE, Kim HD, Lee DH, Park JS Abstract BACKGROUND: Dysphagia after stroke can cause a variety of complications, especially aspiration pneumonia, which can be life-threatening. Therefore, rehabilitation methods to reduce aspiration in patients with dysphagia are important. OBJECTIVE: In the present study, we aimed to investigate the effects of Shaker exercise on aspiration and oral diet level in stroke survivors with dysphagia. METHODS: Participants were randomly assigned to an experimental group (n = 16) or a control group (n = 16). Participants in the experimental grou...
Source: NeuroRehabilitation - Category: Rehabilitation Tags: NeuroRehabilitation Source Type: research
Conclusions—Compared with nicardipine, labetalol was associated with increased in-hospital infections, but not mortality or modified Rankin Score>2. These findings do not support our hypothesis that labetalol use improves outcomes relative to nicardipine in intracerebral hemorrhage.
Source: Stroke - Category: Neurology Authors: Tags: Autonomic Nervous System, Clinical Studies, Hypertension, Quality and Outcomes, Intracranial Hemorrhage Original Contributions Source Type: research
ConclusionMorbidity and mortality events after ECT treatments were relatively low, supporting ECT as a low‐risk medical procedure.
Source: Acta Psychiatrica Scandinavica - Category: Psychiatry Authors: Tags: Original Article Source Type: research
This study aimed to detect early and easily assessable predictors of dysphagia in a large cohort of patients with acute ischemic stroke.Methods: Our analysis was based on data from a prospective in-hospital registry. Patients with ischemic stroke were included over the course of 3 years. Patients were scheduled to undergo a clinical swallowing investigation within the first 24 h after hospital admission. Step-wise multivariate logistic regression was used to identify independent predictors of dysphagia in general and of pneumonia in particular.Results: 1,646 patients with ischemic stroke were included. Stroke severity in t...
Source: Cerebrovascular Diseases - Category: Neurology Source Type: research
This study identified a cohort of patients with detectable unsensed penetration or aspiration on videofluoroscopic swallowing study (VFSS), and followed this cohort over time for development of pulmonary events and death. We then evaluated the association of aspiration severity and dietary modification recommendations on incidence of these endpoints. Study DesignRetrospective chart review. MethodsA total of 2,616 VFSS exam reports were reviewed from our institution performed between January 1, 2009 and December 31, 2010. Aspiration or unsensed penetration (PAS of 5 or greater) was detected in 564 (21.5%) of these patients,...
Source: The Laryngoscope - Category: ENT & OMF Authors: Tags: Triological Society Candidate Thesis Source Type: research
Conclusions: This study provides evidence in real world to support the performance of EVT in acute anterior circulation stroke patients in Chinese population. Patients with small infarct core, successful recanalization, good collateral status, and short treatment delay without sICH or pneumonia may benefit from EVT.Cerebrovasc Dis 2017;44:248-258
Source: Cerebrovascular Diseases - Category: Neurology Source Type: research
Conclusions—24/7 dysphagia screening can be effectively performed by nurses and leads to reduced pneumonia rates. Therefore, empowering nurses to do a formal bedside screening for swallowing dysfunction in stroke patients timely after admission is warranted whenever speech–language therapists are not available.
Source: Stroke - Category: Neurology Authors: Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Brief Reports Source Type: research
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