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Sample records for reverses swallowing disability

  1. Development of the Nutrition and Swallowing Checklist, a Screening Tool for Nutrition Risk and Swallowing Risk in People with Intellectual Disability.

    ERIC Educational Resources Information Center

    Stewart, Lyn

    2003-01-01

    This article discusses nutrition problems in people with intellectual disabilities, the need for nutrition risk screening, and the development of the Nutrition and Swallowing Checklist in New South Wales. The checklist ensures carer involvement in identifying risks and an interdisciplinary approach to the assessment and management of nutrition and…

  2. Transcranial direct current stimulation reverses neurophysiological and behavioural effects of focal inhibition of human pharyngeal motor cortex on swallowing

    PubMed Central

    Vasant, Dipesh H; Mistry, Satish; Michou, Emilia; Jefferson, Samantha; Rothwell, John C; Hamdy, Shaheen

    2014-01-01

    The human cortical swallowing system exhibits bilateral but functionally asymmetric representation in health and disease as evidenced by both focal cortical inhibition (pre-conditioning with 1 Hz repetitive transcranial magnetic stimulation; rTMS) and unilateral stroke, where disruption of the stronger (dominant) pharyngeal projection alters swallowing neurophysiology and behaviour. Moreover, excitatory neurostimulation protocols capable of reversing the disruptive effects of focal cortical inhibition have demonstrated therapeutic promise in post-stroke dysphagia when applied contralaterally. In healthy participants (n = 15, 8 males, mean age (±SEM) 35 ± 9 years), optimal parameters of transcranial direct current stimulation (tDCS) (anodal, 1.5 mA, 10 min) were applied contralaterally after 1 Hz rTMS pre-conditioning to the strongest pharyngeal projection. Swallowing neurophysiology was assessed in both hemispheres by intraluminal recordings of pharyngeal motor-evoked responses (PMEPs) to single-pulse TMS as a measure of cortical excitability. Swallowing behaviour was examined using a pressure-based reaction time protocol. Measurements were made before and for up to 60 min post intervention. Subjects were randomised to active or sham tDCS after 1 Hz rTMS on separate days and data were compared using repeated measures ANOVA. Active tDCS increased PMEPs bilaterally (F1,14 = 7.4, P = 0.017) reversing the inhibitory effects of 1 Hz rTMS in the pre-conditioned hemisphere (F1,14 = 10.1, P = 0.007). Active tDCS also enhanced swallowing behaviour, increasing the number of correctly timed challenge swallows compared to sham (F1,14 = 6.3, P = 0.025). Thus, tDCS to the contralateral pharyngeal motor cortex reverses the neurophysiological and behavioural effects of focal cortical inhibition on swallowing in healthy individuals and has therapeutic potential for dysphagia rehabilitation. PMID:24247983

  3. Reversing disability of irreversible lung disease.

    PubMed Central

    Tiep, B. L.

    1991-01-01

    Pulmonary rehabilitation is a comprehensive multifaceted team approach for integrating medical management, coping skills, self-management techniques, and exercise reconditioning. It provides patients with chronic lung disease the ability to adapt and live full and nearly normal lives. These changes are possible because the overall disability includes significant reversible components: Patients have bronchospasm, infection, and cor pulmonale; they respond to progressively impaired lungs by progressive inactivity, leading to physical deconditioning. Both factors contribute to dyspnea. Because patients naturally fear dyspnea, they panic easily. During panic, their work of breathing may increase and respiratory failure may result. Pulmonary rehabilitation provides good medical management; provides exercises to increase strength, endurance, and tolerance to dyspnea; and trains patients in panic control. These programs have not been shown to lengthen life span or improve static lung function. They increase exercise performance and render patients functional, independent, and subject to fewer hospital admissions. Pulmonary rehabilitation is the only approach to chronic lung disease short of lung transplantation that improves the long-term outlook for these patients. Images PMID:1866957

  4. Swallowing Disorders

    MedlinePlus

    ... Awards Enhancing Diversity Find People About NINDS NINDS Swallowing Disorders Information Page Synonym(s): Dysphagia Table of Contents ( ... Clinical Trials Organizations Publicaciones en Español What are Swallowing Disorders? Having trouble swallowing (dysphagia) is a symptom ...

  5. Swallowing soap

    MedlinePlus

    ... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

  6. Swallowing difficulty

    MedlinePlus

    Dysphagia; Impaired swallowing; Choking - food; Globus sensation ... The process of swallowing involves several steps. These include Chewing food Moving it into the back of the mouth Moving it down the ...

  7. Dirt - swallowing

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/002840.htm Dirt - swallowing To use the sharing features on this page, ... enable JavaScript. This article is about poisoning from swallowing or eating dirt. This article is for information ...

  8. Swallow syncope

    PubMed Central

    Armstrong, Paul W.; McMillan, Denis G.; Simon, Jerome B.

    1985-01-01

    Swallowing is considered a rare cause of syncope. The five patients described in this report had a spectrum of gastrointestinal tract or cardiovascular disease. For each patient there was a clear association between swallowing and the onset of syncope. Prompt diagnosis of this potentially lethal condition is essential, and electrocardiographic monitoring during swallowing is advisable in all cases in which syncope is suspected. PMID:3995448

  9. Swallowing difficulty

    MedlinePlus

    ... at the bottom of the esophagus to relax ( Achalasia ) Scarring that narrows the esophagus. This may be ... used if cancer is causing the swallowing problem. Achalasia or spasms of the esophagus may also respond ...

  10. Endoscopic Evaluation of Swallowing (Endoscopy)

    MedlinePlus

    ... the Public / Speech, Language and Swallowing / Swallowing Endoscopic Evaluation of Swallowing (Endoscopy) Do you have problems swallowing? ... Some names you might hear are: Endoscopy Endoscopic Evaluation of swallowing FEES (Fiberoptic Endoscopic Evaluation of Swallowing) ...

  11. Videofluoroscopic Swallowing Study (VFSS)

    MedlinePlus

    ... hear are: videofluoroscopic swallowing study, or videofluoroscopy modified barium swallow, or MBS esophagram cookie swallow The American ... give you different foods and drinks mixed with barium. The barium makes the food and liquid show ...

  12. Self-Triggered Functional Electrical Stimulation During Swallowing

    PubMed Central

    Burnett, Theresa A.; Mann, Eric A.; Stoklosa, Joseph B.; Ludlow, Christy L.

    2006-01-01

    Hyolaryngeal elevation is essential for airway protection during swallowing and is mainly a reflexive response to oropharyngeal sensory stimulation. Targeted intramuscular electrical stimulation can elevate the resting larynx and, if applied during swallowing, may improve airway protection in dysphagic patients with inadequate hyolaryngeal motion. To be beneficial, patients must synchronize functional electrical stimulation (FES) with their reflexive swallowing and not adapt to FES by reducing the amplitude or duration of their own muscle activity. We evaluated the ability of nine healthy adults to manually synchronize FES with hyolaryngeal muscle activity during discrete swallows, and tested for motor adaptation. Hooked-wire electrodes were placed into the mylo- and thyrohyoid muscles to record electromyographic activity from one side of the neck and deliver monopolar FES for hyolaryngeal elevation to the other side. After performing baseline swallows, volunteers were instructed to trigger FES with a thumb switch in synchrony with their swallows for a series of trials. An experimenter surreptitiously disabled the thumb switch during the final attempt, creating a foil. From the outset, volunteers synchronized FES with the onset of swallow-related thyrohyoid activity (~225 ms after mylohyoid activity onset), preserving the normal sequence of muscle activation. A comparison between average baseline and foil swallows failed to show significant adaptive changes in the amplitude, duration, or relative timing of activity for either muscle, indicating that the central pattern generator for hyolaryngeal elevation is immutable with short term stimulation that augments laryngeal elevation during the reflexive, pharyngeal phase of swallowing. PMID:16107520

  13. Tailored Barium Swallow Study

    MedlinePlus

    ... a perfect study, but it is the best method to gather information about how you/your child swallows and the risk there may be for food or liquids going into the airway. The Speech Pathologist plans the TBS so that a sample of a few swallows of various textures shows ...

  14. Watercolor paints - swallowing

    MedlinePlus

    ... If the person swallowed the paint, give them water or milk right away, unless a provider tells you not to. DO NOT give anything to drink if the person has symptoms that make it ... Use soap and water to wash any paint off skin and clothes.

  15. Syncope with Swallowing.

    PubMed

    Manu, Stephen; Aziz, Peter F

    2016-05-01

    Swallowing can be a trigger for syncope and can cause significant morbidity and mortality if not recognized. A 13-year-old presented with clusters of transient complete atrioventricular block after repair of a sinus venosus atrial septal defect. Pacemaker implantation was successful in treating these symptoms. PMID:26891888

  16. The Swallow Park Sundials

    NASA Astrophysics Data System (ADS)

    De Villiers, P.

    2014-02-01

    The Hermanus Astronomy Centre recently erected a pair of back-to-back sundials in Swallow Park in the centre of Hermanus as part of the upgrading of this historical public park by the Ward committee. Since these two are intended to be the first of many different design sundials to be erected in Hermanus by the HAC, the designs were purposefully chosen to be "unusual" to illustrate the point that even unfamiliar designs and orientations give the same end result....

  17. Reversing the Export of People with Learning Disabilities and Complex Health Needs

    ERIC Educational Resources Information Center

    Pritchard, Andrew; Roy, Ashok

    2006-01-01

    Background: There is an increase in people with learning disabilities with offending and other disturbed behaviour who are placed in the local community and out of their area of origin. Aims: To compare clients placed locally and out of area. Method: All authorities in an English region were surveyed and interviewed about their clients placed…

  18. Swallowing Disorders: What Families Should Know.

    ERIC Educational Resources Information Center

    Rader, Tom; Rende, Barbara

    Swallowing problems can result from a catastrophic illness or injury, and the family's role is very important in implementing the swallowing precautions recommended by the rehabilitation team. Explained in this pamphlet are the stages of the normal swallowing sequence, symptoms of a swallowing disorder, medical conditions associated with…

  19. [Dysphagia. Are swallowing sounds diagnostically useful?].

    PubMed

    Kley, C; Biniek, R

    2005-12-01

    The origin and importance of swallowing sounds in dysphagia have been discussed in previous research. Those studies report a general similarity in the sound patterns of different swallowing actions. The current paper confirms this. In addition, the origin of swallowing sound patterns is examined more closely. Finally, we simultaneously analyzed the swallowing sounds of healthy voluntary subjects and patients with swallowing disorders using X-ray cinematography. Videoendoscopy was also done. As expected, we found a variety of sound sequences differing from those of healthy subjects. Patients with tracheal tubes or cannulae constitute a special group whose swallowing sounds give additional information about the act of swallowing. PMID:16133430

  20. Utility of a Clinical Swallowing Exam for Understanding Swallowing Physiology.

    PubMed

    Rangarathnam, Balaji; McCullough, Gary H

    2016-08-01

    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 examination of historical measures, oral motor/speech/voice, and trial swallows. The VFSS consisted of swallows of controlled portions of thin, thick, puree, and solid boluses. Previous results from these patients demonstrated significant accuracy in making binary estimates of aspiration and the presence of dysphagia. This analysis of data focused on physiologic measures, as well as overall dysphagia severity and diet recommendations. Significant associations between CSE and VFSS ratings were observed for hyolaryngeal elevation, overall swallowing severity, and diet recommendations. These findings were specific for certain bolus consistencies. These data suggest that the CSE may not provide significant physiological information other than hyolaryngeal excursion. This does not preclude the fact that the CSE is important in providing substantial information about overall dysphagia severity. It appears that the CSE is more powerful than simply a "screening" tool. More prospective research designs are warranted to substantiate the strengths of the CSE. PMID:26970759

  1. Difficulty Swallowing After Stroke (Dysphagia)

    MedlinePlus

    ... can reduce sensation. After a stroke, food or liquid could enter the airway/lungs without the survivor ... working. The survivor may be given food and liquid to swallow. Efforts to make sure survivors with ...

  2. Foreign object - inhaled or swallowed

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/000036.htm Foreign object - inhaled or swallowed To use the sharing features ... please enable JavaScript. If you breathe a foreign object into your nose, mouth, or respiratory tract, it ...

  3. What Happens to Swallowed Gum?

    MedlinePlus

    ... Medical Words En Español What Other Kids Are Reading Back-to-School Butterflies? Read This Chloe & Nurb ... t chew gum until they fully understand the importance of not swallowing it. By age 5, most ...

  4. Understanding differences between healthy swallows and penetration-aspiration swallows via compressive sensing of tri-axial swallowing accelerometry signals

    NASA Astrophysics Data System (ADS)

    Sejdić, Ervin; Dudik, Joshua M.; Kurosu, Atsuko; Jestrović, Iva; Coyle, James L.

    2014-05-01

    Swallowing accelerometry is a promising tool for non-invasive assessment of swallowing difficulties. A recent contribution showed that swallowing accelerometry signals for healthy swallows and swallows indicating laryn- geal penetration or tracheal aspiration have different time-frequency structures, which may be problematic for compressive sensing schemes based on time-frequency dictionaries. In this paper, we examined the effects of dif- ferent swallows on the accuracy of a compressive sensing scheme based on modulated discrete prolate spheroidal sequences. We utilized tri-axial swallowing accelerometry signals recorded from four patients during routinely schedule videofluoroscopy exams. In particular, we considered 77 swallows approximately equally distributed between healthy swallows and swallows presenting with some penetration/aspiration. Our results indicated that the swallow type does not affect the accuracy of a considered compressive sensing scheme. Also, the results con- firmed previous findings that each individual axis contributes different information. Our findings are important for further developments of a device which is to be used for long-term monitoring of swallowing difficulties.

  5. Respiratory-Swallowing Coordination and Swallowing Safety in Patients with Parkinson’s Disease

    PubMed Central

    Huebner, Irene; Rosenbek, John C.; Okun, Michael S.; Sapienza, Christine M.

    2013-01-01

    The purpose of this study was to determine if individuals with Parkinson’s disease (PD) demonstrate abnormal respiratory events when swallowing thin liquids. In addition, this study sought to define associations between respiratory events, swallowing apnea duration, and penetration–aspiration (P–A) scale scores. Thirty-nine individuals with PD were administered ten trials of a 5-ml thin liquid bolus. P–A scale score quantified the presence of penetration and aspiration during the swallowing of a 3-oz sequential bolus. Participants were divided into two groups based on swallowing safety judged during the 3-oz sequential swallowing: Group 1 = P–A ≤ 2; Group 2 = P–A ≥ 3. Swallows were examined using videofluoroscopy coupled with a nasal cannula to record respiratory signals during the event(s). Findings indicated that expiration was the predominant respiratory event before and after swallowing apnea. The data revealed no differences in our cohort versus the percentages of post-swallowing events reported in the literature for healthy adults. In addition, individuals with decreased swallowing safety, as measured by the P–A scale, were more likely to inspire after swallows and to have shorter swallowing apnea duration. Individuals who inspired before swallow also had longer swallowing apnea duration. The occurrence of inspiratory events after a swallow and the occurrence of shorter swallowing apnea durations may serve as important indicators during clinical swallowing assessments in patients at risk for penetration or aspiration with PD. PMID:20623304

  6. Effects of chemoradiotherapy on voice and swallowing

    PubMed Central

    Lazarus, Cathy L.

    2009-01-01

    Purpose of review Chemotherapy has been found to result in comparable survival rates to surgery for head and neck cancer. However, toxicity can often be worse after chemoradiotherapy, with impairment in voice, swallowing, nutrition, and quality of life. Investigators are attempting to modify radiotherapy treatment regimens to spare organs that have an impact on swallowing. This review will highlight voice and swallowing impairment seen after chemoradiotherapy, as well as treatment for voice and swallowing disorders in this population. Results of newer radiotherapy regimens will also be highlighted. Recent findings Specific oropharyngeal swallowing motility disorders after chemoradiotherapy have been identified. Damage to specific structures has been correlated with specific pharyngeal phase swallow impairment. Swallowing function and quality of life have been examined over time, with improvement seen in both. Preventive/prophylactic swallow exercise programs have been encouraging. Chemoradiotherapy effects on voice have been identified in terms of acoustic, aerodynamic, and patient and clinician-rated perception of function. Improvement in voice has also been observed over time after chemoradiotherapy. Voice therapy has been found to have a positive impact on voice and perceptual measures in this population. Summary Current studies show some improvement in swallow function after swallow and voice therapy in patients treated with chemoradiotherapy. Further, there is a suggestion of improved swallow function with sparing of organs with specific radiotherapy protocols. Future research needs to focus on specific voice and swallow treatment regimens in the head and neck cancer patient treated with chemoradiotherapy, specifically, timing, frequency, duration, and specific treatment types. PMID:19337126

  7. Does Barium Influence Tongue Behaviors during Swallowing?

    ERIC Educational Resources Information Center

    Steele, Catriona M.; van Lieshout, Pascal H. H. M.

    2005-01-01

    The validity of videofluoroscopic swallowing assessments rests on the understanding that thin, nectar-, honey-, and spoon-thick radiopaque liquids resemble nonopaque liquids, both in their consistency and in the variations in swallowing that they elicit. Tongue movements during sequential swallows of opaque and nonopaque liquids were studied in 8…

  8. How to swallow an elephant

    SciTech Connect

    Powell, K.B.

    1995-03-01

    There is an old East Indian fable of a young man who went to see a wise man. The young man had a question - {open_quotes}How can I become rich and powerful?{close_quotes} The wise man paused for a moment then asked a question in return - {open_quotes}How can you swallow an elephant?{close_quotes} The young man was astounded, {open_quotes}There is no way a man can swallow an elephant!{close_quotes} {open_quotes}Yes, there is,{close_quotes} replied the wise man, {open_quotes}You just have to do it one bite at a time.{close_quotes} Many large problems can only be handled the same way that an elephant is swallowed, one bite at a time. Global warming and other environmental problems are obviously of elephant-swallowing scale. Some have set a goal for our society of reducing atmospheric greenhouse gases, particularly carbon dioxide (CO{sub 2}), by 20%. The cost to accomplish this has been estimated to be about five trillion dollars! As big as this elephant is, I suspect that its size is understated, if all the factors involved are included. The proponents of the plan tell us that it is well worth the cost to save the world. Therein lies another elephant-style problem.

  9. Teledynamic Evaluation of Oropharyngeal Swallowing

    ERIC Educational Resources Information Center

    Malandraki, Georgia A.; McCullough, Gary; He, Xuming; McWeeny, Elizabeth; Perlman, Adrienne L.

    2011-01-01

    Purpose: The objective of the present investigation was to test the feasibility and clinical utility of a real-time Internet-based protocol for remote, telefluoroscopic evaluation of oropharyngeal swallowing. Method: In this prospective cohort study, the authors evaluated 32 patients with a primary diagnosis of stroke or head/neck cancer. All…

  10. Lung Volume during Swallowing: Single Bolus Swallows in Healthy Young Adults

    ERIC Educational Resources Information Center

    Hegland, Karen M. Wheeler; Huber, Jessica E.; Pitts, Teresa; Sapienza, Christine M.

    2009-01-01

    Purpose: This study examined the relationship between swallowing and lung volume initiation in healthy adults during single swallows of boluses differing in volume and consistency. Differences in lung volume according to respiratory phase surrounding the swallow were also assessed. Method: Nine men and 11 women between the ages of 19 and 28 years…

  11. Delayed Initiation of the Pharyngeal Swallow: Normal Variability in Adult Swallows

    ERIC Educational Resources Information Center

    Martin-Harris, Bonnie; Brodsky, Martin B.; Michel, Yvonne; Lee, Fu-Shing; Walters, Bobby

    2007-01-01

    Purpose: The purpose of this investigation was to determine bolus head timing and location relations with the onset of hyoid movement at the initiation of the pharyngeal swallow and at the onset of swallow-related apnea. Method: Bolus head timing and location and the timing of swallow-related apnea were recorded from frame-by-frame analyses of…

  12. Surface electromyography pattern of human swallowing

    PubMed Central

    Monaco, Annalisa; Cattaneo, Ruggero; Spadaro, Alessandro; Giannoni, Mario

    2008-01-01

    Background The physiology of swallowing is characterized by a complex and coordinated activation of many stomatognathic, pharyngeal, and laryngeal muscles. Kinetics and electromyographic studies have widely investigated the pharyngeal and laryngeal pattern of deglutition in order to point out the differences between normal and dysphagic people. In the dental field, muscular activation during swallowing is believed to be the cause of malocclusion. Despite the clinical importance given to spontaneous swallowing, few physiologic works have studied stomatognathic muscular activation and mandibular movement during spontaneous saliva swallowing. The aim of our study was to investigate the activity patterns of the mandibular elevator muscles (masseter and anterior temporalis muscles), the submental muscles, and the neck muscles (sternocleidomastoid muscles) in healthy people during spontaneous swallowing of saliva and to relate the muscular activities to mandibular movement. Methods The spontaneous swallowing of saliva of 111 healthy individuals was analyzed using surface electromyography (SEMG) and a computerized kinesiography of mandibular movement. Results Fifty-seven of 111 patients swallowed without occlusal contact (SNOC) and 54 individuals had occlusal contact (SOC). The sternocleidomastoid muscles showed a slight, but constant activation during swallowing. The SEMG of the submental and sternocleidomastoid muscles showed no differences between the two groups. The SEMG of the anterior temporalis and masseter muscles showed significant differences (p < 0.0001). The duration of swallowing was significantly higher in the SNOC subjects. Gender and age were not related to electromyographic activation. Healthy SOC and SNOC behaved in different ways. Conclusion The data suggest that there is not a single "normal" or "typical" pattern for spontaneous saliva swallowing. The polygraph seemed a valuable, simple, non-invasive and reliable tool to study the physiology of

  13. Swallowing: A Professional and Parental Perspective

    ERIC Educational Resources Information Center

    Roche, William J.; Petronchak, JoAnn; Eicher, Peggy S.

    2008-01-01

    For humans, successful drinking is a necessity early in life. In fact, swallowing can be observed with ultrasound at approximately the 16th week of pregnancy. The fetus "drinks" amniotic fluid as a way to filter fetal debris and to help maintain the amniotic fluid level for its mother. All this "swallowing practice" in utero enables the fetus to…

  14. Lung Volume Measured during Sequential Swallowing in Healthy Young Adults

    ERIC Educational Resources Information Center

    Hegland, Karen Wheeler; Huber, Jessica E.; Pitts, Teresa; Davenport, Paul W.; Sapienza, Christine M.

    2011-01-01

    Purpose: Outcomes from studying the coordinative relationship between respiratory and swallow subsystems are inconsistent for sequential swallows, and the lung volume at the initiation of sequential swallowing remains undefined. The first goal of this study was to quantify the lung volume at initiation of sequential swallowing ingestion cycles and…

  15. Acoustic discrimination of healthy swallows from upper airway movements.

    PubMed

    Skowronski, Mark D; Crary, Michael A; Shrivastav, Rahul

    2013-08-01

    Spontaneous swallowing in dysphagic individuals has been shown to occur at a lower rate compared to healthy controls, and passive swallowing detection may function as a valid screening test to identify dysphagia in at-risk populations. To automate swallow identification, acoustic source and vocal tract features were extracted from two types of swallows and eight upper airway movements from nine healthy subjects. Swallow vs non-swallow classification accuracy was 96.3 ± 1.1%. The results provide useful methods for further development of automated tools for identification of patients with swallowing impairment. PMID:23927214

  16. Sleep Stage Coordination of Respiration and Swallowing: A Preliminary Study.

    PubMed

    Okuno, Kentaro; Nohara, Kanji; Takai, Etsuko; Sakai, Takayoshi; Fleetham, John A; Ayas, Najib T; Lowe, Alan A; Almeida, Fernanda R

    2016-08-01

    Swallowing is an important physiological response that protects the airway. Although aspiration during sleep may cause aspiration pneumonia, the mechanisms responsible have not yet been elucidated. We evaluated the coordination between respiration and swallowing by infusing water into the pharynx of healthy young adults during each sleep stage. Seven normal subjects participated in the study. During polysomnography recordings, to elicit a swallow we injected distilled water into the pharynx during the awake state and each sleep stage through a nasal catheter. We assessed swallow latency, swallow apnea time, the respiratory phase during a swallow, the number of swallows, and coughing. A total number of 79 swallows were recorded. The median swallow latency was significantly higher in stage 2 (10.05 s) and stage 3 (44.17 s) when compared to awake state (4.99 s). The swallow latency in stage 3 showed a very wide interquartile range. In two subjects, the result was predominantly prolonged compared to the other subjects. There was no significant difference in the swallow apnea time between sleep stages. The presence of inspiration after swallowing, repetitive swallowing, and coughing after swallowing was more frequent during sleep than when awake. 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. PMID:27338262

  17. Obesity epidemic: time to swallow the frog.

    PubMed

    Andersen, Ross E

    2003-11-01

    Mark Twain once said, "If you have to swallow a frog, don't stare at it too long." I believe that members of the healthcare community have been staring at the obesity epidemic for too long. PMID:20086443

  18. Accidental swallowing of orthodontic expansion appliance key.

    PubMed

    Monini, André da Costa; Maia, Luiz Guilherme Martins; Jacob, Helder Baldi; Gandini, Luiz Gonzaga

    2011-08-01

    Ingestion of a foreign object, including a dental object, can lead to a trip to the emergency room. This article describes the accidental swallowing of a key that was used to activate a rapid maxillary expander. An orthodontic patient swallowed the key while trying to activate the appliance at home. The object's trajectory was followed on radiographs until it was eliminated. Possible clinical complications, legal implications of this situation, and practices for prevention are described. PMID:21803265

  19. Instrumentation for bedside analysis of swallowing disorders.

    PubMed

    Greco, Catiuscia S S; Nunes, Luiz G Q; Melo, Pedro L

    2010-01-01

    Disordered swallowing, or dysphagia, is a common problem seen in patients undergoing treatment for cancer, stroke and neurodegenerative illnesses. This disease is associated with aspiration-induced chest infections. The methods currently used for diagnosis, however, are qualitative or based on expensive equipment. Swallowing accelerometry is a promising low-cost, quantitative and noninvasive tool for the evaluation of swallowing. This work describes the design and application of a bedside instrument able to evaluate swallowing mechanisms and to identify patients at risk of aspiration. Three-axis swallowing accelerometry was used to measure the neck vibrations associated with deglutition, providing analog signals to a virtual instrument developed in LabVIEW environment. In vivo tests in normal subjects as well as tests with disphagic patients showed that the system was able to easily and non-invasively detect changes in the swallowing acceleration pattern associated with increasing values of water volume (p < 0.02) and disphagia. We concluded that the developed system could be a useful tool for the objective bedside evaluation of patients at risk of aspiration. PMID:21096774

  20. Computer-assisted detection of swallowing difficulty.

    PubMed

    Lee, Jung Chan; Seo, Han Gil; Lee, Woo Hyung; Kim, Hee Chan; Han, Tai Ryoon; Oh, Byung-Mo

    2016-10-01

    To evaluate classification performance of a support vector machine (SVM) classifier for diagnosing swallowing difficulty based on the hyoid movement data attained from videofluoroscopic swallowing study, the hyoid kinematics during the swallowing of 2 mL of liquid barium solution were analyzed for 90 healthy volunteers and 116 dysphagic stroke patients. SVM was used to classify the kinematic results as normal or dysfunctional swallowing. Various kernel functions and kernel parameters were used for optimization. Features were selected to find an optimal feature subset and to minimize redundancy. Accuracy, sensitivity, specificity, and area under a receiving operating characteristic curve (AUC) were used to assess the discrimination performance. In 19 out of 26 features, mean comparison revealed a significant difference between healthy subjects and dysphagic patients. By reducing the number of features to 10, an AUC of 0.9269 could be reached. Common features showing the best classification in both kernel functions included forward maximum excursion time, upward maximum excursion time, maximum excursion length, upward maximum velocity time, upward maximum acceleration time, maximum acceleration, maximum acceleration time, and mean acceleration. SVM-based classification method with the use of kernel functions showed an outstanding (AUC of 0.9269) discrimination performance for either healthy or dysphagic hyoid movement during swallowing. We expect that this classification method will be useful as an adjunct diagnostic tool by providing automatic detection of swallowing dysfunction as well as a research tool providing deeper understanding of pathophysiology. PMID:27480734

  1. Smartphone-Based Real-time Assessment of Swallowing Ability From the Swallowing Sound

    PubMed Central

    Ueno, Tomoyuki; Teramoto, Yohei; Nakai, Kei; Hidaka, Kikue; Ayuzawa, Satoshi; Eguchi, Kiyoshi; Matsumura, Akira; Suzuki, Kenji

    2015-01-01

    Dysphagia can cause serious challenges to both physical and mental health. Aspiration due to dysphagia is a major health risk that could cause pneumonia and even death. The videofluoroscopic swallow study (VFSS), which is considered the gold standard for the diagnosis of dysphagia, is not widely available, expensive and causes exposure to radiation. The screening tests used for dysphagia need to be carried out by trained staff, and the evaluations are usually non-quantifiable. This paper investigates the development of the Swallowscope, a smartphone-based device and a feasible real-time swallowing sound-processing algorithm for the automatic screening, quantitative evaluation, and the visualisation of swallowing ability. The device can be used during activities of daily life with minimal intervention, making it potentially more capable of capturing aspirations and risky swallow patterns through the continuous monitoring. It also consists of a cloud-based system for the server-side analyzing and automatic sharing of the swallowing sound. The real-time algorithm we developed for the detection of dry and water swallows is based on a template matching approach. We analyzed the wavelet transformation-based spectral characteristics and the temporal characteristics of simultaneous synchronised VFSS and swallowing sound recordings of 25% barium mixed 3-ml water swallows of 70 subjects and the dry or saliva swallowing sound of 15 healthy subjects to establish the parameters of the template. With this algorithm, we achieved an overall detection accuracy of 79.3% (standard error: 4.2%) for the 92 water swallows; and a precision of 83.7% (range: 66.6%–100%) and a recall of 93.9% (range: 72.7%–100%) for the 71 episodes of dry swallows. PMID:27170905

  2. Swallowing dysfunction following endotracheal intubation: Age matters.

    PubMed

    Tsai, Min-Hsuan; Ku, Shih-Chi; Wang, Tyng-Guey; Hsiao, Tzu-Yu; Lee, Jang-Jaer; Chan, Ding-Cheng; Huang, Guan-Hua; Chen, Cheryl Chia-Hui

    2016-06-01

    To evaluate postextubation swallowing dysfunction (PSD) 21 days after endotracheal extubation and to examine whether PSD is time-limited and whether age matters.For this prospective cohort study, we evaluated 151 adult critical care patients (≥20 years) who were intubated for at least 48 hours and had no pre-existing neuromuscular disease or swallowing dysfunction. Participants were assessed for time (days) to pass bedside swallow evaluations (swallow 50 mL of water without difficulty) and to resume total oral intake. Outcomes were compared between younger (20-64 years) and older participants (≥65 years).PSD, defined as inability to swallow 50 mL of water within 48 hours after extubation, affected 92 participants (61.7% of our sample). At 21 days postextubation, 17 participants (15.5%) still failed to resume total oral intake and were feeding-tube dependent. We found that older participants had higher PSD rates at 7, 14, and 21 days postextubation, and took significantly longer to pass the bedside swallow evaluations (5.0 vs 3.0 days; P = 0.006) and to resume total oral intake (5.0 vs 3.0 days; P = 0.003) than their younger counterparts. Older participants also had significantly higher rates of subsequent feeding-tube dependence than younger patients (24.1 vs 5.8%; P = 0.008).Excluding patients with pre-existing neuromuscular dysfunction, PSD is common and prolonged. Age matters in the time needed to recover. Swallowing and oral intake should be monitored and interventions made, if needed, in the first 7 to 14 days postextubation, particularly for older patients. PMID:27310972

  3. Chemical Sensing Regulates Mastication/Swallowing.

    PubMed

    Yamamura, Kensuke; Kurose, Masayuki; Okamoto, Keiichiro

    2016-01-01

    Mastication and swallowing are the first stage of digestion involving several motor processes such as food intake, intra-oral food transport, bolus formation and chewing and swallowing reflex. These complicated motor functions are accomplished by the well-coordinated activities in the jaw, hyoid, tongue, facial and pharyngeal muscles. Although the basic activity patterns of these movements are controlled by the brainstem pattern generators, these movements generate various peripheral sensory inputs. Among the sensory inputs, it is well-known that somatic sensory inputs play important roles in reflexively modulating the movements so that the final motor outputs fit the environmental demand. However, little is known about the effects of chemical sensory inputs such as taste and olfaction originating from the ingested foods by these movements. A possible reason could be raised that cognition of the chemical sensory inputs at the higher brain also influences the movements, so it is difficult to discuss the neural mechanisms underlying the observed effect. In this review, we focus on the effects of chemical sensory inputs on the masticatory movements and initiation of swallowing. We first summarize chemical sensory inputs occurring during mastication and swallowing, and their receptive mechanisms. In addition, we will introduce the effect of application of monosodium L-glutamate (MSG) solution as an umami taste to the oropharynx on the swallow initiation which is involuntary controlled and the possible neural mechanisms underlying this effect is discussed. PMID:26881439

  4. Effects of pollution on swallowing: how little we know

    SciTech Connect

    Palmer, J.B.; Silver, K.H. )

    1992-06-01

    Swallowing is an essential function of the upper alimentary tract. It is highly complex, requiring precise coordination of numerous nerves and muscles of the oral cavity, pharynx, larynx, and esophagus. Swallowing is integrated with other physiologic functions, including mastication and respiration. Impairments of swallowing may result from many different structural or physiologic disorders. Little is currently known about the direct effects of pollution on swallowing. Structures critical to swallowing, however, are vulnerable to damage by environmental hazards such as exposure to ionizing radiation or intake of toxins by ingestion or inhalation. The relationship of swallowing to environmental lung disease is an area of particular interest because impaired swallowing may result in aspiration of food particles into the lung, and because pollutants may hamper airway defense mechanisms. In this article, we discuss the possible impact of selected environmental agents on swallowing and suggest future directions for research.26 references.

  5. Esophageal perforation in a sword swallower.

    PubMed

    Scheinin, S A; Wells, P R

    2001-01-01

    We present the case of a 59-year-old man who sustained an esophageal perforation as a result of sword swallowing. An esophagogram established the diagnosis, and surgical repair was attempted. However, 19 days later, a persistent leak and deterioration of the patient's condition necessitated a transhiatal esophagectomy with a left cervical esophagogastrostomy. The patient recovered and has resumed his daily activities at the circus, with the exception of sword swallowing. This case report presents an unusual mechanism for a potentially lethal injury. Our search of the English-language medical literature revealed no other report of esophageal perforation resulting from sword swallowing. Management of such an injury is often difficult, and a favorable outcome is dependent on prompt diagnosis and treatment. PMID:11330747

  6. Transdermal clonidine in patients with swallowing dysfunction.

    PubMed

    Goldenberg, Gregory; Bharathan, Thayyullathil; Shifrin, Inna

    2014-09-01

    Patients with swallowing dysfunction are usually very ill and have a constellation of challenging issues requiring palliation. Accumulation of oropharyngeal secretions leads to a substantial effort of medical teams including doctors, nurses, respiratory therapists, and ancillary staff. We present 10 patients successfully treated with application of transdermal clonidine film. It was well tolerated, provided quick control of secretions, and reduced staff labor. We suggest that transdermal clonidine can be used as antisialogogue in patients with swallowing dysfunction. Clonidine pharmacology is physiologic grounds for this clinical application. PMID:24813023

  7. Effects of Verbal Cue on Bolus Flow during Swallowing

    ERIC Educational Resources Information Center

    Daniels, Stephanie K.; Schroeder, Mae Fern; DeGeorge, Pamela C.; Corey, David M.; Rosenbek, John C.

    2007-01-01

    Purpose: To examine the effects of verbal cuing to initiate swallowing on bolus flow measures in healthy adults. Method: Videofluoroscopic examinations were completed in 12 healthy older adults (median age = 69 years) as they swallowed 5 ml of self-administered liquid barium in 2 conditions: verbally cued and noncued swallows. In the cued…

  8. Cortical swallowing processing in early subacute stroke

    PubMed Central

    2011-01-01

    Background Dysphagia is a major complication in hemispheric as well as brainstem stroke patients causing aspiration pneumonia and increased mortality. Little is known about the recovery from dysphagia after stroke. The aim of the present study was to determine the different patterns of cortical swallowing processing in patients with hemispheric and brainstem stroke with and without dysphagia in the early subacute phase. Methods We measured brain activity by mean of whole-head MEG in 37 patients with different stroke localisation 8.2 +/- 4.8 days after stroke to study changes in cortical activation during self-paced swallowing. An age matched group of healthy subjects served as controls. Data were analyzed by means of synthetic aperture magnetometry and group analyses were performed using a permutation test. Results Our results demonstrate strong bilateral reduction of cortical swallowing activation in dysphagic patients with hemispheric stroke. In hemispheric stroke without dysphagia, bilateral activation was found. In the small group of patients with brainstem stroke we observed a reduction of cortical activation and a right hemispheric lateralization. Conclusion Bulbar central pattern generators coordinate the pharyngeal swallowing phase. The observed right hemispheric lateralization in brainstem stroke can therefore be interpreted as acute cortical compensation of subcortically caused dysphagia. The reduction of activation in brainstem stroke patients and dysphagic patients with cortical stroke could be explained in terms of diaschisis. PMID:21392404

  9. Effect of swallowing exercises in independent elderly.

    PubMed

    Sugiyama, Tetsuya; Ohkubo, Mai; Honda, Yasutoshi; Tasaka, Akinori; Nagasawa, Keiko; Ishida, Ryo; Sakurai, Kaoru

    2013-01-01

    The aim of this study was to investigate the effects of swallowing exercises on oral function in independent elderly patients visiting the Department of Prosthodontics at Tokyo Dental College Chiba Hospital. Twenty-nine patients aged over 65 years (15 men and 14 women; mean age, 75.0 years) in whom treatment was completed at this college were enrolled in the study. The patients were instructed on how to perform swallowing exercises monthly (including at baseline) for the first 2 months from the start of the study and asked to perform those exercises at least once daily. At the beginning and end of the study (a 3-month study period), the Repetitive Saliva Swallowing Test was conducted and occlusal force, oral diadochokinesis, unstimulated whole saliva flow rate, stimulated whole saliva flow rate, salivary pH at rest, and salivary buffering capacity measured to determine the effects of the exercises on oral function. Analyses demonstrated significant increases in diadochokinesis rate (/ta/ and /ka/) and unstimulated whole saliva flow rate (p<0.05), suggesting that the swallowing exercises promote the maintenance and improvement of oral function in the independent elderly. PMID:23903582

  10. Feeding and Swallowing Dysfunction in Genetic Syndromes

    ERIC Educational Resources Information Center

    Cooper-Brown, Linda; Copeland, Sara; Dailey, Scott; Downey, Debora; Petersen, Mario Cesar; Stimson, Cheryl; Van Dyke, Don C.

    2008-01-01

    Children with genetic syndromes frequently have feeding problems and swallowing dysfunction as a result of the complex interactions between anatomical, medical, physiological, and behavioral factors. Feeding problems associated with genetic disorders may also cause feeding to be unpleasant, negative, or even painful because of choking, coughing,…

  11. The Neurobiology of Swallowing and Dysphagia

    ERIC Educational Resources Information Center

    Miller, Arthur J.

    2008-01-01

    The neurobiological study of swallowing and its dysfunction, defined as dysphagia, has evolved over two centuries beginning with electrical stimulation applied directly to the central nervous system, and then followed by systematic investigations that have used lesioning, transmagnetic stimulation, magnetoencephalography, and functional magnetic…

  12. [Preventing swallowing disorders in neurological patients].

    PubMed

    Poindessous, Jean-Luc; Basta, Martial; Da Silva, José; Tillard, Audrey; Rasquier, Stéphanie; Héron, Anne

    2015-12-01

    Swallowing disorders in neurological rehabilitation are common and important as they can have harmful consequences. A multi-disciplinary hospital team was created to study ways of preventing their occurrence. This article presents the areas to focus on and the main orientations of patient management. PMID:26654505

  13. Senescent Swallowing: Impact, Strategies and Interventions

    PubMed Central

    Ney, Denise; Weiss, Jennifer; Kind, Amy; Robbins, JoAnne

    2010-01-01

    The risk for disordered oropharyngeal swallowing (dysphagia) increases with age. Loss of swallowing function can have devastating health implications including dehydration, malnutrition, and pneumonia, as well as reduced quality of life. Age-related changes place older adults at risk for dysphagia for two major reasons: One is that natural, healthy aging takes its toll on head and neck anatomy and physiologic and neural mechanisms underpinning swallowing function. This progression of change contributes to alterations in the swallowing in healthy older adults and is termed presbyphagia, naturally diminishing functional reserve. Second, disease prevalence increases with age and dysphagia is a co-morbidity of many age-related diseases and/or their treatments. Sensory changes, medication, sarcopenia and age-related diseases are discussed herein. Relatively recent findings that health complications are associated with dysphagia are presented. Nutrient requirements, fluid intake and nutritional assessment for older adults are reviewed relative to their relations to dysphagia. Dysphagia screening and the pros and cons of tube feeding as a solution are discussed. Optimal intervention strategies for elders with dysphagia ranging from compensatory interventions to more rigorous exercise approaches are presented. Compelling evidence of improved functional swallowing and eating outcomes resulting from active rehabilitation focusing on increasing strength of head and neck musculature is provided. In summary, while oropharyngeal dysphagia may be life-threatening, so are some of the traditional alternatives, particularly for frail, elderly patients. While the state of the evidence calls for more research, this review indicates the behavioral, dietary and environmental modifications emerging in this past decade are compassionate, promising and in many cases preferred alternatives to the always present option of tube feeding. PMID:19483069

  14. Swallowing Disorders in Severe Brain Injury in the Arousal Phase.

    PubMed

    Bremare, A; Rapin, A; Veber, B; Beuret-Blanquart, F; Verin, E

    2016-08-01

    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 %) and pharyngeal (66.7 %) food bolus transport disorders; and alterations in airway protection mechanisms (80 %). Swallowing test under endoscopic control showed a disorder in swallowing coordination in 55.6 % of patients tested. Seven (63.6 %) patients resumed oral feeding within an average of 6 weeks after admission to rehabilitation center and 14 weeks after acquired brain injury. Six (85.7 %) of these seven patients continued to require modified solid and liquid textures. Swallowing disorders are a major concern in severe brain injury in the arousal phase. Early bedside assessment of swallowing is essential for detection of swallowing disorders to propose appropriate medical rehabilitation care to these patients in a state of altered consciousness. PMID:27090424

  15. An Audit to Evaluate the Safety and Efficacy of Percutaneous Endoscopic Gastrostomy Placement in Patients with Learning Disabilities

    ERIC Educational Resources Information Center

    Ayres, Lachlan; Black, Chris; Scheepers, Mark; Shaw, Ian

    2015-01-01

    Percutaneous endoscopic gastrostomy insertion is an effective method of providing enteral nutrition to patients with neurologically unsafe swallowing or failure of feeding. Patients with severe learning disabilities may develop unsafe swallowing and benefit from percutaneous endoscopic gastrostomy placement. It is unclear whether this intervention…

  16. RESPIRATORY–SWALLOW PHASE PATTERNS AND THEIR RELATIONSHIP TO SWALLOWING IMPAIRMENT IN PATIENTS TREATED FOR OROPHARYNGEAL CANCER

    PubMed Central

    Brodsky, Martin B.; McFarland, David H.; Dozier, Thomas S.; Blair, Julie; Ayers, Christopher; Michel, Yvonne; Gillespie, M. Boyd; Day, Terry A.

    2012-01-01

    Background Unstable respiratory–swallowing coordination has been associated with disorders and disease. The goals of this study were (1) to describe respiratory–swallow patterns in patients with dysphagia consequent to treatments for cancers of the oropharynx and (2) to determine the association between respiratory–swallow patterns, airway invasion, and overall severity of swallowing impairment. Methods This prospective, cross-sectional design compared respiratory–swallow patterns in 20 patients treated for oropharyngeal cancer and 20 healthy, age-matched control participants. Nasal airflow direction was synchronously recorded with videofluoroscopic imaging in participants who swallowed 5-mL thin liquid barium boluses. Results Respiratory–swallow patterns differed between groups. Most control participants initiated and completed swallowing bracketed by expiratory airflow. Swallowing in patients often interrupted inspiratory flow and was associated with penetration or aspiration of the bolus. Conclusions We suggest nonexpiratory bracketed respiratory–swallowing phase patterns in patients with oropharyngeal cancer may place patients at greater risk of airway penetration or aspiration during swallowing. PMID:19780056

  17. The Effect of the Cervical Orthosis on Swallowing Physiology and Cervical Spine Motion During Swallowing.

    PubMed

    Mekata, Kojiro; Takigawa, Tomoyuki; Matsubayashi, Jun; Toda, Kazukiyo; Hasegawa, Yasuhiro; Ito, Yasuo

    2016-02-01

    Cervical orthosis is used to immobilize the neck in various disorders such as trauma and post-operation. However, it is still uncertain how cervical orthosis restricts the degree of movement of the cervical spine during swallowing and how they affect swallowing physiology. The purpose of this study was to evaluate these issues using the Philadelphia(®) Collar. We conducted videofluorography of swallowing in 39 healthy subjects (23 men, 16 women; mean age of 34.3 years) with and without cervical orthosis. To compare the two conditions regarding the cervical spine motion, we determined the angular and positional changes of the occipital bone (C0) and each cervical vertebra (C1-C7) from the oral phase to the pharyngeal phase. Similarly, to compare swallowing physiology, we assessed the start and end times and the durations of soft palate elevation, rapid hyoid anterosuperior movement, epiglottis inversion, closure of the laryngeal vestibule, and pharyngoesophageal segment (PES) opening. Finally, we compared the transit times of contrast agent in the two conditions. The respective extensions of C1, C2, and C3 were 0.31°, 0.07°, and 0.05° (mean) with cervical orthosis, and the respective flexions of C1, C2, and C3 were 0.98°, 1.42°, and 0.85° (mean) without. These results suggested that cervical orthosis restricted the flexion of C1-C3. Analysis of swallowing physiology revealed that the average durations of hyoid anterosuperior elevation, epiglottic inversion, and PES opening were prolonged by 0.09, 0.19, and 0.05 s, respectively. In conclusion, the cervical orthosis restricted the movement of the cervical spine during swallowing and changed swallowing physiology. PMID:26607160

  18. Swallowing during ongoing fluid ingestion in the rat.

    PubMed

    Kaplan, J M; Grill, H J

    1989-10-01

    In order to identify fixed versus flexible aspects of swallowing and oromotor control, we developed a method for the concurrent analysis of swallow frequency, swallow volume, and the temporal correlation between swallowing and rhythmic orolingual movements during prolonged bouts of fluid ingestion in unanesthetized, unrestrained rats. Rats actively ingested 0.1 M sucrose solutions infused intraorally: (a) at a constant rate within sessions; and (b) during separate sessions across which the rate of intraoral infusion (= ingestion rate) was varied. Salient characteristics of 'intraoral intake' included: (1) covariation of swallow frequency and swallow volume to mediate adjustments in the rate of ingestion; (2) emission of rhythmic coupled movements (5-7 Hz) of the jaw and tongue that serve to transport fluid through the mouth; (3) a 20-40 ms increase in the duration of the rhythmic movement cycle associated with swallow onset; and (4) emergence of pauses between bursts of rhythmic oromotor behavior with increases in cumulative intake. That intraoral intake and fluid ingestion via spout-licking (Weijnen et al., Brain Behav. Evol., 25, 1985) share all of these features suggests strongly that common neural processes, relatively uninfluenced by sources of sensory feedback attending contact with an environmental fluid source, underlie these aspects of normal fluid ingestion. The dynamic adjustment of swallow frequency and swallow volume presents a challenge to traditional models of reflexive swallow initiation derived primarily from the neurophysiological study of acute, non-behaving preparations. PMID:2804670

  19. Effects of Effortful Swallow on Cardiac Autonomic Regulation.

    PubMed

    Gomes, Lívia M S; Silva, Roberta G; Melo, Monique; Silva, Nayra N; Vanderlei, Franciele M; Garner, David M; de Abreu, Luiz Carlos; Valenti, Vitor E

    2016-04-01

    Swallowing-induced changes in heart rate have been recently reported. However, it is not apparent the responses of heart rate variability (HRV) elicited by effortful swallow maneuver. We investigated the acute effects of effortful swallowing maneuver on HRV. This study was performed on 34 healthy women between 18 and 35 years old. We assessed heart rate variability in the time (SDNN, RMSSD, and pNN50) and frequency (HF, LF, and LF/HF ratio) domains and, visual analysis through the Poincaré plot. The subjects remained at rest for 5 min during spontaneous swallowing and then performed effortful swallowing for 5 min. HRV was analyzed during spontaneous and effortful swallowing. We found no significant differences for SDNN, pNN50, RMSSD, HF in absolute units (ms(2)). There is a trend for increase of LF in absolute (p = 0.05) and normalized (p = 0.08) units during effortful swallowing. HF in normalized units reduced (p = 0.02) during effortful swallowing and LF/HF ratio (p = 0.03) increased during effortful swallowing. In conclusion effortful swallow maneuver in healthy women increased sympathetic cardiac modulation, indicating a cardiac overload. PMID:26650792

  20. Swallowing Disorders - Multiple Languages: MedlinePlus

    MedlinePlus

    ... enable JavaScript. Chinese - Simplified (简体中文) Chinese - Traditional (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) ... 繁體中文 (Chinese - Traditional) Bilingual PDF Health Information Translations French (français) Barium Swallow Déglutition barytée - français (French) Bilingual ...

  1. Swallowing Disorders - Multiple Languages: MedlinePlus

    MedlinePlus

    ... 繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Russian (Русский) Somali (af Soomaali) Spanish (español) ... 嚥下障害 - 日本語 (Japanese) Bilingual PDF Health Information Translations Korean (한국어) Barium Swallow 바륨 조영검사 - 한국어 (Korean) Bilingual ...

  2. Vegetative expansion and seed output of swallow-worts (Vincetoxicum spp.)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Swallow-worts (Vincetoxicum rossicum, pale swallow-wort, and V. nigrum, black swallow-wort) are herbaceous, perennial, twining vines related to milkweeds (Apocynaceae). Pale swallow-wort is native to Ukraine and southeastern European Russia; black swallow-wort is native to southwestern Europe. Bot...

  3. Variability of the Pharyngeal Phase of Swallow in the Cat

    PubMed Central

    Spearman, Daniel G.; Poliacek, Ivan; Rose, Melanie J.; Bolser, Donald C.; Pitts, Teresa

    2014-01-01

    Objective The pharyngeal phase of swallow has been thought to be a stereotypical motor behavior. Study Design This is a prospective, preclinical, hypothesis driven, one group by three-task design. Methods We sought to compare the effects of pharyngeal swabbing, water only, and water plus punctate mechanical stimulation on the spatiotemporal features of the pharyngeal phase of swallow in the cat. Swallow was elicited under these three conditions in six anaesthetized cats. Electromyographic activity was recorded from seven muscles used to evaluate swallow: mylohyoid, geniohyoid, thyrohyoid, thyroarytenoid, thyropharyngeus, cricopharyngeus, and parasternal. Results Pharyngeal swabbing in comparison to the other stimulus conditions, results in decreases in post-swallow cricopharyngeus activity (upper esophageal sphincter); a significant increase in parasternal (schluckatmung; swallow breath) activity; and increases in thyrohyoid (laryngeal elevator), thyroarytenoid (laryngeal adductor) and parasternal muscles burst duration. Pearson correlations were found of moderate strength between 19% of burst duration comparisons and weak to moderate relationships between 29% of burst amplitude comparisons. However, there were no positive significant relationships between phase durations and electromyogram amplitudes between any of the muscles studied during swallow. Conclusions The results support the concept that a stereotypical behavior, such as pharyngeal swallowing in animal models, can be modified by sensory feedback from pharyngeal mucosal mechanoreceptors. Furthermore, differences in swallow phase durations and amplitudes provide evidence that separate regulatory mechanisms exist which regulate spatial and temporal aspects of the behavior. PMID:25171095

  4. Using Sensory Properties of Food to Trigger Swallowing: A Review

    PubMed Central

    Loret, C.

    2015-01-01

    The effect of food consistency on swallowing function has been widely studied, and it is well recognized that by delaying the flow of the food bolus, thickened liquids can help in the management of swallowing dysfunction. However, fewer studies have been carried out on the impact of food sensory properties and related liking on swallowing function. This paper reviews the role of taste, olfaction, and trigeminal perceptions on swallowing function and highlights the need for a deeper investigation of this aspect of patient diet modification. PMID:24915399

  5. The influence of product and oral characteristics on swallowing.

    PubMed

    Engelen, Lina; Fontijn-Tekamp, Anneke; van der Bilt, Andries

    2005-08-01

    The urge to swallow food could be triggered by a threshold level in both food particle size and lubrication of the food bolus. Thus, both oral physiology and product characteristics may influence the swallowing threshold. We quantified the swallowing threshold in a group of 266 healthy adult subjects (age 42 +/- 12 years) by counting the number of chewing cycles needed to prepare food for swallowing. The influence of oral physiology on the swallowing threshold was determined by measuring salivary flow rate, maximum bite force and masticatory performance. We used about 10 cm(3) of bread, toast, melba toast, breakfast cake, peanuts and cheese to determine the influence on the swallowing threshold of various food characteristics, e.g. hardness, moisture and fat. Furthermore, we tested the effect of buttering the bread, toast, melba toast and breakfast cake on the swallowing threshold. Salivary flow rates were significantly and negatively correlated with the number of chewing cycles of melba toast and breakfast cake. Hence, subjects with more saliva needed less chewing cycles for these dry products. Maximum bite force and masticatory performance had an influence on the swallowing threshold for the hard products only (carrot and peanut). Although significant, the correlation coefficients were less than 0.28. Thus, the oral physiology parameters explained less than 10% of the variance in the swallowing threshold. We found significantly different numbers of chewing cycles for the various foods, ranging from 17 for cake to 63 for carrot. Hard and dry products needed more chewing cycles until swallowing. Buttering the food significantly reduced the number of chewing cycles needed before swallowing. This was especially true for the dry products cake, melba toast and toast. Hard and dry products require more chewing cycles and longer time in mouth until swallowing for sufficient breakdown to take place and for enough saliva to be added to form a coherent bolus safe for

  6. Swallowing/ventilation interactions during oral swallow in normal children and children with cerebral palsy.

    PubMed

    Casas, M J; Kenny, D J; McPherson, K A

    1994-01-01

    Many children with cerebral palsy (CP) suffer from feeding disorders. Twenty children with spastic CP and 20 neurologically normal children (age range 6.2-12.9 years) were monitored with ultrasound imaging of the oral cavity synchronized with surface electromyographic (EMG) recordings of masseter and infrahyoid muscles and respiratory inductance plethysmograph (RIP) recordings during feeding tasks. A lip-cup contact detector signaled contact of the drinking cup on the lip during liquid tasks. Children with CP required more time than normals for collection and organization of 5 ml and 75 ml liquid boluses for swallowing. The ventilatory preparation phase, recovery to baseline resting ventilatory pattern after swallowing, and total time for task completion were longer in children with CP for 5-ml and 75-ml tasks. The interval from lip-cup contact until alteration of ventilation from baseline resting ventilatory pattern was longer for children with CP during 75-ml tasks but not for 5-ml tasks. The interval from completion of the task-related cookie swallow until initiation of the next swallow was longer in children with CP than in normal children. These data provide evidence that children with CP manage solid boluses more easily than liquid boluses and small liquid boluses more easily than large liquid boluses. This investigation statistically confirms empirically based recommendations that children with CP be allowed more time to complete feeding tasks and consume small volume drinks rather than large volume drinks. PMID:8131424

  7. Multimodal swallowing evaluation with high-resolution manometry reveals subtle swallowing changes in early and mid-stage Parkinson disease

    PubMed Central

    Jones, Corinne A; Ciucci, Michelle R

    2015-01-01

    Background Parkinson disease (PD) has detrimental effects on swallowing function. Treatment options are largely behavioral; thus, patients would benefit from an earlier start to therapy. Early swallowing changes in PD are not well-known, so patients do not typically receive swallowing treatment until later in the progression of PD. Objective We used predictive modeling to determine what quantitative swallowing variables best differentiate individuals with early to mid-stage PD from healthy controls. Methods Participants included twenty-six individuals with early to mid-stage PD and 26 healthy, age- and sex-matched controls. Swallowing was evaluated by simultaneous high-resolution manometry and videofluoroscopy as well as the Sydney Swallow Questionnaire (SSQ). Binomial logistic regression was performed on 4 sets of data: 1) high-resolution manometry only; 2) videofluoroscopy only; 3) SSQ only; and 4) all data combined. Results A model from a combined data set had the highest accuracy in differentiating individuals with PD from controls. The model included maximum pressure in the velopharynx (soft palate), pressure variability in the velopharynx, and the SSQ item concerning difficulty with saliva swallowing. No significant models could be generated using the videofluoroscopy data. Conclusions Individuals with PD show quantitative changes in pressure generation and are able to self-assess aspects of swallowing function in the early and mid-stages of PD, even in the absence of swallowing changes seen on videofluoroscopy. A multimodal approach for the assessment of swallowing may be more accurate for determining subtle swallowing changes that occur in the early stages of PD. PMID:26891176

  8. Assessment of Infant Oral Sensorimotor and Swallowing Function

    ERIC Educational Resources Information Center

    Rogers, Brian; Arvedson, Joan

    2005-01-01

    The development of feeding and swallowing is the result of a complex interface between the developing nervous system, various physiological systems, and the environment. The purpose of this article is to review the neurobiology, development, and assessment of feeding and swallowing during early infancy. In recent years, there have been exciting…

  9. Use of Electromagnetic Midsagittal Articulography in the Study of Swallowing

    ERIC Educational Resources Information Center

    Steele, Catriona M.; Van Lieshout, Pascal H.H.M.

    2004-01-01

    The tongue functions as the primary articulator during the oropharyngeal stages of swallowing. However, detailed descriptions of the kinematics and spatiotemporal variability of tongue behaviors during swallowing are limited to a handful of analyses of data from the X-ray microbeam database. In this article, a new technique, electromagnetic…

  10. Integrating Academic and Clinical Learning Using a Clinical Swallowing Assessment

    ERIC Educational Resources Information Center

    Phillips, Daniel E.

    2013-01-01

    This article describes an experiential learning activity designed to integrate classroom knowledge and a clinical swallowing assessment. Twenty master's-level graduate students in a dysphagia course conducted a clinical swallowing assessment with a resident of an independent retirement community. The exercise was designed to allow students an…

  11. Swallow Characteristics in Patients with Oculopharyngeal Muscular Dystrophy

    ERIC Educational Resources Information Center

    Palmer, Phyllis M.; Neel, Amy T.; Sprouls, Gwyneth; Morrison, Leslie

    2010-01-01

    Purpose: This prospective investigation evaluates oral weakness and its impact on swallow function, weight, and quality of life in patients with oculopharyngeal muscular dystrophy (OPMD). Method: Intraoral pressure, swallow pressure, and endurance were measured using an Iowa Oral Performance Instrument in participants with OPMD and matched…

  12. Mechanisms of Airway Protection during Chin-Down Swallowing

    ERIC Educational Resources Information Center

    Macrae, Phoebe; Anderson, Cheryl; Humbert, Ianessa

    2014-01-01

    Purpose: This study examined the effects of chin-down swallowing on laryngeal vestibule closure. It also investigated the technique's rehabilitative impact, by assessing the stability of effects across multiple trials and aftereffects in neutral swallows on cessation of the technique. Method: Duration of laryngeal vestibule closure (dLVC) was…

  13. Swallow-wort (Vincetoxicum spp.) biological control update

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pale swallow-wort (Vincetoxicum rossicum = Cynanchum rossicum) and black swallow-wort (V. nigrum = C. louiseae) are herbaceous, perennial, viney milkweeds introduced from Europe (Apocynaceae-subfamily Asclepiadoideae). Both species are becoming increasingly invasive in a variety of natural and manag...

  14. Temporal and durational patterns associating respiration and swallowing.

    PubMed

    Klahn, M S; Perlman, A L

    1999-01-01

    This study obtained initial normative data on the temporal coordination of respiration and swallowing events in 12 young adults using a first-generation Respirodeglutometer. In addition, direction of airflow before and after deglutive apnea was obtained. Three swallows of two viscosities of bolus material were performed by each subject, yielding a total of 72 swallows. Qualitative and quanitative analyses were performed. Time of onset of submental surface electromyography and time of laryngeal movement were found to differ between males and females. Males began submental muscle contraction before females and laryngeal movement after females. Duration of deglutition apnea for all swallows was 0.75 +/- 0.14 sec. Expiration occurred before the deglutition apnea 93% of the time and after the deglutition apnea 100% of the time. A modal pattern of events obtained with the Respirodeglutometer was present in 42% of the swallows, and an additional 47% had only one event differ from that order. PMID:10341108

  15. Oral Care for Developmentally Disabled Children: The Primary Dentition Stage.

    ERIC Educational Resources Information Center

    Kenny, David J.; Judd, Peter L.

    1988-01-01

    Developmental disabilities and chronic illness can impact the oral health of children in the preeruptive and primary dentition stages. The article covers prevention and management of dental caries; gingival changes; trauma to the primary dentition; sucking, swallowing, and mastication; extraorally fed patients; and factitial injuries. Home-care…

  16. Decoding human swallowing via electroencephalography: a state-of-the-art review

    NASA Astrophysics Data System (ADS)

    Jestrović, Iva; Coyle, James L.; Sejdić, Ervin

    2015-10-01

    Swallowing and swallowing disorders have garnered continuing interest over the past several decades. Electroencephalography (EEG) is an inexpensive and non-invasive procedure with very high temporal resolution which enables analysis of short and fast swallowing events, as well as an analysis of the organizational and behavioral aspects of cortical motor preparation, swallowing execution and swallowing regulation. EEG is a powerful technique which can be used alone or in combination with other techniques for monitoring swallowing, detection of swallowing motor imagery for diagnostic or biofeedback purposes, or to modulate and measure the effects of swallowing rehabilitation. This paper provides a review of the existing literature which has deployed EEG in the investigation of oropharyngeal swallowing, smell, taste and texture related to swallowing, cortical pre-motor activation in swallowing, and swallowing motor imagery detection. Furthermore, this paper provides a brief review of the different modalities of brain imaging techniques used to study swallowing brain activities, as well as the EEG components of interest for studies on swallowing and on swallowing motor imagery. Lastly, this paper provides directions for future swallowing investigations using EEG.

  17. Oral medication delivery in impaired swallowing: thickening liquid medications for safe swallowing alters dissolution characteristics.

    PubMed

    Manrique, Yady J; Sparkes, Arron M; Cichero, Julie A Y; Stokes, Jason R; Nissen, Lisa M; Steadman, Kathryn J

    2016-09-01

    Acetaminophen (paracetamol) is available in a wide range of oral formulations designed to meet the needs of the population across the age-spectrum, but for people with impaired swallowing, i.e. dysphagia, both solid and liquid medications can be difficult to swallow without modification. The effect of a commercial polysaccharide thickener, designed to be added to fluids to promote safe swallowing by dysphagic patients, on rheology and acetaminophen dissolution was tested using crushed immediate-release tablets in water, effervescent tablets in water, elixir and suspension. The inclusion of the thickener, comprised of xanthan gum and maltodextrin, had a considerable impact on dissolution; acetaminophen release from modified medications reached 12-50% in 30 min, which did not reflect the pharmacopeia specification for immediate release preparations. Flow curves reflect the high zero-shear viscosity and the apparent yield stress of the thickened products. The weak gel nature, in combination with high G' values compared to G'' (viscoelasticity) and high apparent yield stress, impact drug release. The restriction on drug release from these formulations is not influenced by the theoretical state of the drug (dissolved or dispersed), and the approach typically used in clinical practice (mixing crushed tablets into pre-prepared thickened fluid) cannot be improved by altering the order of incorporation or mixing method. PMID:26857812

  18. Interactive image processing in swallowing research

    NASA Astrophysics Data System (ADS)

    Dengel, Gail A.; Robbins, JoAnne; Rosenbek, John C.

    1991-06-01

    Dynamic radiographic imaging of the mouth, larynx, pharynx, and esophagus during swallowing is used commonly in clinical diagnosis, treatment and research. Images are recorded on videotape and interpreted conventionally by visual perceptual methods, limited to specific measures in the time domain and binary decisions about the presence or absence of events. An image processing system using personal computer hardware and original software has been developed to facilitate measurement of temporal, spatial and temporospatial parameters. Digitized image sequences derived from videotape are manipulated and analyzed interactively. Animation is used to preserve context and increase efficiency of measurement. Filtering and enhancement functions heighten image clarity and contrast, improving visibility of details which are not apparent on videotape. Distortion effects and extraneous head and body motions are removed prior to analysis, and spatial scales are controlled to permit comparison among subjects. Effects of image processing on intra- and interjudge reliability and research applications are discussed.

  19. Using Teacher Prompts and Habit Reversal to Reduce Fingernail Biting in a Student with Attention Deficit Hyperactivity Disorder and a Mild Intellectual Disability

    ERIC Educational Resources Information Center

    Waller, Raymond J.; Kent, Susan; Johnson, Miriam E.

    2007-01-01

    Fingernail biting is a habit that is developed by numerous people, especially children and teenagers. Many clinicians believe that the habit of fingernail biting stems from nervousness or anxiety. Students, especially students with disabilities, can be easily distracted from instruction, can become the target of negative peer attention, and can…

  20. Psychosocial Effects of Reverse-Integrated Basketball Activity Compared to Separate and No Physical Activity in Young People with Physical Disability

    ERIC Educational Resources Information Center

    Hutzler, Yeshayahu; Chacham-Guber, Anat; Reiter, Shunit

    2013-01-01

    The purpose of this study was to examine the impact of participation in different sport modalities on quality of life (QOL) and perceived social competence (PSC) in young people with physical disability. Ninety participants (33 females and 57 males) were monitored across four conditions: competitive separate physical activity (COSPA), recreational…

  1. Swallowed dentures: Two cases and a review

    PubMed Central

    Gachabayov, Mahir; Isaev, Mubariz; Orujova, Lala; Isaev, Emin; Yaskin, Evgeniy; Neronov, Dmitriy

    2015-01-01

    Introduction Denture ingestion or aspiration is a problem requiring awareness of different specialists including dentists, surgeons, otolaryngologists, anesthesiologists etc. in terms of prevention, early diagnosis and adequate treatment. Complications of swallowed dentures include hollow viscus necrosis, perforation, penetration to neighbor organs leading to fistulae, bleeding and obstruction. Presentation of cases First case is a 54-year-old female who accidentally swallowed retractable one-tooth denture during fall about 22 h before admission and clinical manifestation of acute small bowel obstruction developed. The patient underwent laparotomy, enterotomy with retrieval of the foreign body. The second case is a 31-year-old male who accidentally ingested fixed one-tooth prosthesis while eating which impacted in the ileocaecal valve. During the preparation to colonoscopy the denture spontaneously passed out with stools. Discussion Denture ingestion is more common among patients with psychoneurologic deficit, alcohol and drug abusers. Among healthy and younger population denture ingestion is rare. Both reported patients are not elder. Thus dislodgement of removable or fixed dentures is another risk factor of denture ingestion. Most common site of denture impaction is esophagus; small bowel impaction is rare. Moreover, in most reported cases, small bowel impaction of ingested dentures leads to small bowel perforation. In our first case the complication of denture ingestion appeared to be bowel obstruction what is even rarer. Conclusion Fixed dentures can be accidentally ingested as well as removable dentures. Denture loosening leads to accidental denture ingestion. Patients with denture loosening should be recommended to visit dentist as soon as possible. PMID:26635957

  2. Clock gene variation in Tachycineta swallows

    PubMed Central

    Dor, Roi; Cooper, Caren B; Lovette, Irby J; Massoni, Viviana; Bulit, Flor; Liljesthrom, Marcela; Winkler, David W

    2012-01-01

    Many animals use photoperiod cues to synchronize reproduction with environmental conditions and thereby improve their reproductive success. The circadian clock, which creates endogenous behavioral and physiological rhythms typically entrained to photoperiod, is well characterized at the molecular level. Recent work provided evidence for an association between Clock poly-Q length polymorphism and latitude and, within a population, an association with the date of laying and the length of the incubation period. Despite relatively high overall breeding synchrony, the timing of clutch initiation has a large impact on the fitness of swallows in the genus Tachycineta. We compared length polymorphism in the Clock poly-Q region among five populations from five different Tachycineta species that breed across a hemisphere-wide latitudinal gradient (Fig. 1). Clock poly-Q variation was not associated with latitude; however, there was an association between Clock poly-Q allele diversity and the degree of clutch size decline within breeding seasons. We did not find evidence for an association between Clock poly-Q variation and date of clutch initiation in for any of the five Tachycineta species, nor did we found a relationship between incubation duration and Clock genotype. Thus, there is no general association between latitude, breeding phenology, and Clock polymorphism in this clade of closely related birds. Figure 1 Photos of Tachycineta swallows that were used in this study: A) T. bicolor from Ithaca, New York, B) T. leucorrhoa from Chascomús, Argentina, C) T. albilinea from Hill Bank, Belize, D) T. meyeni from Puerto Varas, Chile, and E) T. thalassina from Mono Lake, California, Photographers: B: Valentina Ferretti; A, C-E: David Winkler. PMID:22408729

  3. Sensory Input Pathways and Mechanisms in Swallowing: A Review

    PubMed Central

    Miller, Arthur J.

    2010-01-01

    Over the past 20 years, research on the physiology of swallowing has confirmed that the oropharyngeal swallowing process can be modulated, both volitionally and in response to different sensory stimuli. In this review we identify what is known regarding the sensory pathways and mechanisms that are now thought to influence swallowing motor control and evoke its response. By synthesizing the current state of research evidence and knowledge, we identify continuing gaps in our knowledge of these mechanisms and pose questions for future research. PMID:20814803

  4. Acoustic technique for determining timing of velopharyngeal closure in swallowing.

    PubMed

    Smith, D; Hamlet, S; Jones, L

    1990-01-01

    A pure tone sound source was introduced at a nostril and monitored by a miniature accelerometer on the throat. During velopharyngeal closure in a swallow, the pure tone component in the accelerometer signal was attenuated. Throat accelerometer recordings were made simultaneously with videofluoroscopy of a modified barium swallow in adults with normal velopharyngeal mechanisms. It was verified that the period of sound attenuation corresponded to the period of velar closure. This noninvasive method of monitoring otherwise silent velopharyngeal closure holds promise for normative studies on swallowing function, as an adjunct method in longitudinal assessment, and as a training aid. PMID:2249490

  5. Cervical auscultation as an adjunct to the clinical swallow examination: a comparison with fibre-optic endoscopic evaluation of swallowing.

    PubMed

    Bergström, Liza; Svensson, Per; Hartelius, Lena

    2014-10-01

    This prospective, single-blinded study investigated the validity and reliability of cervical auscultation (CA) under two conditions; (1) CA-only, using isolated swallow-sound clips, and (2) CSE + CA, using extra clinical swallow examination (CSE) information such as patient case history, oromotor assessment, and the same swallow-sound clips as condition one. The two CA conditions were compared against a fibre-optic endoscopic evaluation of swallowing (FEES) reference test. Each CA condition consisted of 18 swallows samples compiled from 12 adult patients consecutively referred to the FEES clinic. Patients' swallow sounds were simultaneously recorded during FEES via a Littmann E3200 electronic stethoscope. These 18 swallow samples were sent to 13 experienced dysphagia clinicians recruited from the UK and Australia who were blinded to the FEES results. Samples were rated in terms of (1) if dysphagic, (2) if the patient was safe on consistency trialled, and (3) dysphagia severity. Sensitivity measures ranged from 83-95%, specificity measures from 50-92% across the conditions. Intra-rater agreement ranged from 69-97% total agreement. Inter-rater reliability for dysphagia severity showed substantial agreement (rs = 0.68 and 0.74). Results show good rater reliability for CA-trained speech-language pathologists. Sensitivity and specificity for both CA conditions in this study are comparable to and often better than other well-established CSE components. PMID:24236910

  6. Neural and cortical analysis of swallowing and detection of motor imagery of swallow for dysphagia rehabilitation-A review.

    PubMed

    Yang, H; Ang, K K; Wang, C; Phua, K S; Guan, C

    2016-01-01

    Swallowing is an essential function in our daily life; nevertheless, stroke or other neurodegenerative diseases can cause the malfunction of swallowing function, ie, dysphagia. The objectives of this review are to understand the neural and cortical basis of swallowing and tongue, and review the latest techniques on the detection of motor imagery of swallow (MI-SW) and motor imagery of tongue movements (MI-TM), so that a practical system can be developed for the rehabilitation of poststroke dysphagia patients. Specifically, we firstly describe the swallowing process and how the swallowing function is assessed clinically. Secondly, we review the techniques that performed the neural and cortical analysis of swallowing and tongue based on different modalities such as functional magnetic resonance imaging, positron emission tomography, near-infrared spectroscopy (NIRS), and magnetoencephalography. Thirdly, we review the techniques that performed detection and analysis of MI-SW and MI-TM for dysphagia stroke rehabilitation based on electroencephalography (EEG) and NIRS. Finally, discussions on the advantages and limitations of the studies are presented; an example system and future research directions for the rehabilitation of stroke dysphagia patients are suggested. PMID:27590970

  7. Super Guppy Swallows T-38s; Heads for El Paso

    NASA Video Gallery

    Two NASA T-38 aircraft were swallowed whole by NASA's Super Guppy recently on Dryden Flight Research Center's back ramp. The Guppy then airlifted the two retired T-38s to El Paso, Texas, where they...

  8. Swallowing and speech therapy after definitive treatment for laryngeal cancer.

    PubMed

    Samlan, Robin A; Webster, Kimberly T

    2002-10-01

    As the trend in laryngeal cancer treatment shifts towards organ-conservation surgeries and organ-preservation protocols, patients will more often retain anatomy vital to communication and swallowing. Despite a conservative approach, results of treatment may have debilitating effects. Rehabilitation efforts are directed towards a return to functional, if not normal, status. Although there are predictable trends in voice and swallowing disorders of patients with laryngeal cancer, posttreatment dysphonia and dysphagia are diverse in presentation. Considering the significant diversity of this population, speech pathologists should work closely with otolaryngologists to determine the most appropriate treatment for each patient. As this article demonstrates, voice and swallowing therapy are necessary components of the rehabilitation process following treatment for head and neck cancers. As always, treatment is tailored to the specific individual and based on information obtained during a thorough evaluation by a speech pathologist. Fortunately, with the help of voice and swallowing therapy, many patients return to functional communication and oral feeding. PMID:12587251

  9. Coordination of cough and swallow in vivo and in silico

    PubMed Central

    Pitts, Teresa; Morris, Kendall; Lindsey, Bruce; Davenport, Paul; Poliacek, Ivan; Bolser, Donald

    2012-01-01

    Cough and swallow are airway protective behaviors. The pharyngeal phase of swallow prevents aspiration of oral material (saliva, food and liquid), by epiglottal movement, laryngeal adduction, and clearing of the mouth and pharynx. Cough is an aspiration-response behavior which removes material from the airway. Coordination of these behaviors is vital to protect the airway from further aspiration-promoting events, such as a swallow occurring during the inspiratory phase of cough. The operational characteristics, primary strategies, and peripheral inputs which coordinate cough and swallow are unknown. This lack of knowledge impedes understanding and treatment of deficits in airway protection, such as the co-occurrence of dystussia and dysphagia common in Parkinson's and Alzheimer's diseases, as well as stroke. PMID:22198014

  10. Parameters of Instrumental Swallowing Evaluations: Describing a Diagnostic Dilemma.

    PubMed

    Pisegna, Jessica M; Langmore, Susan E

    2016-06-01

    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 asked (1) which anatomical sites they could visualize on each video, (2) where they saw pharyngeal residue after a swallow, (3) their overall clinical impression of the pharyngeal residue, and (4) their opinions of the evaluation styles. Clinicians reported a significant difference in the visualization of anatomical sites, 11 of the 15 sites were reported as better-visualized on the FEES than on the MBS video (p < 0.05). Clinicians also rated residue to be present in more locations on the FEES than on the MBS. Clinicians' overall impressions of the severity of residue on the same exact swallow were significantly different depending on the evaluation type (FEES vs. MBS for patient 1 χ(2) = 20.05, p < 0.0001; patient 2 χ(2) = 7.52, p = 0.006), with FEES videos rated more severely. FEES advantages were: more visualization of pharyngeal and laryngeal swallowing anatomy and residue. However, as a result, clinicians provided more severe impressions of residue amount on FEES. On one hand, this suggests that FEES is a more sensitive tool than MBS studies, but on the other hand, clinicians might provide more severe interpretations on FEES. PMID:26987971

  11. Ginger Orally Disintegrating Tablets to Improve Swallowing in Older People.

    PubMed

    Hirata, Ayumu; Funato, Hiroki; Nakai, Megumi; Iizuka, Michiro; Abe, Noriaki; Yagi, Yusuke; Shiraishi, Hisashi; Jobu, Kohei; Yokota, Junko; Hirose, Kahori; Hyodo, Masamitsu; Miyamura, Mitsuhiko

    2016-01-01

    We previously prepared and pharmaceutically evaluated ginger orally disintegrating (OD) tablets, optimized the base formulation, and carried out a clinical trial in healthy adults in their 20 s and 50s to measure their effect on salivary substance P (SP) level and improved swallowing function. In this study, we conducted clinical trials using the ginger OD tablets in older people to clinically evaluate the improvements in swallowing function resulting from the functional components of the tablet. The ginger OD tablets were prepared by mixing the excipients with the same amount of mannitol and sucrose to a concentration of 1% ginger. Eighteen healthy older adult volunteers aged 63 to 90 were included in the swallowing function test. Saliva was collected before and 15 min after administration of the placebo and ginger OD tablets. Swallowing endoscopy was performed by an otolaryngologist before administration and 15 min after administration of the ginger OD tablets. A scoring method was used to evaluate the endoscopic swallowing. Fifteen minutes after taking the ginger OD tablets, the salivary SP amount was significantly higher than prior to ingestion or after taking the placebo (p<0.05). Among 10 subjects, one scored 1-3 using the four evaluation criteria. Overall, no aspiration occurred and a significant improvement in the swallowing function score was observed (p<0.05) after taking the ginger OD tablets. Our findings showed that the ginger OD tablets increased the salivary SP amount and improved swallowing function in older people with appreciably reduced swallowing function. PMID:27374286

  12. A Targeted Swallow Screen for the Detection of Postoperative Dysphagia.

    PubMed

    Gee, Erica; Lancaster, Elizabeth; Meltzer, Jospeh; Mendelsohn, Abie H; Benharash, Peyman

    2015-10-01

    Postoperative dysphagia leads to aspiration pneumonia, prolonged hospital stay, and is associated with increased mortality. A simple and sensitive screening test to identify patients requiring objective dysphagia evaluation is presently lacking. In this study, we evaluated the efficacy of a novel targeted swallow screen evaluation. This was a prospective trial involving all adult patients who underwent elective cardiac surgery with cardiopulmonary bypass at our institution over an 8-week period. Within 24 hours of extubation and before the initiation of oral intake, all postsurgical patients were evaluated using the targeted swallow screen. A fiberoptic endoscopic evaluation of swallowing was requested for failed screenings. During the study, 50 postcardiac surgery patients were screened. Fifteen (30%) failed the targeted swallow screen, and ten of the fifteen (66%) failed the subsequent fiberoptic endoscopic evaluation of swallowing exam and were confirmed to have dysphagia. The screening test had 100 per cent sensitivity for detecting dysphagia in our patient population, and a specificity of 87.5 per cent. The overall incidence of dysphagia was 20 per cent. We have shown that a targeted swallow evaluation can efficiently screen patients during the postcardiac surgery period. Furthermore, we have shown that the true incidence of dysphagia after cardiac surgery is significantly higher than previously recognized in literature. PMID:26463293

  13. Disability Identity--Disability Pride

    ERIC Educational Resources Information Center

    Martin, Nicola

    2012-01-01

    This paper discusses a way of thinking about disability which has emerged out of the UK Disabled People's Movement over the last three decades in opposition to the preceding medical model of disability which viewed disability as synonymous with problem. Disabled people are increasingly challenging the notion that their embodiment is inherently…

  14. Intellectual disability

    MedlinePlus

    Intellectual disability is a condition diagnosed before age 18 that includes below-average intellectual function and a lack of ... Intellectual disability affects about 1 to 3% of the population. There are many causes of intellectual disability, but doctors ...

  15. Learning Disabilities

    MedlinePlus

    ... Enhancing Diversity Find People About NINDS NINDS Learning Disabilities Information Page Table of Contents (click to jump ... Español Additional resources from MedlinePlus What are Learning Disabilities? Learning disabilities are disorders that affect the ability ...

  16. Mechanisms of recovery of swallow after supraglottic laryngectomy.

    PubMed

    Logemann, J A; Gibbons, P; Rademaker, A W; Pauloski, B R; Kahrilas, P J; Bacon, M; Bowman, J; McCracken, E

    1994-10-01

    This study examines oropharyngeal swallow disorders and measures of pharyngeal and laryngeal movement during deglutition from videofluorographic studies of oropharyngeal swallow in 9 patients who had undergone supraglottic laryngectomy and 9 age-matched normal subjects. The swallows of surgical patients were examined at 2 weeks and 3 months postoperatively. Two critical factors in recovery of swallowing were identified: (a) airway closure at the laryngeal entrance, that is, the space between the arytenoid cartilage and the base of the tongue, and (b) the movement of the tongue base to make complete contact with the posterior pharyngeal wall. When patients achieved these two functions, they returned to normal swallowing. The duration of tongue base contact to the posterior pharyngeal wall and extent of anterior movement of the arytenoid increased significantly from 2 weeks to 3 months in the surgical patients. At 2 weeks postsurgery, patients who had undergone supraglottic laryngectomy exhibited significantly shorter airway closure and tongue base to pharyngeal wall contact, reduced laryngeal elevation, increased width of cricopharyngeal (CP) opening, and later onset of airway closure and tongue base movement than normal subjects. These significant differences remained at 3 months postoperatively, although swallow measures were moving toward normal in the patients who had undergone supraglottic laryngectomy. Comparison of patients not eating at 2 weeks with patients at the time of first eating revealed significantly longer duration of tongue base contact to the pharyngeal wall, longer duration of airway closure, and greater movement of the arytenoid in patients who were eating. Results indicate that the focus of swallowing therapy after supraglottic laryngectomy should be on improvement of posterior movement of the tongue base and anterior tilting of the arytenoid to close the airway entrance and improve bolus propulsion (in the case of the tongue base). PMID

  17. Amniotic fluid volume and fetal swallowing rate in sheep

    SciTech Connect

    Tomoda, S.; Brace, R.A.; Longo, L.D.

    1985-07-01

    To investigate amniotic fluid (AF) dynamics and volume regulatory mechanisms, the authors measured the concentration of radioiodinated (/sup 125/I) serum albumin (RISA), /sup 51/Cr-labeled red blood cells (Cr-RBC), and /sup 103/Ru-labeled microspheres after injection into the amniotic cavity and determined AF volume and fetal swallowing rate in 22 singleton pregnant sheep. Under normal conditions 2-3 h were required for complete mixing of RISA and Cr-RBC within AF; however, when the fetus was dead only 3-5 h were required. AF volume of 17 sheep on the 5th postoperative day averaged 975 +/- 128 ml by RISA and 986 +/- 130 ml by Cr-RBC. AF volume determined with RISA and Cr-RBC correlated well. In contrast, AF volume measurement with microspheres produced erratic results. The disappearance rate of the labels in 17 ewes on the 5th postoperative day averaged 4.9 +/- 0.7%/h for RISA and 5.5 +/- 0.7 for Cr-RBC, and the calculated rates of fetal swallowing were 935 +/- 78 ml/day by RISA and 1,085 +/- 102 by Cr-RBC. In dead fetuses the disappearance rates were almost zero, suggesting that the labels disappear mainly by swallowing. Absolute volume swallowed and swallowed volume per fetal weight correlated with gestational age. AF volume correlated with fetal weight. Radiolabeled albumin or red blood cells may be used to simultaneously measure amniotic fluid volume and the rate of fetal swallowing. Furthermore it appears that fetal swallowing increases with gestational age.

  18. A procedure for denoising dual-axis swallowing accelerometry signals.

    PubMed

    Sejdić, Ervin; Steele, Catriona M; Chau, Tom

    2010-01-01

    Dual-axis swallowing accelerometry is an emerging tool for the assessment of dysphagia (swallowing difficulties). These signals however can be very noisy as a result of physiological and motion artifacts. In this note, we propose a novel scheme for denoising those signals, i.e. a computationally efficient search for the optimal denoising threshold within a reduced wavelet subspace. To determine a viable subspace, the algorithm relies on the minimum value of the estimated upper bound for the reconstruction error. A numerical analysis of the proposed scheme using synthetic test signals demonstrated that the proposed scheme is computationally more efficient than minimum noiseless description length (MNDL)-based denoising. It also yields smaller reconstruction errors than MNDL, SURE and Donoho denoising methods. When applied to dual-axis swallowing accelerometry signals, the proposed scheme exhibits improved performance for dry, wet and wet chin tuck swallows. These results are important for the further development of medical devices based on dual-axis swallowing accelerometry signals. PMID:19940343

  19. Application of Kinesio Taping method for newborn swallowing difficultly

    PubMed Central

    Lin, Chien-Lin; Wu, Wei-Ting; Chang, Ke-Vin; Lin, Hong-Yi; Chou, Li-Wei

    2016-01-01

    Abstract Background: Preterm infants are at an increased risk of sucking problems, swallowing difficulty, and poor nourishment. During the neonatal period, the neurobehavioral organization of a preterm baby is poor compared with that of appropriate gestational age infants. Kinesio Taping has been widely used for edema control, joint protection, and proprioception training. With the help of augmentation of the sensory input for muscle facilitation and inhibition through tapping, the coordination of the target muscle groups can be improved. Until now, no research is available on the use of Kinesio Taping for the swallowing difficulty of infant. Methods: We reported a preterm infant suffering from brain edema at birth and swallowing difficultly until 40 weeks. The swallowing reflex was delayed. Moreover, lip closure and rooting reflex combined with the dysfunction grade of jaw movement were poor. We performed KT methods on the baby under the theory of the direction of the tape for facilitate or inhibit the muscle. Result: After the Kinesio Taping treatment, the sucking function was improved with good lip closure.One week later, the baby was discharged without the use of an oral gastric tube. Conclusion: Kinesio Taping contributed significantly to the improvement of impaired sucking and swallowing and could be implemented as a regular rehabilitative approach for infants suffering from these difficulties. PMID:27495080

  20. The relationship between masticatory and swallowing behaviors and body weight.

    PubMed

    Isabel, Carlos Alberto Camargo; Moysés, Marcos Ribeiro; van der Bilt, Andries; Gameiro, Gustavo Hauber; Ribeiro, José Carlos Rabelo; Pereira, Luciano José

    2015-11-01

    The present study aimed to compare the main objective parameters of mastication among individuals with different body mass indexes. One hundred and sixty participants matched for gender and age were divided in the following groups according to their body mass index (BMI): Obese group (30 ≤ BMI < 35), Overweight group (25 ≤ BMI < 30), normal range group (18.5 ≤ BMI < 25) and underweight group (17 ≤ BMI < 18.5). Each group was composed by forty subjects. The maximum bite force, the masticatory performance, chewing rate and three variables related to swallowing (number of chewing cycles, chewing time, and median particle size) were assessed in all groups. The oral conditions, including the number of teeth, number of occlusal units and salivary flow (unstimulated and stimulated) were also evaluated. Regardless of the BMI, males had a larger bite force and better masticatory and swallowing performances than females. They also chewed faster than females. Individuals of the obese group had the largest median particles sizes (both after 20 chewing cycles and at the moment of swallowing), which indicates a less good masticatory performance. The median particle sizes were negatively correlated with the number of teeth and number of occlusal units in the obese group. We did not observe large differences in masticatory performance and swallowing variables among the four weight groups, although there was a tendency that individuals of the obese group swallowed larger particles. The results of this study do not support the existence of an "obese chewing style". PMID:26253216

  1. A swallowed sewing needle migrating to the liver

    PubMed Central

    Avcu, Serhat; Ünal, Özkan; Özen, Özkan; Bora, Aydın; Dülger, Ahmet Cumhur

    2009-01-01

    Context: Swallowing foreign bodies is a common problem in children. Although most objects pass through the gastrointestinal tract with no untoward effect; long, sharppointed, or slender objects can perforate the gut. Migration of a swallowed object to the liver is extremely rare and very few cases have been reported in the literature up to now. The aim of this study is to draw attention to this subject once again by contributing a case report of a child with hepatic migration of a swallowed sewing needle. Case Report: A 16-year-old girl presented to the emergency room of pediatrics department in our hospital with complaints of abdominal pain, nausea and vomiting. Physical examination revealed tenderness on the right upper quadrant of the abdomen. Laboratory examination revealed increased hepatic enzymes as well as increased white blood cell count. Abdominal ultrasonography and computed tomography examinations revealed foreign body in the liver accompanied by surrounding abscess formation. The foreign body (sewing needle) was removed surgically after two operations. Conclusion: The children may not be able to remember the swallowing of the foreign body or they may try to hide such a condition. The radiological diagnosis in such cases which can be achieved by X-rays, ultrasonography or computed tomography is of critical importance, as well as getting detailed patient history for foreign body swallowing. PMID:22666694

  2. Central Nervous System Control of Voice and Swallowing

    PubMed Central

    Ludlow, Christy L.

    2015-01-01

    This review of the central nervous control systems for voice and swallowing has suggested that the traditional concepts of a separation between cortical and limbic and brain stem control should be refined and more integrative. For voice production, a separation of the non-human vocalization system from the human learned voice production system has been posited based primarily on studies of non-human primates. However, recent humans studies of emotionally based vocalizations and human volitional voice production has shown more integration between these two systems than previously proposed. Recent human studies have shown that reflexive vocalization as well as learned voice production not involving speech, involve a common integrative system. On the other hand, recent studies of non-human primates have provided evidence of some cortical activity during vocalization and cortical changes with training during vocal behavior. For swallowing, evidence from the macaque and functional brain imaging in humans indicates that the control for the pharyngeal phase of swallowing is not primarily under brain stem mechanisms as previously proposed. Studies suggest that the initiation and patterning of swallowing for the pharyngeal phase is also under active cortical control for both spontaneous as well as volitional swallowing in awake humans and non-human primates. PMID:26241238

  3. Automatic food intake detection based on swallowing sounds

    PubMed Central

    Makeyev, Oleksandr; Lopez-Meyer, Paulo; Schuckers, Stephanie; Besio, Walter; Sazonov, Edward

    2012-01-01

    This paper presents a novel fully automatic food intake detection methodology, an important step toward objective monitoring of ingestive behavior. The aim of such monitoring is to improve our understanding of eating behaviors associated with obesity and eating disorders. The proposed methodology consists of two stages. First, acoustic detection of swallowing instances based on mel-scale Fourier spectrum features and classification using support vector machines is performed. Principal component analysis and a smoothing algorithm are used to improve swallowing detection accuracy. Second, the frequency of swallowing is used as a predictor for detection of food intake episodes. The proposed methodology was tested on data collected from 12 subjects with various degrees of adiposity. Average accuracies of >80% and >75% were obtained for intra-subject and inter-subject models correspondingly with a temporal resolution of 30s. Results obtained on 44.1 hours of data with a total of 7305 swallows show that detection accuracies are comparable for obese and lean subjects. They also suggest feasibility of food intake detection based on swallowing sounds and potential of the proposed methodology for automatic monitoring of ingestive behavior. Based on a wearable non-invasive acoustic sensor the proposed methodology may potentially be used in free-living conditions. PMID:23125873

  4. Hard to swallow: Developmental biological insights into pediatric dysphagia.

    PubMed

    LaMantia, Anthony-Samuel; Moody, Sally A; Maynard, Thomas M; Karpinski, Beverly A; Zohn, Irene E; Mendelowitz, David; Lee, Norman H; Popratiloff, Anastas

    2016-01-15

    Pediatric dysphagia-feeding and swallowing difficulties that begin at birth, last throughout childhood, and continue into maturity--is one of the most common, least understood complications in children with developmental disorders. We argue that a major cause of pediatric dysphagia is altered hindbrain patterning during pre-natal development. Such changes can compromise craniofacial structures including oropharyngeal muscles and skeletal elements as well as motor and sensory circuits necessary for normal feeding and swallowing. Animal models of developmental disorders that include pediatric dysphagia in their phenotypic spectrum can provide mechanistic insight into pathogenesis of feeding and swallowing difficulties. A fairly common human genetic developmental disorder, DiGeorge/22q11.2 Deletion Syndrome (22q11DS) includes a substantial incidence of pediatric dysphagia in its phenotypic spectrum. Infant mice carrying a parallel deletion to 22q11DS patients have feeding and swallowing difficulties that approximate those seen in pediatric dysphagia. Altered hindbrain patterning, craniofacial malformations, and changes in cranial nerve growth prefigure these difficulties. Thus, in addition to craniofacial and pharyngeal anomalies that arise independently of altered neural development, pediatric dysphagia may result from disrupted hindbrain patterning and its impact on peripheral and central neural circuit development critical for feeding and swallowing. The mechanisms that disrupt hindbrain patterning and circuitry may provide a foundation to develop novel therapeutic approaches for improved clinical management of pediatric dysphagia. PMID:26554723

  5. Suppression of Abdominal Motor Activity during Swallowing in Cats and Humans

    PubMed Central

    Pitts, Teresa; Gayagoy, Albright G.; Rose, Melanie J.; Poliacek, Ivan; Condrey, Jillian A.; Musslewhite, M. Nicholas; Shen, Tabitha Y.; Davenport, Paul W.; Bolser, Donald C

    2015-01-01

    Diseases affecting pulmonary mechanics often result in changes to the coordination of swallow and breathing. We hypothesize that during times of increased intrathoracic pressure, swallow suppresses ongoing expiratory drive to ensure bolus transport through the esophagus. To this end, we sought to determine the effects of swallow on abdominal electromyographic (EMG) activity during expiratory threshold loading in anesthetized cats and in awake-healthy adult humans. Expiratory threshold loads were applied to recruit abdominal motor activity during breathing, and swallow was triggered by infusion of water into the mouth. In both anesthetized cats and humans, expiratory cycles which contained swallows had a significant reduction in abdominal EMG activity, and a greater percentage of swallows were produced during inspiration and/or respiratory phase transitions. These results suggest that: a) spinal expiratory motor pathways play an important role in the execution of swallow, and b) a more complex mechanical relationship exists between breathing and swallow than has previously been envisioned. PMID:26020240

  6. Suppression of the swallowing reflex by stimulation of the red nucleus.

    PubMed

    Satoh, Yoshihide; Tsuji, Kojun; Tsujimura, Takanori; Ishizuka, Ken'Ichi; Inoue, Makoto

    2015-07-01

    We study whether the red nucleus is involved in control of swallowing. The swallowing reflex was induced in anesthetized rats by repetitive electrical stimulation of the superior laryngeal nerve. The electromyographic activities of the mylohyoid and thyrohyoid muscles were recorded in order to identify the swallowing reflex. Repetitive electrical stimulation applied to the red nucleus reduced the number of swallows. The onset latency of the first swallow was increased during repetitive electrical stimulation applied to the magnocellular part of the red nucleus. Microinjection of monosodium glutamate into the red nucleus also reduced the number of swallows. The onset latency of the first swallow was increased after microinjection of monosodium glutamate into the magnocellular part of the red nucleus. These results imply that the red nucleus is involved in the control of swallowing. PMID:26012722

  7. Learning Disabilities.

    ERIC Educational Resources Information Center

    Clow, John, Ed.; Woolschlager, Ruth B., Ed.

    The learning disabilities monograph contains five brief articles dealing with various aspects of learning disabilities as they related to business education. "Learning Disabilities: A Challenge for the Vocational Business Educator" (Dorothy Munger) concerns screening students with learning disabilities into rather than out of business education…

  8. Recent Advances in Sensing Oropharyngeal Swallowing Function in Japan

    PubMed Central

    Ono, Takahiro; Hori, Kazuhiro; Masuda, Yuji; Hayashi, Toyohiko

    2010-01-01

    Dysphagia (difficulty in swallowing) is an important issue in the elderly because it causes aspiration pneumonia, which is the second largest cause of death in this group. It also causes decline in activities of daily living and quality of life. The oral phase of swallowing has been neglected, despite its importance in the evaluation of dysphagia, because adequate protocols and measuring devices are unavailable. However, recent advances in sensor technology have enabled straightforward, non-invasive measurement of the movement of important swallowing-related organs such as the lips and tongue, as well as the larynx. In this article, we report the present state and possibility of clinical application of such systems developed in Japan. PMID:22315534

  9. Swallow Syncope: Clinical Presentation, Diagnostic Criteria, and Therapeutic Options

    PubMed Central

    Garg, Shashank; Girotra, Mohit; Glasser, Stephen; Dutta, Sudhir K.

    2014-01-01

    We recently encountered three patients with episodes of syncope associated with food ingestion. A 31-year-old woman had an episode of syncope in the hospital while drinking soda. Transient asystole was noted on the telemonitor, confirming the diagnosis of swallow syncope. The other two patients were 78- and 80 year old gentlemen, respectively, who presented with recurrent and transient episodes of dizziness during deglutition. Extensive work-up of syncope was negative in both cases and a diagnosis of swallow syncope was made by clinical criteria. These cases illustrate the challenging problem of swallow syncope. The diagnosis can be suspected on the basis of clinical presentation and confirmed with the demonstration of transient brady-arrhythmia during deglutition. Medical management includes avoiding trigger foods, use of anticholinergics, and/or placement of a permanent cardiac pacemaker. PMID:25038205

  10. Respiratory phase resetting and airflow changes induced by swallowing in humans.

    PubMed Central

    Paydarfar, D; Gilbert, R J; Poppel, C S; Nassab, P F

    1995-01-01

    1. Relationships between the timing of respiration and deglutition were studied in thirty awake healthy subjects at rest. Deglutition was monitored by submental electromyography, pharyngeal manometry and videofluoroscopy. Respiration was recorded by measurement of oronasal airflow and chest wall movement. Three types of deglutition were studied: injected bolus swallows, spontaneous swallows, and visually cued swallows of boluses previously placed in the mouth. 2. The effect of each swallow on respiratory rhythm was characterized by measurement of cophase, defined as the interval between the onset of deglutitive submental EMG activity to the onset of subsequent rescheduled inspirations. Cophase was determined for swallows initiated at different phases of the respiratory cycle. In all subjects deglutition caused phase resetting of respiratory rhythm. Cophase was largest for swallows initiated near the the inspiratory-expiratory (E-I) transition and smallest for swallows initiated near the expiratory-inspiratory (E-I) transition. The pattern of respiratory resetting by deglutition was topologically classified as type 0. This pattern was shown for swallows induced by bolus injection or visual cue, and for spontaneous swallows. 3. The incidence of spontaneous deglutition was influenced by the position of the swallow in the respiratory cycle. Few spontaneous swallows were initiated near the E-I transition whereas most occurred from late inspiration to mid-expiration. 4. Deglutition caused an abrupt decrease in airflow leading to an interval of apnoea, followed by a period of expiration. The duration of deglutition apnoea for spontaneous swallows was shorter than that for 5 ml bolus swallows, and was unaffected by the respiratory phase of swallow initiation. The period of expiration after swallowing was longest for swallows initiated at the I-E transition, and shortest for E-I swallows. 5. The intervals between bolus injection and the onset of deglutition apnoea, and the

  11. Tracking the hyoid bone in videofluoroscopic swallowing studies

    NASA Astrophysics Data System (ADS)

    Kellen, Patrick M.; Becker, Darci; Reinhardt, Joseph M.; van Daele, Douglas

    2008-03-01

    Difficulty swallowing, or dysphagia, has become a growing problem. Swallowing complications can lead to malnutrition, dehydration, respiratory infection, and even death. The current gold standard for analyzing and diagnosing dysphagia is the videofluoroscopic barium swallow study. In these studies, a fluoroscope is used to image the patient ingesting barium solutions of different volumes and viscosities. The hyoid bone anchors many key muscles involved in swallowing and plays a key role in the process. Abnormal hyoid bone motion during a swallow can indicate swallowing dysfunction. Currently in clinical settings, hyoid bone motion is assessed qualitatively, which can be subject to intra-rater and inter-rater bias. This paper presents a semi-automatic method for tracking the hyoid bone that makes quantitative analysis feasible. The user defines a template of the hyoid on one frame, and this template is tracked across subsequent frames. The matching phase is optimized by predicting the position of the template based on kinematics. An expert speech pathologist marked the position of the hyoid on each frame of ten studies to serve as the gold standard. Results from performing Bland-Altman analysis at a 95% confidence interval showed a bias of 0.0+/-0.08 pixels in x and -0.08+/-0.09 pixels in y between the manually-defined gold standard and the proposed method. The average Pearson's correlation between the gold standard and the proposed method was 0.987 in x and 0.980 in y. This paper also presents a method for automatically establishing a patient-centric coordinate system for the interpretation of hyoid motion. This coordinate system corrects for upper body patient motion during the study and identifies superior-inferior and anterior-posterior motion components. These tools make the use of quantitative hyoid motion analysis feasible in clinical and research settings.

  12. Patterns and causes of change in a cliff swallow colony during a 17-year period

    USGS Publications Warehouse

    Krapu, G.L.

    1986-01-01

    The number of cliff swallow (Petrochelidon pyrrhonata) nests at a farmstead in southeastern North Dakota increased at an average annual rate of 87% with house sparrow (Passer domesticus) removal during 1957-60 and 1970-72. Harassment of nesting cliff swallows by house sparrows, adult swallow mortality from cold weather in late May, and collapse of nests were the principal observed factors limiting swallow population growth during a 17-year period.

  13. Protocol for the use of videofluoroscopy in pediatric swallowing dysfunction.

    PubMed

    Zerilli, K S; Stefans, V A; DiPietro, M A

    1990-05-01

    A clinical and research protocol was developed to compare the sensitivity and clinical value of videofluoroscopy with the traditional bedside clinical evaluation in the evaluation of children's swallowing dysfunction. The bedside and videofluoroscopic evaluations of 33 children were reviewed retrospectively. Our findings indicated that recommendations for feeding changed for 14 of the children as a result of the information gained from videofluoroscopic evaluation. The results suggest that videofluoroscopy provides therapists with more objective evidence than a bedside evaluation for determining the etiology of swallowing dysfunction and directing the management or treatment of this dysfunction. PMID:2353715

  14. Does soil pH influence swallow-wort distribution in its current range?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The perennial non-native vines, pale swallow-wort (Cynanchum rossicum [Kleopow] Borhidi) and black swallow-wort (Cynanchum louiseae [L.] Kartesz & Gandhi), are established invaders in the northeastern United States and southeastern Canada, and are spreading westward. The swallow-worts typically colo...

  15. Tongue Movements during Water Swallowing in Healthy Young and Older Adults

    ERIC Educational Resources Information Center

    Steele, Catriona M.; Van Lieshout, Pascal

    2009-01-01

    Purpose: The purpose of this study was to explore the nature and extent of variability in tongue movement during healthy swallowing as a function of aging and gender. In addition, changes were quantified in healthy tongue movements in response to specific differences in the nature of the swallowing task (discrete vs. sequential swallows). Method:…

  16. Statistical Learning, Letter Reversals, and Reading

    ERIC Educational Resources Information Center

    Treiman, Rebecca; Gordon, Jessica; Boada, Richard; Peterson, Robin L.; Pennington, Bruce F.

    2014-01-01

    Reversal errors play a prominent role in theories of reading disability. We examined reversal errors in the writing of letters by 5- to 6-year-old children. Of the 130 children, 92 had a history of difficulty in producing speech sounds, a risk factor for reading problems. Children were more likely to reverse letter forms that face left, such as…

  17. Electrical Stimulation and Swallowing: How Much Do We Know?

    PubMed Central

    Humbert, Ianessa A.; Michou, Emilia; MacRae, Phoebe R.; Crujido, Lisa

    2012-01-01

    Consequences of dysphagia substantially reduce quality of life, increase the risk of medical complications and mortality, and pose a substantial cost to healthcare systems. As a result, it is of no wonder that the clinical and scientific communities are showing interest in new avenues for dysphagia rehabilitation. Electrical stimulation (e-stim) for the treatment of swallowing impairments is among the most studied swallowing interventions in the published literature, yet many unanswered questions about its efficacy remain. In the meantime, many speech-language pathologists who treat dysphagia are attending educational and training sessions to obtain certifications to use this technique. Here, we review the values and limitations of the published literature on the topic of e-stim for swallowing to assist clinicians in decision making in their clinical practice. The discussion provides a review of swallowing anatomy and physiology, the fundamentals of e-stim, and information essential for the readers’ independent critique of these studies—all of which are crucial for evaluating the possible effects of e-stim. PMID:22851342

  18. Abundance and genetic damage of barn swallows from Fukushima.

    PubMed

    Bonisoli-Alquati, A; Koyama, K; Tedeschi, D J; Kitamura, W; Sukuzi, H; Ostermiller, S; Arai, E; Møller, A P; Mousseau, T A

    2015-01-01

    A number of studies have assessed or modeled the distribution of the radionuclides released by the accident at the Fukushima-Daiichi Nuclear Power Plant (FDNPP). Few studies however have investigated its consequences for the local biota. We tested whether exposure of barn swallow (Hirundo rustica) nestlings to low dose ionizing radiation increased genetic damage to their peripheral erythrocytes. We estimated external radiation exposure by using thermoluminescent dosimeters, and by measuring radioactivity of the nest material. We then assessed DNA damage by means of the neutral comet assay. In addition, we conducted standard point-count censuses of barn swallows across environmental radiation levels, and estimated their abundance and local age ratio. Radioactivity of nest samples was in the range 479-143,349 Bq kg(-1), while external exposure varied between 0.15 and 4.9 mGy. Exposure to radioactive contamination did not correlate with higher genetic damage in nestlings. However, at higher levels of radioactive contamination the number of barn swallows declined and the fraction of juveniles decreased, indicating lower survival and lower reproduction and/or fledging rate. Thus, genetic damage to nestlings does not explain the decline of barn swallows in contaminated areas, and a proximate mechanism for the demographic effects documented here remains to be clarified. PMID:25838205

  19. Persistence of Respiratory-Swallowing Coordination after Laryngectomy.

    ERIC Educational Resources Information Center

    Charbonneau, Isabelle; Lund, James P.; McFarland, David H.

    2005-01-01

    The present study was designed to provide additional insights into the neural mechanisms underlying respiratory-swallowing coupling by studying potential alterations in movement coordination when upper airway protection is no longer necessary. Twelve laryngectomized participants, all at least 3 years postsurgery, were compared to age- and…

  20. Screening technologies for detection of swallowed packages of narcotics

    NASA Astrophysics Data System (ADS)

    Burnett, Lowell J.; Magnuson, Erik E.; Sheldon, Alan G.; Kumar, Sankaran

    1997-01-01

    An increasingly popular method of transporting modest quantities of narcotics across international borders is to employ 'swallowers'. These are people who typically enter the country as international airline passengers after swallowing small, water-tight packages of heroin and/or cocaine. Rapid and accurate identification of swallowers in the airport environment poses difficult technical changes. Commonly used medical inspection technologies fall into one of two categories. Either they are unsuitable for widespread use, or they do not provide adequate information. An example of the former is x-ray scanning, while an example of the latter is ultrasonic imaging. Quantum Magnetics has developed a system to screen selected airline passengers for the presence of swallowed narcotics. The system utilizes magnetic resonance, which provides the physical basis for the magnetic resonance imaging systems widely used in the medical community as an alternative to x-rays. The system is currently operational, and laboratory performance testing is complete. Both the design of the system and its performance will be discussed. This work was sponsored in part by the Office of National Drug Control Policy and the US Customs Service.

  1. Evaluation of Manometric Measures during Tongue-Hold Swallows

    ERIC Educational Resources Information Center

    Doeltgen, Sebastian H.; Witte, Ulrike; Gumbley, Freya; Huckabee, Maggie-Lee

    2009-01-01

    Purpose: Based on visual inspection, prior research documented increased movement of the posterior pharyngeal wall in healthy volunteers during tongue-hold swallows. This manometric study investigated the immediate effects of the tongue-hold maneuver on pharyngeal peak pressure generation, duration of pressure generation, and pressure slope…

  2. Swallow syncope caused by third-degree atrioventricular block.

    PubMed

    Aaberg, Anne Marie Roust; Eriksson, Anna Elin; Madsen, Per Lav; Dixen, Ulrik

    2015-01-01

    We report a case of a patient with more than 30 years of repeated syncopes, always following food intake. The patient was diagnosed with a swallow-related third-degree atrioventricular block and successfully treated with an artificial pacemaker. PMID:26508117

  3. Coordination of oral cavity and laryngeal movements during swallowing.

    PubMed

    Gay, T; Rendell, J K; Spiro, J; Mosier, K; Lurie, A G

    1994-07-01

    In this study, dynamic imaging was used to track the movements of oral cavity and laryngeal structures during swallowing in 10 normal adults subjects. The movements of tiny lead pellet markers attached to the lips, tongue, mandible, and soft palate, as well as anatomic landmarks on the hyoid bone, were measured in relation to a reference pellet affixed to the upper central incisors. Sagittal views of the oral cavity were obtained using standard videofluorography. Each subject produced 10 swallows of 12 ml of tap water followed by 5 swallows with a bite block placed between the molars. The recorded video images were input to a microcomputer where the x- and y-coordinates of the pellets were measured. Results of the analyses revealed considerable temporal overlap in the timing of oral cavity and laryngeal movements, widespread individual variability in coordination patterns and movement trajectories, and selective effects of the bite block. These data suggest the existence of individual adaptive strategies in the programming and control of swallowing movements. PMID:7961257

  4. Coordination in oro-pharyngeal biomechanics during human swallowing.

    PubMed

    Li, Qiang; Minagi, Yoshitomo; Hori, Kazuhiro; Kondoh, Jugo; Fujiwara, Shigehiro; Tamine, Kenichi; Inoue, Makoto; Maeda, Yoshinobu; Chen, Yongjin; Ono, Takahiro

    2015-08-01

    In swallowing, the tongue contacts against the hard palate to generate pressure for propelling a bolus from the oral cavity into the pharynx. Meanwhile, the hyoid and larynx move upward and forward to facilitate the bolus from the pharynx into the esophagus. It has been well known that sequential coordination between those actions is critical for safety accomplishment of swallowing. However, the absence of noninvasive assessment for it limits the detection to the physiological symptom of dysphagia. We applied a sensor sheet on the hard palate to measure tongue contact pressure and a bend sensor on the frontal neck to monitor the laryngeal movement, which was synchronized with hyoid motion for assessing the coordination between both actions in 14 healthy male subjects when swallowing 5ml of water. The sequential order of tongue pressure and hyoid movement was successfully displayed. Tongue pressure was produced after slight movement of the hyoid and closely to the hyoid elevation, then reached a maximum when the hyoid stabilized in the most anterior-superior position, and ceased concurrently with the onset of hyoid descent. Additionally, the synchronized data from both sensors showed positive correlations between identified time points on the laryngeal signal waveform and onset, peak and offset of tongue pressure. Our sensing system successfully showed the coordination between tongue pressure production and hyoid motion, and could be a simple and noninvasive method for clinicians to evaluate the oral and pharyngeal stages of swallowing. PMID:25957912

  5. Swallowing Disorders in Parkinson's Disease: Impact of Lingual Pumping

    ERIC Educational Resources Information Center

    Argolo, Natalie; Sampaio, Marília; Pinho, Patrícia; Melo, Ailton; Nóbrega, Ana Caline

    2015-01-01

    Background: Lingual pumping (LP) is a repetitive, involuntary, anteroposterior movement of the tongue on the soft palate that is executed prior to transferring the food bolus to the pharynx, but we also observed LP when multiple swallows were taken. LP may be associated with rigidity and bradykinesia in patients with Parkinson's disease (PD). This…

  6. Ellen Swallow Richards (1842-1911): Ecological Foremother.

    ERIC Educational Resources Information Center

    Thompson, Patricia J.

    Most educated women (in the sciences and other fields) still have a hard time discarding the patriarchal socialization and pressures in their own fields which prevent them from seeing this extraordinary woman as an environmental pioneer and ecological foremother. Ellen Swallow Richards merits attention and respect as a foremother of what would…

  7. Effects of Lingual Effort on Swallow Pressures Following Radiation Treatment

    ERIC Educational Resources Information Center

    Lenius, Kerry; Stierwalt, Julie; LaPointe, Leonard L.; Bourgeois, Michelle; Carnaby, Giselle; Crary, Michael

    2015-01-01

    Purpose: This article investigated the effects of increased oral lingual pressure on pharyngeal pressures during swallowing in patients who have undergone radiotherapy for head and neck cancer. It was hypothesized that increased oral lingual pressure would result in increased pharyngeal pressures. Method: A within-subject experimental design was…

  8. Analysis of vocal and swallowing functions after horizontal glottectomy.

    PubMed

    Topaloğlu, İlhan; Bal, Muhlis; Salturk, Ziya; Berkiten, Güler; Atar, Yavuz

    2016-08-01

    We conducted a cross-sectional study to assess vocal and swallowing functions after horizontal glottectomy. Our study population was made up of 22 men aged 45 to 72 years (mean: 58.3) who underwent horizontal glottectomy and completed at least 1 year of follow-up. To compare postoperative results, 20 similarly aged men were included as a control group; all glottectomy patients and all controls were smokers. We used three methods-acoustic and aerodynamic voice analyses, the GRBAS (grade, roughness, breathiness, asthenicity, and strain) scale, and the voice handicap index-30 (VHI-30)-to assess vocal function objectively, perceptually, and subjectively, respectively. We also assessed swallowing function objectively by fiberoptic endoscopic evaluation of swallowing (FEES) and subjectively with the M.D. Anderson dysphagia inventory (MDADI). The 22 patients were also subcategorized into three groups according to the extent of their arytenoid cartilage resection, and their outcomes were compared. Acoustic and aerodynamic analyses showed that the mean maximum phonation time was significantly shorter and the fundamental frequency was significantly lower in the glottectomy group than in the controls (p = 0.001 for both), and that the mean jitter and shimmer values and the mean harmonics-to-noise ratio were all significantly higher (p = 0.001 for all); there were no significant differences among the three arytenoid subgroups. Self-assessments revealed that there were no statistically significant differences among the three subgroups in GRBAS scale scores except for the breathiness score (p = 0.045), which was lower in the arytenoid preservation subgroup than in the total resection subgroup; there were no statistically significant differences among the three subgroups in VHI-30 scores. Finally, swallow testing found no statistically significant differences in FEES scores or MDADI scores. We conclude that horizontal glottectomy caused a deterioration in vocal function, but

  9. Neural network pattern recognition of lingual-palatal pressure for automated detection of swallow.

    PubMed

    Hadley, Aaron J; Krival, Kate R; Ridgel, Angela L; Hahn, Elizabeth C; Tyler, Dustin J

    2015-04-01

    We describe a novel device and method for real-time measurement of lingual-palatal pressure and automatic identification of the oral transfer phase of deglutition. Clinical measurement of the oral transport phase of swallowing is a complicated process requiring either placement of obstructive sensors or sitting within a fluoroscope or articulograph for recording. Existing detection algorithms distinguish oral events with EMG, sound, and pressure signals from the head and neck, but are imprecise and frequently result in false detection. We placed seven pressure sensors on a molded mouthpiece fitting over the upper teeth and hard palate and recorded pressure during a variety of swallow and non-swallow activities. Pressure measures and swallow times from 12 healthy and 7 Parkinson's subjects provided training data for a time-delay artificial neural network to categorize the recordings as swallow or non-swallow events. User-specific neural networks properly categorized 96 % of swallow and non-swallow events, while a generalized population-trained network was able to properly categorize 93 % of swallow and non-swallow events across all recordings. Lingual-palatal pressure signals are sufficient to selectively and specifically recognize the initiation of swallowing in healthy and dysphagic patients. PMID:25618539

  10. Submental sEMG and Hyoid Movement during Mendelsohn Maneuver, Effortful Swallow, and Expiratory Muscle Strength Training

    ERIC Educational Resources Information Center

    Wheeler-Hegland, Karen M.; Rosenbek, John C.; Sapienza, Christine M.

    2008-01-01

    Purpose: This study investigated the concurrent biomechanical and electromyographic properties of 2 swallow-specific tasks (effortful swallow and Mendelsohn maneuver) and 1 swallow-nonspecific (expiratory muscle strength training [EMST]) swallow therapy task in order to examine the differential effects of each on hyoid motion and associated…

  11. Human swallowing simulation based on videofluorography images using Hamiltonian MPS method

    NASA Astrophysics Data System (ADS)

    Kikuchi, Takahiro; Michiwaki, Yukihiro; Kamiya, Tetsu; Toyama, Yoshio; Tamai, Tasuku; Koshizuka, Seiichi

    2015-09-01

    In developed nations, swallowing disorders and aspiration pneumonia have become serious problems. We developed a method to simulate the behavior of the organs involved in swallowing to clarify the mechanisms of swallowing and aspiration. The shape model is based on anatomically realistic geometry, and the motion model utilizes forced displacements based on realistic dynamic images to reflect the mechanisms of human swallowing. The soft tissue organs are modeled as nonlinear elastic material using the Hamiltonian MPS method. This method allows for stable simulation of the complex swallowing movement. A penalty method using metaballs is employed to simulate contact between organ walls and smooth sliding along the walls. We performed four numerical simulations under different analysis conditions to represent four cases of swallowing, including a healthy volunteer and a patient with a swallowing disorder. The simulation results were compared to examine the epiglottic downfolding mechanism, which strongly influences the risk of aspiration.

  12. Disability retirement

    NASA Technical Reports Server (NTRS)

    Eck, R. L.

    1975-01-01

    Eligibility for disability retirement is discussed. General guidelines and a few standards are given. Usually the same basic medical principles apply to the evaluation of claims for disability retirement as apply to determining medical suitability for initial employment.

  13. Developmental Disabilities

    MedlinePlus

    Developmental disabilities are severe, long-term problems. They may be physical, such as blindness. They may affect mental ability, ... everyday living. There are many causes of developmental disabilities, including Genetic or chromosome abnormalities. These cause conditions ...

  14. Intellectual disability

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/001523.htm Intellectual disability To use the sharing features on this page, please enable JavaScript. Intellectual disability is a condition diagnosed before age 18 that ...

  15. Clinical Characteristics and Lesions Responsible for Swallowing Hesitation After Acute Cerebral Infarction.

    PubMed

    Saito, Tsukasa; Hayashi, Keisuke; Nakazawa, Hajime; Ota, Tetsuo

    2016-08-01

    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 was over 10 s. The time required for swallowing jelly was significantly longer than that without the hesitation (median value, 24.1 vs. 8.9 s, P < 0.001). The oral processing time plus the postfaucial aggregation time required for patients with delayed swallowing to swallow thickened water was largely over 5 s and significantly longer than that of patients without swallowing hesitation (median value, 10.2 vs. 3.3 s, P < 0.001). Swallowing hesitation caused by acute unilateral infarction could be separated into two different patterns. Because four of the five patients with a rippling tongue movement in the swallowing hesitation pattern had a lesion in the left primary motor cortex, which induces some kinds of apraxia, swallowing hesitation with a rippling tongue movement seems to be a representative characteristic of apraxia. The patients with swallowing hesitation with a temporary stasis of the tongue in this study tended to have broad lesions in the frontal lobe, especially in the middle frontal gyrus, which is thought to be involved in higher cognition. PMID:27277890

  16. Effect of occlusal vertical dimension on swallowing patterns and perioral electromyographic activity.

    PubMed

    MacAvoy, S K; Jack, H C; Kieser, J; Farella, M

    2016-07-01

    Abnormal swallow patterns have been associated with specific dentofacial traits, such as an anterior open bite, but the cause-effect relationship between swallowing and malocclusion remains highly controversial. The aim of this research was to determine the effects of acute change in occlusal vertical dimension (OVD) on intraoral pressure swallow patterns and perioral electromyographic activity (EMG) during swallowing. Ten volunteers (five female, five male; 27-32 years) repeated standardised swallowing tasks as the OVD was progressively increased using mandibular trays of different heights. Standardised swallowing tasks were performed repetitively with each tray in place. Individual swallowing waveforms were quantitatively and qualitatively analysed. Peak pressure, swallow duration, time to peak pressure and lip EMG peak activity were assessed for each swallow. Data were analysed using mixed-model analysis. As OVD increased, lip peak pressure during swallowing increased almost threefold (+2·1 kPa; P ≤ 0·001), whereas swallow duration increased by 12·7 per cent (+160 ms; P = 0·01) at lip level and by 26·4 per cent (+270 ms; P < 0·001) at tongue level. Perioral muscle activity during swallows increased by 43·7 per cent (P ≤ 0·01) up to the OVD where resting lip seal was not attainable. Swallowing waveforms varied markedly between individuals, but interindividual waveforms were only minimally affected. The adaptive response and the waveform similarities associated with OVD variation supports the existence of a central control mechanism for swallowing, which may be modified by peripheral inputs. PMID:27027864

  17. Early deficits in cortical control of swallowing in Alzheimer’s disease

    PubMed Central

    Humbert, Ianessa A.; McLaren, Donald G.; Kosmatka, Kris; Fitzgerald, Michelle; Johnson, Sterling; Porcaro, Eva; Kays, Stephanie; Umoh, Eno-Obong; Robbins, JoAnne

    2010-01-01

    The goal of this study was to determine whether functional changes in cortical control of swallowing are evident in early Alzheimer’s disease (AD), before dysphagia (swallowing impairment) is evident. Cortical function was compared between an early AD group and a group of age-matched controls during swallowing. Swallowing oropharyngeal biomechanics examined from videofluoroscopic recordings were also obtained to more comprehensively characterize changes in swallowing associated with early AD. Our neuroimaging results show that the AD group had significantly lower BOLD response in many cortical areas that are traditionally involved in normal swallowing (i.e. pre and postcentral gyri, Rolandic and frontal opercula). There were no regions where the AD group recruited more brain activity than the healthy controls during swallowing and only 13% of all active voxels were unique to the AD group, even at this early stage. This suggests that the AD group is not recruiting new regions, nor are they compensating within regions that are active during swallowing. In videofluoroscopic measures, the AD group had significantly reduced hyo-laryngeal elevation than the controls. Although, swallowing impairment is usually noted in the late stages of AD, changes in cortical control of swallowing may begin long before dysphagia becomes apparent. PMID:20308785

  18. Predation by ants controls swallow bug (Hemiptera: Cimicidae: Oeciacus vicarius) infestations.

    PubMed

    Brown, Charles R; Page, Catherine E; Robison, Grant A; O'Brien, Valerie A; Booth, Warren

    2015-06-01

    The swallow bug (Oeciacus vicarius) is the only known vector for Buggy Creek virus (BCRV), an alphavirus that circulates in cliff swallows (Petrochelidon pyrrhonota) and house sparrows (Passer domesticus) in North America. We discovered ants (Crematogaster lineolata and Formica spp.) preying on swallow bugs at cliff swallow colonies in western Nebraska, U.S.A. Ants reduced the numbers of visible bugs on active swallow nests by 74-90%, relative to nests in the same colony without ants. Ant predation on bugs had no effect on the reproductive success of cliff swallows inhabiting the nests where ants foraged. Ants represent an effective and presumably benign way of controlling swallow bugs at nests in some colonies. They may constitute an alternative to insecticide use at sites where ecologists wish to remove the effects of swallow bugs on cliff swallows or house sparrows. By reducing bug numbers, ant presence may also lessen BCRV transmission at the spatial foci (bird colony sites) where epizootics occur. The effect of ants on swallow bugs should be accounted for in studying variation among sites in vector abundance. PMID:26047195

  19. Pulse swallowing frequency divider with low power and compact structure

    NASA Astrophysics Data System (ADS)

    Haijun, Gao; Lingling, Sun; Chaobo, Cai; Haiting, Zhan

    2012-11-01

    A pulse swallowing frequency divider with low power and compact structure is presented. One of the DFFs in the divided by 2/3 prescaler is controlled by the modulus control signal, and automatically powered off when it has no contribution to the operation of the prescaler. The DFFs in the program counter and the swallow counter are shared to compose a compact structure, which reduces the power consumption further. The proposed multi-modulus frequency divider was implemented in a standard 65 nm CMOS process with an area of 28 × 22 μm2. The power consumption of the divider is 0.6 mW under 1.2 V supply voltage when operating at 988 MHz.

  20. Innate immune response development in nestling tree swallows

    USGS Publications Warehouse

    Stambaugh, T.; Houdek, B.J.; Lombardo, M.P.; Thorpe, P.A.; Caldwell, Hahn D.

    2011-01-01

    We tracked the development of innate immunity in nestling Tree Swallows (Tachycineta bicolor) and compared it to that of adults using blood drawn from nestlings during days 6, 12, and 18 of the ???20-day nestling period and from adults. Innate immunity was characterized using an in vitro assay of the ability of whole blood to kill Escherichia coli. The ability of whole blood to kill E. coli increased as nestlings matured. Neither this component of innate immunity nor right wing chord length on day18 were as developed as in adults indicating that development of the innate immune system and growth both continued after fledging. Narrow sense heritability analyses suggest that females with strong immune responses produced nestlings with strong immune responses. These data suggest nestling Tree Swallows allocated sufficient energy to support rapid growth to enable fledging by day 18, but that further development of innate immunity occurred post-fledging. ?? 2011 by the Wilson Ornithological Society.

  1. Swallowing disorders: proposal of a method for forensic medicine assessment.

    PubMed

    Fattori, B; Ursino, F; Matteucci, F; Mallardi, V; Nacci, A

    2007-06-01

    For a correct classification of dysphagia, morphologic instrumental investigations capable of analysing the anatomical structures of the digestive tract, are undoubtedly essential, but the most important investigations are the functional investigations, such as videofluoroscopy, fiberoptic endoscopic evaluation of swallowing, oro-pharyngo-oesophageal scintigraphy, manometry and pH-metry. Results of these examinations enable us to identify, in patients with dysphagia, the extent of permanent damage, as a consequence of injury to the structures designated to swallowing, must be such that it at least minimally impairs and decreases the relative function, but to a degree that can be detected and, in some manner, measured. From a legal point of view, alterations in swallowing, caused by damage to structures belonging to the respiratory-digestive tract, can be found in crimes against persons and particularly in those involving body injury. In the case of civil, but also in private or social insurance proceedings, it is necessary to distinguish which parameters are to be used as reference for evaluating and quantifying the injury in terms of reimbursement. With the introduction of complete biological well-being, injury is considered as an impairment of the worth and right to enjoy psychological-physical integrity as a quality of life. The criteria currently used internationally take into account the conception of psychological-physical efficiency; nevertheless, in Italian forensic medicine, there is no table that offers a thorough quantification of swallowing modifications, if one excludes oesophageal disorders. Herewith, an evaluation table, dividing oro-pharyngo-oesophageal dysphagia into five, progressively serious classes, is proposed. PMID:17883190

  2. Optimal contrast enhancement liquid for dynamic MRI of swallowing.

    PubMed

    Ohkubo, M; Higaki, T; Nishikawa, K; Otonari-Yamamoto, M; Sugiyama, T; Ishida, R; Wakoh, M

    2016-09-01

    Several dynamic magnetic resonance imaging (MRI) techniques to observe swallowing and their parameters have been reported. Although these studies used several contrast enhancement liquids, no studies were conducted to investigate the most suitable liquids. The purpose of this study was to identify the optimal contrast enhancement liquid for dynamic MRI of swallowing. MRI was performed using a new sequence consisting of true fast imaging with steady-state precession, generalised auto-calibrating partially parallel acquisition and a keyhole imaging technique. Seven liquids were studied, including pure distilled water, distilled water with thickener at 10, 20 and 30 mg mL(-1) concentrations and oral MRI contrast medium at 1, 2 or 3 mg mL(-1) . Distilled water showed the highest signal intensity. There were statistically significant differences among the following contrast media: distilled water with thickener at 20 mg mL(-1) and the oral MRI contrast medium at 2 mg mL(-1) and 1 mg mL(-1) . It can be concluded that the optimal liquid for dynamic MRI of swallowing is a water-based substance that allows variations in viscosity. PMID:27328011

  3. Epidermal electronics for electromyography: An application to swallowing therapy.

    PubMed

    Constantinescu, Gabriela; Jeong, Jae-Woong; Li, Xinda; Scott, Dylan K; Jang, Kyung-In; Chung, Hyun-Joong; Rogers, John A; Rieger, Jana

    2016-08-01

    Head and neck cancer treatment alters the anatomy and physiology of patients. Resulting swallowing difficulties can lead to serious health concerns. Surface electromyography (sEMG) is used as an adjuvant to swallowing therapy exercises. sEMG signal collected from the area under the chin provides visual biofeedback from muscle contractions and is used to help patients perform exercises correctly. However, conventional sEMG adhesive pads are relatively thick and difficult to effectively adhere to a patient's altered chin anatomy, potentially leading to poor signal acquisition in this population. Here, the emerging technology of epidermal electronics is introduced, where ultra-thin geometry allows for close contouring of the chin. The two objectives of this study were to (1) assess the potential of epidermal electronics technology for use with swallowing therapy and (2) assess the significance of the reference electrode placement. This study showed comparative signals between the new epidermal sEMG patch and the conventional adhesive patches used by clinicians. Furthermore, an integrated reference yielded optimal signal for clinical use; this configuration was more robust to head movements than when an external reference was used. Improvements for future iterations of epidermal sEMG patches specific to day-to-day clinical use are suggested. PMID:27255865

  4. Pharyngeal swallowing disorders: selection for and outcome after myotomy.

    PubMed Central

    Mason, R J; Bremner, C G; DeMeester, T R; Crookes, P F; Peters, J H; Hagen, J A; DeMeester, S R

    1998-01-01

    OBJECTIVE: To develop selection criteria based on the mechanical properties of pharyngoesophageal swallowing that indicate when patients with pharyngeal dysphagia will benefit from a myotomy. SUMMARY BACKGROUND DATA: The pathophysiology of pharyngoesophageal swallowing disorders is complex. The disorder is of interest to several medical specialists (gastroenterologists, otorhinolaryngologists, general and thoracic surgeons), which contributes to confusion about the entity. The management is compounded because it is most frequently seen in the elderly, is often associated with generalized neuromuscular disease, and occurs with a high prevalence of concomitant disease. The selection of patients for myotomy is difficult and of major importance to the quality of life of the affected patients. METHOD: One hundred seven patients without a Zenker diverticulum but with pharyngeal dysphagia underwent a detailed manometric assessment of the upper esophageal sphincter (UES). Cricopharyngeal opening was identified by the presence of a subatmospheric pressure drop before bolus arrival. Impaired pharyngoesophageal segment compliance resulting in a resistance to pharyngoesophageal flow was determined by measuring the intrabolus pressure generated by a 5-ml liquid bolus. RESULTS: Thirty-one of 107 patients underwent a myotomy (29%). Both impaired sphincter opening and increased intrabolus pressure predicted a good outcome. CONCLUSION: Myotomy is beneficial in patients with pharyngeal swallowing disorders and manometric evidence of defective sphincter opening and increased intrabolus pressure. Images Figure 1. Figure 2. Figure 3. PMID:9790349

  5. Relative Efficacy of Swallowing versus Non-swallowing Tasks in Dysphagia Rehabilitation: Current Evidence and Future Directions

    PubMed Central

    Drulia, Teresa C.; Ludlow, Christy L.

    2014-01-01

    Clinical trials published in 2012 and the first six months of 2013 were reviewed. These involved either traditional dysphagia therapy, indirect methods not involving dysphagia therapy or a combination of direct and indirect methods. Of 27 studies, 7 were RCTs, 5 were controlled clinical trials and the remainder were uncontrolled case series. Sixteen studies combined an indirect treatment with traditional dysphagia therapy; only one study examined one technique for direct swallowing therapy. Effect sizes were computed and contrasted for each trial. Traditional dysphagia therapy had small to moderate effect sizes (between 0.3 and 0.6) while spontaneous recovery in acute stroke had effect sizes of 1.2. Placebo effects on patient ratings of degree of improvement on swallowing were estimated as small to moderate. To improve effect sizes, adaptive research designs are needed to develop the optimal methods and dosages of therapy before future clinical trials. PMID:24470988

  6. Swallowing in Parkinson Patients versus Healthy Controls: Reliability of Measurements in Videofluoroscopy

    PubMed Central

    Baijens, Laura W. J.; Speyer, Renée; Passos, Valéria Lima; Pilz, Walmari; Roodenburg, Nel; Clave, Pere

    2011-01-01

    Objective. To determine and describe the pathophysiological aspects of oropharyngeal swallowing in patients with Parkinson's disease more accurately, a pilot study of qualitative as well as quantitative parameters of swallowing was performed using videofluoroscopy (VFS). Methods. Ten patients with a diagnosis of idiopathic Parkinson's disease having dysphagic complaints and ten healthy age- and gender-matched control subjects underwent a standardized videofluoroscopic swallowing protocol. Information on the swallowing function was derived from temporal, spatial, and descriptive visuoperceptual parameters. Intra- and interrater reliability was calculated. Results. No significant differences were found between Parkinson patients and healthy control subjects for the majority of the reliable variables. Conclusions. It was concluded that swallowing function seemed to be preserved in the early stages of Parkinson's disease. Furthermore, the reliability of many quantitative as well as qualitative swallowing parameters proved insufficient, raising questions about the interpretation of study outcomes in videofluoroscopy. PMID:21977026

  7. Noninvasive Mechanical Ventilation Improves Breathing-Swallowing Interaction of Ventilator Dependent Neuromuscular Patients: A Prospective Crossover Study

    PubMed Central

    Garguilo, Marine; Lejaille, Michèle; Vaugier, Isabelle; Orlikowski, David; Terzi, Nicolas; Lofaso, Frédéric; Prigent, Hélène

    2016-01-01

    Background Respiratory involvement in neuromuscular disorders may contribute to impaired breathing-swallowing interactions, swallowing disorders and malnutrition. We investigated whether the use of non-invasive ventilation (NIV) controlled by the patient could improve swallowing performances in a population of neuromuscular patients requiring daytime NIV. Methods Ten neuromuscular patients with severe respiratory failure requiring extensive NIV use were studied while swallowing without and with NIV (while ventilated with a modified ventilator allowing the patient to withhold ventilation as desired). Breathing-swallowing interactions were investigated by chin electromyography, cervical piezoelectric sensor, nasal flow recording and inductive plethysmography. Two water-bolus sizes (5 and 10ml) and a textured yogurt bolus were tested in a random order. Results NIV use significantly improved swallowing fragmentation (defined as the number of respiratory interruption of the swallowing of a single bolus) (p = 0.003) and breathing-swallowing synchronization (with a significant increase of swallows followed by an expiration) (p <0.0001). Patient exhibited piecemeal swallowing which was not influenced by NIV use (p = 0.07). NIV use also significantly reduced dyspnea during swallowing (p = 0.04) while preserving swallowing comfort, regardless of bolus type. Conclusion The use of patient controlled NIV improves swallowing parameters in patients with severe neuromuscular respiratory failure requiring daytime NIV, without impairing swallowing comfort. Trial Registration ClinicalTrials.gov NCT01519388 PMID:26938617

  8. Managing eating and drinking difficulties (dysphagia) with children who have learning disabilities: What is effective?

    PubMed

    Harding, Celia; Cockerill, Helen

    2015-07-01

    People who work with children who have neurological and learning disabilities frequently need to manage the health and emotional risks associated with eating, drinking and swallowing (dysphagia). Some approaches can support children to develop oral feeding competence or to maximise their ability to maintain some oral intake supplemented with tube feeding. However, some clinicians feel that oral-motor exercises can support eating and drinking skills as well as speech and language development, whereas there is little evidence to support this.The implied "beneficial" association between oral-motor exercises, speech and swallowing skills gives a false impression in terms of future outcomes for parents and carers of children with learning disabilities. This paper considers oral-motor approaches in the remediation of dysphagia and the need for a cultural shift away from this view. Realistic and useful outcomes for people with learning disabilities need to be an essential part of therapeutic intervention. PMID:24414040

  9. Late onset tracheo-oesophageal fistula following a swallowed dental plate.

    PubMed

    Rajesh, P B; Goiti, J J

    1993-01-01

    Swallowing dentures and dental plates has been a cause of distress among elderly patients. Tracheo-oesophageal fistula caused by a foreign body is rare and of the cases reported in the literature only one was due to a swallowed denture which resulted in a recurrent laryngeal nerve palsy [4]. We describe a delayed onset tracheo-oesophageal fistula due to a swallowed dental plate in a young patient. PMID:8129961

  10. Brain and behavioral effects of swallowing carbonated water on the human pharyngeal motor system.

    PubMed

    Elshukri, Omsaad; Michou, Emilia; Mentz, Hannah; Hamdy, Shaheen

    2016-02-15

    Chemical stimulation of the swallowing network with carbonation and citric acid has been investigated, showing potential benefits on swallowing of dysphagic patients. Despite this, the underlying mechanisms for these effects are not fully understood. Here we investigated the effects of 5 ml liquid bolus swallows of carbonated, citric acid, and still water on a swallowing reaction-time tasks paradigm in 16 healthy adults (8 male, mean age 33 ± 3.7 yr, protocol 1). We then investigated the net effects of "sensory bolus interventions" (40 repeated swallows every 15 s) of the three different liquid boluses on corticobulbar excitability, as examined with single-pulse transcranial magnetic stimulation (TMS) in 16 participants (8 female, mean age 33 ± 3.7 yr, protocol 2). The findings showed that a larger number of correctly timed swallows (within a predetermined time window) was accomplished mainly with carbonated liquids (z = -2.04, P = 0.04 vs. still water, protocol 1). Both carbonated and citric acid liquid interventions with 40 swallows increased corticobulbar excitability of the stronger pharyngeal projection, suggesting a similar modulatory pathway for the effects on swallowing. However, carbonation showed superiority (P = 0.04, F = 4.75, 2-way ANOVA), with the changes lasting up to 60 min following the intervention. These results hold significance for future further and in-depth physiological investigations of the differences between different stimuli on swallowing neural network. PMID:26607248

  11. Objective Measures of Swallowing Function Applied to the Dysphagia Population: A One Year Experience.

    PubMed

    Kendall, Katherine A; Ellerston, Julia; Heller, Amanda; Houtz, Daniel R; Zhang, Chong; Presson, Angela P

    2016-08-01

    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 correlation between objective deficits and Eating Assessment Tool (EAT-10) scores and body mass index. Poor pharyngeal constriction (34.5 %) and airway protection deficits (65.5 %) were the most common swallowing abnormalities. Reflux-related dysphagia (36 %), nonspecific pharyngeal dysphagia (24 %), Parkinson disease (16 %), esophageal abnormality (13 %), and brain insult (10 %) were the most common diagnoses. Poor pharyngeal constriction was significantly associated with an esophageal motility abnormality (p < 0.001) and central neurologic insult. In general, dysphagia symptoms as determined by the EAT-10 did not correlate with swallowing function abnormalities. This preliminary study indicates that reflux disease is common in patients with dysphagia and that associated esophageal abnormalities are common in dysphagic populations and may be associated with specific pharyngeal swallowing abnormalities. However, symptom scores from the EAT-10 did not correspond to swallowing pathophysiology. PMID:27106909

  12. A Comparative Analysis of DBSCAN, K-Means, and Quadratic Variation Algorithms for Automatic Identification of Swallows from Swallowing Accelerometry Signals

    PubMed Central

    Dudik, Joshua M.; Kurosu, Atsuko; Coyle, James L

    2015-01-01

    Background Cervical auscultation with high resolution sensors is currently under consideration as a method of automatically screening for specific swallowing abnormalities. To be clinically useful without human involvement, any devices based on cervical auscultation should be able to detect specified swallowing events in an automatic manner. Methods In this paper, we comparatively analyze the density-based spatial clustering of applications with noise algorithm (DBSCAN), a k-means based algorithm, and an algorithm based on quadratic variation as methods of differentiating periods of swallowing activity from periods of time without swallows. These algorithms utilized swallowing vibration data exclusively and compared the results to a gold standard measure of swallowing duration. Data was collected from 23 subjects that were actively suffering from swallowing difficulties. Results Comparing the performance of the DBSCAN algorithm with a proven segmentation algorithm that utilizes k-means clustering demonstrated that the DBSCAN algorithm had a higher sensitivity and correctly segmented more swallows. Comparing its performance with a threshold-based algorithm that utilized the quadratic variation of the signal showed that the DBSCAN algorithm offered no direct increase in performance. However, it offered several other benefits including a faster run time and more consistent performance between patients. All algorithms showed noticeable differen-tiation from the endpoints provided by a videofluoroscopy examination as well as reduced sensitivity. Conclusions In summary, we showed that the DBSCAN algorithm is a viable method for detecting the occurrence of a swallowing event using cervical auscultation signals, but significant work must be done to improve its performance before it can be implemented in an unsupervised manner. PMID:25658505

  13. Learning Disabilities

    ERIC Educational Resources Information Center

    Sittiprapaporn, Wichian, Ed.

    2012-01-01

    Learning disability is a classification that includes several disorders in which a person has difficulty learning in a typical manner. Depending on the type and severity of the disability, interventions may be used to help the individual learn strategies that will foster future success. Some interventions can be quite simplistic, while others are…

  14. Learning disabilities.

    PubMed

    Lyon, G R

    1996-01-01

    Approximately 5% of all public school students are identified as having a learning disability (LD). LD is not a single disorder, but includes disabilities in any of seven areas related to reading, language, and mathematics. These separate types of learning disabilities frequently co-occur with one another and with social skill deficits and emotional or behavioral disorders. Most of the available information concerning learning disabilities relates to reading disabilities, and the majority of children with learning disabilities have their primary deficits in basic reading skills. An important part of the definition of LD is its exclusions: learning disabilities cannot be attributed primarily to mental retardation, emotional disturbance, cultural difference, or disadvantage. Thus, the concept of LD focuses on the notion of a discrepancy between a child's academic achievement and his or her apparent capacity to learn. Recent research indicates, however, that disability in basic reading skills is primarily caused by deficits in phonological awareness, which is independent of any achievement-capacity discrepancy. Deficits in phonological awareness can be identified in late kindergarten and first grade using inexpensive, straightforward testing protocol. Interventions have varying effectiveness, depending largely on the severity of the individual child's disability. The prevalence of learning disability identification has increased dramatically in the past 20 years. The "real" prevalence of LD is subject to much dispute because of the lack of an agreed-upon definition of LD with objective identification criteria. Some researchers have argued that the currently recognized 5% prevalence rate is inflated; others argue that LD is still underidentified. In fact, it appears that there are both sound and unsound reasons for the increase in identification rates. Sound reasons for the increase include better research, a broader definition of disability in reading, focusing on

  15. Effects of pharyngeal water stimulation on swallowing behaviors in healthy humans.

    PubMed

    Nakamura, Yuki; Hatakeyama, Aya; Kitada, Yasuyuki; Tsujimura, Takanori; Taniguchi, Hiroshige; Inoue, Makoto

    2013-10-01

    The aims of the present study were to determine whether the interval between swallows and the electromyographic (EMG) burst patterns of the suprahyoid muscles is affected by peripheral inputs during swallowing. Eighteen normal adults were asked to perform repetitive voluntary swallowing as quickly as possible, and three variables of swallowing were measured and evaluated, i.e., the swallowing intervals and the time interval between the onset and peak (rising time) and between the peak and offset (falling time) of the suprahyoid EMG burst. During recording, pharyngeal fluid infusion was applied with distilled water or 0.3 M NaCl solution at a very slow infusion rate (0.2 mL/min). The former and latter were used to activate and inhibit the excitation of water-sensitive receptors in the pharynx, respectively. The swallowing interval was significantly shorter during infusion of water than during infusion of NaCl solution. The rising time was also significantly shorter during infusion of water than during infusion of NaCl solution. There was a linear positive correlation between these values and facilitatory effects: the longer either the swallowing interval or rising time with infusion of 0.3 M NaCl solution, the stronger the facilitation of swallowing by the activation of water receptors. Facilitatory effects on the swallowing interval and rising time showed a linear correlation. It is suggested that weak liquid stimulation changed sensory inputs into the swallowing center and synchronously modulated the swallowing interval and time interval between the onset and peak of the EMG burst. PMID:23857168

  16. Development of suck and swallow mechanisms in infants

    PubMed Central

    Lau, Chantal

    2015-01-01

    Preterm infants’ hospital discharge is often delayed due to their inability to feed by mouth safely and competently. No evidence-based supported guidelines are currently available for health professionals caring for these infants. Available interventions advocating benefits are not readily acknowledged for lack of rigorous documentation inasmuch as any improvements may ensue from infants’ normal maturation. Through research, a growing understanding of the development of nutritive sucking skills has emerged shedding light on how and why infants may encounter oral feeding difficulties due to the immaturity of specific physiologic functions. Unfortunately, this knowledge has yet to be translated to the clinical practice to improve the diagnoses of oral feeding problems through the development of relevant assessment tools and to enhance infants’ oral feeding skills through the development of efficacious preventive and therapeutic interventions. This review focuses on the maturation of the various physiologic functions implicated in the transport of a bolus from the oral cavity to the stomach. Although infant’s readiness to oral feeding is deemed attained when suck, swallow, and respiration are coordinated, we do not have a clear definition of what coordination implies. We have learned that each of these functions encompasses a number of elements that mature at different times and rates. Consequently, it would appear that the proper functioning of sucking, the swallow processing, and respiration need to occur at two levels: first, the elements within each function must reach an appropriate functional maturation that can work in synchrony with each other to generate an appropriate suck, swallow process, and respiration; and second the elements of all these distinct functions, in turn, must be able to do the same at an integrative level to ensure the safe and efficient transport of a bolus from the mouth to the stomach. PMID:26226992

  17. Swallowing accelerometry signal feature variations with sensor displacement.

    PubMed

    Mamun, Khondaker A; Steele, Catriona M; Chau, Tom

    2015-07-01

    Dual-axis accelerometry has recently shown promise as a non-invasive method for detecting swallowing impairment using signal processing and pattern classification algorithms. However, it is unknown whether variations in sensor placement alter signal characteristics, threatening the accuracy of signal processing classifiers for aspiration detection. To address this question, water swallows were recorded in 14 healthy adults using a dual-axis accelerometer in 13 different positions (baseline, and 2, 4, 6 and 8 mm above, below and to the right of baseline). The baseline position was midline, immediately below the thyroid cartilage during quiet breathing. After segmentation and pre-processing, signal features were extracted in multiple domains (time, frequency, time-frequency). The effect of sensor position on signal feature distributions was examined with non-parametric statistical analysis. The analysis showed that the sensor could be displaced by as much as 4 mm inferior and lateral to the baseline position and by up to 6 mm above the baseline location without significantly altering time-frequency features. In other words, when considering the baseline position as the origin, the admissible region for sensor placement spans 10 mm in the superior-inferior axis and 8 mm in the medial-lateral direction. Results of this study suggest that time-frequency representations of accelerometry signals are most robust to sensor placement variations around the baseline position. The implication of this finding is that a swallowing accelerometry classifier based on time-frequency features can likely tolerate small variations in sensor location without degradation in classification performance. PMID:26003287

  18. Real time swallowing measurement system by using photometric stereo

    NASA Astrophysics Data System (ADS)

    Fujino, Masahiro; Kato, Kunihito; Mura, Emi; Nagai, Hajime

    2015-04-01

    In this paper, we propose a measurement system to evaluate the swallowing by estimating the movement of the thyroid cartilage. We developed a measurement system based on the vision sensor in order to achieve the noncontact and non-invasive sensor. The movement of the subject's thyroid cartilage is tracked by the three dimensional information of the surface of the skin measured by the photometric stereo. We constructed a camera system that uses near-IR light sources and three camera sensors. We conformed the effectiveness of the proposed system by experiments.

  19. Fluid mechanics of eating, swallowing and digestion - overview and perspectives.

    PubMed

    Engmann, Jan; Burbidge, Adam S

    2013-02-26

    From a very simplistic viewpoint, the human digestive system can be regarded as a long tube (with dramatic variations in diameter, cross-section, wall properties, pumping mechanisms, regulating valves and in-line sensors). We single out a few fluid mechanical phenomena along the trajectory of a food bolus from the mouth to the small intestine and discuss how they influence sensorial perception, safe transport, and nutrient absorption from a bolus. The focus is on lubrication flows between the tongue and palate, the oropharyngeal stage of swallowing and effects of flow on absorption in the small intestine. Specific challenges and opportunities in this research area are highlighted. PMID:23233019

  20. POLYCHLORINATED BYPHENOLS AND P,P'-DDE IN TREE SWALLOW EGGS AND NESTLINGS FROM A SUPERFUND SITE

    EPA Science Inventory

    This study assessed biologically available contaminant concentrations in tree swallow (Tachycineta bicolor) eggs and nestlings from a marine Superfund site. Tree swallows are used widely to assess and monitor aquatic contamination due to their preference for nesting near water an...

  1. Understanding the statistical persistence of dual-axis swallowing accelerometry signals.

    PubMed

    Sejdić, Ervin; Steele, Catriona M; Chau, Tom

    2010-01-01

    Swallowing accelerometry is a biomechanical approach for the assessment of difficulties during deglutition. However, the effects of various swallowing tasks and different anthropometric/demographic variables on the statistical behavior of these accelerometric signals are unknown. In particular, to understand the statistical persistence of these signals, we used detrended fluctuation analysis (DFA) to analyze accelerometric data collected from 408 healthy participants during dry, wet and wet chin tuck swallowing tasks. The results of DFA were then examined for potential influences of age, gender or body mass index. Several important conclusions were reached. First, the strongest persistence was observed for the wet chin tuck swallows. Second, the vibrations in the superior-inferior (S-I) direction generally have stronger temporal dependencies than those in the anterior-posterior (A-P) direction. Both of these phenomena can be attributed to the dominating influence of head movements on the amplitude of vibrations in the S-I direction. Third, gender, age and body mass index of the participants did not impact the observed persistence for dry and wet chin tuck swallows, while a gender effect was identified for wet swallows. In particular, male participants experienced more Brownian-like statistical dependencies in their swallowing signals. Future developments in the field should attempt to remove signal components associated with strong statistical persistence, as they tend to be associated with non-swallowing phenomena. PMID:21035113

  2. Vocal Variability Post Swallowing in Individuals with and without Oropharyngeal Dysphagia

    PubMed Central

    Santos, Karoline Weber dos; Scheeren, Betina; Maciel, Antonio Carlos; Cassol, Mauriceia

    2014-01-01

    Introduction Voice modification after swallowing may indicate changes in the transit of the bolus. Objective The aim of this study is to verify the use of perceptual voice analysis to detect oropharyngeal dysphagia. Study Design Case series. Methods Twenty-seven patients with dysphagia as diagnosed by videofluoroscopy and 25 without were evaluated. The sustained vowel /a/ was recorded before this exam and after swallowing different consistencies (pasty, liquid and solid). For the voice evaluation, the GRBAS scale (grade, roughness, breathiness, asthenia and strain) and the parameter “wet voice” were used. Three judges blinded to study group and time of emission performed voice analysis. Results Individuals with dysphagia showed significant decrease in grade of voice and asthenia and increase in strain after swallowing pasty substances, differing from individuals without dysphagia who showed no modification of the parameters after swallowing. The wet voice parameter showed no difference after swallowing in both study groups. Conclusion The decrease in grade and asthenia and increased strain are indicative of a swallowing disorder, indicating increased vocal strain to clean the vocal tract of food. The modification of vocal production after swallowing proved to be a trusted resource for detection of swallowing disorders. PMID:25992153

  3. Optimizing the swallow protocol of clinical high resolution esophageal manometry studies

    PubMed Central

    Xiao, Yinglian; Nicodème, Frédéric; Kahrilas, Peter J.; Roman, Sabine; Lin, Zhiyue; Pandolfino, John E.

    2013-01-01

    Background The Chicago Classification of Esophageal Motility Disorders (CC) is based on 10 water swallows performed in the supine position. The aim of the study was to assess whether upright and provocative swallows provided important information beyond that obtained from the standard supine manometric protocol. Methods Two independent investigators reviewed high resolution manometry (HRM) studies of 148 patients with both supine and upright liquid swallows and additional studies from patients with provocative swallows (increased volume, viscosity, and a marshmallow) for a resultant change in CC diagnoses. Significant diagnostic changes were defined as a change from normal or borderline motor function to abnormal motor function, EGJ outflow obstruction or achalasia. Discordant diagnoses were reviewed and the Kappa test was used to evaluate the agreement between diagnoses in the different protocols. Key Results The overall agreement in diagnosis between the 5 supine swallows and the 5 upright swallows was good (k=0.583). Changing to the upright position elicited a significant diagnostic change in 10.1% (15/148) of cases. The provocative swallows suggested an alternative diagnosis from the supine position in 14 of 75 studies (18.7%); 11 of these changed to EGJ obstruction during viscous or solid bolus challenges. Conclusion Changing position in HRM elicited a significant change in diagnosis in about 10% of studies while provocative bolus challenges with viscous liquid and marshmallows increased the detection of EGJ outflow obstruction. Performing manometric evaluations in both positions with provocative swallows may increase the yield of standard HRM technique. PMID:22863083

  4. Prevalence and Severity of Voice and Swallowing Difficulties in Mitochondrial Disease

    ERIC Educational Resources Information Center

    Read, Jennifer L.; Whittaker, Roger G.; Miller, Nick; Clark, Sue; Taylor, Robert; McFarland, Robert; Turnbull, Douglass

    2012-01-01

    Background: Mutations of mitochondrial DNA (mtDNA) cause a broad spectrum of clinical phenotypes. Anecdotal evidence suggests that voice and swallow problems are a common feature of these diseases. Aims: To characterize accurately the prevalence and severity of voice and swallow problems in a large cohort of patients with mitochondrial disease.…

  5. The Influence of Stimulus Taste and Chemesthesis on Tongue Movement Timing in Swallowing

    ERIC Educational Resources Information Center

    Steele, Catriona M.; van Lieshout, Pascal H. H. M.; Pelletier, Cathy A.

    2012-01-01

    Purpose: To explore the influence of taste and trigeminal irritation (chemesthesis) on durational aspects of tongue movement in liquid swallowing, controlling for the influence of perceived taste intensity. Method: Electromagnetic midsagittal articulography was used to trace tongue movements during discrete liquid swallowing with 5 liquids: water,…

  6. Phytophagous arthropods of invasive swallow-wort vines (Vincetoxicum spp.) in New York

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pale swallow-wort (Vincetoxicum rossicum [Kleopow] Barbar.) and black swallow-wort (V. nigrum [L.] Moench), European species of herbaceous, perennial viny milkweeds, have become increasingly invasive in various natural and managed habitats in the northeastern United States and southeastern Canada, i...

  7. Tongue Pressure and Submental Surface Electromyography Measures during Noneffortful and Effortful Saliva Swallows in Healthy Women

    ERIC Educational Resources Information Center

    Yeates, Erin M.; Steele, Catriona M.; Pelletier, Cathy A.

    2010-01-01

    Purpose: The effortful swallow, a compensatory technique frequently employed by speech-language pathologists for their patients with dysphagia, is still not fully understood in terms of how it modifies the swallow. In particular, although age-related changes are known to reduce maximum isometric tongue pressure, it is not known whether age affects…

  8. Development of Swallowing and Feeding: Prenatal through First Year of Life

    ERIC Educational Resources Information Center

    Delaney, Amy L.; Arvedson, Joan C.

    2008-01-01

    The development of feeding and swallowing involves a highly complex set of interactions that begin in embryologic and fetal periods and continue through infancy and early childhood. This article will focus on swallowing and feeding development in infants who are developing normally with a review of some aspects of prenatal development that provide…

  9. Evidence-Based Systematic Review: Effects of Neuromuscular Electrical Stimulation on Swallowing and Neural Activation

    ERIC Educational Resources Information Center

    Clark, Heather; Lazarus, Cathy; Arvedson, Joan; Schooling, Tracy; Frymark, Tobi

    2009-01-01

    Purpose: To systematically review the literature examining the effects of neuromuscular electrical stimulation (NMES) on swallowing and neural activation. The review was conducted as part of a series examining the effects of oral motor exercises (OMEs) on speech, swallowing, and neural activation. Method: A systematic search was conducted to…

  10. Leaf anthracnose, a new disease of swallow-worts from Russia

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Black swallow-wort Vincetoxicum nigrum (L.) Moench (synonym=Cynanchum louiseae Kartesz & Gandhi) and pale swallow-wort Vincetoxicum rossicum (Kleopow) Borhidi (synonym=Cynanchum rossicum (Kleopow) Borhidi) are invasive plants belonging to the family Apocynaceae and are the targets of biological cont...

  11. Tongue Pressure Modulation during Swallowing: Water versus Nectar-Thick Liquids

    ERIC Educational Resources Information Center

    Steele, Catriona M.; Bailey, Gemma L.; Molfenter, Sonja M.

    2010-01-01

    Purpose: Evidence of tongue-palate pressure modulation during swallowing between thin and nectar-thick liquids stimuli has been equivocal. This mirrors a lack of clear evidence in the literature of tongue and hyoid movement modulation between nectar-thick and thin liquid swallows. In the current investigation, the authors sought to confirm whether…

  12. New biological information on the invasive swallow-worts (Vincetoxicum spp.)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Vincetoxicum nigrum (L.) Moench [Cynanchum louiseae Kartesz & Gandhi] (black swallow-wort) and V. rossicum (Kleopow) Barbar. [Cynanchum rossicum (Kleopow) Borhidi] (pale swallow-wort) are herbaceous perennial vines in the Apocynaceae native to Europe. Both species are considered invasive in their in...

  13. Leaf anthracnose, a new disease of swallow-worts caused by Colletotrichum lineola from Russia

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Black swallow-wort Vincetoxicum nigrum (L.) Moench and pale swallow-wort Vincetoxicum rossicum (Kleopow) Borhidi (family Apocynaceae subfamily Asclepiadoideae) are invasive plants and are the targets of biological control efforts to control their spread in the USA. In 2010, diseased leaves of a rela...

  14. Mechanism of Sequential Swallowing during Straw Drinking in Healthy Young and Older Adults

    ERIC Educational Resources Information Center

    Daniels, Stephanie K.; Corey, David M.; Hadskey, Leslie D.; Legendre, Calli; Priestly, Daniel H.; Rosenbek, John C.; Foundas, Anne L.

    2004-01-01

    Recent research has revealed differences between isolated and sequential swallowing in healthy young adults; however, the influence of normal aging on sequential swallowing has not been studied. Thus, the purpose of this investigation was to examine the effects of normal aging on deglutition during sequential straw drinking. Videofluoroscopic…

  15. Utility of Clinical Swallowing Examination Measures for Detecting Aspiration Post-Stroke

    ERIC Educational Resources Information Center

    McCullough, G. H.; Rosenbek, J. C.; Wertz, R. T.; McCoy, S.; Mann, G.; McCullough, K.

    2005-01-01

    The purpose of this investigation was to determine the utility of clinical swallowing examination (CSE) measures for detecting aspiration as defined by videofluoroscopic swallowing examination (VFSE). This study, involving 165 participants, is a follow-up to a previously published investigation of 60 participants. Findings are compared with that…

  16. Comparison of Clinician Judgments and Measurements of Swallow Response Time: A Preliminary Report

    ERIC Educational Resources Information Center

    Karnell, Michael P.; Rogus, Nicole M.

    2005-01-01

    Practicing clinicians frequently offer judgments about aspects of swallowing physiology rather than performing actual measurements. Little is known about the accuracy of those judgments. The purpose of this preliminary study was to explore agreement of clinicians' judgments of pharyngeal swallow response time (PSRT) with temporal measurements of…

  17. Mercury Contamination in Tree Swallows Nesting at Northern Wisconsin Inland Lakes that Differ in Methylation Potential

    EPA Science Inventory

    Tree swallows (Tachycineta bicolor) are a useful species to assess the bioavailability and effects of trace elements, including mercury, because they will nest in boxes in relatively close proximity to one another. Because tree swallows feed on the aerial stages of benthic aquat...

  18. Biomechanical Correlates of Surface Electromyography Signals Obtained during Swallowing by Healthy Adults

    ERIC Educational Resources Information Center

    Crary, Michael A.; Carnaby (Mann), Giselle D.; Groher, Michael E.

    2006-01-01

    Purpose: The purpose of this study was to describe biomechanical correlates of the surface electromyographic signal obtained during swallowing by healthy adult volunteers. Method: Seventeen healthy adults were evaluated with simultaneous videofluoroscopy and surface electromyography (sEMG) while swallowing 5 mL of liquid barium sulfate. Three…

  19. Response of invasive swallow-worts (Vincetoxicum spp.) to repeated artificial defoliation or clipping

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Eurasian vines pale swallow-wort (Vincetoxicum rossicum) (PSW) and black swallow-wort (V. nigrum) (BSW) are invasive perennials that have infested natural areas in the northeastern United States and southern Canada. A biological control program is being developed, though it is unclear how thes...

  20. ACCUMULATION OF PCB CONGENERS IN NESTLING TREE SWALLOWS (TACHYCINETA BICOLOR) ON THE HUDSON RIVER, NEW YORK

    EPA Science Inventory

    Together, these two papers establish a quantitative linkage between PCB concentrations in nestling tree swallows and in the insects that they consume. As such, these papers provide strong support for the use of nestling swallows as a biomonitoring species for exposure assessment ...

  1. Reversing hard won victories in the name of human rights: a critique of the General Comment on Article 12 of the UN Convention on the Rights of Persons with Disabilities.

    PubMed

    Freeman, Melvyn Colin; Kolappa, Kavitha; de Almeida, Jose Miguel Caldas; Kleinman, Arthur; Makhashvili, Nino; Phakathi, Sifiso; Saraceno, Benedetto; Thornicroft, Graham

    2015-09-01

    The UN Convention on the Rights of Persons with Disabilities (CRPD) is a major milestone in safeguarding the rights of persons with disabilities. However, the General Comment on Article 12 of the CRPD threatens to undermine critical rights for persons with mental disabilities, including the enjoyment of the highest attainable standard of health, access to justice, the right to liberty, and the right to life. Stigma and discrimination might also increase. Much hinges on the Committee on the Rights of Persons with Disabilities' view that all persons have legal capacity at all times irrespective of mental status, and hence involuntary admission and treatment, substitute decision-making, and diversion from the criminal justice system are deemed indefensible. The General Comment requires urgent consideration with the full participation of practitioners and a broad range of user and family groups. PMID:26236004

  2. New directions for understanding neural control in swallowing: the potential and promise of motor learning.

    PubMed

    Humbert, Ianessa A; German, Rebecca Z

    2013-03-01

    Oropharyngeal swallowing is a complex sensorimotor phenomenon that has had decades of research dedicated to understanding it more thoroughly. However, the underlying neural mechanisms responsible for normal and disordered swallowing remain very vague. We consider this gap in knowledge the result of swallowing research that has been broad (identifying phenomena) but not deep (identifying what controls the phenomena). The goals of this review are to address the complexity of motor control of oropharyngeal swallowing and to review the principles of motor learning based on limb movements as a model system. We compare this literature on limb motor learning to what is known about oropharyngeal function as a first step toward suggesting the use of motor learning principles in swallowing research. PMID:23192633

  3. Fast Fourier transform analysis of sounds made while swallowing various foods.

    PubMed

    Taniwaki, Mitsuru; Kohyama, Kaoru

    2012-10-01

    The cervical auscultation method was applied to investigate sounds generated while swallowing various foods with unique physical properties, including liquid (water), semiliquid (yogurt), and solid (konjac jelly). To study the differences among swallowing sounds for various foods, fast Fourier transform (FFT) analysis was applied to signals that were attributed to the flow of a food bolus, which is a swallowable soft mass of chewed food. An FFT program was developed that enabled the calculation of a spectrum for a specified region of time domain swallowing sound signals. The intensity of spectra in the frequency range between 400 and 1000 Hz significantly differed: liquid > semiliquid > solid. The FFT spectrum in this range was suggested to represent the frequency characteristics of the swallowing sounds of various foods. PMID:23039442

  4. New Directions for Understanding Neural Control in Swallowing: The Potential and Promise of Motor Learning

    PubMed Central

    Humbert, Ianessa A.

    2013-01-01

    Oropharyngeal swallowing is a complex sensorimotor phenomenon that has had decades of research dedicated to understanding it more thoroughly. However, the underlying neural mechanisms responsible for normal and disordered swallowing remain very vague. We consider this gap in knowledge the result of swallowing research that has been broad (identifying phenomena) but not deep (identifying what controls the phenomena). The goals of this review are to address the complexity of motor control of oropharyngeal swallowing and to review the principles of motor learning based on limb movements as a model system. We compare this literature on limb motor learning to what is known about oropharyngeal function as a first step toward suggesting the use of motor learning principles in swallowing research. PMID:23192633

  5. The effects of compressive sensing on extracted features from tri-axial swallowing accelerometry signals

    NASA Astrophysics Data System (ADS)

    Sejdić, Ervin; Movahedi, Faezeh; Zhang, Zhenwei; Kurosu, Atsuko; Coyle, James L.

    2016-05-01

    Acquiring swallowing accelerometry signals using a comprehensive sensing scheme may be a desirable approach for monitoring swallowing safety for longer periods of time. However, it needs to be insured that signal characteristics can be recovered accurately from compressed samples. In this paper, we considered this issue by examining the effects of the number of acquired compressed samples on the calculated swallowing accelerometry signal features. We used tri-axial swallowing accelerometry signals acquired from seventeen stroke patients (106 swallows in total). From acquired signals, we extracted typically considered signal features from time, frequency and time-frequency domains. Next, we compared these features from the original signals (sampled using traditional sampling schemes) and compressively sampled signals. Our results have shown we can obtain accurate estimates of signal features even by using only a third of original samples.

  6. Lead concentrations and reproduction in highway-nesting barn swallows

    USGS Publications Warehouse

    Grue, C.E.; O'Shea, T.J.; Hoffman, D.J.

    1984-01-01

    Swallows (Hirundo rustica) collected within the right-of-way of a major Maryland highway were greater than those found in Barn Swallows nesting within a rural area. Lead concentrations in the feathers of adults from the highway colony were also greater than Lead concentrations in the carcasses and stomach contents of adult and nestling Barn those of rural adults, but concentrations in the feathers of nestlings from the two locations were similar. Activity of u-aminolevulinic acid dehydratase in red blood cells was lower in highway-nesting adults and their young than in their rural counterparts, although hemoglobin concentrations and hematocrits did not differ. The number of eggs, nestlings, and body weights of the latter at 16-18 days of age were similar in the two colonies, as were body weights of adults from the two areas. These results suggest that contamination of roadside habitats by lead from automotive emissions does not pose a serious hazard to birds that are aerial feeders.

  7. Energy intake estimation from counts of chews and swallows

    PubMed Central

    Fontana, Juan M.; Higgins, Janine A.; Schuckers, Stephanie C.; Bellisle, France; Pan, Zhaoxing; Melanson, Edward L.; Neuman, Michael R.; Sazonov, Edward

    2014-01-01

    Current, validated methods for dietary assessment rely on self-report, which tends to be inaccurate, time-consuming, and burdensome. The objective of this work was to demonstrate the suitability of estimating energy intake using individually-calibrated models based on Counts of Chews and Swallows (CCS models). In a laboratory setting, subjects consumed three identical meals (training meals) and a fourth meal with different content (validation meal). Energy intake was estimated by four different methods: weighed food records (gold standard), diet diaries, photographic food records, and CCS models. Counts of chews and swallows were measured using wearable sensors and video analysis. Results for the training meals demonstrated that CCS models presented the lowest reporting bias and a lower error as compared to diet diaries. For the validation meal, CCS models showed reporting errors that were not different from the diary or the photographic method. The increase in error for the validation meal may be attributed to differences in the physical properties of foods consumed during training and validation meals. However, this may be potentially compensated for by including correction factors into the models. This study suggests that estimation of energy intake from CCS may offer a promising alternative to overcome limitations of self-report. PMID:25447016

  8. Emergency admissions due to swallowed foreign bodies in adults

    PubMed Central

    Erbil, Bülent; Karaca, Mehmet Ali; Aslaner, Mehmet Ali; İbrahimov, Zaur; Kunt, Mehmet Mahir; Akpinar, Erhan; Özmen, Mehmet Mahir

    2013-01-01

    AIM: To study a retrospective analysis of patients who presented to the emergency departments (ED) with complaints related to foreign body ingestions. METHODS: Patients older than 16 years of age who presented to the ED between January 1st and December 31st of 2010 with complaints related to swallowed foreign bodies were identified from electronic health records and patient charts. RESULTS: A total of 100 patients presented with a complaint of foreign body ingestion during the study period. Overall, an X-ray was performed on 75 patients, and a fiberoptic evaluation was performed on 45 patients. A foreign body was detected in 46 (46%) patients. The diagnostic yield of the X-ray was 27 (36%) out of 75 patients, while the diagnostic yield of the fiberoptic evaluations was 21 (47%) out of 45 patients. The detected foreign bodies were mostly located in the esophagus (17 out of 46 foreign bodies detected). When the types of ingested foreign bodies were evaluated, 52 (52%) patients reported ingesting food, and 19 (19%) patients reported swallowing pins. An X-ray was performed on 33 patients with accidental food ingestions but yielded a positive result in only two cases. In 12 out of 21 patients with accidental food ingestion who underwent fiberoptic evaluation, the foreign material was detected and removed. CONCLUSION: Plain radiography is helpful in the localization of radiopaque swollen foreign bodies, while fiberoptic methods are useful as both diagnostic and therapeutic tools, regardless of radiopacity. PMID:24151363

  9. The Effects of Oral-Motor Exercises on Swallowing in Children: An Evidence-Based Systematic Review

    ERIC Educational Resources Information Center

    Arvedson, Joan; Clark, Heather; Lazarus, Cathy; Schooling, Tracy; Frymark, Tobi

    2010-01-01

    Aim: The aim of this unregistered evidence-based systematic review was to determine the state and quality of evidence on the effects of oral motor exercises (OME) on swallowing physiology, pulmonary health, functional swallowing outcomes, and drooling management in children with swallowing disorders. Method: A systematic search of 20 electronic…

  10. Evaluation of an EMG bioimpedance measurement system for recording and analysing the pharyngeal phase of swallowing.

    PubMed

    Schultheiss, Corinna; Schauer, Thomas; Nahrstaedt, Holger; Seidl, Rainer O

    2013-07-01

    A neuroprosthetic device for treating swallowing disorders requires an implantable measurement system capable to analysing the timing and quality of the swallowing process in real time. A combined EMG bioimpedance (EMBI) measurement system was developed and is evaluated here. The study was planned and performed as a case-control study. The studies were approved by the Charité Berlin ethics committee in votes EA1/160/09 and EA1/161/09. Investigations were carried out on healthy volunteers in order to examine the usefulness and reproducibility of measurements, the ability to distinguish between swallowing and head movements and the effect of different food consistencies. The correlation between bioimpedance and anatomical and functional changes occurring during the pharyngeal phase of swallowing in non-healthy patients was examined using videofluoroscopy (VFSS). 31 healthy subjects (15♂, 16♀) were tested over the course of 1350 swallows and 19 (17♂, 2♀) non-healthy patients over the course of 54 swallows. The signal curves obtained from both transcutaneous and subcutaneous measurement were similar, characteristic and reproducible (r > 0.5) and correlated with anatomical and functional changes during the pharyngeal phase of swallowing observed using VFSS. Statistically significant differences between head movements and swallowing movements, food volumes and consistencies were found. Neither the conductivity of the food, the sex of the test subject nor the position of the measurement electrodes exerted a statistically significant effect on the measured signal. EMBI is able to reproducibly map the pharyngeal phase of swallowing and changes associated with it both transcutaneously and subcutaneously. The procedure therefore appears to be suitable for use in performing automated evaluation of the swallowing process and for use as a component of an implant. PMID:23440435

  11. Respiratory-Swallow Training in Patients with Head and Neck Cancer

    PubMed Central

    Martin-Harris, Bonnie; McFarland, David; Hill, Elizabeth G.; Strange, Charlton B.; Focht, Kendrea L.; Wan, Zhuang; Blair, Julie; McGrattan, Katlyn

    2014-01-01

    Objective To test a novel intervention to train swallowing to occur in the mid-to-low expiratory phase of quiet breathing to improve swallowing safety and efficiency. Design Safety and efficacy non-randomized clinical trial with one-month follow-up. Setting Head and neck cancer (HNC) ambulatory clinics. Participants Thirty patients with HNC and chronic dysphagia completed the intervention. Fifteen of these patients participated in a one-month follow-up visit. Interventions Training protocol based on hierarchy of motor skill acquisition to encourage autonomous and optimal respiratory-swallowing coordination. Visual feedback of respiratory phase and volume for swallowing initiation was provided by nasal airflow and rib cage/abdomen signals. Main Outcome Measures Respiratory-swallow phase pattern, Modified Barium Swallow Impairment Profile™© (MBSImP) scores, Penetration Aspiration Scale (PAS) scores, M.D. Anderson Dysphagia Inventory scores Results Using visual feedback, patients were trained to initiate swallows during the mid-expiratory phase of quiet breathing and to continue to expire after swallowing. This optimal phase patterning increased significantly after treatment (p <0.0001). Changes in respiratory-swallowing coordination were associated with improvements in three MBSImP component scores: laryngeal vestibular closure (p = 0.0004), tongue base retraction (p <0.0001), and pharyngeal residue (p = 0.01). Significant improvements were also seen in PAS scores (p <0.0001). Relative to pre-treatment values, patients participating in one-month follow-up had increased optimal phase patterning (p <0.0001), improved laryngeal vestibular closure (p = 0.01), tongue base retraction (p = 0.003), and pharyngeal residue (p = 0.006) MBSImP scores, and improved PAS scores (p <0.0001). Conclusions Improvements in respiratory-swallowing coordination can be trained using a systematic protocol and respiratory phase-lung volume related biofeedback in patients with HNC and

  12. Movements of the mandibles and tongue during mastication and swallowing in Pteropus giganteus (megachiroptera): a cineradiographical study.

    PubMed

    Greet, D G; de Vree, F

    1984-01-01

    Quantitative lateral and dorsoventral cineradiography shows that the masticatory movements of the mandible, condyles, tongue, and hyoid of Pteropus giganteus (Chiroptera) move along highly regular paths that are characteristic for each of the three food types tested. Mandibular movements are predominantly orthal, although a small forward translation occurs early in opening and small lateral deflections occur in both opening and closing phases. These deflections are related to the existence of active (bolus bearing) and balancing sides of the jaws, chewing being not truly bilateral. The deflections are associated with a shift of both condyles toward one side. In consequence the active condyle is located in a lateral part of the associated fossa, the inactive condyle in a medial part. Food transfer from side to side involves a reversal of the chewing direction during opening. Such reversals are especially frequent near the end of a chewing sequence. The fore, middle, and hind parts of the tongue differ in their movement patterns. Movements of the fore part, and to a lesser extent of the middle part, follow the open-close movements of the lower jaw. The hind part of the tongue moves predominantly dorsally during slow closing and ventrally during fast opening and fast closing. All three parts move forward during slow closing and slow opening, and backward during fast opening and fast closing. Movements of the hyoid are closely synchronized with those of the hind part of the tongue. Furthermore, tongue and hyoid movements are synchronized with jaw movements. All cycles of Pteropus giganteus are transport cycles, and the synchrony appears to reflect the consistency of the food (soft pulp, juices). Food consistency also accounts for the high swallowing rate and the absence of any significant difference between nonswallowing and swallowing cycles. PMID:6708112

  13. Evaluating Swallowing Muscles Essential for Hyolaryngeal Elevation by Using Muscle Functional Magnetic Resonance Imaging

    SciTech Connect

    Pearson, William G.; Hindson, David F.; Langmore, Susan E.; Zumwalt, Ann C.

    2013-03-01

    Purpose: Reduced hyolaryngeal elevation, a critical event in swallowing, is associated with radiation therapy. Two muscle groups that suspend the hyoid, larynx, and pharynx have been proposed to elevate the hyolaryngeal complex: the suprahyoid and longitudinal pharyngeal muscles. Thought to assist both groups is the thyrohyoid, a muscle intrinsic to the hyolaryngeal complex. Intensity modulated radiation therapy guidelines designed to preserve structures important to swallowing currently exclude the suprahyoid and thyrohyoid muscles. This study used muscle functional magnetic resonance imaging (mfMRI) in normal healthy adults to determine whether both muscle groups are active in swallowing and to test therapeutic exercises thought to be specific to hyolaryngeal elevation. Methods and Materials: mfMRI data were acquired from 11 healthy subjects before and after normal swallowing and after swallowing exercise regimens (the Mendelsohn maneuver and effortful pitch glide). Whole-muscle transverse relaxation time (T2 signal, measured in milliseconds) profiles of 7 test muscles were used to evaluate the physiologic response of each muscle to each condition. Changes in effect size (using the Cohen d measure) of whole-muscle T2 profiles were used to determine which muscles underlie swallowing and swallowing exercises. Results: Post-swallowing effect size changes (where a d value of >0.20 indicates significant activity during swallowing) for the T2 signal profile of the thyrohyoid was a d value of 0.09; a d value of 0.40 for the mylohyoid, 0.80 for the geniohyoid, 0.04 for the anterior digastric, and 0.25 for the posterior digastric-stylohyoid in the suprahyoid muscle group; and d values of 0.47 for the palatopharyngeus and 0.28 for the stylopharyngeus muscles in the longitudinal pharyngeal muscle group. The Mendelsohn maneuver and effortful pitch glide swallowing exercises showed significant effect size changes for all muscles tested, except for the thyrohyoid. Conclusions

  14. Effect of laparotomy on the swallow-breathing relationship in the cat.

    PubMed

    Pitts, Teresa; Rose, Melanie J; Poliacek, Ivan; Condrey, Jillian; Davenport, Paul W; Bolser, Donald C

    2015-02-01

    Swallow occurs predominantly in the expiratory phase (E) of breathing. This phase preference is thought to contribute to airway protection by limiting the passage of material through the pharyngeal airway with little or no inspiratory (I) airflow. This phase preference is attributed to central interactions between the swallow and breathing pattern generators. We speculated that changes in peripheral mechanical factors would influence the respiratory phase preference for swallow initiation. We induced swallowing in anesthetized spontaneously breathing cats by injection of water into the oropharynx. In animals with intact abdomens, 83 % of swallows were initiated during E, 7 % during I, 7 % during E-I phase transition, and 3 % during I-E transition. In animals with open anterior midline laparotomy, only 38 % of swallows were initiated during E, 33 % during I, 17 % during the E-I transition, and 12 % during I-E. The results support an important role for feedback from somatic and/or visceral thoraco-abdominal mechanoreceptors for swallow-breathing coordination after laparotomy. PMID:25331536

  15. Effects of Topical Nasal Anesthetic on Fiberoptic Endoscopic Examination of Swallowing with Sensory Testing (FEESST)

    PubMed Central

    McCullough, Gary H.; Guidry, Tiffany J.; Mennemeier, Mark; Schluterman, Keith

    2013-01-01

    Objections to the use of topical nasal anesthesia (TNA) during fiberoptic endoscopic evaluation of swallowing (FEES) with sensory testing (FEESST) have been raised, primarily because of the possibility of desensitizing the pharyngeal and laryngeal mucosa and affecting both the sensory and motor aspects of the swallow. Furthermore, it has been suggested that TNA is not necessary during FEES as it does not improve patient comfort or make the procedure easier for the endoscopist. The purpose of this double-blind, randomized, controlled, crossover clinical trial was to determine how gel TNA during flexible endoscopic evaluation of swallowing with sensory testing affects sensation, swallowing, and comfort rating scores in healthy nondysphagic participants. Laryngopharyngeal sensory thresholds and swallowing durations were compared between two conditions: TNA and sham. Transition duration decreased statistically significantly during the TNA condition compared to the sham for 10 ml only (p < 0.05). All other swallowing measures did not change between the conditions. Laryngopharyngeal sensory thresholds and perceptions did not change between conditions. No change was observed for subject comfort scores, ease of exam, or quality of view. Future studies should evaluate TNA administration variables, including concentration, dosage amount, and method of application, to determine the optimal strategy for providing comfort while avoiding altered swallowing. PMID:23828313

  16. Oropharyngeal swallowing after stroke in the left basal ganglion/internal capsule.

    PubMed

    Logemann, J A; Shanahan, T; Rademaker, A W; Kahrilas, P J; Lazar, R; Halper, A

    1993-01-01

    One of the foci of Martin Donner's work was the neural control of swallowing. This present investigation continues that work by examining oropharyngeal swallowing in 8 patients identified with a single, small, left-basal ganglion/internal capsule infarction and 8 age-matched normal subjects. Stroke patients were assessed with a bedside clinical and radiographic swallowing assessment, and normal subjects received only the radiographic study. Results revealed disagreement between the bedside and radiographic assessments in one of the 8 stroke patients. Stroke and normal subjects differed significantly on some swallow measures on various bolus viscosities, but behaved the same as normal subjects on a number of measures. Differences in swallowing in the stroke subjects were not enough to prevent them from eating orally. The significant differences seen in the basal ganglia/internal capsule stroke subjects may result from damage to the sensorimotor pathways between the cortex and brainstem. These differences emphasize the importance of cortical input to the brainstem swallowing center in maintaining the systematic modulations characteristic of normal swallowing physiology. PMID:8359043

  17. Acoustic characteristics of voluntary expiratory sounds after swallow for detecting dysphagia.

    PubMed

    Yamashita, M; Yokoyama, K; Takei, Y; Furuya, N; Nakamichi, Y; Ihara, Y; Takahashi, K; Groher, M E

    2014-09-01

    This research was designed to investigate the acoustic characteristics of voluntary expiratory sounds after swallow for detecting dysphagia. Forty-nine patients with complaints of swallow difficulty received a videofluorographic (VF) examination. They were divided into three groups: nine who did not have any apparent disease (Group N), 22 patients with head and neck cancer (Group H&N) and 18 patients with other diseases including cerebrovascular disease (Group OD). After liquid barium swallows, they exhaled voluntarily without voicing. Videofluorographic findings were classified into four groups: normal (Normal), acceptable swallow (Acceptable), swallow with residue (Resid) and swallows with penetration or aspiration (Pen/Asp). The duration of expiratory sounds was measured on the time waveform. Frequency characteristics of expiratory sounds were obtained using one-third octave band analysis ranging from 62·5 to 2000·0 Hz of central frequency. The averaged level of the 1000·0-Hz band was chosen as the reference band level (RB level). The revised averaged level of each band was obtained by subtracting the RB level from the averaged level of each band. Zero decibel of the revised magnitude of the 125·0-Hz band was set as the critical value to differentiate dysphagia (Resid or Pen/Asp) from no dysphagia (Normal or Acceptable). Comparison of this assessment with VF findings showed a significant percentage agreement (85·4%). These results suggest that frequency characteristics of post-swallow expiratory sounds can differentiate dysphagia from no dysphagia among multiple dysphagic patient groups. PMID:24841831

  18. Differentiation of cerebral representation of occlusion and swallowing with fMRI.

    PubMed

    Mihai, Paul G; von Bohlen Und Halbach, Oliver; Lotze, Martin

    2013-05-15

    Early work on representational specificity and recent findings on temporomandibular joint (TMJ) movement representation raise doubts that a specific swallow representation does exist. Additionally, during cortical stimulation TMJ movements and swallowing show a high overlap of representational areas in the primary motor cortex. It has thus been hypothesized that they overall might share the same neural structures. To differentiate these two movements, we performed a functional MRI (fMRI) study that enabled a direct comparison of functional representation of both actions in the same subject group. Effort during these tasks was controlled by skin conductance response. When balancing effort, we found a comparable neural representation pattern for both tasks but increased resources necessary to perform swallowing in direct comparison between tasks. For the first time, with the usage of fMRI, we demonstrated a representation in the brainstem for swallowing and occlusion. Increased activation for swallowing was observed in bilateral sensorimotor cortex, bilateral premotor and supplementary motor cortex, motor cingulate, thalamus, cerebellar hemispheres, left pallidum, bilateral pons, and midbrain. Peaks of activation in primary motor cortex between both conditions were about 5 mm adjacent. Brainstem activation was found corresponding to the sensory nucleus of the trigeminal nerve, the solitary nucleus for swallowing, and the trigeminal nucleus for occlusion. Our data suggest that cerebral representation of occlusion and swallowing are spatially widely overlapping, differing predominantly with respect to the quantity of neural resources involved. Both brainstem and primary motor representation differ in location with respect to somatotopy and contribution of cranial nerve nuclei. PMID:23494122

  19. Swallowing and deep brain stimulation in Parkinson's disease: a systematic review.

    PubMed

    Troche, Michelle S; Brandimore, Alexandra E; Foote, Kelly D; Okun, Michael S

    2013-09-01

    The purpose of this review is to assess the current state of the literature on the topic of deep brain stimulation (DBS) and its effects on swallowing function in Parkinson's disease (PD). Pubmed, Cochrane review, and web of science searches were completed on all articles addressing DBS that contained a swallowing outcome measure. Outcome measures included the penetration/aspiration scale, pharyngeal transit time, oropharyngeal residue, drooling, aspiration pneumonia, death, hyolaryngeal excursion, epiglottic inversion, UPDRS scores, and presence of coughing/throat clearing during meals. The search identified 13 studies specifically addressing the effects of DBS on swallowing. Critical assessment of the 13 identified peer-reviewed publications revealed nine studies employing an experimental design, (e.g. "on" vs. "off", pre- vs. post-DBS) and four case reports. None of the nine experimental studies were found to identify clinically significant improvement or decline in swallowing function with DBS. Despite these findings, several common threads were identified across experimental studies and will be examined in this review. Additionally, available data demonstrate that, although subthalamic nucleus (STN) stimulation has been considered to cause more impairment to swallowing function than globus pallidus internus (GPi) stimulation, there are no experimental studies directly comparing swallowing function in STN vs. GPi. Moreover, there has been no comparison of unilateral vs. bilateral DBS surgery and the coincident effects on swallowing function. This review includes a critical analysis of all experimental studies and discusses methodological issues that should be addressed in future studies. PMID:23726461

  20. A Swallow Preservation Protocol Improves Function for Veterans Receiving Chemoradiation for Head and Neck Cancer

    PubMed Central

    Peng, Kevin A.; Kuan, Edward C.; Unger, Lindsey; Lorentz, William C.; Wang, Marilene B.; Long, Jennifer L.

    2016-01-01

    Objective Determine the efficacy of a swallow preservation protocol (SPP) on maintaining swallow function in patients undergoing chemoradiation (CRT) or radiation therapy alone (RT) for head and neck squamous cell carcinoma (HNSCC). Study design Retrospective case series. Setting Veterans Affairs medical center. Subjects and Methods Patients treated with CRT or RT for HNSCC between February 2006 and November 2013 were studied. Those enrolled in the SPP participated in swallowing, jaw, and tongue exercises during cancer therapy. The comparator group received no swallowing intervention during CRT. A previously described functional outcome swallowing scale (FOSS; 0 = no symptoms and 5 = nonoral feeding for all nutrition) was used to quantify dysphagia prior to and at the completion of cancer therapy, and an analysis was performed to compare swallowing function. Results Forty-one (all male; mean age, 66 years) and 66 patients (all male; mean age, 61 years) were included in the SPP and comparator groups, respectively. In the SPP group, mean pre- and posttreatment FOSS scores were 2.2 and 2.2, respectively, while the corresponding scores in the comparator group were 1.8 and 2.7, respectively, with posttreatment FOSS scores being significantly worse than pre-treatment FOSS scores in the comparator group only. Conclusion Patients enrolled in the SPP demonstrated preserved swallowing function over the course of cancer treatment compared with a comparator group. This confirms the importance of early evaluation and intervention for dysphagia prior to and during CRT or RT alone. PMID:25829388

  1. National Council on Disability

    MedlinePlus

    ... Cradle report and issues new policy toolkit and plain language toolkit regarding the rights of parents with disabilities. ... Policy Toolkits Disabled Parents Toolkit Disabled Parents Toolkit (plain language version) Deinstitutionalization Disability in Indian Country Contact Us ...

  2. A trade-off between reproduction and feather growth in the barn swallow (Hirundo rustica).

    PubMed

    Saino, Nicola; Romano, Maria; Rubolini, Diego; Ambrosini, Roberto; Romano, Andrea; Caprioli, Manuela; Costanzo, Alessandra; Bazzi, Gaia

    2014-01-01

    Physiological trade-offs mediated by limiting energy, resources or time constrain the simultaneous expression of major functions and can lead to the evolution of temporal separation between demanding activities. In birds, plumage renewal is a demanding activity, which accomplishes fundamental functions, such as allowing thermal insulation, aerodynamics and socio-sexual signaling. Feather renewal is a very expensive and disabling process, and molt is often partitioned from breeding and migration. However, trade-offs between feather renewal and breeding have been only sparsely studied. In barn swallows (Hirundo rustica) breeding in Italy and undergoing molt during wintering in sub-Saharan Africa, we studied this trade-off by removing a tail feather from a large sample of individuals and analyzing growth bar width, reflecting feather growth rate, and length of the growing replacement feather in relation to the stage in the breeding cycle at removal and clutch size. Growth bar width of females and length of the growing replacement feather of both sexes were smaller when the original feather had been removed after clutch initiation. Importantly, in females both growth bar width and replacement feather length were negatively predicted by clutch size, and more strongly so for large clutches and when feather removal occurred immediately after clutch completion. Hence, we found strong, coherent evidence for a trade-off between reproduction, and laying effort in particular, and the ability to generate new feathers. These results support the hypothesis that the derived condition of molting during wintering in long-distance migrants is maintained by the costs of overlapping breeding and molt. PMID:24826890

  3. Role of Barium Swallow in Diagnosing Clinically Significant Anastomotic Leak following Esophagectomy

    PubMed Central

    Roh, Simon; Iannettoni, Mark D.; Keech, John C.; Bashir, Mohammad; Gruber, Peter J.; Parekh, Kalpaj R.

    2016-01-01

    Background Barium swallow is performed following esophagectomy to evaluate the anastomosis for detection of leaks and to assess the emptying of the gastric conduit. The aim of this study was to evaluate the reliability of the barium swallow study in diagnosing anastomotic leaks following esophagectomy. Methods Patients who underwent esophagectomy from January 2000 to December 2013 at our institution were investigated. Barium swallow was routinely done between days 5–7 to detect a leak. These results were compared to clinically determined leaks (defined by neck wound infection requiring jejunal feeds and or parenteral nutrition) during the postoperative period. The sensitivity and specificity of barium swallow in diagnosing clinically significant anastomotic leaks was determined. Results A total of 395 esophagectomies were performed (mean age, 62.2 years). The indications for the esophagectomy were as follows: malignancy (n=320), high-grade dysplasia (n=14), perforation (n=27), benign stricture (n=7), achalasia (n=16), and other (n=11). A variety of techniques were used including transhiatal (n=351), McKeown (n=35), and Ivor Lewis (n=9) esophagectomies. Operative mortality was 2.8% (n=11). Three hundred and sixty-eight patients (93%) underwent barium swallow study after esophagectomy. Clinically significant anastomotic leak was identified in 36 patients (9.8%). Barium swallow was able to detect only 13/36 clinically significant leaks. The sensitivity of the swallow in diagnosing a leak was 36% and specificity was 97%. The positive and negative predictive values of barium swallow study in detecting leaks were 59% and 93%, respectively. Conclusion Barium swallow is an insensitive but specific test for detecting leaks at the cervical anastomotic site after esophagectomy. PMID:27066433

  4. Swallowing transit times and valleculae residue in stable chronic obstructive pulmonary disease

    PubMed Central

    2014-01-01

    Background Breathing and swallowing are physiologically linked to ensure effortless gas exchange during oronasal breathing and to prevent aspiration during swallowing. Studies have indicated consistent aspiration in chronic obstructive pulmonary disease, mainly related to delayed swallowing reflex and problems with lingual propulsion and pharyngeal peristalsis as a result of bilateral weakness and incoordination of the related muscles. The purpose of the present study was to evaluate swallowing transit times and valleculae residue characteristics of stable COPD patients who have no swallowing complaints. Methods Our study population included 20 stable patients with COPD and no swallowing complaints and 20 healthy controls. Swallowing was assessed through videofluoroscopic examination and involved the analysis of the following parameters: (1) pharyngeal stages of deglutition; (2) the duration of bolus movement through the oral cavity and pharynx (i.e. transit times); (3) valleculae residue ratio; (4) penetration/aspiration. Results Participants of the study did not present any signs of penetration-aspiration for any of the tested consistencies. Patients with COPD presented longer pharyngeal transit times during the ingestion of the liquid consistency and during the ingestion of the paste consistency. Regarding the duration of tongue base contact with the posterior pharyngeal wall, COPD patients also presented longer durations for the liquid and paste consistencies. No significant difference was observed for the distribution of individuals among the different valleculae residue severity levels. Conclusions Our study suggests that stable COPD patients may present physiological adaptations as a protective swallowing maneuver to avoid aspiration/penetration of pharyngeal contents. Moreover, valleculae residue cannot be seen as an isolated factor when trying to explain swallowing alterations in this population. PMID:24739506

  5. 'Pharyngocise': Randomized Controlled Trial of Preventative Exercises to Maintain Muscle Structure and Swallowing Function During Head-and-Neck Chemoradiotherapy

    SciTech Connect

    Carnaby-Mann, Giselle; Crary, Michael A.; Schmalfuss, Ilona

    2012-05-01

    Purpose: Dysphagia after chemoradiotherapy is common. The present randomized clinical trial studied the effectiveness of preventative behavioral intervention for dysphagia compared with the 'usual care.' Methods and Materials: A total of 58 head-and-neck cancer patients treated with chemoradiotherapy were randomly assigned to usual care, sham swallowing intervention, or active swallowing exercises (pharyngocise). The intervention arms were treated daily during chemoradiotherapy. The primary outcome measure was muscle size and composition (determined by T{sub 2}-weighted magnetic resonance imaging). The secondary outcomes included functional swallowing ability, dietary intake, chemosensory function, salivation, nutritional status, and the occurrence of dysphagia-related complications. Results: The swallowing musculature (genioglossus, hyoglossuss, and mylohyoid) demonstrated less structural deterioration in the active treatment arm. The functional swallowing, mouth opening, chemosensory acuity, and salivation rate deteriorated less in the pharyngocise group. Conclusion: Patients completing a program of swallowing exercises during cancer treatment demonstrated superior muscle maintenance and functional swallowing ability.

  6. Patient and operator dose during fluoroscopic examination of swallow mechanism.

    PubMed

    Crawley, M T; Savage, P; Oakley, F

    2004-08-01

    Dose-area product (DAP) measurements were made for 21 patients undergoing a modified barium swallow. The procedures were performed by a radiologist and speech and language therapist, to characterize swallowing disorders in patients with head or spinal injury, stroke, other neurological conditions or simple globus symptoms, in order to inform feeding strategies. The DAP values were used to estimate effective dose to the patient, in order to provide a measure of the radiation risk associated with the procedure. Whole body doses to operators, together with equivalent doses to extremities and eyes were also measured to inform the employer's risk assessment. Median DAP for the series was 3.5 (3.1-5.2) Gycm(2) with a corresponding effective dose to the patient of 0.85 (0.76-1.3) mSv, and a low associated risk, mainly of cancer induction, of about 1 in 16 000. The organ receiving the greatest dose was the thyroid, with a calculated median equivalent dose of 13.9 (12.3-20.7) mSv. Median screening time was 3.7 (2.5-4.3) min. Mean operator doses were 0.5 mSv equivalent dose (eyes), 0.9 mSv (extremities), and less than 0.3 mSv whole body dose. Extrapolating for an annual workload of 50 patients per year, this work will lead to annual operator doses of less than 0.6 mSv whole body dose, and approximately 1 mSv equivalent dose (eyes) and 1.8 mSv (extremities), against corresponding legal dose limits of 20 mSv, 150 mSv and 500 mSv, respectively. PMID:15326042

  7. Aging effects on oropharyngeal swallow and the role of dental care in oropharyngeal dysphagia.

    PubMed

    Logemann, J A; Curro, F A; Pauloski, B; Gensler, G

    2013-11-01

    Difficulty with oropharyngeal swallow requires careful diagnosis and treatment from a team of professionals including the patients' physicians and the speech-language pathologist specializing in dysphagia. The dentist can be a critical team member in prevention, early identification, and management of oropharyngeal dysphagia. This manuscript reviews the physiology of normal oropharyngeal swallow and the effects of normal aging on this physiology. Typical etiologies for oropharyngeal dysphagia are defined as is the most commonly used physiologic diagnostic procedure, the modified barium swallow (MBS). The critical role of the dentist in identifying risk of oropharyngeal dysphagia, making appropriate referrals, and improving oral hygiene to prevent aspiration pneumonia in the elderly is discussed. PMID:23574512

  8. Swallowing dynamics status post caustic ingestion in a pediatric patient: A multidisciplinary case report.

    PubMed

    Miller, Claire Kane; Rutter, Michael J; von Allmen, Daniel; Stoops, Marilyn; Putnam, Philip; Stevens, Luann; Willging, J Paul

    2016-07-01

    A case report of a 10 year old male illustrates the effect of damage to the tongue base, hypopharynx, cricopharyngeus, and esophagus on the sensory and motor components of the swallowing mechanism. The characteristics of the dysphagia were manifested clinically, radiographically, and endoscopically. A myectomy was required to restore functional swallowing as scar tissue formation in the cricopharyngeus severely interfered with the dynamic components of swallowing. A collaborative approach facilitated communication and effective treatment planning; the multidisciplinary components in the management of this case are discussed. PMID:27260570

  9. Reversible Sterilization

    ERIC Educational Resources Information Center

    Largey, Gale

    1977-01-01

    Notes that difficult questions arise concerning the use of sterilization for alleged eugenic and euthenic purposes. Thus, how reversible sterilization will be used with relation to the poor, mentally ill, mentally retarded, criminals, and minors, is questioned. (Author/AM)

  10. Reversible Cardiomyopathies

    PubMed Central

    Patel, Harsh; Madanieh, Raef; Kosmas, Constantine E; Vatti, Satya K; Vittorio, Timothy J

    2015-01-01

    Cardiomyopathies (CMs) have many etiological factors that can result in severe structural and functional dysregulation. Fortunately, there are several potentially reversible CMs that are known to improve when the root etiological factor is addressed. In this article, we discuss several of these reversible CMs, including tachycardia-induced, peripartum, inflammatory, hyperthyroidism, Takotsubo, and chronic illness–induced CMs. Our discussion also includes a review on their respective pathophysiology, as well as possible management solutions. PMID:26052233

  11. with Disabilities

    ERIC Educational Resources Information Center

    Cote, Debra L.; Jones, Vita L.; Sparks, Shannon L.; Aldridge, Patricia A.

    2012-01-01

    Parents from culturally diverse backgrounds need to feel that they play a vital role in the future success of their sons or daughters with disabilities. Differences in culture and ethnicity can affect families' involvement in transition planning and the goals that they emphasize for their children. Families of diverse backgrounds were…

  12. Intellectual Disability

    MedlinePlus

    ... follows: _________________ Definition of “Intellectual Disability” under IDEA Until Rosa’s Law was signed into law by President Obama ... the term “mental retardation” instead of “intellectual disability.” Rosa’s Law changed the term to be used in ...

  13. Intellectual Disability

    MedlinePlus

    ... known causes of intellectual disability – like Down syndrome, fetal alcohol syndrome, fragile X syndrome, genetic conditions, birth defects, and infections – happen before birth. Others happen while a baby is being born or soon after ... fetal, el síndrome X frágil, afecciones genéticas, defectos congénitos ...

  14. The relationship of the 'inferior constrictor swallow' and 'globus hystericus' or the hypopharyngeal syndrome.

    PubMed

    Gray, L P

    1983-07-01

    The term 'Globus Hystericus' is considered to be a very bad term for such a common condition and it is recommended that it be replaced by the 'Hypopharyngeal Syndrome'. The normal modified swallow initiated from the lingual tonsil--epiglottis area, called the Inferior Constrictor Swallow, can cause all the symptoms. The epiglottis does not bend. There are two groups of symptoms: the first due to sensation from local irritation of the lingual tonsil; and the second due to vicious circles causing increased muscle tension and strain swallowing. If there is pain or dysphagia or impairment in swallowing, then it is not the Hypopharyngeal Syndrome. The key-note of treatment is the logical explanation of these symptoms and that the vicious circles must be broken. PMID:6875362

  15. Swallows as a sentinel species for contaminant exposure and effect studies

    USGS Publications Warehouse

    Custer, Christine M.

    2011-01-01

    Tree swallows are an important model species to study the effects of contaminants in wild bird populations and have been used extensively in studies across North America. The advantages of swallows compared to other avian species are detailed. Three case histories are provided where swallows have been successfully used in Natural Resource Damage and Ecological Risk Assessments. The final two sections of this chapter are for individuals who want more in-depth information and include a summary of the chemical classes for which there are swallow data, including effect levels when known. Information provided in this section can be used to put exposure to most classes of contaminants into context with other sites across North America. Finally, commonly used endpoints, ranging from population-level down to cellular and genetic endpoints, are discussed including considerations and pitfalls, and when further work is needed to more fully understand the role of environmental and biological variation in interpreting these endpoints.

  16. DDE not implicated in cliff swallow, Petrochelidon pyrrhonota, mortality during severe spring weather in Oregon

    USGS Publications Warehouse

    Henny, C.J.; Blus, L.J.; Stafford, C.J.

    1982-01-01

    Large numbers ofCliff Swallows (Petrochelidon pyrrhonota) died in late May near Burns, Oregon, during cold, wet weather. The brains of five dead birds did not contain lethal concentrations of DDE, and no PCBs were detected.

  17. Disablement, Disability and the Nigerian Society.

    ERIC Educational Resources Information Center

    Abang, Theresa B.

    1988-01-01

    The condition of the disabled in developing nations, particularly Nigeria, is considered. Discussed are prevention of disability by control of infectious diseases, effects of myth and superstition on attitudes toward the disabled, the lack of medical facilities, and the rights of the disabled to an education and building access. (Author/DB)

  18. Trace element concentrations and bioindicator responses in tree swallows from northwestern Minnesota.

    PubMed

    Custer, Christine M; Custer, Thomas W; Warburton, David; Hoffman, David J; Bickham, John W; Matson, Cole W

    2006-07-01

    Extremely high concentrations of cadmium (3.5 microg/g dry wgt.) and elevated concentrations of chromium (>10 microg/g dry wgt.) and mercury (1.6 microg/g dry wgt.) were reported in waterbird tissues at Agassiz National Wildlife Refuge in northwestern Minnesota in 1994. Tree swallows (Tachycineta bicolor) were studied during 1998-2001 at three drainages into the Refuge, two pools on the Refuge, and at a nearby reference location to document whether high levels of contaminants were still present, and if so to quantify the source and severity of the contamination. Trace elements were measured in tree swallow eggs, livers, and diet. Reproductive success and bioindicator responses were monitored. In 2000, water was drawn down on Agassiz Pool, one of the main pools on the Refuge. This presented an opportunity to evaluate the response of trace element concentrations in the diet and tissues of tree swallows after reflooding. High concentrations of trace elements were not detected in swallow tissues, nor were there differences among locations. Less than 20% of swallow samples had detectable concentrations of cadmium or chromium. Mercury concentrations were low and averaged <0.25 microg/g dry wgt. in swallow tissues. Trace elements, including mercury, did not increase in tree swallows following the 2000 drawdown at Agassiz Pool. Hatching success and survival of nestlings to 12 days-of-age for tree swallows on the Refuge were similar to the national average and consistent with background trace element concentrations. Bioindicator measurements were within the normal ranges as well. PMID:16897545

  19. Sucking and swallowing rates after palatal anesthesia: an electromyographic study in infant pigs

    PubMed Central

    Waranch, Danielle R.; Campbell-Malone, Regina; Ding, Peng; Gierbolini-Norat, Estela M.; Lukasik, Stacey L.; German, Rebecca Z.

    2013-01-01

    Infant mammalian feeding consists of rhythmic suck cycles and reflexive pharyngeal swallows. Although we know how oropharyngeal sensation influences the initiation and frequency of suck and swallow cycles, the role of palatal sensation is unknown. We implanted EMG electrodes into the mylohyoid muscle, a muscle active during suckling, and the thyrohyoid muscle, a muscle active during swallowing, in eight infant pigs. Pigs were then bottle-fed while lateral videofluoroscopy was simultaneously recorded from the electrodes. Two treatments were administered prior to feeding and compared with control feedings: 1) palatal anesthesia (0.5% bupivacaine hydrochloride), and 2) palatal saline. Using the timing of mylohyoid muscle and thyrohyoid muscle activity, we tested for differences between treatment and control feedings for swallowing frequency and suck cycle duration. Following palatal anesthesia, four pigs could not suck and exhibited excessive jaw movement. We categorized the four pigs that could suck after palatal anesthesia as group A, and those who could not as group B. Group A had no significant change in suck cycle duration and a higher swallowing frequency after palatal saline (P = 0.021). Group B had significantly longer suck cycles after palatal anesthesia (P < 0.001) and a slower swallowing frequency (P < 0.001). Swallowing frequency may be a way to predict group membership, since it was different in control feedings between groups (P < 0.001). The qualitative and bimodal group response to palatal anesthesia may reflect a developmental difference. This study demonstrates that palatal sensation is involved in the initiation and frequency of suck and swallow cycles in infant feeding. PMID:23636723

  20. Effects of age and stimulus on submental mechanomyography signals during swallowing.

    PubMed

    Lee, Joon; Chau, Tom; Steele, Catriona M

    2009-09-01

    Mechanomyography (MMG) is the measurement of the vibrations associated with muscle contraction. As an indicator of muscle activity in swallowing, MMG has several potential advantages over conventional electromyography (EMG), including robustness to variations in sensor placement, perspiration, and food spillage. The objective of this study was to investigate the effects of participant age and stimulus on submental muscle activity as measured by MMG. Nasal airflow was utilized as a reference signal. Four liquid stimuli were investigated: water, nectar-thick and honey-thick apple juices, and a thin-liquid barium suspension. Each of 15 healthy adults completed nine swallowing sequences, each consisting of four discrete swallows via a self-administered cup-drinking task, with an MMG sensor at a midline submental location and a nasal cannula at the nares. Muscle activity and swallowing apneas in the signals were identified with pseudo-automatic segmentation algorithms. Various timing and amplitude features were extracted from each segmented swallow. Muscle activity onset preceded the onset of swallow apnea. Significant main effects of stimulus were found for the duration of muscle activity and for the time difference between the offsets of muscle activity and swallow apnea. No other main or interaction effects were significant. In general, the timing and amplitude variations of submental muscle activity revealed by MMG seem to agree with previously reported findings using EMG. The minor discrepancies between the results of this study and those of previous EMG studies are likely due to differences in experimental tasks. MMG may serve as an alternative measure of muscle activity during swallowing and further investigation is warranted. PMID:19142682

  1. Role of Physical Bolus Properties as Sensory Inputs in the Trigger of Swallowing

    PubMed Central

    Peyron, Marie-Agnès; Gierczynski, Isabelle; Hartmann, Christoph; Loret, Chrystel; Dardevet, Dominique; Martin, Nathalie; Woda, Alain

    2011-01-01

    Background Swallowing is triggered when a food bolus being prepared by mastication has reached a defined state. However, although this view is consensual and well supported, the physical properties of the swallowable bolus have been under-researched. We tested the hypothesis that measuring bolus physical changes during the masticatory sequence to deglutition would reveal the bolus properties potentially involved in swallowing initiation. Methods Twenty normo-dentate young adults were instructed to chew portions of cereal and spit out the boluses at different times in the masticatory sequence. The mechanical properties of the collected boluses were measured by a texture profile analysis test currently used in food science. The median particle size of the boluses was evaluated by sieving. In a simultaneous sensory study, twenty-five other subjects expressed their perception of bolus texture dominating at any mastication time. Findings Several physical changes appeared in the food bolus as it was formed during mastication: (1) in rheological terms, bolus hardness rapidly decreased as the masticatory sequence progressed, (2) by contrast, adhesiveness, springiness and cohesiveness regularly increased until the time of swallowing, (3) median particle size, indicating the bolus particle size distribution, decreased mostly during the first third of the masticatory sequence, (4) except for hardness, the rheological changes still appeared in the boluses collected just before swallowing, and (5) physical changes occurred, with sensory stickiness being described by the subjects as a dominant perception of the bolus at the end of mastication. Conclusions Although these physical and sensory changes progressed in the course of mastication, those observed just before swallowing seem to be involved in swallowing initiation. They can be considered as strong candidates for sensory inputs from the bolus that are probably crucially involved in the triggering of swallowing, since they

  2. Effect of aging on oral and swallowing function after meal consumption

    PubMed Central

    Hiramatsu, Tetsuya; Kataoka, Hideyuki; Osaki, Mari; Hagino, Hiroshi

    2015-01-01

    Background/purpose Dysphagia may worsen due to fatigue of the infrahyoid and suprahyoid muscle groups as a result of repetitive swallowing during a meal. We investigated the hypothesis that meal consumption may reduce tongue strength and endurance in older adults (OAs). Methods Tongue–palate pressure, oral diadochokinesis, repetitive saliva swallowing, and surface electromyography activity before and after a meal were measured in 23 young adults (YAs) and 23 OA volunteers. Results There was a statistically significant difference in both tongue pressure and the number of voluntary swallows between YAs and OAs. Peak tongue pressure was significantly lower in OAs than YAs both before and after meal consumption. The most notable finding was that the first time interval (the time from test initiation to the beginning of the first swallow) was prolonged after meal consumption only in OAs, whereas the first time interval showed no difference between YAs and OAs before meal consumption with reference to the repetitive saliva swallowing test. The initiation of swallowing was prolonged by both meal consumption and aging; there was a significant interaction between these two factors. The number of repetitions of the monosyllable/pa/was statistically similar between YAs and OAs before meal consumption, but it was significantly lower in OAs after meal consumption. Conclusion Aging leads to declining tongue pressure and motor function of the lips. It is possible that swallowing function declines in older individuals when meal consumption is prolonged, especially at the end of mealtime, as a result of their efforts in mastication and swallowing. PMID:25624755

  3. Trace element concentrations and bioindicator responses in tree swallows from northwestern Minnesota

    USGS Publications Warehouse

    Custer, Christine M.; Custer, T.W.; Warburton, D.; Hoffman, D.J.; Bickham, J.W.; Matson, C.W.

    2006-01-01

    Abstract Extremely high concentrations of cadmium (3.5 ug/g dry wgt.) and elevated concentrations of chromium (>10 ug/g dry wgt.) and mercury (1.6 ug/g dry wgt.) were reported in waterbird tissues at Agassiz National Wildlife Refuge in northwestern Minnesota in 1994. Tree swallows (Tachycineta bicolor) were studied during 1998-2001 at three drainages into the Refuge, two pools on the Refuge, and at a nearby reference location to document whether high levels of contaminants were still present, and if so to quantify the source and severity of the contamination. Trace elements were measured in tree swallow eggs, livers, and diet. Reproductive success and bioindicator responses were monitored. In 2000, water was drawn down on Agassiz Pool, one of the main pools on the Refuge. This presented an opportunity to evaluate the response of trace element concentrations in the diet and tissues of tree swallows after reflooding. High concentrations of trace elements were not detected in swallow tissues, nor were there differences among locations. Less than 20% of swallow samples had detectable concentrations of cadmium or chromium. Mercury concentrations were low and averaged <0.25 ug/g dry wgt. in swallow tissues. Trace elements, including mercury, did not increase in tree swallows following the 2000 drawdown at Agassiz Pool. Hatching success and survival of nestlings to 12 days-of-age for tree swallows on the Refuge were similar to the national average and consistent with background trace element concentrations. Bioindicator measurements were within the normal ranges as well.

  4. Accumulation of PCB congeners in nestling tree swallows (Tachycineta bicolor) on the Hudson River, New York

    USGS Publications Warehouse

    Echols, K.R.; Tillitt, D.E.; Nichols, J.W.; Secord, A.L.; McCarty, J.P.

    2004-01-01

    Tree swallows (Tachycineta bicolor) were used as a sentinel species to monitor the contamination and bioavailability of polychlorinated biphenyls (PCBs) in the Hudson River watershed. Several tree swallow nest box colonies around and downstream from Hudson Falls, NY, were studied. Tree swallow eggs, adults, and 5-, 10-, and 15-day-old nestlings were collected and analyzed for 103 PCB congeners. Emergent insects collected by net (primarily Odonata) or as a food bolus (primarily Diptera) taken from the mouths of adult tree swallows returning to the nest were analyzed in the same manner. Total PCB concentrations (wet weight) in eggs from two contaminated sites ranged from 9000 to 25 000 ng/g and accumulated to 32 000 and 96 000 ng/g in 15-day-old nestling at two contaminated sites. The congener patterns of PCBs in eggs, nestlings, and adults were compared to those found in emergent insects (Odonata and Diptera) using principal components analysis. The PCB patterns of the biota differed from that of Aroclor technical mixtures. PCB patterns in adult tree swallows were similar to those in eggs, while the patterns in dietary insects were similar to nestling tree swallows. Uptake rate constants were determined for tree swallow nestlings and compared between the two contaminated sites. The estimated PCB congener uptake rate constants were 0.008-0.02 d-1 based on uptake in nestlings until day 15 post-hatch. The rate constants were comparable between the two study areas and may be used to predict nestling contamination at other locations. Our studies confirm the utility of nestling tree swallows to evaluate localized PCB contamination.

  5. Feasibility and usefulness of using swallow contrast-enhanced ultrasound to diagnose Zenker's diverticulum: preliminary results.

    PubMed

    Cui, Xin-Wu; Ignee, Andre; Baum, Ulrich; Dietrich, Christoph F

    2015-04-01

    Zenker's diverticulum (ZD) may be misdiagnosed on conventional ultrasound as a thyroid nodule or other lesion. A barium esophagram is usually used to confirm the diagnosis; however, this procedure exposes the patient to radiation. The aim of this study was to evaluate the feasibility of using swallow contrast-enhanced ultrasound (swallow-CEUS) to diagnose ZD. Ten consecutive patients with ZD (7 men and 3 women, aged 67 ± 11 y) were included in the study. In 4 patients, ZD was incidentally found on head and neck ultrasound, and in 6 patients, ZD was suspected because of dysphagia. All lesions could be detected on conventional ultrasound before swallow-CEUS. Ten healthy volunteers (8 men and 2 women, aged 60 ± 12 y) were chosen as a control group. Written informed consent was obtained. With the patient in the sitting or upright position, conventional ultrasound was performed first to image the lesion, then the patient was asked to swallow ultrasound contrast agent (UCA) (2-4 drops of SonoVue diluted with about 200 mL of tap water). Transity of the contrast agent in the esophagus was imaged with CEUS. Retention of the UCA in the diverticulum was monitored for at least 3 min. All patients underwent a barium esophagram as the gold standard. Swallow-CEUS revealed that in all patients (100%), the UCA was transported from the pharynx to the esophagus while the patient swallowed. ZD appeared as a pouch-shaped structure at the posterior pharyngo-esophageal junction that retained UCA longer than 3 min. The barium esophagram confirmed the diagnosis of ZD in all patients. For the 10 volunteers, no abnormal structure (retaining UCA) was detected during or after swallowing of UCA. With the advantages of no radiation and bedside availability, swallow-CEUS may become a method of choice in confirmation of the diagnosis of ZD, especially when ZD is suspected on conventional ultrasound. PMID:25701519

  6. Voice and swallowing disorders: functional results and quality of life following supracricoid laryngectomy with cricohyoidoepiglottopexy.

    PubMed

    Portas, Juliana Godoy; Queija, Débora dos Santos; Arine, Leonora Pereira; Ferreira, Alessandra Sampaio; Dedivitis, Rogério A; Lehn, Carlos Neutzling; Barros, Ana Paula Brandão

    2009-10-01

    We conducted a prospective study of 11 patients with laryngeal cancer who underwent supracricoid laryngectomy with cricohyoidoepiglottopexy. Our goal was to evaluate their postoperative voice and swallowing function and to ascertain the impact that surgery had on patient-perceived quality of life. Postoperative assessments were made by auditory perception analyses, objective voice analyses, the Voice Handicap Index questionnaire, the Quality of Life in Swallowing Disorders questionnaire, and videofluoroscopy. Following surgery, 8 patients experienced severe dysphonia and 3 experienced moderate dysphonia. Also, 5 patients experienced mild to severe dysphagia whereas 6 patients experienced normal or near-normal swallowing function. Postoperative acoustic measurements were higher than expected, and spectrographic evaluation revealed the presence of high-grade noise without predominant concentration over the spectrum. Some association with the grade of dysphonia and self-perception of voice handicap was observed. With regard to swallowing, 5 patients (45.5%) showed a decrease in laryngeal remnant elevation and a slight or moderate degree of stasis in the oropharynx. Overall, patients reported good quality of life regarding both voice and swallowing. No relationship between the functional swallowing and the number of preserved arytenoid cartilages was observed. PMID:19826987

  7. Detection of Food Intake from Swallowing Sequences by Supervised and Unsupervised Methods

    PubMed Central

    Lopez-Meyer, Paulo; Makeyev, Oleksandr; Schuckers, Stephanie; Melanson, Edward L.; Neuman, Michael R.; Sazonov, Edward

    2010-01-01

    Studies of food intake and ingestive behavior in free-living conditions most often rely on self-reporting-based methods that can be highly inaccurate. Methods of Monitoring of Ingestive Behavior (MIB) rely on objective measures derived from chewing and swallowing sequences and thus can be used for unbiased study of food intake with free-living conditions. Our previous study demonstrated accurate detection of food intake in simple models relying on observation of both chewing and swallowing. This article investigates methods that achieve comparable accuracy of food intake detection using only the time series of swallows and thus eliminating the need for the chewing sensor. The classification is performed for each individual swallow rather than for previously used time slices and thus will lead to higher accuracy in mass prediction models relying on counts of swallows. Performance of a group model based on a supervised method (SVM) is compared to performance of individual models based on an unsupervised method (K-means) with results indicating better performance of the unsupervised, self-adapting method. Overall, the results demonstrate that highly accurate detection of intake of foods with substantially different physical properties is possible by an unsupervised system that relies on the information provided by the swallowing alone. PMID:20352335

  8. Development of a Portable Non-Invasive Swallowing and Respiration Assessment Device †

    PubMed Central

    Shieh, Wann-Yun; Wang, Chin-Man; Chang, Chia-Shuo

    2015-01-01

    Dysphagia is a condition that happens when a person cannot smoothly swallow food from the mouth to the stomach. It causes malnourishment in patients, or can even cause death due to aspiration pneumonia. Recently, more and more researchers have focused their attention on the importance of swallowing and respiration coordination, and the use of non-invasive assessment systems has become a hot research trend. In this study, we aimed to integrate the timing and pattern monitoring of respiration and swallowing by using a portable and non-invasive approach which can be applied at the bedside in hospitals or institutions, or in a home environment. In this approach, we use a force sensing resistor (FSR) to detect the motions of the thyroid cartilage in the pharyngeal phase. We also use the surface electromyography (sEMG) to detect the contraction of the submental muscle in the oral phase, and a nasal cannula to detect nasal airflow for respiration monitoring during the swallowing process. All signals are received and processed for swallowing event recognition. A total of 19 volunteers participated in the testing and over 57 measurements were made. The results show that the proposed approach can effectively distinguish the swallowing function in people of different ages and genders. PMID:26024414

  9. Multichannel intraluminal impedance and esophageal manometry data for unrestricted swallowing: establishing normal values.

    PubMed

    Wilson, J A; Mainie, I; Tutuian, R; Agrawal, A; Castell, D O

    2008-01-01

    Standard esophageal manometric testing evaluates swallowing in the supine position using small boluses, with a recovery period imposed between swallows. Manometric tests of more physiologic unrestricted swallowing have had limited practical application due to highly variable results. The purpose of this study is to apply multichannel intraluminal impedance and manometry (MII-EM) to test esophageal function during unrestricted upright meal consumption, and to assess results in a normal healthy population. Ten healthy volunteers with normal esophageal impedance and manometry by published criteria underwent MII-EM testing using a combined 5-channel catheter. After transnasal placement of the catheter, each subject sat upright and consumed a meal that consisted of two pieces of toasted bread and two ounces of Gatorade. There were no restrictions placed on chewing, swallowing, or eating time. All data assessed by the MII-EM meal test were normally distributed. Impedance results with limited variability included the meal duration, number of swallows, postprandial emptying time and the percent of bolus presence times at 15, 10, and 5 cm above the lower esophageal sphincter. Manometric results with limited variability included the number of peristaltic sequences, mean time between these sequences and their distal esophageal amplitudes. MII-EM can be used to collect data with minimal variability in healthy subjects during unrestricted upright meal consumption. This technique may be used to identify abnormal motility patterns during physiologic swallowing. PMID:18197939

  10. The Food Contaminant Mycotoxin Deoxynivalenol Inhibits the Swallowing Reflex in Anaesthetized Rats

    PubMed Central

    Abysique, Anne; Tardivel, Catherine; Troadec, Jean-Denis; Félix, Bernadette

    2015-01-01

    Deoxynivalenol (DON), one of the most abundant mycotoxins found on cereals, is known to be implicated in acute and chronic illnesses in both humans and animals. Among the symptoms, anorexia, reduction of weight gain and decreased nutrition efficiency were described, but the mechanisms underlying these effects on feeding behavior are not yet totally understood. Swallowing is a major motor component of ingestive behavior which allows the propulsion of the alimentary bolus from the mouth to the esophagus. To better understand DON effects on ingestive behaviour, we have studied its effects on rhythmic swallowing in the rat, after intravenous and central administration. Repetitive electrical stimulation of the superior laryngeal nerve or of the tractus solitarius, induces rhythmic swallowing that can be recorded using electromyographic electrodes inserted in sublingual muscles. Here we provide the first demonstration that, after intravenous and central administration, DON strongly inhibits the swallowing reflex with a short latency and in a dose dependent manner. Moreover, using c-Fos staining, a strong neuronal activation was observed in the solitary tract nucleus which contains the central pattern generator of swallowing and in the area postrema after DON intravenous injection. Our data show that DON modifies swallowing and interferes with central neuronal networks dedicated to food intake regulation. PMID:26192767

  11. The Food Contaminant Mycotoxin Deoxynivalenol Inhibits the Swallowing Reflex in Anaesthetized Rats.

    PubMed

    Abysique, Anne; Tardivel, Catherine; Troadec, Jean-Denis; Félix, Bernadette

    2015-01-01

    Deoxynivalenol (DON), one of the most abundant mycotoxins found on cereals, is known to be implicated in acute and chronic illnesses in both humans and animals. Among the symptoms, anorexia, reduction of weight gain and decreased nutrition efficiency were described, but the mechanisms underlying these effects on feeding behavior are not yet totally understood. Swallowing is a major motor component of ingestive behavior which allows the propulsion of the alimentary bolus from the mouth to the esophagus. To better understand DON effects on ingestive behaviour, we have studied its effects on rhythmic swallowing in the rat, after intravenous and central administration. Repetitive electrical stimulation of the superior laryngeal nerve or of the tractus solitarius, induces rhythmic swallowing that can be recorded using electromyographic electrodes inserted in sublingual muscles. Here we provide the first demonstration that, after intravenous and central administration, DON strongly inhibits the swallowing reflex with a short latency and in a dose dependent manner. Moreover, using c-Fos staining, a strong neuronal activation was observed in the solitary tract nucleus which contains the central pattern generator of swallowing and in the area postrema after DON intravenous injection. Our data show that DON modifies swallowing and interferes with central neuronal networks dedicated to food intake regulation. PMID:26192767

  12. Development of a portable non-invasive swallowing and respiration assessment device.

    PubMed

    Shieh, Wann-Yun; Wang, Chin-Man; Chang, Chia-Shuo

    2015-01-01

    Dysphagia is a condition that happens when a person cannot smoothly swallow food from the mouth to the stomach. It causes malnourishment in patients, or can even cause death due to aspiration pneumonia. Recently, more and more researchers have focused their attention on the importance of swallowing and respiration coordination, and the use of non-invasive assessment systems has become a hot research trend. In this study, we aimed to integrate the timing and pattern monitoring of respiration and swallowing by using a portable and non-invasive approach which can be applied at the bedside in hospitals or institutions, or in a home environment. In this approach, we use a force sensing resistor (FSR) to detect the motions of the thyroid cartilage in the pharyngeal phase. We also use the surface electromyography (sEMG) to detect the contraction of the submental muscle in the oral phase, and a nasal cannula to detect nasal airflow for respiration monitoring during the swallowing process. All signals are received and processed for swallowing event recognition. A total of 19 volunteers participated in the testing and over 57 measurements were made. The results show that the proposed approach can effectively distinguish the swallowing function in people of different ages and genders. PMID:26024414

  13. Biochemical Reversal of Aging

    NASA Astrophysics Data System (ADS)

    Ely, John T. A.

    2006-03-01

    We cite our progress on biochemical reversal of aging. However, it may be circa 2 years before we have necessary substances at low cost. Meanwhile, without them, a number of measures can be adopted providing marked improvement for the problems of aging in modern societies. For example, enzymes are needed to excrete toxins that accelerate aging; Hg is the ultimate toxin that disables all enzymes (including those needed to excrete Hg itself). Low Hg level in the urine, due to loss of excretory ability, causes the diagnosis of Hg toxicity to almost always be missed. Hg sources must be removed from the body! Another example is excess sugar; hyperglycemia decreases intracellular ascorbic acid (AA) by competitively inhibiting the insulin- mediated active transport of AA into cells. Thus, immunity is impaired by low leucocyte AA. AA is needed for new proteins in aging tissues. Humans must supplement AA; their need same as in AA-synthesizing mammals.

  14. Disability Experience and Measurement.

    PubMed

    Verbrugge, Lois M

    2016-10-01

    Top themes of international research on disability in the past three decades are discussed: disability dynamics, buffers and barriers for disability, disability trends, and disability among very old persons. Each theme is highlighted by research examples. Turning to measurement, I discuss traditional measures of disability, new longer and shorter ones, and composites like disability-free life expectancy, noting their merits. Contemporary models of disability are presented, ranging from visual images to formal theories. The article ends on how scientists can facilitate movement of disability science into health care practice and policy. PMID:27590795

  15. The mechanics and behavior of cliff swallows during tandem flights.

    PubMed

    Shelton, Ryan M; Jackson, Brandon E; Hedrick, Tyson L

    2014-08-01

    Cliff swallows (Petrochelidon pyrrhonota) are highly maneuverable social birds that often forage and fly in large open spaces. Here we used multi-camera videography to measure the three-dimensional kinematics of their natural flight maneuvers in the field. Specifically, we collected data on tandem flights, defined as two birds maneuvering together. These data permit us to evaluate several hypotheses on the high-speed maneuvering flight performance of birds. We found that high-speed turns are roll-based, but that the magnitude of the centripetal force created in typical maneuvers varied only slightly with flight speed, typically reaching a peak of ~2 body weights. Turning maneuvers typically involved active flapping rather than gliding. In tandem flights the following bird copied the flight path and wingbeat frequency (~12.3 Hz) of the lead bird while maintaining position slightly above the leader. The lead bird turned in a direction away from the lateral position of the following bird 65% of the time on average. Tandem flights vary widely in instantaneous speed (1.0 to 15.6 m s(-1)) and duration (0.72 to 4.71 s), and no single tracking strategy appeared to explain the course taken by the following bird. PMID:24855672

  16. Swallowable fluorometric capsule for wireless triage of gastrointestinal bleeding.

    PubMed

    Nemiroski, A; Ryou, M; Thompson, C C; Westervelt, R M

    2015-12-01

    Real-time detection of gastrointestinal bleeding remains a major challenge because there does not yet exist a minimally invasive technology that can both i) monitor for blood from an active hemorrhage and ii) uniquely distinguish it from blood left over from an inactive hemorrhage. Such a device would be an important tool for clinical triage. One promising solution, which we have proposed previously, is to inject a fluorescent dye into the blood stream and to use it as a distinctive marker of active bleeding by monitoring leakage into the gastrointestinal tract with a wireless fluorometer. This paper reports, for the first time to our knowledge, the development of a swallowable, wireless capsule with a built-in fluorometer capable of detecting fluorescein in blood, and intended for monitoring gastrointestinal bleeding in the stomach. The embedded, compact fluorometer uses pinholes to define a microliter sensing volume and to eliminate bulky optical components. The proof-of-concept capsule integrates optics, low-noise analog sensing electronics, a microcontroller, battery, and low power Zigbee radio, all into a cylindrical package measuring 11 mm × 27 mm and weighing 10 g. Bench-top experiments demonstrate wireless fluorometry with a limit-of-detection of 20 nM aqueous fluorescein. This device represents a major step towards a technology that would enable simple, rapid detection of active gastrointestinal bleeding, a capability that would save precious time and resources and, ultimately, reduce complications in patients. PMID:26490455

  17. Swallowing performance after radiation therapy for carcinoma of the esophagus

    SciTech Connect

    O'Rourke, I.C.; Tiver, K.; Bull, C.; Gebski, V.; Langlands, A.O.

    1988-05-15

    The purpose of the study reported in this article was to tabulate the incidence and etiologic factors of importance in the development of strictures after radiotherapy for carcinoma of the esophagus and to analyze the outcome of patients who develop such strictures. Eighty patients were treated with radiotherapy, 50 having radical and 30 having palliative treatment. Sixty-nine patients had squamous cell carcinoma, four had adenocarcinoma, one had sarcoma, one had mucoepidermoid carcinoma, and five had undifferentiated tumors. Forty percent developed no stricture, 30% had benign fibrotic stricture, and 28% developed malignant stricture. The etiologic factors analysed included age, pretreatment swallowing score, histology and length (size) of tumor; stage of disease, dose of radiotherapy, and use of chemotherapy. None of these factors were shown to be of etiologic importance. The survival of patients who developed benign strictures was found to be significantly longer (1-year survival 88%) than those who developed no stricture (50%) or malignant stricture (19%). Using a success score for palliation of dysphagia, it was found that the majority of patients (71%) who developed a benign stricture had a moderately successful outcome--they were able to tolerate a full or soft diet and required dilatation with a median duration between dilatations of 5 months. Patients who developed a malignant stricture were palliated poorly by dilatation alone, and most required esophageal intubation.

  18. Radial and longitudinal asymmetry of human pharyngeal pressures during swallowing.

    PubMed

    Sears, V W; Castell, J A; Castell, D O

    1991-12-01

    Radial asymmetry of upper esophageal sphincter resting pressure has been previously described; however, neither radial nor longitudinal asymmetry of pharyngeal pressures has been demonstrated. The authors used a specially designed intraluminal transducer catheter (Konigsberg; Konigsberg Instruments, Pasadena, CA) with four solid-state transducers separated by 3 cm and oriented circumferentially at 90 degrees intervals to measure pharyngeal pressures. Two wet swallows at each 1-cm interval along the length of the pharynx were measured in 12 normal volunteers (10 male, 2 female; mean age, 38 years). Pressure data were collected on-line by an Apple IIe microcomputer (Apple Computer Inc., Cupertino, CA) at 100 Hz and analyzed for both radial and longitudinal asymmetry. Significant (P less than 0.05) longitudinal asymmetry was shown in all positions except right lateral. Radial asymmetry was present for the first 4 cm only, with anterior and posterior pressures significantly (P less than 0.05) higher than lateral pressures. It was concluded that pharyngeal pressure responses show both axial and longitudinal asymmetry in the distal pharynx. Awareness of transducer position and orientation is essential in the evaluation of pharyngeal pressures. PMID:1955121

  19. Voluntary Modulation of Hemodynamic Responses in Swallowing Related Motor Areas: A Near-Infrared Spectroscopy-Based Neurofeedback Study

    PubMed Central

    Kober, Silvia Erika; Gressenberger, Bettina; Kurzmann, Jürgen; Neuper, Christa; Wood, Guilherme

    2015-01-01

    In the present study, we show for the first time that motor imagery of swallowing, which is defined as the mental imagination of a specific motor act without overt movements by muscular activity, can be successfully used as mental strategy in a neurofeedback training paradigm. Furthermore, we demonstrate its effects on cortical correlates of swallowing function. Therefore, N = 20 healthy young adults were trained to voluntarily increase their hemodynamic response in swallowing related brain areas as assessed with near-infrared spectroscopy (NIRS). During seven training sessions, participants received either feedback of concentration changes in oxygenated hemoglobin (oxy-Hb group, N = 10) or deoxygenated hemoglobin (deoxy-Hb group, N = 10) over the inferior frontal gyrus (IFG) during motor imagery of swallowing. Before and after the training, we assessed cortical activation patterns during motor execution and imagery of swallowing. The deoxy-Hb group was able to voluntarily increase deoxy-Hb over the IFG during imagery of swallowing. Furthermore, swallowing related cortical activation patterns were more pronounced during motor execution and imagery after the training compared to the pre-test, indicating cortical reorganization due to neurofeedback training. The oxy-Hb group could neither control oxy-Hb during neurofeedback training nor showed any cortical changes. Hence, successful modulation of deoxy-Hb over swallowing related brain areas led to cortical reorganization and might be useful for future treatments of swallowing dysfunction. PMID:26575032

  20. The evaluation of swallowing in patients with spinocerebellar ataxia and oropharyngeal dysphagia: A comparison study of videofluoroscopic and sonar doppler

    PubMed Central

    Abdulmassih, Edna Márcia da Silva; Teive, Hélio Afonso Ghizoni; Santos, Rosane Sampaio

    2013-01-01

    Sumarry Introduction: Spinocerebellar ataxia (SCA) is a degenerative disease that can cause loss of coordination of voluntary muscle movement such as that required for swallowing. Aims: The purposes of this cross-sectional and comparative case study were: (1) to assess the severity of dysphagia through a videofluoroscopic swallow study, and (2) to compare differences in frequency, intensity, and duration of sound waves produced during swallowing in normal and SCA patients by using sonar Doppler. Method: During swallow evaluation using videofluoroscopy, a sonar Doppler transducer was placed on the right side of the neck, at the lateral edge of the trachea, just below the cricoid cartilage to capture the sounds of swallowing in 30 SCA patients and 30 controls. Result: The prevalence in the dynamic evaluation of swallowing videofluoroscopy was by changes in the oral phase of swallowing. The analysis of variance of the averages found in each variable - frequency, intensity and duration of swallowing - shows there was a significant correlation when compared to the healthy individual curve. Conclusion: The study demonstrates the prevalence of oral dysphagia observed in dynamic videofluoroscopic swallow evaluation. In patients with SCA, the mean initial frequency (IF), initial intensity (II), and final intensity (FI) were higher and the time (T) and peak frequency (PF) were lower, demonstrating a pattern of cricopharyngeal opening very close to that found in normal populations. PMID:26038680

  1. Effects of coal fly ash on tree swallow reproduction in Watts Bar Reservoir, Tennessee.

    PubMed

    Walls, Suzanne J; Meyer, Carolyn B; Iannuzzi, Jacqueline; Schlekat, Tamar H

    2015-01-01

    Coal-fly ash was released in unprecedented amounts (4.1 × 10(6) m(3) ) into the Emory River from the Tennessee Valley Authority Kingston Fossil Plant on Watts Bar Reservoir in Tennessee. Tree swallows were exposed to ash-related constituents at the ash release via their diet of emergent aquatic insects, whose larval forms can accumulate constituents from submerged river sediments. Reproduction of tree swallow colonies was assessed over a 2-year period by evaluating whether 1) ash constituent concentrations were elevated in egg, eggshell, and nestling tissues at colonies near ash-impacted river reaches compared to reference colonies, 2) production of fledglings per nesting female was significantly lower in ash-impacted colonies versus reference colonies, and 3) ash constituent concentrations or diet concentrations were correlated with nest productivity measures (clutch size, hatching success, and nestling survival, and fledglings produced per nest). Of the 26 ash constituents evaluated, 4 (Se, Sr, Cu, and Hg) were significantly elevated in tissues potentially from the ash, and 3 (Se, Sr, and Cu) in tissues or in swallow diet items were weakly correlated to at least one nest-productivity measure or egg weight. Tree swallow hatching success was significantly reduced by 12%, but fledgling production per nest was unaffected due to larger clutch sizes in the impacted than reference colonies. Bioconcentration from the ash to insects in the diet to tree swallow eggs appears to be low. Overall, adverse impacts of the ash on tree swallow reproduction were not observed, but monitoring is continuing to further ensure Se from the residual ash does not adversely affect tree swallow reproduction over time. Integr Environ Assess Manag 2015;11:56-66. © 2014 SETAC. PMID:25345977

  2. Effects of early intervention of swallowing therapy on recovery from dysphagia following stroke

    PubMed Central

    Bakhtiyari, Jalal; Sarraf, Payam; Nakhostin-Ansari, Noureddin; Tafakhori, Abbas; Logemann, Jeri; Faghihzadeh, Soghrat; Harirchian, Mohammad Hossein

    2015-01-01

    Background: Dysphagia is common after stroke. The onset time of swallowing rehabilitation following stroke has an important role in the recovery of dysphagia and preventing of its complications, but it was either highly variable or was not stated in previous trials. The aim of this study was investigation effects of onset time of swallowing therapy on recovery from dysphagia following stroke. Methods: Sixty dysphagia patients due to stroke range of age 60-74 (67.1 ± 3.8), participated in this randomized clinical trial study. The patients allocated in Early, Medium and Late groups, on the base of initiation of swallowing therapy after the stroke. After basic clinical and video fluoroscopic swallowing study assessments, traditional swallowing therapy was initiated 3 times per week for 3 months. The outcome measures were North-Western dysphagia patient check sheet, functional oral intake scale, video fluoroscopy, and frequency of pneumonia. Statistical analysis was done by repeated measure ANOVA, Bonferroni and χ2 tests. Results: Three groups of patients in terms of demographic and clinical characteristics were similar in the pre-treatment P > 0.050. Onset time of swallowing therapy after stroke was effective on swallowing recovery on the main outcome variables. So that in first group patients, recovery was rather than other groups P < 0.050. Furthermore, the frequency of pneumonia in the early group was less than other groups and in the early group no patients experienced pneumonia P = 0.002. Conclusion: Our data suggested that early interventions for dysphagia in stroke have an important role in recovery from dysphagia and prevention of complications like aspiration pneumonia. PMID:26622975

  3. The Incidence and Nature of Letter Orientation Errors in Reading Disability.

    ERIC Educational Resources Information Center

    Terepocki, Megan; Kruk, Richard S.; Willows, Dale M.

    2002-01-01

    A study investigated letter orientation confusions (reversals) in the reading and writing of 10 children with reading disabilities and 10 typical readers (age 10). Individuals with reading disability made more orientation confusions. Orientation errors were more frequent for reversible than for nonreversible items in tasks involving long-term…

  4. Facts about Developmental Disabilities

    MedlinePlus

    ... Children with kernicterus are more likely to have cerebral palsy, hearing and vision problems, and problems with their ... developmental disabilities, such as: ADHD , autism spectrum disorder , cerebral palsy , hearing loss , intellectual disability , learning disability, vision impairment , ...

  5. Rural People with Disabilities

    MedlinePlus

    ... with Disabilities in Rural Areas . What are the requirements of the Americans with Disabilities Act for small ... U.S. Equal Employment Opportunity Commission. What are the requirements of the Americans with Disabilities Act for local ...

  6. What Are Learning Disabilities?

    MedlinePlus

    ... Research Information Clinical Trials Resources and Publications Learning Disabilities: Condition Information Skip sharing on social media links Share this: Page Content What are learning disabilities? Learning disabilities are conditions that affect how a ...

  7. Sexuality and Intellectual Disability

    MedlinePlus

    ... Curiae Briefs Legislative Goals Consortium for Citizens with Disabilities National Goals 2015 SIS Product Information Benefits of ... SIS Use Order SIS-A Contact Us Intellectual Disability Historical Context Definition FAQs on Intellectual Disability Diagnostic ...

  8. Vasectomy reversal.

    PubMed

    Belker, A M

    1987-02-01

    A vasovasostomy may be performed on an outpatient basis with local anesthesia, but also may be performed on an outpatient basis with epidural or general anesthesia. Local anesthesia is preferred by most of my patients, the majority of whom choose this technique. With proper preoperative and intraoperative sedation, patients sleep lightly through most of the procedure. Because of the length of time often required for bilateral microsurgical vasoepididymostomy, epidural or general anesthesia and overnight hospitalization are usually necessary. Factors influencing the preoperative choice for vasovasostomy or vasoepididymostomy in patients undergoing vasectomy reversal are considered. The preoperative planned choice of vasovasostomy or vasoepididymostomy for patients having vasectomy reversal described herein does not have the support of all urologists who regularly perform these procedures. My present approach has evolved as the data reported in Tables 1 and 2 have become available, but it may change as new information is evaluated. However, it offers a logical method for planning choices of anesthesia and inpatient or outpatient status for patients undergoing vasectomy reversal procedures. PMID:3811050

  9. Reproductive success and contaminants in tree swallows (Tachycineta bicolor) breeding at a wastewater treatment plant.

    PubMed

    Dods, Patti L; Birmingham, Erinn M; Williams, Tony D; Ikonomou, Michael G; Bennie, Donald T; Elliott, John E

    2005-12-01

    The uptake and effects of contaminants were measured in the insectivorous tree swallow (Tachycineta bicolor) at a wastewater treatment site. The study examined reproductive, immunological, and growth endpoints in tree swallows exposed to chlorinated hydrocarbon contaminants and to 4-nonylphenol in wastewater lagoons at the Iona Wastewater Treatment Plant, Vancouver (BC, Canada). Clutch size was significantly lower in tree swallows breeding at Iona Island in 2000 and 2001 compared to the reference site. In 2000, fledging success was significantly lower and mean mass of nestling livers was significantly higher in the tree swallows breeding at the Iona Island Wastewater Treatment Plant. Additional factors that may influence reproductive success, such as parental provisioning and diet composition, did not differ significantly between sites. Levels of 4-nonylphenol detected in sediment and insects were elevated at the Iona Island Wastewater Treatment Plant (2000: lagoon sediment 82,000 ng/g dry wt, insects 310 ng/g wet wt; 2001: lagoon sediment 383,900 ng/g dry wt, insects 156 ng/g wet wt) compared to the reference site (2000: pond sediment 1,100 ng/g dry wt, insects not sampled; 2001: pond sediment 642 ng/g dry wt, insects 98 ng/g wet wt). These results indicate that tree swallows might be a useful indicator species for exposure to 4-nonylphenol at wastewater treatment sites: however, further work is necessary to determine the extent of uptake and effects of 4-nonylphenol in riparian insectivorous birds. PMID:16445092

  10. Barium swallow study in routine clinical practice: a prospective study in patients with chronic cough*,**

    PubMed Central

    Nin, Carlos Shuler; Marchiori, Edson; Irion, Klaus Loureiro; Paludo, Artur de Oliveira; Alves, Giordano Rafael Tronco; Hochhegger, Daniela Reis; Hochhegger, Bruno

    2013-01-01

    OBJECTIVE: To assess the routine use of barium swallow study in patients with chronic cough. METHODS: Between October of 2011 and March of 2012, 95 consecutive patients submitted to chest X-ray due to chronic cough (duration > 8 weeks) were included in the study. For study purposes, additional images were obtained immediately after the oral administration of 5 mL of a 5% barium sulfate suspension. Two radiologists systematically evaluated all of the images in order to identify any pathological changes. Fisher's exact test and the chi-square test for categorical data were used in the comparisons. RESULTS: The images taken immediately after barium swallow revealed significant pathological conditions that were potentially related to chronic cough in 12 (12.6%) of the 95 patients. These conditions, which included diaphragmatic hiatal hernia, esophageal neoplasm, achalasia, esophageal diverticulum, and abnormal esophageal dilatation, were not detected on the images taken without contrast. After appropriate treatment, the symptoms disappeared in 11 (91.6%) of the patients, whereas the treatment was ineffective in 1 (8.4%). We observed no complications related to barium swallow, such as contrast aspiration. CONCLUSIONS: Barium swallow improved the detection of significant radiographic findings related to chronic cough in 11.5% of patients. These initial findings suggest that the routine use of barium swallow can significantly increase the sensitivity of chest X-rays in the detection of chronic cough-related etiologies. PMID:24473762