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Sleep Stage Coordination of Respiration and Swallowing: A Preliminary Study
This study suggests that the coordination between respiration and swallowing as a defense mechanism against aspiration was impaired during sleep. Our results supported physiologically the fact that healthy adult individuals aspirate pharyngeal secretions during sleep. (Source: Dysphagia)
Source: Dysphagia - June 22, 2016 Category: Speech Therapy Source Type: research

Estimation of the Dose of Radiation Received by Patient and Physician During a Videofluoroscopic Swallowing Study
In this study, we investigated the dose of radiation (entrance skin dose, ESD) estimated to be received by a patient during VFSS using a human phantom (via a skin-dose monitor sensor placed on the neck of the human phantom). We also investigated the effective dose (ED) and dose equivalent (DE) received by a physician (wearing two personal dosimeters) during an actual patient procedure. One dosimeter (whole body) was worn under a lead apron at the chest, and the other (specially placed to measure doses received by the lens of the eye) outside the lead apron on the neck collar to monitor radiation doses in parts of the body ...
Source: Dysphagia - June 17, 2016 Category: Speech Therapy Source Type: research

A Longitudinal Study of Symptoms of Oropharyngeal Dysphagia in an Elderly Community-Dwelling Population
Abstract Dysphagia has been estimated to affect around 8–16 % of healthy elderly individuals living in the community. The present study investigated the stability of perceived dysphagia symptoms over a 3-year period and whether such symptoms predicted death outcomes. A population of 800 and 550 elderly community-dwelling individuals were sent the Sydney Swallow Questionnaire (SSQ) in 2009 and 2012, respectively, where an arbitrary score of 180 or more was chosen to indicate symptomatic dysphagia. The telephone interview cognitive screen measured cognitive performance and the Geriatric Depression Scale m...
Source: Dysphagia - June 14, 2016 Category: Speech Therapy Source Type: research

Clinical Characteristics and Lesions Responsible for Swallowing Hesitation After Acute Cerebral Infarction
Abstract Some stroke patients with a unilateral lesion demonstrate acute dysphagia characterized by a markedly prolonged swallowing time, making us think they are reluctant to swallow. In order to clarify the clinical characteristics and causative lesions of delayed swallowing, we conducted a retrospective analysis of 20 right-handed patients without a history of swallowing dysfunction who underwent videofluorography on suspicion of dysphagia after a first ischemic stroke. The oral processing time plus the postfaucial aggregation time required to swallow jelly for patients classified as having delayed swallowing w...
Source: Dysphagia - June 7, 2016 Category: Speech Therapy Source Type: research

The Reliability of Oral and Pharyngeal Dimensions Captured with Acoustic Pharyngometry
Abstract Acoustic Pharyngometry (APh) is a method for quantifying oropharyngeal tract configuration using sound wave reflection and is commonly used in diagnostics and research of sleep apnea. The standard preset output of APh (minimal cross-sectional area) has been established as reliable. However, by conducting post-processing measures on specific breathing tasks, APh data can also reveal oral length, oral volume, pharyngeal length, and pharyngeal volume. Given that these measures may have utility in dysphagia research, the reliability of these measures is unknown and is the focus of the current study. Ten young...
Source: Dysphagia - June 3, 2016 Category: Speech Therapy Source Type: research

A Preliminary Study of How the Viscosity of Dietary Fluids and Videofluoroscopy Fluids can be Matched
This study examined the method by which the viscosity of mealtime and videofluoroscopy fluid can be matched through adjustment of the amount of xanthan gum-based thickener added to them. Viscosity measurement was made with a cone-plate viscometer. Samples were tested at 5, 25, 45, and 65 ± 0.1 °C and shear rates of 5–200 s−1. We found that the adjusted amount of thickener differs depending on the shear rate and temperature, and that the amount of thickener added to samples without barium sulfate should be increased by 26.8–37.5 % as compared to samples with barium sulfa...
Source: Dysphagia - May 4, 2016 Category: Speech Therapy Source Type: research

Number of Gastrointestinal Symptoms is a Useful Means of Identifying Patients with Cancer for Dysphagia
Abstract Dysphagia is a symptom suggestive of severe underlying pathology, although its causes include organic and non-organic disorders. The epidemiology of dysphagia is, however, poorly understood. We evaluated the prevalence of dysphagia in outpatients in Japan, measured the proportion ultimately found to have an organic cause, and recorded the nature of their symptoms and the underlying disorder. Of 5362 consecutive outpatients attending the Digestive Center at our hospital between June 1, 2010 and December 31, 2012, 186 patients (3.5 %) had dysphagia with a frequency score of ≥5 out of 6. The most com...
Source: Dysphagia - April 25, 2016 Category: Speech Therapy Source Type: research

Analysis of Clinicians’ Perceptual Cough Evaluation
This study examined the relationships between subjective descriptors and objective airflow measures of cough. We hypothesized that coughs with specific airflow characteristics would share common subjective perceptual descriptions. Thirty clinicians (speech-language pathologists, otolaryngologists, and neurologists) perceptually evaluated ten cough audio samples with specific airflow characteristics determined by peak expiratory flow rate, cough expired volume, cough duration, and number of coughs in the cough epoch. Participants rated coughs by strength, duration, quality, quantity, and overall potential effectiveness for ...
Source: Dysphagia - April 25, 2016 Category: Speech Therapy Source Type: research

Objective Measures of Swallowing Function Applied to the Dysphagia Population: A One Year Experience
Abstract Quantitative, reliable measures of swallowing physiology can be made from an modified barium swallowing study. These quantitative measures have not been previously employed to study large dysphagic patient populations. The present retrospective study of 139 consecutive patients with dysphagia seen in a university tertiary voice and swallowing clinic sought to use objective measures of swallowing physiology to (1) quantify the most prevalent deficits seen in the patient population, (2) identify commonly associated diagnoses and describe the most prevalent swallowing deficits, and (3) determine any correlat...
Source: Dysphagia - April 21, 2016 Category: Speech Therapy Source Type: research

Pathophysiology of Radiation-Induced Dysphagia in Head and Neck Cancer
Abstract Oncologic treatments, such as curative radiotherapy and chemoradiation, for head and neck cancer can cause long-term swallowing impairments (dysphagia) that negatively impact quality of life. Radiation-induced dysphagia comprised a broad spectrum of structural, mechanical, and neurologic deficits. An understanding of the biomolecular effects of radiation on the time course of wound healing and underlying morphological tissue responses that precede radiation damage will improve options available for dysphagia treatment. The goal of this review is to discuss the pathophysiology of radiation-induced injury a...
Source: Dysphagia - April 19, 2016 Category: Speech Therapy Source Type: research

Swallowing Disorders in Severe Brain Injury in the Arousal Phase
The objective of this study was to determine the clinical characteristics of swallowing disorders in severe brain injury in the arousal phase after coma. Between December 1, 2013 and June 30, 2014, eleven patients with severe acquired brain injury who were admitted to rehabilitation center (Male 81.8 %; 40.7 ± 14.6 years) were included in the study. Evaluation of swallowing included a functional examination, clinical functional swallowing test, and naso-endoscopic swallowing test. All patients had swallowing disorders at admission. The first functional swallowing test showed oral (77.8 %) an...
Source: Dysphagia - April 17, 2016 Category: Speech Therapy Source Type: research

Concordance Between Aspiration Detected on Upper Gastrointestinal Series and Videofluoroscopic Swallow Study in Bottle-Fed Children
Abstract The increasing incidence of pediatric dysphagia has raised questions about how to identify children at risk for aspiration. Multiple investigative imaging modalities are considered in diagnostic algorithms, since dysphagia may involve any or all phases of swallowing. Although upper gastrointestinal (UGI) series and videofluoroscopic swallow study (VFSS) are common procedures, the utility of UGI for detection of aspiration and the impact of oropharyngeal imaging during UGI on radiation exposure have not been well described. We hypothesized that diagnosis of aspiration on UGI would be predictive of aspirati...
Source: Dysphagia - April 5, 2016 Category: Speech Therapy Source Type: research

An Unusual Cause of Dysphagia
(Source: Dysphagia)
Source: Dysphagia - April 5, 2016 Category: Speech Therapy Source Type: research

Effect of Bolus Viscosity on the Safety and Efficacy of Swallowing and the Kinematics of the Swallow Response in Patients with Oropharyngeal Dysphagia: White Paper by the European Society for Swallowing Disorders (ESSD)
Conclusions The ESSD concludes that there is evidence for increasing viscosity to reduce the risk of airway invasion and that it is a valid management strategy for OD. However, new thickening agents should be developed to avoid the negative effects of increasing viscosity on residue, palatability, and treatment compliance. New randomised controlled trials should establish the optimal viscosity level for each phenotype of dysphagic patients and descriptors, terminology and viscosity measurements must be standardised. This white paper is the first step towards the development of a clinical guideline on b...
Source: Dysphagia - March 24, 2016 Category: Speech Therapy Source Type: research

5th ESSD Congress, Swallowing Disorders: From Compensation to Recovery, Barcelona October 1–3, 2015
(Source: Dysphagia)
Source: Dysphagia - March 24, 2016 Category: Speech Therapy Source Type: research

Detecting Aspiration and Penetration Using FEES With and Without Food Dye
The objective of this investigation was to determine if there were differences in identifying airway invasion (penetration or aspiration) during fiberoptic endoscopic evaluations of swallowing (FEES) for green-dyed versus non-dyed liquids. Forty adult inpatients in an acute care hospital underwent FEES, with both green-dyed liquids and naturally white liquids. Three speech-language pathologists rated aspiration and penetration for trials of nectar-thick milk and thin milk, both with and without green food dye. A subset of participants having excess pharyngeal/laryngeal secretions, as measured by the Secretions Severity Sca...
Source: Dysphagia - March 18, 2016 Category: Speech Therapy Source Type: research

Parameters of Instrumental Swallowing Evaluations: Describing a Diagnostic Dilemma
Abstract The aim of this study was to compare selected parameters of two swallow evaluations: fiberoptic endoscopic evaluation of swallowing (FEES) and the modified barium swallow (MBS) study. This was a cross-sectional, descriptive study. Fifty-five clinicians were asked to watch video recordings of swallow evaluations of 2 patients that were done using fluoroscopy and endoscopy simultaneously. In a randomized order, clinicians viewed 4 edited videos from simultaneous evaluations: the FEES and MBS videos of patient 1 and 2 each taking one swallow of 5 mL applesauce. Clinicians filled out a questionnaire that...
Source: Dysphagia - March 16, 2016 Category: Speech Therapy Source Type: research

Comments on Selected Recent Dysphagia Literature
(Source: Dysphagia)
Source: Dysphagia - March 16, 2016 Category: Speech Therapy Source Type: research

Conducting Real-Time Videofluoroscopic Swallow Study via Telepractice: A Preliminary Feasibility and Reliability Study
Abstract A small number of studies have examined the feasibility of conducting videofluoroscopic swallow studies (VFSS) via telepractice. While the results have confirmed this potential, the systems tested to date have either reported issues that impacted the ability to analyze/interpret the VFSS recordings in real time, or they were not designed to enable real-time interpretation. Further system design is needed to establish a telepractice model that enables the VFSS assessment to be both guided and interpreted live in real time. The aim of this study was to test the feasibility and reliability of using a tel...
Source: Dysphagia - March 15, 2016 Category: Speech Therapy Source Type: research

A Systematic Review of the Prevalence of Oropharyngeal Dysphagia in Stroke, Parkinson’s Disease, Alzheimer’s Disease, Head Injury, and Pneumonia
Abstract Oropharyngeal dysphagia is a common condition after stroke, Parkinson’s disease (PD), and Alzheimer’s disease (AD), and can cause serious complications including malnutrition, aspiration pneumonia, and premature mortality. Despite its high prevalence among the elderly and associated serious complications, dysphagia is often overlooked and under-diagnosed in vulnerable patient populations. This systematic review aimed to improve understanding and awareness of the prevalence of dysphagia in susceptible patient populations. MEDLINE, EMBASE, the Cochrane library, PROSPERO, and disease-specific web...
Source: Dysphagia - March 12, 2016 Category: Speech Therapy Source Type: research

Utility of a Clinical Swallowing Exam for Understanding Swallowing Physiology
Abstract A clinical swallowing examination (CSE) is generally believed to be inadequate for making judgments regarding swallowing physiology compared to objective assessments. A large volume of studies has heavily focused on identifying aspiration using a CSE and research addressing physiologic information gathered from a CSE is sparse. The purpose of this study was to examine the utility of the CSE for assessing physiology compared to videofluoroscopic swallowing studies (VFSS). Data were derived from a prior investigation of sixty adult patients post-stroke tested with CSE and VFSS. The CSE included an exami...
Source: Dysphagia - March 12, 2016 Category: Speech Therapy Source Type: research

A Study of Healthy Adults’ Oro-lingual Effort During Swallowing Using OroPress, A New Portable Wireless Measurement Tool
Abstract OroPress is a new, low profile, portable, wireless tool that enables stable measurement of tongue pressure during isometric (‘pushing’) tasks and, more importantly, during swallowing. Using this tool, a pressure–time product, the OroPress Absolute (OPA) parameter, has been developed as a representative measure of lingual effort during swallowing. In a sample of 57 adults aged 20–80+ years, of both sexes and without dysphagia, tongue-palate contact pressures generated while swallowing 5 ml, 10 ml of water and 5 ml custard, were recorded using OroPress. Data were exami...
Source: Dysphagia - March 3, 2016 Category: Speech Therapy Source Type: research

A Randomized Trial Comparing Two Tongue-Pressure Resistance Training Protocols for Post-Stroke Dysphagia
The objective of this study was to compare the outcomes of two tongue resistance training protocols. One protocol (“tongue-pressure profile training”) emphasized the pressure-timing patterns that are typically seen in healthy swallows by focusing on gradual pressure release and saliva swallowing tasks. The second protocol (“tongue-pressure strength and accuracy training”) emphasized strength and accuracy in tongue-palate pressure generation and did not include swallowing tasks. A prospective, randomized, parallel allocation trial was conducted. Of 26 participants who were screened for eligibility, 1...
Source: Dysphagia - March 2, 2016 Category: Speech Therapy Source Type: research

Does a Water Protocol Improve the Hydration and Health Status of Individuals with Thin Liquid Aspiration Following Stroke? A Randomized Controlled Trial
This study aimed to contribute to the evidence of the effectiveness of water protocols with a particular emphasis on health outcomes, especially hydration. An RCT was conducted with patients with known thin liquid aspiration post stroke randomized to receiving thickened liquids only or a water protocol. For the 14 participants in rehabilitation facilities whose data proceeded to analysis, there was no difference in the total amount of beverages consumed between the water protocol group (mean = 1103 ml per day, SD = 215 ml) and the thickened liquids only group (mean = 1103 ml, SD...
Source: Dysphagia - February 17, 2016 Category: Speech Therapy Source Type: research

A Pilot Study of the Tongue Pull-Back Exercise for Improving Tongue-Base Retraction and Two Novel Methods to Add Resistance to the Tongue Pull-Back
Abstract This pilot study investigated the tongue pull-back (TPB) exercise to improve tongue-base retraction as well as two methods to add resistance to the TPB. Surface electromyography (sEMG) to the submental triangle was used as an indication of tongue-base activity on 13 healthy adults during: (1) saliva swallow, (2) 15 mL water swallow, (3) effortful swallow, (4) unassisted TPB, (5) TPB with added resistance by holding the tongue with gauze (finger-resisted TPB), and (6) TPB with the tongue clipped to a spring-loaded tension resistance device (device-resisted TPB). Order of the exercises was randomized. ...
Source: Dysphagia - February 9, 2016 Category: Speech Therapy Source Type: research

Society for Neuroscience 2015 Satellite Symposium
(Source: Dysphagia)
Source: Dysphagia - February 5, 2016 Category: Speech Therapy Source Type: research

Evaluating the Training Effects of Two Swallowing Rehabilitation Therapies Using Surface Electromyography—Chin Tuck Against Resistance (CTAR) Exercise and the Shaker Exercise
In this study, the efficacy of two dysphagia interventions, the Chin Tuck against Resistance (CTAR) and Shaker exercises, were evaluated based on two principles in exercise science—muscle-specificity and training intensity. Both exercises were developed to strengthen the suprahyoid muscles, whose contractions facilitate the opening of the upper esophageal sphincter, thereby improving bolus transfer. Thirty-nine healthy adults performed two trials of both exercises in counter-balanced order. Surface electromyography (sEMG) recordings were simultaneously collected from suprahyoid muscle group and sternocleidomastoid mu...
Source: Dysphagia - February 2, 2016 Category: Speech Therapy Source Type: research

Comments on Selected Recent Dysphagia Literature
(Source: Dysphagia)
Source: Dysphagia - February 2, 2016 Category: Speech Therapy Source Type: research

Defining Swallowing-Related Quality of Life Profiles in Individuals with Amyotrophic Lateral Sclerosis
Abstract Although it is known that dysphagia contributes to significant malnutrition, pneumonia, and mortality in amyotrophic lateral sclerosis (ALS), it remains unclear how swallowing impairment impacts quality of life in this vulnerable patient population. The aim of the current study was to (1) delineate swallow-related quality of life (SR-QOL) profiles in individuals with ALS and (2) evaluate relationships between SR-QOL, degree of swallowing impairment, and ALS global disease progression. Eighty-one ALS patients underwent a standardized videofluoroscopic swallow study and completed the swallowing quality ...
Source: Dysphagia - February 2, 2016 Category: Speech Therapy Source Type: research

Validation of the Spanish Version of the Eating Assessment Tool-10 (EAT-10 spa ) in Colombia. A Blinded Prospective Cohort Study
Abstract Dysphagia might affect 12 % of the general population, and its complications include pneumonia, malnutrition, social isolation, and death. No validated Spanish symptom survey exists to quantify dysphagia symptoms among Latin Americans. Therefore, we performed a prospective cohort study in a tertiary care university hospital to validate the Spanish version of the 10-Item Eating-Assessment-Tool (EAT-10spa) for use in Colombia. After an interdisciplinary committee of five bilingual specialists evaluated the EAT-10spa (translated and validated in Spain) and deemed it appropriate for the Colombian cu...
Source: Dysphagia - January 23, 2016 Category: Speech Therapy Source Type: research

Observers’ Agreement on Measurements in Fiberoptic Endoscopic Evaluation of Swallowing
This study analyzed the effect that dysphagia etiology, different observers, and bolus consistency might have on the level of agreement for measurements in FEES images reached by independent versus consensus panel rating. Sixty patients were included and divided into two groups according to dysphagia etiology: neurological or head and neck oncological. All patients underwent standardized FEES examination using thin and thick liquid consistencies. Two observers scored the same exams, first independently and then in a consensus panel. Four ordinal FEES variables were analyzed. Statistical analysis was performed using a linea...
Source: Dysphagia - January 23, 2016 Category: Speech Therapy Source Type: research

Validation of Clinical Observations of Mastication in Persons with ALS
Abstract Amyotrophic lateral sclerosis (ALS) is a progressive neurological disease that can result in difficulties with mastication leading to malnutrition, choking or aspiration, and reduced quality of life. When evaluating mastication, clinicians primarily observe spatial and temporal aspects of jaw motion. The reliability and validity of clinical observations for detecting jaw movement abnormalities is unknown. The purpose of this study is to determine the reliability and validity of clinician-based ratings of chewing performance in neuro-typical controls and persons with varying degrees of chewing impairme...
Source: Dysphagia - January 23, 2016 Category: Speech Therapy Source Type: research

Voluntary Cough Airflow Differentiates Safe Versus Unsafe Swallowing in Amyotrophic Lateral Sclerosis
Abstract Dysphagia and aspiration are prevalent in amyotrophic lateral sclerosis (ALS) and contribute to malnutrition, aspiration pneumonia, and death. Early detection of at risk individuals is critical to ensure maintenance of safe oral intake and optimal pulmonary function. We therefore aimed to determine the discriminant ability of voluntary cough airflow measures in detecting penetration/aspiration status in ALS patients. Seventy individuals with ALS (El-Escorial criteria) completed voluntary cough spirometry testing and underwent a standardized videofluoroscopic swallowing evaluation (VFSE). A rater blind...
Source: Dysphagia - January 23, 2016 Category: Speech Therapy Source Type: research

Simulation-Based Dysphagia Training: Teaching Interprofessional Clinical Reasoning in a Hospital Environment
This study evaluated hospital readiness and interprofessional clinical reasoning in speech-language pathology and dietetics students following a simulation-based teaching package. Thirty-one students participated in two half-day simulation workshops. The training included orientation to the hospital setting, part-task skill learning and immersive simulated cases. Students completed workshop evaluation forms. They filled in a 10-question survey regarding confidence, knowledge and preparedness for working in a hospital environment before and immediately after the workshops. Students completed written 15-min clinical vignette...
Source: Dysphagia - January 23, 2016 Category: Speech Therapy Source Type: research

Relationship Between Tongue Base Region Pressures and Vallecular Clearance
Abstract Tongue base pressures have been thought to provide primary bolus clearance through the pharynx during swallowing. The relationship between bolus driving pressures and residue remaining in the valleculae after the swallow has not been defined. Thirty-seven dysphagic patients who were evaluated with both videofluoroscopy (VFSS) and high-resolution manometry (HRM) were identified within the University of Wisconsin Voice and Swallowing Outcomes database. Patients were categorized according to binary ratings of presence or absence of vallecular stasis as well as incomplete or complete tongue retraction on VFSS...
Source: Dysphagia - January 21, 2016 Category: Speech Therapy Source Type: research

Objective Evaluation Tool for Texture-Modified Food (OET-TMF): Development of the Tool and Validation
Abstract Texture-modified diets (TMDs) should fulfil nutritional goals, guarantee homogenous texture, and meet food safety regulations. The food industry has created texture-modified food (TMF) that meets the TMD requirements of quality and safety for inpatients. To design and develop a tool that allows the objective selection of foodstuffs for TMDs that ensures nutritional requirements and swallowing safety of inpatients in order to improve their quality of life, especially regarding their food satisfaction. An evaluation tool was designed to objectively determine the adequacy of food included in the TMD menus of...
Source: Dysphagia - January 21, 2016 Category: Speech Therapy Source Type: research

A Meta-Analysis of the Incidence of Patient-Reported Dysphagia After Anterior Cervical Decompression and Fusion with the Zero-Profile Implant System
The objective of this study was to determine the incidence of dysphagia after ACDF with the Zero-profile Implant System. Studies were collected from PubMed, EMBASE, the Cochrane library and the China Knowledge Resource Integrated Database using the keywords “Zero-profile OR Zero-p) AND (dysphagia OR [swallowing dysfunction]”. The software STATA (Version 13.0) was used for statistical analysis. Statistical heterogeneity across the various trials, a test of publication bias and sensitivity analysis was performed. 30 studies with a total of 1062 patients were included in this meta-analysis. The occurrence of post-...
Source: Dysphagia - January 11, 2016 Category: Speech Therapy Source Type: research

Clinical Conundrum: Killian-Jamieson Diverticulum with Paraesophageal Hernia
We present a case of a Killian-Jamieson diverticulum associated with a concurrent large type III paraesophageal hernia causing significant solid-food dysphagia, post-prandial regurgitation of solid foods, and chronic cough managed with open transcervical diverticulectomy and laparoscopic paraesophageal hernia repair with Nissen fundoplication. (Source: Dysphagia)
Source: Dysphagia - January 11, 2016 Category: Speech Therapy Source Type: research

‘What About Swallowing?’ Diagnostic Performance of Daily Clinical Practice Compared with the Eating Assessment Tool-10
This study compares the diagnostic performance of a single open question ‘What about swallowing?’ (usual care) with the Eating Assessment Tool (EAT-10) as reference test in screening for oropharyngeal dysphagia (OD). 303 outpatients at risk of OD were recruited at three university hospitals: 162 men and 141 women with a mean age of 70 years. All data were retrieved by phone. To identify patients at risk of dysphagia, two different cut-off scores for the EAT-10 total score were retrieved from the literature. The diagnostic performance of the single question was determined by comparing dichotomized answers t...
Source: Dysphagia - January 11, 2016 Category: Speech Therapy Source Type: research

Pharyngeal Residue Severity Rating Scales Based on Fiberoptic Endoscopic Evaluation of Swallowing: A Systematic Review
Abstract Identification of pharyngeal residue severity located in the valleculae and pyriform sinuses has always been a primary goal during fiberoptic endoscopic evaluation of swallowing (FEES). Pharyngeal residue is a clinical sign of potential prandial aspiration making an accurate description of its severity an important but difficult challenge. A reliable, validated, and generalizable pharyngeal residue severity rating scale for FEES would be beneficial. A systematic review of the published English language literature since 1995 was conducted to determine the quality of existing pharyngeal residue severity rat...
Source: Dysphagia - January 11, 2016 Category: Speech Therapy Source Type: research

Predictive Factors for Prophylactic Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement and Use in Head and Neck Patients Following Intensity-Modulated Radiation Therapy (IMRT) Treatment: Concordance, Discrepancies, and the Role of Gabapentin
Abstract The prophylactic placement of a percutaneous endoscopic gastrostomy (PEG) tube in the head and neck cancer (HNC) patient is controversial. We sought to identify factors associated with prophylactic PEG placement and actual PEG use. Since 2010, data regarding PEG placement and use were prospectively recorded in a departmental database from January 2010 to December 2012. HNC patients treated with intensity-modulated radiation therapy (IMRT) were retrospectively evaluated from 2010 to 2012. Variables potentially associated with patient post-radiation dysphagia from previous literature, and our experience was...
Source: Dysphagia - January 11, 2016 Category: Speech Therapy Source Type: research

The Physiology of Eructation
Abstract Eructation is composed of three independent phases: gas escape, upper barrier elimination, and gas transport phases. The gas escape phase is the gastro-LES inhibitory reflex that causes transient relaxation of the lower esophageal sphincter, which is activated by distension of stretch receptors of the proximal stomach. The upper barrier elimination phase is the transient relaxation of the upper esophageal sphincter along with airway protection. This phase is activated by stimulation of rapidly adapting mechanoreceptors of the esophageal mucosa. The gas transport phase is esophageal reverse peristalsis med...
Source: Dysphagia - December 22, 2015 Category: Speech Therapy Source Type: research

Radiopaque Stomach-Shaped Bezoar in a Suicidal Patient
(Source: Dysphagia)
Source: Dysphagia - December 22, 2015 Category: Speech Therapy Source Type: research

Effects of Effortful Swallow on Cardiac Autonomic Regulation
In conclusion effortful swallow maneuver in healthy women increased sympathetic cardiac modulation, indicating a cardiac overload. (Source: Dysphagia)
Source: Dysphagia - December 9, 2015 Category: Speech Therapy Source Type: research

Comments on Selected Recent Dysphagia Literature
(Source: Dysphagia)
Source: Dysphagia - December 1, 2015 Category: Speech Therapy Source Type: research

A Comparative Study Between Modified Starch and Xanthan Gum Thickeners in Post-Stroke Oropharyngeal Dysphagia
Abstract Thickeners are used in post-stroke oropharyngeal dysphagia (OD) as a compensatory therapeutic strategy against aspirations. To compare the therapeutic effects of modified starch (MS) and xanthan gum (XG) thickeners on swallow safety and efficacy in chronic post-stroke OD patients using clinical and videofluoroscopic (VFS) assessment. Patients were studied by clinical assessment (volume-viscosity swallow test, V-VST) and VFS using 3 volumes (5, 10, 20 mL) and 3 viscosities (liquid, nectar and spoon thick), comparing MS and XG. We studied 122 patients (46MS, 76XG). (A) V-VST showed that both thickeners...
Source: Dysphagia - November 25, 2015 Category: Speech Therapy Source Type: research

Systematic Review: Non-Instrumental Swallowing and Feeding Assessments in Pediatrics
Abstract There is a high incidence of parental reporting of abnormal swallowing and feeding function and the negative impacts thereof on children. As such there is a need for well validated assessments in the area of pediatric swallowing and feeding. While instrumental assessments are well validated, there is limited information available to guide the selection and use of non-instrumental assessments for swallowing and feeding function. The aim of this study was to identify and report on non-instrumental assessments available to clinicians for pediatric swallowing and/or feeding function in order to support clinic...
Source: Dysphagia - November 25, 2015 Category: Speech Therapy Source Type: research

The Effect of the Cervical Orthosis on Swallowing Physiology and Cervical Spine Motion During Swallowing
In conclusion, the cervical orthosis restricted the movement of the cervical spine during swallowing and changed swallowing physiology. (Source: Dysphagia)
Source: Dysphagia - November 25, 2015 Category: Speech Therapy Source Type: research

Dysphagia in Parkinson’s Disease
Abstract More than 80 % of patients with Parkinson’s disease (PD) develop dysphagia during the course of their disease. Swallowing impairment reduces quality of life, complicates medication intake and leads to malnutrition and aspiration pneumonia, which is a major cause of death in PD. Although the underlying pathophysiology is poorly understood, it has been shown that dopaminergic and non-dopaminergic mechanisms are involved in the development of dysphagia in PD. Clinical assessment of dysphagia in PD patients is challenging and often delivers unreliable results. A modified water test assessing maximu...
Source: Dysphagia - November 21, 2015 Category: Speech Therapy Source Type: research

Oral Alimentation in Neonatal and Adult Populations Requiring High-Flow Oxygen via Nasal Cannula
Abstract Use of high-flow oxygen via nasal cannula (HFO2-NC) is increasingly common in intensive care unit (ICU) settings. Despite the critical interface between respiration and swallowing, and the high acuity of patients in ICUs, the impact of HFO2-NC on feeding and swallowing is unknown. The present prospective, single-center, cohort study investigated the impact of HFO2-NC use on oral alimentation in neonatal and adult ICU patients. Oral alimentation status was evaluated in 100 consecutive ICU inpatients (50 neonatal and 50 adult) requiring HFO2-NC. Participant characteristics, respiratory support, successful i...
Source: Dysphagia - November 21, 2015 Category: Speech Therapy Source Type: research