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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 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 ...

  6. 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 ...

  7. 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 ...

  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. 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

  15. 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.

  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. 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 ...

  3. 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 ...

  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. 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…

  9. [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

  10. 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

  11. 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

  12. 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,…

  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. 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…

  9. 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…

  10. 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…

  11. 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…

  12. 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…

  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. 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

  4. 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

  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. 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

  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. 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...

  10. 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

  11. 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

  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. 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

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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

  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. 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

  8. 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

  9. 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…

  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. 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:…

  15. 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...

  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. 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…

  18. 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

  19. 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

  20. 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

  1. 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…

  2. 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.

  3. 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…

  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. 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

  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. 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

  18. 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

  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. 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

  11. 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

  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. 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...

  2. 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…

  3. 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…

  4. 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…

  5. 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...

  6. 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…

  7. 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...

  8. 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...

  9. 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…

  10. 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…

  11. 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…

  12. 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...

  13. 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

  14. 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.…

  15. 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,…

  16. 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 ...

  17. 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…

  18. 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

  19. 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

  20. 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...

  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. 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.

  3. 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

  4. 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

  5. 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

  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. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

  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. 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 ...

  12. 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 ...

  13. 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…

  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. 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

  18. 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

  19. 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.

  20. 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

  1. 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

  2. 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

  3. 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.

  4. 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

  5. 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)

  6. 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

  7. 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

  8. 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

  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. 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

  11. 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

  12. 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

  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. 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.

  17. 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

  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. 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 , ...

  4. 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 ...

  5. 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 ...

  6. 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 ...

  7. 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…

  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. 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

  10. Altered swallowing function in elderly patients without dysphagia: radiologic findings in 56 cases.

    PubMed

    Ekberg, O; Feinberg, M J

    1991-06-01

    Swallowing disorder is an increasing problem in our aging population. A majority of these patients have a functional abnormality of the oral, pharyngeal, and/or esophageal stage of swallowing. However, what constitutes normalcy is not well understood, and baseline swallowing in elderly persons without dysphagia has not been adequately described. We therefore evaluated 56 persons with a mean age of 83 years who had no symptoms of dysphagia or eating difficulty. Videofluoroscopy and radiographs with the subject erect and recumbent were obtained. Normal deglutition, as defined in young persons, was present in only 16%. Oral abnormalities (difficulty ingesting, controlling, and delivering bolus relative to swallowing initiation) were seen in 63%. Pharyngeal dysfunction (bolus retention and lingual propulsion or pharyngeal constrictor paresis) was seen in 25%. Pharyngoesophageal segment abnormalities were observed in 39% (mostly cricopharyngeal muscle dysfunction). Esophageal abnormalities (mostly motor in nature) were observed in 36%. What has been described as swallowing dysfunction in young persons may not be abnormal in very elderly persons. It is difficult to distinguish the effect of normal aging from the effects of specific diseases or gradual degenerative changes. PMID:2028863

  11. Analysis of Video Fluoroscopic Swallowing Study in Patients with Vocal Cord Paralysis

    PubMed Central

    Jang, Yoon Young; Lee, Sang Jun; Jeon, Jae Yong

    2013-01-01

    We reviewed the findings of a video fluoroscopic swallowing study (VFSS) of 28 patients with vocal cord paralysis (VCP) who complained of swallowing difficulties. VFSSs were performed with thick and thin liquid using modified Logemann methods. The patients were grouped according to whether their VCP was of central or peripheral origin, and the VFSS findings of the groups were compared. The patients showed oral phase dysfunction and pharyngeal dysfunction, especially when the cause was of central origin. Oral phase abnormalities were found in 13 patients and pharyngeal phase abnormalities were found in all patients, including penetration in 20 patients and aspiration in 14 patients. Improper lip closure (LC) and bolus formation (BF) and a delay in triggering pharyngeal swallow (TPS) and upper esophageal sphincter release (UESR) were significantly more frequent in patients with central VCP. With thin-liquid swallowing, pharyngeal transit time (PTT) and pharyngeal delay time (PDT) were significantly more prolonged in central VCP. The results suggest that the delay in triggering and poor coordination of swallowing were profound in patients with central VCP, but dysfunction in peripheral VCP may originate from poor pharyngeal movement. PMID:21773847

  12. Experimental infection of cliff swallows (Petrochelidon pyrrhonota) with varying doses of West Nile virus

    USGS Publications Warehouse

    Oesterle, P.T.; Nemeth, N.M.; VanDalen, Kaci K.; Sullivan, H.; Bentler, K.T.; Young, G.R.; McLean, R.G.; Clark, L.; Smeraski, C.; Hall, J.S.

    2009-01-01

    Cliff swallows (Petrochelidon pyrrhonota) were inoculated with differing doses of West Nile virus (WNV) to evaluate their potential role as reservoir hosts in nature. Swallows often nest in large colonies in habitats and months associated with high mosquito abundance and early WNV transmission in North America. Additionally, cliff swallow diet consists of insects, including mosquitoes, leading to an additional potential route of WNV infection. The average peak viremia titer among infected cliff swallows was 106.3 plaque-forming units (PFU)/mL serum and the reservoir competence index was 0.34. There was no correlation between dose and probability of becoming infected or viremia peak and duration. Oral shedding was detected from 2 to 14 days post-inoculation with an average peak titer of 1044 PFU/swab. These results suggest that cliff swallows are competent reservoir hosts of WNV and therefore, they may play a role in early seasonal amplification and maintenance of WNV. Copyright ?? 2009 by The American Society of Tropical Medicine and Hygiene.

  13. Automatic Detection of Swallowing Events by Acoustical Means for Applications of Monitoring of Ingestive Behavior

    PubMed Central

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

    2010-01-01

    Our understanding of etiology of obesity and overweight is incomplete due to lack of objective and accurate methods for Monitoring of Ingestive Behavior (MIB) in the free living population. Our research has shown that frequency of swallowing may serve as a predictor for detecting food intake, differentiating liquids and solids, and estimating ingested mass. This paper proposes and compares two methods of acoustical swallowing detection from sounds contaminated by motion artifacts, speech and external noise. Methods based on mel-scale Fourier spectrum, wavelet packets, and support vector machines are studied considering the effects of epoch size, level of decomposition and lagging on classification accuracy. The methodology was tested on a large dataset (64.5 hours with a total of 9,966 swallows) collected from 20 human subjects with various degrees of adiposity. Average weighted epoch recognition accuracy for intra-visit individual models was 96.8% which resulted in 84.7% average weighted accuracy in detection of swallowing events. These results suggest high efficiency of the proposed methodology in separation of swallowing sounds from artifacts that originate from respiration, intrinsic speech, head movements, food ingestion, and ambient noise. The recognition accuracy was not related to body mass index, suggesting that the methodology is suitable for obese individuals. PMID:19789095

  14. Swallowing kinematics and airway protection after palatal local anesthesia in infant pigs

    PubMed Central

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

    2015-01-01

    Objective Abnormal kinematics during swallowing can result in aspiration which may become life threatening. We tested the role of palatal sensation in the motor control of pharyngeal swallow in infants. Study Design In eight infant pigs, we reduced palatal sensation using local anesthesia (PLA) and measured the impact on swallowing kinematics and airway protection. Methods The pigs drank milk containing barium while we simultaneously recorded videofluoroscopy and electromyography from fine wire bipolar electrodes in several hyolaryngeal muscles. We compared these results to control feedings and feedings following palatal saline injections (PSA). Results After PLA, four pigs had extreme jaw movements and abnormal tongue movement uncharacteristic of sucking. For this reason, we evaluated differences between these “Group B” pigs and the others that could suck normally after PLA, “Group A”. In the four Group A pigs, after PLA there was less hyoid elevation (p<0.001) but normal jaw and tongue movements. In Group B, in addition to greater jaw movement (p<0.001) there was more anterior and superior tongue movement (p<0.001) and a larger range of hyoid movement (p<0.001) Conclusion The airway was protected in all of the pigs, indicating that these changes allowed successful adaptation to the reduction in palatal sensation. However, the oral and pharyngeal phases of the swallow were functionally linked and trigeminal sensation influenced the motor control of the pharyngeal swallow. PMID:23686446

  15. 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

  16. Reliability for Identification of a Select Set of Temporal and Physiologic Features of Infant Swallows.

    PubMed

    Gosa, Memorie M; Suiter, Debra M; Kahane, Joel C

    2015-06-01

    There is little reported evidence regarding the reliability of temporal and physiologic features of infant swallowing from videofluoroscopic swallowing studies (VFSS). The purpose of this retrospective study was to determine a reliable set of temporal and physiologic features from infant swallowing that can be measured from analysis of VFSS. Temporal and physiologic features for testing were determined from review of previously reported features of infant VFSS in the literature. Two novel analysts underwent three training sessions to learn and practice visual recognition of the proposed features. The two analysts then assessed 25 swallows from 10 total subjects' VFSS. To establish inter- and intra-rater reliability, calculation of Pearson's r was used for features that met criteria for parametric analysis and Spearman's rank correlation coefficient was used for the non-continuous features. Percent agreement was used to report on the reliability of the dichotomous features due to insufficient variability for Spearman's rho analyses. Fifteen of the 16 tested features were found to have acceptable inter- and intra-rater reliability measures, with each analyst achieving a correlation of 0.75 or higher. This project identifies 15 variables that can be reliably measured from infant VFSS. This information can be used to assist with determination of normal versus abnormal swallow features and in developing and testing therapeutic strategies for infants with dysphagia. PMID:25840787

  17. ORAL AND NONORAL SENSORIMOTOR INTERVENTIONS FACILITATE SUCK-SWALLOW-RESPIRATION FUNCTIONS AND THEIR COORDINATION IN PRETERM INFANTS

    PubMed Central

    Fucile, Sandra; McFarland, David H; Gisel, Erika G; Lau, Chantal

    2011-01-01

    Background Preterm infants are at high risk of encountering oral feeding difficulties. Early sensorimotor interventions may improve oral feeding skills in preterm infants. Aim To further explore the effects of an oral (O), tactile/kinesthetic (T/K), and combined (O+T/K) sensorimotor intervention on preterm infants’ nutritive sucking, swallowing and their coordination with respiration. Study design Seventy-five infants (29 [0.3, standard error of mean, SEM] weeks gestation, 49 males/26 females) were randomly assigned to an O group involving sensorimotor input to the oral structures; a T/K group involving sensorimotor input to the trunk and limbs; a combined (O+T/K) group; and a control group. Outcome measures Stage of sucking, suction and expression amplitudes (mmHg), suck-swallow ratio, stability of suck-swallow interval, and swallow-respiration patterns. Results The O group had significantly more advanced sucking stages, and greater suction and expression amplitudes than controls [p≤0.035, effect size (ES) >0.6]. The suck-swallow ratio and stability of suck-swallow intervals did not significantly differ among groups (p≥0.181, ES≤0.3). The three interventions led to fewer swallows bracketed by prolonged respiratory pauses compared to controls (pause-swallow-pause, p≤0.044, ES≥0.7). The T/K and combined (O+T/K) groups had greater occurrence of swallows bracketed by expiration than the control and O groups (expiration-swallow-expiration, p≤0.039, ES ≥0.3) Conclusion The O intervention enhanced specific components of nutritive sucking. All three interventions resulted in improved swallow-respiration coordination. Sensorimotor interventions have distributed beneficial effects that go beyond the specific target of input. PMID:21962771

  18. Forward acoustic performance of a shock-swallowing high-tip-speed fan (QF-13)

    NASA Technical Reports Server (NTRS)

    Lucas, J. G.; Woodward, R. P.; Mackinnon, M. J.

    1980-01-01

    Forward noise and overall aerodynamic performance data are presented for a high-tip-speed fan having rotor blade airfoils designed to alter the conventional leading-edge bow shocks to weak, oblique shocks which are swallowed within the interblade channels. It was anticipated that the swallowed shocks would minimize the generation of multiple-pure-tone noise. In the speed range where the shocks presumably were swallowed, the multiple-tone noise was lowered only about 3 decibels. Comparison with several high-speed fans on a thrust-corrected basis indicates that the present fan was the quietest in total forward noise at low speeds but offered no advantage at high speeds.

  19. Aerodynamic heating on 3-D bodies including the effects of entropy-layer swallowing

    NASA Technical Reports Server (NTRS)

    Dejarnette, F. R.; Hamilton, H. H.

    1974-01-01

    A relatively simple method was developed previously (authors, 1973) for calculating laminar, transitional, and turbulent heating rates on three-dimensional bodies in hypersonic flows. This method was shown to yield reasonably accurate results for laminar heating on blunted circular and elliptical cones and an earlier version of the space shuttle vehicle. As the boundary layer along the surface grows, more and more of the inviscid-flow mass is entrained into the boundary layer, and the streamlines which passed through the nearly normal portion of the bow shock wave are 'swallowed' by the boundary layer. This phenomenon is often referred to as entropy-layer or streamline swallowing, and it can have a significant effect on the calculated heating rates. An approximate, yet simple, method for including the effects of entropy-layer swallowing in the heating-rate calculations is given.

  20. Early Identification and Treatment of Communication and Swallowing Deficits in Parkinson Disease

    PubMed Central

    Ciucci, Michelle R.; Grant, Laura M.; Paul Rajamanickam, Eunice S.; Hilby, Breanna L.; Blue, Katherine V.; Jones, Corinne A.; Kelm-Nelson, Cynthia A.

    2015-01-01

    Parkinson disease (PD) is a complex, progressive, neurodegenerative disorder that leads to a wide range of deficits including fine and gross sensorimotor impairment, autonomic dysfunction, mood disorders, and cognitive decline. Traditionally, the focus for diagnosis and treatment has been on sensorimotor impairment related to dopamine depletion. It is now widely recognized, however, that PD-related pathology affects multiple central nervous system neurotransmitters and pathways. Communication and swallowing functions can be impaired even in the early stages, significantly affecting health and quality of life. The purpose of this article is to review the literature on early intervention for communication and swallowing impairment in PD. Overarching themes were that (1) studies and interpretation of data from studies in early PD are limited; (2) best therapy practices have not been established, in part due to the heterogeneous nature of PD; and (3) as communication and swallowing problems are pervasive in PD, further treatment research is essential. PMID:24166192

  1. Quantifying swallowing function for healthy adults in different age groups using acoustic analysis

    NASA Astrophysics Data System (ADS)

    Leung, Man-Yin

    Dysphagia is a medical condition that can lead to devastating complications including weight loss, aspiration pneumonia, dehydration, and malnutrition; hence, timely identification is essential. Current dysphagia evaluation tools are either invasive, time consuming, or highly dependent on the experience of an individual clinician. The present study aims to develop a non-invasive, quantitative screening tool for dysphagia identification by capturing acoustic data from swallowing and mastication. The first part of this study explores the feasibility of using acoustic data to quantify swallowing and mastication. This study then further identifies mastication and swallowing trends in a neurotypical adult population. An acoustic capture protocol for dysphagia screening is proposed. Finally, the relationship among speaking, lingual and mastication rates are explored. Results and future directions are discussed.

  2. Swallowing disorders in tracheostomised patients: a multidisciplinary/multiprofessional approach in decannulation protocols

    PubMed Central

    2014-01-01

    Safe removal of tracheal cannula is a major goal in the rehabilitation of tracheostomised patients to achieve progressive independence from mechanical support and reduce the risk of respiratory complications. A tracheal cannula may also cause significant discomfort to the patient, making verbal communication difficult. Particularly when cuffed, tracheal cannula reduces the normal movement of the larynx which can further compromise the basic swallowing defect. A close connection between respiratory, phonating, swallowing and feeding abilities to be recovered, implies a strict integration among different professionals of the rehabilitation team. An appropriate management of tracheostomy cannula is closely connected with assessment and treatment of swallowing disorders in order to limit the development of severe pulmonary and nutritional complications, but at present there are no uniform protocols in the scientific literature. Furthermore, several studies report as an essential criterion for decannulation the presence of good patient consciousness, which is often altered in patients with tracheostomy, but a general agreement is lacking. PMID:25006457

  3. Vocalization removal for improved automatic segmentation of dual-axis swallowing accelerometry signals.

    PubMed

    Sejdić, Ervin; Falk, Tiago H; Steele, Catriona M; Chau, Tom

    2010-07-01

    Automatic segmentation of dual-axis swallowing accelerometry signals can be severely affected by strong vocalizations. In this paper, a method based on periodicity detection is proposed to detect and remove such vocalizations. Periodic signal components are detected using conventional speech processing techniques and information from both axes are combined to improve vocalization detection accuracy. Experiments with 408 healthy subjects performing dry, wet, and wet chin tuck swallows show that the proposed method attains an average 95.3% sensitivity and 96.3% specificity. When applied in conjunction with an automatic segmentation algorithm, it is observed that segmentation accuracy improves by approximately 55%. These results encourage further development of medical devices for the detection of swallowing difficulties. PMID:20483652

  4. Emergence and Performance of Two Swallow-wort Species on Soils of Varying pH and Origin

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Two alien vines, pale swallow-wort, (Vincetoxicum rossicum) and black swallow-wort (V. nigrum), are increasingly problematic invaders in the Northeastern U.S. and Southeastern Canada. These herbaceous perennial species aggressively colonize and rapidly dominate forest understories, old fields, rare...

  5. Nitric Oxide and Histamine Signal Attempts to Swallow: A Component of Learning that Food Is Inedible in "Aplysia"

    ERIC Educational Resources Information Center

    Katzoff, Ayelet; Miller, Nimrod; Susswein, Abraham J.

    2010-01-01

    Memory that food is inedible in "Aplysia" arises from training requiring three contingent events. Nitric oxide (NO) and histamine are released by a neuron responding to one of these events, attempts to swallow food. Since NO release during training is necessary for subsequent memory and NO substitutes for attempts to swallow, it was suggested that…

  6. Defining Swallowing-Related Quality of Life Profiles in Individuals with Amyotrophic Lateral Sclerosis

    PubMed Central

    Gaziano, Joy; Watts, Stephanie; Robison, Raele; Plowman, Emily K.

    2016-01-01

    Although it is known that dysphagia contributes to significant malnutrition, pneumonia, and mortality in amyotrophic lateral sclerosis (ALS), it remains unclear how swallowing impairment impacts quality of life in this vulnerable patient population. The aim of the current study was to (1) delineate swallow-related quality of life (SR-QOL) profiles in individuals with ALS and (2) evaluate relationships between SR-QOL, degree of swallowing impairment, and ALS global disease progression. Eighty-one ALS patients underwent a standardized videofluoroscopic swallow study and completed the swallowing quality of life (SWAL-QOL) instrument and ALS functional rating scale-revised (ALSFRS-R). Penetration Aspiration Scale (PAS) scores were derived by a blinded rater. Correlation analyses and a between groups ANOVA (safe vs. penetrators vs. aspirators) were performed. Mean SWAL-QOL score for this cohort was 75.94 indicating a moderate degree of SR-QOL impairment with fatigue, eating duration, and communication representing the most affected domains. Correlations were revealed between the SWAL-QOL and (1) PAS (r = −0.39, p < 0.001) and (2) ALSFRS-R (r = 0.23, p < 0.05). Mean (SD) SWAL-QOL scores for safe versus penetrator versus aspirator groups were 81.2 (2.3) versus 77 (3.4) versus 58.7 (5.9), respectively, with a main effect observed [F(2,78) = 9.71, p < 0.001]. Post hoc testing revealed lower SWAL-QOL scores for aspirators versus safe swallowers (p < 0.001) and aspirators versus penetrators (p < 0.001). Overall, SR-QOL was moderately reduced in this cohort of ALS patients and profoundly impacted in ALS aspirators and individuals with advanced disease. These findings highlight the importance of early multidisciplinary intervention to not only avoid malnutrition, weight loss, and pulmonary sequelae but also the associated reduced QOL seen in these individuals. PMID:26837611

  7. Impaired swallowing mechanics of post radiation therapy head and neck cancer patients: A retrospective videofluoroscopic study

    PubMed Central

    Pearson Jr, William G; Davidoff, Alisa A; Smith, Zachary M; Adams, Dorothy E; Langmore, Susan E

    2016-01-01

    AIM: To determine swallowing outcomes and hyolaryngeal mechanics associated with post radiation therapy head and neck cancer (rtHNC) patients using videofluoroscopic swallow studies. METHODS: In this retrospective cohort study, videofluoroscopic images of rtHNC patients (n = 21) were compared with age and gender matched controls (n = 21). Penetration-aspiration of the bolus and bolus residue were measured as swallowing outcome variables. Timing and displacement measurements of the anterior and posterior muscular slings elevating the hyolaryngeal complex were acquired. Coordinate data of anatomical landmarks mapping the action of the anterior muscles (suprahyoid muscles) and posterior muscles (long pharyngeal muscles) were used to calculate the distance measurements, and slice numbers were used to calculate time intervals. Canonical variate analysis with post-hoc discriminant function analysis was performed on coordinate data to determine multivariate mechanics of swallowing associated with treatment. Pharyngeal constriction ratio (PCR) was also measured to determine if weak pharyngeal constriction is associated with post radiation therapy. RESULTS: The rtHNC group was characterized by poor swallowing outcomes compared to the control group in regards to: Penetration-aspiration scale (P < 0.0001), normalized residue ratio scale (NRRS) for the valleculae (P = 0.002) and NRRS for the piriform sinuses (P = 0.003). Timing and distance measurements of the anterior muscular sling were not significantly different in the two groups, whereas for the PMS time of displacement was abbreviated (P = 0.002) and distance of excursion was reduced (P = 0.02) in the rtHNC group. A canonical variate analysis shows a significant reduction in pharyngeal mechanics in the rtHNC group (P < 0.0001). The PCR was significantly higher in the test group than the control group (P = 0.0001) indicating reduced efficiency in pharyngeal clearance. CONCLUSION: Using videofluoroscopy, this study shows

  8. Non-invasive monitoring of chewing and swallowing for objective quantification of ingestive behavior

    PubMed Central

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

    2008-01-01

    A methodology of studying of ingestive behavior by non-invasive monitoring of swallowing (deglutition) and chewing (mastication) has been developed. The target application for the developed methodology is to study the behavioral patterns of food consumption and producing volumetric and weight estimates of energy intake. Monitoring is non-invasive based on detecting swallowing by a sound sensor located over laryngopharynx or by a bone conduction microphone and detecting chewing through a below-the-ear strain sensor. Proposed sensors may be implemented in a wearable monitoring device, thus enabling monitoring of ingestive behavior in free living individuals. In this paper, the goals in the development of this methodology are two-fold. First, a system comprised of sensors, related hardware and software for multimodal data capture is designed for data collection in a controlled environment. Second, a protocol is developed for manual scoring of chewing and swallowing for use as a gold standard. The multi-modal data capture was tested by measuring chewing and swallowing in twenty one volunteers during periods of food intake and quiet sitting (no food intake). Video footage and sensor signals were manually scored by trained raters. Inter-rater reliability study for three raters conducted on the sample set of 5 subjects resulted in high average intra-class correlation coefficients of 0.996 for bites, 0.988 for chews, and 0.98 for swallows. The collected sensor signals and the resulting manual scores will be used in future research as a gold standard for further assessment of sensor design, development of automatic pattern recognition routines, and study of the relationship between swallowing/chewing and ingestive behavior. PMID:18427161

  9. Adapting Human Videofluoroscopic Swallow Study Methods to Detect and Characterize Dysphagia in Murine Disease Models

    PubMed Central

    Lever, Teresa E.; Braun, Sabrina M.; Brooks, Ryan T.; Harris, Rebecca A.; Littrell, Loren L.; Neff, Ryan M.; Hinkel, Cameron J.; Allen, Mitchell J.; Ulsas, Mollie A.

    2015-01-01

    This study adapted human videofluoroscopic swallowing study (VFSS) methods for use with murine disease models for the purpose of facilitating translational dysphagia research. Successful outcomes are dependent upon three critical components: test chambers that permit self-feeding while standing unrestrained in a confined space, recipes that mask the aversive taste/odor of commercially-available oral contrast agents, and a step-by-step test protocol that permits quantification of swallow physiology. Elimination of one or more of these components will have a detrimental impact on the study results. Moreover, the energy level capability of the fluoroscopy system will determine which swallow parameters can be investigated. Most research centers have high energy fluoroscopes designed for use with people and larger animals, which results in exceptionally poor image quality when testing mice and other small rodents. Despite this limitation, we have identified seven VFSS parameters that are consistently quantifiable in mice when using a high energy fluoroscope in combination with the new murine VFSS protocol. We recently obtained a low energy fluoroscopy system with exceptionally high imaging resolution and magnification capabilities that was designed for use with mice and other small rodents. Preliminary work using this new system, in combination with the new murine VFSS protocol, has identified 13 swallow parameters that are consistently quantifiable in mice, which is nearly double the number obtained using conventional (i.e., high energy) fluoroscopes. Identification of additional swallow parameters is expected as we optimize the capabilities of this new system. Results thus far demonstrate the utility of using a low energy fluoroscopy system to detect and quantify subtle changes in swallow physiology that may otherwise be overlooked when using high energy fluoroscopes to investigate murine disease models. PMID:25866882

  10. An audit of the quality of inpatient care for adults with learning disability in the UK

    PubMed Central

    Sheehan, Rory; Gandesha, Aarti; Hassiotis, Angela; Gallagher, Pamela; Burnell, Matthew; Jones, Glyn; Kerr, Michael; Hall, Ian; Chaplin, Robert; Crawford, Michael J

    2016-01-01

    Objectives To audit patient hospital records to evaluate the performance of acute general and mental health services in delivering inpatient care to people with learning disability and explore the influence of organisational factors on the quality of care they deliver. Setting Nine acute general hospital Trusts and six mental health services. Participants Adults with learning disability who received inpatient hospital care between May 2013 and April 2014. Primary and secondary outcome measures Data on seven key indicators of high-quality care were collected from 176 patients. These covered physical health/monitoring, communication and meeting needs, capacity and decision-making, discharge planning and carer involvement. The impact of services having an electronic system for flagging patients with learning disability and employing a learning disability liaison nurse was assessed. Results Indicators of physical healthcare (body mass index, swallowing assessment, epilepsy risk assessment) were poorly recorded in acute general and mental health inpatient settings. Overall, only 34 (19.3%) patients received any assessment of swallowing and 12 of the 57 with epilepsy (21.1%) had an epilepsy risk assessment. For most quality indicators, there was a non-statistically significant trend for improved performance in services with a learning disability liaison nurse. The presence of an electronic flagging system showed less evidence of benefit. Conclusions Inpatient care for people with learning disability needs to be improved. The work gives tentative support to the role of a learning disability liaison nurse in acute general and mental health services, but further work is needed to confirm these benefits and to trial other interventions that might improve the quality and safety of care for this high-need group. PMID:27091821

  11. Metal accumulation and metallothionein concentrations in tree swallow nestlings near acidified lakes

    SciTech Connect

    St. Louis, V.; Breebaart, L. . Dept. of Zoology); Barlow, J.C. . Dept. of Zoology Royal Ontario Museum, Toronto, Ontario . Dept. of Ornithology); Klaverkamp, J.F. . Dept. of Fisheries and Oceans)

    1993-07-01

    The authors studied metal accumulation in hepatic and renal tissues of tree swallow (Tachycineta bicolor) nestlings at acidified and nonacid reference lakes in northwestern Ontario. Hepatic concentrations of metallothionein (metal-binding proteins, MT) in tree swallow nestlings were negatively correlated with pH of the nest-site lake. Combined concentrations of Cu and Zn in the liver were correlated with liver MT concentrations, but Cd was not. Although no overt signs of metal toxicity were observed in nestlings near acid lakes, the results clearly provided evidence that metals are transferred from acid lakes to birds and that these metals are correlated with increases in hepatic MT production.

  12. Aortoesophageal Fistula and Aortic Pseudoaneurysm Induced by Swallowed Fish Bone: A Report of Two Cases

    SciTech Connect

    Chen Aiping Yu Hong; Li Huimin; Xiao Xiangsheng Liu Shiyuan

    2011-02-15

    Esophageal perforation caused by accidental swallowing of fish bones can lead to rare complications, such as aortoesophageal fistula accompanied by aortic pseudoaneurysm, which can be fatal if not properly handled. We report two rare cases of aortoesophageal fistula and aortic pseudoaneurysm caused by esophagus perforation after accidental swallow of fish bone; the patients also had purulent mediastinitis and esophagitis. The treatment of aortic pseudoaneurysm was successful in both cases, with one patient undergoing surgical resection and aortic neoplasty and the other patient undergoing endovascular stent graft placement. Long-term antibiotic treatment was administered to both patients after surgery. There were no postsurgical complications, and the patients recovered without incident.

  13. Association of sarcopenia with swallowing problems, related to nutrition and activities of daily living of elderly individuals

    PubMed Central

    Shiozu, Hiroyasu; Higashijima, Misako; Koga, Tomoshige

    2015-01-01

    [Purpose] The purpose of the current study was to clarify problems associated with swallowing, related to nutrition and activities of daily living (ADL), in elderly individuals with sarcopenia. [Subjects and Methods] Seventy-seven subjects were assigned to a sarcopenia or a non-sarcopenia group according to a definition used by the European Working Group on Sarcopenia in Older People. Analyses were conducted including and excluding subjects with a central nervous system disorders in order to focus on the influence of sarcopenia. The swallowing ability, ADL, and nutrition levels were compared between the 2 groups. [Results] Swallowing function as well as ADL and nutrition levels were significantly lower in the sarcopenia group than in the non-sarcopenia group. [Conclusion] It is important to include dimensions of swallowing, nutrition, and ADL in the assessment and treatment of swallowing problems in elderly individuals with sarcopenia. PMID:25729176

  14. SU-E-J-193: Application of Surface Mapping in Detecting Swallowing for Head-&-Neck Cancer

    SciTech Connect

    Cao, D; Xie, X; Mehta, V; Shepard, D

    2015-06-15

    Purpose: Recent evidence is emerging that long term swallowing function may be improved after radiotherapy for head-&-neck cancer if doses are limited to certain swallowing structures. Immobilization of patients with head-&-neck cancer is typically done with a mask. This mask, however, doesn’t limit patient swallowing. Patient voluntary or involuntary swallowing may introduce significant tumor motion, which can lead to suboptimal delivery. In this study, we have examined the feasibility of using surface mapping technology to detect patient swallowing during treatment and evaluated its magnitude. Methods: The C-RAD Catalyst system was used to detect the patient surface map. A volunteer lying on the couch was used to simulate the patient under treatment. A virtual marker was placed near the throat and was used to monitor the swallowing action. The target motion calculated by the Catalyst system through deformable registration was also collected. Two treatment isocenters, one placed close to the throat and the other placed posterior to the base-of-tongue, were used to check the sensitivity of surface mapping technique. Results: When the patient’s throat is not in the shadow of the patient’s chest, the Catalyst system can clearly identify the swallowing motion. In our tests, the vertical motion of the skin can reach to about 5mm. The calculated target motion can reach up to 1 cm. The magnitude of this calculated target motion is more dramatic when the plan isocenter is closer to the skin surface, which suggests that the Catalyst motion tracking technique is more sensitive to the swallowing motion with a shallower isocenter. Conclusion: Surface mapping can clearly identify patient swallowing during radiation treatment. This information can be used to evaluate the dosimetric impact of the involuntary swallowing. It may also be used to potentially gate head-&-neck radiation treatments. A prospective IRB approved study is currently enrolling patients in our

  15. A combined approach of bedside clinical examination and flexible endoscopic evaluation of swallowing in poststroke dysphagia: A pilot study

    PubMed Central

    Radhakrishnan, Sureshkumar; Menon, Unnikrishnan K; Anandakuttan, Anandkumar

    2013-01-01

    Background: As with most neurologic conditions, stroke involves impairment of the swallowing mechanism. This could be a spectrum of issues, the worst of which is aspiration. At the same time, the prolonged presence of a naso-gastric tube (NGT) has its own morbidity. Flexible endoscopic evaluation of swallowing (FEES) is one reliable method to assess the structural and functional status of the oropharynx and larynx, during the swallowing process. Objective: To study the utility of FEES in decision-making with respect to resumption of oral intake in stroke patients. To document the findings of FEES in stroke patients, and to look for correlations between these and the site of stroke. Materials and Methods: Protocol insertion of naso-gastric tube in all stroke patients, at presentation. Initial assessment by a neurologist and swallowing therapist, depending on cognitive status of the patient. All patients underwent MRI Brain with diffusion weighted sequences. After detailed clinical examination, they underwent swallow exercises under the supervision of a trained swallowing therapist. The decision to remove NGT was taken clinically by the combined decision of neurologist and swallowing therapist. Then all patients underwent FEES by the ENT surgeon. The final decision for NGT removal was taken as per the FEES findings. Result: Sixteen stroke patients underwent the FEES procedure during a period of six months. The oropharyngeal and laryngeal findings varied depending on the area of stroke involvement. Of these, change in decision regarding swallowing rehabilitation or NGT removal was needed in four patients, following the FEES findings. Conclusions: FEES is an easy, efficient and reliable method to evaluate the swallowing status in stroke patients. In combination with good bedside clinical examination and swallow exercises, it can be a good tool in assessing patients with post- stroke dysphagia. Post-stroke rehabilitation and prevention of aspiration pneumonia can be

  16. Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises.

    PubMed

    Kraaijenga, Sophie A C; van der Molen, Lisette; Jacobi, Irene; Hamming-Vrieze, Olga; Hilgers, Frans J M; van den Brekel, Michiel W M

    2015-11-01

    Concurrent chemoradiotherapy (CCRT) for advanced head and neck cancer (HNC) is associated with substantial early and late side effects, most notably regarding swallowing function, but also regarding voice quality and quality of life (QoL). Despite increased awareness/knowledge on acute dysphagia in HNC survivors, long-term (i.e., beyond 5 years) prospectively collected data on objective and subjective treatment-induced functional outcomes (and their impact on QoL) still are scarce. The objective of this study was the assessment of long-term CCRT-induced results on swallowing function and voice quality in advanced HNC patients. The study was conducted as a randomized controlled trial on preventive swallowing rehabilitation (2006-2008) in a tertiary comprehensive HNC center with twenty-two disease-free and evaluable HNC patients as participants. Multidimensional assessment of functional sequels was performed with videofluoroscopy, mouth opening measurements, Functional Oral Intake Scale, acoustic voice parameters, and (study specific, SWAL-QoL, and VHI) questionnaires. Outcome measures at 6 years post-treatment were compared with results at baseline and at 2 years post-treatment. At a mean follow-up of 6.1 years most initial tumor-, and treatment-related problems remained similarly low to those observed after 2 years follow-up, except increased xerostomia (68%) and increased (mild) pain (32%). Acoustic voice analysis showed less voicedness, increased fundamental frequency, and more vocal effort for the tumors located below the hyoid bone (n = 12), without recovery to baseline values. Patients' subjective vocal function (VHI score) was good. Functional swallowing and voice problems at 6 years post-treatment are minimal in this patient cohort, originating from preventive and continued post-treatment rehabilitation programs. PMID:25381096

  17. Endoscopic Removal of an Inadvertently Swallowed Toothbrush in the Emergency Department

    PubMed Central

    Harvey, Martyn; Cave, Grant; Prince, Gaynor

    2012-01-01

    A 16-year-old girl inadvertently swallowed a toothbrush during attempted manual induction of emesis. The 20 cm toothbrush was successfully removed via overtube facilitated endoscopy using a retractable snare while the patient was sedated in the emergency department. PMID:23326718

  18. Movie MRI at five frames a second for evaluation of speech and swallowing

    NASA Astrophysics Data System (ADS)

    Kumada, Masanobu; Mori, Koichi; Nakajima, Yasoichi; Nozaki, Seiji

    2001-05-01

    Magnetic resonance imaging (MRI) is a noninvasive imaging method that is widely used in the medical field. One of the limitations of MRI is its low time-resolution images of MRI are usually obtained as still images. Here we introduced a newly developed method of ``movie'' MRI with high time-resolution at five images a second. Its good application would include study and evaluation of speech and swallowing. Instrument: MRT-2001 XG with Software ver.5.5. (Toshiba). Coil: head QD coil for the tongue; CTL ARRY coil (3ch) for the neck, Imaging condition: sagital FFE2D; TR=2.8 ms TE=1.2 ms FA=10 deg Matrix=64×128 ST=10 mm NAQ=1 AV FOV=23×35 ; ROAFI; sequential acquisition. Maximum imaging length=51 s. A healthy Japanese male (Tokyo dialect speaker, 39 years). Task: Repetitive utterance of /tenten.../ and intentional swallowing of saliva. Results: In the task of /tenten..../, we could detect, in temporal order, velopharyngeal (VP) closure, opening of the tongue-palate (TP) closure, VP opening, TP closure, VP closure, and so on. In the swallowing task of saliva, we could detect movement of the tongue for conveying saliva to the pharynx, VP closure, backward movement of the tongue root, elevation and descent of the larynx in this temporal order. Our ``Movie MRI'' seemed promising for the noninvasive evaluation of speech and deglutition. Appropriate materials for swallowing evaluation will be presented.

  19. Pharyngeal Pressure Generation during Tongue-Hold Swallows across Age Groups

    ERIC Educational Resources Information Center

    Doeltgen, Sebastian H.; Macrae, Phoebe; Huckabee, Maggie-Lee

    2011-01-01

    Purpose: To compare the effects of the tongue-hold swallowing maneuver on pharyngeal pressure generation in healthy young and elderly research volunteers. Method: Sixty-eight healthy research volunteers (young, n = 34, mean age = 26.8 years, SD = 5.5; elderly, n = 34, mean age = 72.6 years, SD = 4.8; sex equally represented) performed 5…

  20. Tongue-Pressure and Hyoid Movement Timing in Healthy Liquid Swallowing

    ERIC Educational Resources Information Center

    Steele, Catriona; Sasse, Caroline; Bressmann, Tim

    2012-01-01

    It was hypothesized that tongue-palate pressure generation might directly facilitate hyoid movement in swallowing through the anatomical connections of the extrinsic tongue muscles. If true, non-invasive measures of tongue-palate pressure timing might serve as a proxy measure of hyoid excursion. The timing relationships between events in the…

  1. Perception of Wet Vocal Quality in Identifying Penetration/Aspiration during Swallowing

    ERIC Educational Resources Information Center

    Groves-Wright, Kathy Jean; Boyce, Suzanne; Kelchner, Lisa

    2010-01-01

    Purpose: In the present study, the authors investigated the association between wet vocal quality (WVQ) and prandial material in the larynx during phonation. The presence of such material is indicative of oropharyngeal dysphagia and results from entry of material into the laryngeal vestibule during swallowing. The primary aim of the study was to…

  2. Organochlorine contaminants and Tree Swallows along the Fox River and Green Bay, Wisconsin, USA

    USGS Publications Warehouse

    Custer, Christine M.; Custer, T.W.; Allen, P.D.; Stromborg, K.L.; Melancon, M.J.

    1999-01-01

    Green Bay, Wisconsin is contaminated with polychlorinated biphenyls (PCBs) however, whether these contaminants affect reproduction in insectivorous birds is unknown. Tree Swallows, Tachycineta bicolor, are secondary cavity nesters that will nest in boxes and tolerate handling. Because Tree Swallows are aquatic insectivores, residues in their tissues are primarily indicative of contaminants in sediments. We studied swallows at two contaminated and two reference colonies in 1993, 1994, and 1995 in the Green Bay area. Swallows at the two contaminated sites had significantly higher PCB levels in eggs when compared to two reference sites. Eggs from clutches that contained dead embryos had higher PCB concentrations than eggs from clutches where all eggs hatched; there were no contaminant effects overall on reproduction, however. Twelve-day-old nestlings at the two contaminated sites accumulated significantly more PCBs than did nestlings at the reference sites demonstrating that PCB contamination came from the local area. The PCB congener profile in 12-day-old nestlings mirrored the congener profile in their food.

  3. Reproductive success of barn swallows nesting near a selenium-contaminated lake in east Texas, USA

    USGS Publications Warehouse

    King, K.A.; Custer, T.W.; Weaver, D.A.

    1994-01-01

    Reproductive success and contaminant levels in 1986 and 1987 were compared between Barn Swallows nesting at selenium-contaminated Martin Lake, Texas, USA, and swallows nesting at a reference site. Nests were initiated about the same time or earlier at Martin Lake than at the reference site and clutch size was similar between the two locations. Nest success was significantly higher at Martin Lake than at the reference site and no embryo or chick deformities were documented. Selenium concentrations in 14 of 20 eggs from Martin Lake were above background (> 3 ppm, dry weight); two of 20 eggs contained > 5 ppm, a concentration associated with a 20% embryo mortality/deformity rate in some bird species. Selenium concentrations in the kidneys of adult swallows were higher at Martin Lake (mean = 14 ppm dry weight) than at the reference site (5.8 ppm). DDE, the only detected organochlorine compound, was in two of 10 eggs from Martin Lake; these concentrations were below those associated with chronic poisoning and reproductive problems. The maximum mercury concentration in livers of adult Barn Swallows (0.83 ppm, dry weight) was within the range for background levels (< 5 ppm).

  4. Reproductive success of barn swallows nesting near a selenium-contaminated lake in east Texas, USA

    USGS Publications Warehouse

    King, K.A.; Custer, T.W.; Weaver, D.A.

    1994-01-01

    Reproductive success and contaminant levels in 1986 and 1987 were compared between Barn Swallows nesting at selenium-contaminated Martin Lake, Texas, USA, and swallows nesting at a reference site. Nests were initiated about the same time or earlier at Martin Lake than at the reference site and clutch size was similar between the two locations. Nest success was significantly higher a Martin Lake than at the reference site and no embryo or chick deformities were documented. Selenium concentrations in 14 of 20 eggs from Martin Lake were above background ( gt 3 ppm, dry weight); two of 20 eggs contained gt 5 ppm, a concentration associated with a 20% embryo mortality/deformity rate in some bird species. Selenium concentrations in the kidneys of adult swallows were higher at Martin Lake (mean = 14 ppm dry weight) than at the reference site (5.8 ppm). DDE, the only detected organochlorine compound, was in two of 10 eggs from Martin Lake; these concentrations were below those associated with chronic poisoning and reproductive problems. The maximum mercury concentration in livers of adult Barn Swallows (0.83 ppm, dry weight) was within the range for background levels ( lt 5 ppm).

  5. Surface Electromyography for Speech and Swallowing Systems: Measurement, Analysis, and Interpretation

    ERIC Educational Resources Information Center

    Stepp, Cara E.

    2012-01-01

    Purpose: Applying surface electromyography (sEMG) to the study of voice, speech, and swallowing is becoming increasingly popular. An improved understanding of sEMG and building a consensus as to appropriate methodology will improve future research and clinical applications. Method: An updated review of the theory behind recording sEMG for the…

  6. Organochlorine contaminants and Tree Swallows along the Fox River and Green Bay, Wisconsin, USA

    USGS Publications Warehouse

    Custer, Christine M.; Custer, T.W.; Allen, P.D.; Stromborg, K.L.; Melancon, M.J.

    1998-01-01

    Green Bay, Wisconsin is contaminated with polychlorinated biphenyls (PCBs) however, whether these contaminants affect reproduction in insectivorous birds is unknown. Tree Swallows, Tachycineta bicolor, are secondary cavity nesters that will nest in boxes and tolerate handling. Because Tree Swallows are aquatic insectivores, residues in their tissues are primarily indicative of contaminants in sediments. We studied swallows at two contaminated and two reference colonies in 1993, 1994, and 1995 in the Green Bay area. Swallows at the two contaminated sites had significantly higher PCB levels in eggs when compared to two reference sites. Eggs from clutches that contained dead embryos had higher PCB concentrations than eggs from clutches where all eggs hatched; there were no contaminant effects overall on reproduction, however. Twelve-day-old nestlings at the two contaminated sites accumulated significantly more PCBs than did nestlings at the reference sites demonstrating that PCB contamination came from the local area. The PCB congener profile in 12-day-old nestlings mirrored the congener profile in their food.

  7. Chewing and food consistency: effects on bolus transport and swallow initiation.

    PubMed

    Saitoh, Eiichi; Shibata, Seiko; Matsuo, Koichiro; Baba, Mikoto; Fujii, Wataru; Palmer, Jeffrey B

    2007-04-01

    Preswallow bolus formation usually occurs in the mouth for liquids and in the oropharynx for solid foods. We examined the effect of chewing on the relationship between bolus transport and swallow initiation. Fifteen healthy subjects were imaged with lateral projection videofluorography while eating liquids, solid foods, and a mixture of liquid and solid foods in upright and facedown postures. Videotapes were reviewed to measure the location of the leading edge of the barium at swallow initiation. Chewing and initial consistency each altered the relationship between food transport and swallow initiation. In particular, when chewing liquid (or consuming foods with both liquid and solid phases), a portion of the food commonly reached the hypopharynx well before swallow onset. This transport to the hypopharynx was highly dependent on gravity, but transport to the valleculae for chewed solid food was active, depending primarily on tongue-palate contact. Chewing appeared to reduce the effectiveness of the posterior tongue-palate seal, allowing oral contents to spill into the pharynx. Consuming two-phase foods with both solid and liquid phases may increase the risk of aspiration in dysphagic individuals with impaired airway protective reflexes. PMID:17347905

  8. Effects of Dining on Tongue Endurance and Swallowing-Related Outcomes

    ERIC Educational Resources Information Center

    Kays, Stephanie A.; Hind, Jacqueline A.; Gangnon, Ronald E.; Robbins, JoAnne

    2010-01-01

    Purpose: The purpose of this study was to test the hypothesis that eating a meal reduces tongue strength and endurance in healthy old and young adults. It was predicted that older adults would show greater declines in tongue endurance while demonstrating higher perceived effort, longer meal durations, and clinical signs of swallowing difficulty.…

  9. A Continent-Wide Migratory Divide in North American Breeding Barn Swallows (Hirundo rustica).

    PubMed

    Hobson, Keith A; Kardynal, Kevin J; Van Wilgenburg, Steven L; Albrecht, Gretchen; Salvadori, Antonio; Cadman, Michael D; Liechti, Felix; Fox, James W

    2015-01-01

    Populations of most North American aerial insectivores have undergone steep population declines over the past 40 years but the relative importance of factors operating on breeding, wintering, or stopover sites remains unknown. We used archival light-level geolocators to track the phenology, movements and winter locations of barn swallows (Hirdundo rustica; n = 27) from populations across North America to determine their migratory connectivity. We identified an east-west continental migratory divide for barn swallows with birds from western regions (Washington State, USA (n = 8) and Saskatchewan, Canada (n = 5)) traveling shorter distances to wintering areas ranging from Oregon to northern Colombia than eastern populations (Ontario (n = 3) and New Brunswick (n = 10), Canada) which wintered in South America south of the Amazon basin. A single swallow from a stable population in Alabama shared a similar migration route to eastern barn swallows but wintered farther north in northeast Brazil indicating a potential leap frog pattern migratory among eastern birds. Six of 9 (67%) birds from the two eastern populations and Alabama underwent a loop migration west of fall migration routes including around the Gulf of Mexico travelling a mean of 2,224 km and 722 km longer on spring migration, respectively. Longer migration distances, including the requirement to cross the Caribbean Sea and Gulf of Mexico and subsequent shorter sedentary wintering periods, may exacerbate declines for populations breeding in northeastern North America. PMID:26065914

  10. Exposure and effects of perfluoroalkyl substances in tree swallows nesting in Minnesota and Wisconsin, USA

    EPA Science Inventory

    The exposure and effects of perfluoroalkyl substances (PFASs) were studied at eight locations in Minnesota and Wisconsin between 2007 and 2011 using tree swallows (Tachycineta bicolor) as sentinel species. These eight sites covered a range of possible exposure pathways and ecolog...

  11. Management of pale swallow-wort (Vincetoxicum rossicum) using mowing and herbicides in two contrasting habitats

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pale swallow-wort [PSW] (Vincetoxicum rossicum (Kleopow) Barbar.) is an invasive non-native vine that is increasing in prevalence in many natural and semi-natural areas of the northeastern U.S. and southeastern Canada. This herbaceous perennial thrives in old fields and ecotones but can also establi...

  12. First observation of African tigerfish Hydrocynus vittatus predating on barn swallows Hirundo rustica in flight.

    PubMed

    O'Brien, G C; Jacobs, F; Evans, S W; Smit, N J

    2014-01-01

    A population of African tigerfish Hydrocynus vittatus from the Schroda Dam, actively prey on barn swallows Hirundo rustica in flight. This behaviour was discovered during a radio telemetry study and documented using a motion picture video camera. These results show that an avivorous diet is a part of the feeding biology of H. vittatus, and may occur in other populations. PMID:24354922

  13. The Invasive Swallow-worts: What Do We Know About Their Biology and Management?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The swallow-worts [Vincetoxicum rossicum (Kleopow) Barbar. and V. nigrum (L.) Moench] are nonnative, perennial, herbaceous vines in the Apocynaceae that are invading natural areas in the northeastern U.S.A. and southeastern Canada. The species form dense monospecific stands across a wide range of mo...

  14. Impact of Hypena opulenta on invasive swallow-worts (Vincetoxicum spp.) under different light environments

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pale and black swallow-wort (Vincetoxicum rossicum and V. nigrum; Apocynaceae, subfamily Asclepiadoideae) are European viny milkweeds that have become invasive in many habitats in the northeastern U.S.A. and southeastern Canada. A defoliating moth from the Ukraine, Hypena opulenta (Christoph) (Lepid...

  15. Don't Swallow Benadryl Itch Stopping Gel: Use on Skin

    MedlinePlus

    ... swallowed. Read the “Drug Facts” box on the product’s label to identify active ingredients, directions for use, and ... the manufacturer, Johnson and Johnson, has changed the product label to add a new, prominent statement “For Skin ...

  16. The role of oral soft tissues in swallowing function: what can tongue pressure tell us?

    PubMed

    Kieser, J A; Farland, M G; Jack, H; Farella, M; Wang, Y; Rohrle, O

    2014-06-01

    Tongue pressure data taken from healthy subjects during normal oral activities such as mastication, speech and swallowing are providing us with new ways of understanding the role of the tongue in craniofacial growth and function. It has long been recognized that the sequential contact between the tongue and the palate plays a crucial role in the oropharyngeal phase of swallowing. However, because the focus of most research on intraoral pressure has been on the generation of positive pressure by the tongue on the hard palate and teeth, generation and coordination of absolute intraoral pressures and regional pressure gradients has remained unexplored. Ongoing research in our laboratory has uncovered highly variable individual pressure patterns during swallowing, which can nonetheless be divided into four stages: preparatory, primary propulsive, intermediate and terminal. These stages may further be sub-classified according to pressure patterns generated at the individual level as tipper or dipper patterns in the preparatory stage, roller or slapper in the primary propulsive and monophasic or biphasic during the intermediate stage. Interestingly, while an increase in bolus viscosity can result in significant changes to pressure patterns in some individuals, it has little effect in others. Highly individual responses to increased viscosity are also observed with swallowing duration. The above, together with other findings, have important implications for our understanding of the aetiology of widely differing conditions such as protrusive and retrusive malocclusions, dysphagia and sleep apnoea, as well as the development of novel food products. PMID:24152133

  17. An Energy Efficient MAC Protocol for Multi-Hop Swallowable Body Sensor Networks

    PubMed Central

    Lin, Lin; Yang, Chengfeng; Wong, Kai Juan; Yan, Hao; Shen, Junwen; Phee, Soo Jay

    2014-01-01

    Swallowable body sensor networks (BSNs) are composed of sensors which are swallowed by patients and send the collected data to the outside coordinator. These sensors are energy constraint and the batteries are difficult to be replaced. The medium access control (MAC) protocol plays an important role in energy management. This paper investigates an energy efficient MAC protocol design for swallowable BSNs. Multi-hop communication is analyzed and proved more energy efficient than single-hop communication within the human body when the circuitry power is low. Based on this result, a centrally controlled time slotting schedule is proposed. The major workload is shifted from the sensors to the coordinator. The coordinator collects the path-loss map and calculates the schedules, including routing, slot assignment and transmission power. Sensor nodes follow the schedules to send data in a multi-hop way. The proposed protocol is compared with the IEEE 802.15.6 protocol in terms of energy consumption. The results show that it is more energy efficient than IEEE 802.15.6 for swallowable BSN scenarios. PMID:25330049

  18. Development and reproduction of the foxglove aphid (Hemiptera: Aphididae) on invasive swallow-worts (Vincetoxicum spp.)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The foxglove aphid, Aulacorthum solani (Kaltenbach), was recently documented utilizing the invasive species pale and black swallow-wort (Vincetoxicum rossicum (Kleopow) Barbar. and V. nigrum (L.) Moench, respectively) as host plants. Because these are new host plant records for this polyphagous spec...

  19. Quantitative Lingual, Pharyngeal and Laryngeal Ultrasonography in Swallowing Research: A Technical Review

    ERIC Educational Resources Information Center

    Chi-Fishman, Gloria

    2005-01-01

    Because of its distinct advantage in radiation-free soft tissue imaging, ultrasonography has been widely used to study lingual, pharyngeal, hyoid, laryngeal, and even esophageal action during swallowing in individuals of all ages. Qualitative ultrasonographic observations have made considerable contributions to our understanding of deglutition.…

  20. Using Motor Learning Approaches for Treating Swallowing and Feeding Disorders: A Review

    ERIC Educational Resources Information Center

    Sheppard, Justine J.

    2008-01-01

    Purpose: This article discusses children's development of mature swallowing and feeding as a process of skill acquisition and considers the applicability of motor learning concepts for advancing these capabilities in school-aged children. Method: The motor learning literature was reviewed, with concentration on (a) concepts that are relevant for…

  1. A Continent-Wide Migratory Divide in North American Breeding Barn Swallows (Hirundo rustica)

    PubMed Central

    Hobson, Keith A.; Kardynal, Kevin J.; Van Wilgenburg, Steven L.; Albrecht, Gretchen; Salvadori, Antonio; Cadman, Michael D.; Liechti, Felix; Fox, James W.

    2015-01-01

    Populations of most North American aerial insectivores have undergone steep population declines over the past 40 years but the relative importance of factors operating on breeding, wintering, or stopover sites remains unknown. We used archival light-level geolocators to track the phenology, movements and winter locations of barn swallows (Hirdundo rustica; n = 27) from populations across North America to determine their migratory connectivity. We identified an east-west continental migratory divide for barn swallows with birds from western regions (Washington State, USA (n = 8) and Saskatchewan, Canada (n = 5)) traveling shorter distances to wintering areas ranging from Oregon to northern Colombia than eastern populations (Ontario (n = 3) and New Brunswick (n = 10), Canada) which wintered in South America south of the Amazon basin. A single swallow from a stable population in Alabama shared a similar migration route to eastern barn swallows but wintered farther north in northeast Brazil indicating a potential leap frog pattern migratory among eastern birds. Six of 9 (67%) birds from the two eastern populations and Alabama underwent a loop migration west of fall migration routes including around the Gulf of Mexico travelling a mean of 2,224 km and 722 km longer on spring migration, respectively. Longer migration distances, including the requirement to cross the Caribbean Sea and Gulf of Mexico and subsequent shorter sedentary wintering periods, may exacerbate declines for populations breeding in northeastern North America. PMID:26065914

  2. Barium versus Nonbarium Stimuli: Differences in Taste Intensity, Chemesthesis, and Swallowing Behavior in Healthy Adult Women

    ERIC Educational Resources Information Center

    Nagy, Ahmed; Steele, Catriona M.; Pelletier, Cathy A.

    2014-01-01

    Purpose: The authors examined the impact of barium on the perceived taste intensity of 7 different liquid tastant stimuli and the modulatory effect that these differences in perceived taste intensity have on swallowing behaviors. Method: Participants were 80 healthy women, stratified by age group (<40; >60) and genetic taste status…

  3. The Effects of Age and Preoral Sensorimotor Cues on Anticipatory Mouth Movement during Swallowing

    ERIC Educational Resources Information Center

    Shune, Samantha E.; Moon, Jerald B.; Goodman, Shawn S.

    2016-01-01

    Purpose: The aim of this study was to investigate the effects of preoral sensorimotor cues on anticipatory swallowing/eating-related mouth movements in older and younger adults. It was hypothesized that these cues are essential to timing anticipatory oral motor patterns, and these movements are delayed in older as compared with younger adults.…

  4. Family and Cultural Issues in a School Swallowing and Feeding Program

    ERIC Educational Resources Information Center

    Davis-McFarland, Elise

    2008-01-01

    Purpose: This article presents a rationale for speech-language pathologists (SLPs) to provide culturally competent evaluation, diagnostic, and intervention services for children with oral motor, swallowing, and feeding disorders in school settings. There is also a discussion of how changing American public school demographics necessitate the…

  5. Peer-Mediated Procedures to Induce Swallowing and Food Acceptance in Young Children.

    ERIC Educational Resources Information Center

    Greer, R. Douglas; And Others

    1991-01-01

    A peer modeling procedure was shown to induce swallowing in a young child with dysphagia, and to increase food acceptance in a young child who consistently declined food. A peer-mediated procedure, consisting of rotated opportunities to consume food with a peer, increased consumption more than did modeling alone. (Author/JDD)

  6. Dredging and contaminant exposure to tree swallows nesting on the upper Mississippi River

    USGS Publications Warehouse

    Custer, Thomas W.; Dummer, Paul; Custer, Christine M.; Warburton, David

    2013-01-01

    n 2008 and 2009, dredge material from the Mississippi River in Pool 8 south of Brownsville, Minnesota was used to construct nearby islands. Chemical analysis of sediment in 2001 and 2002 in the area to be dredged indicated detectable concentrations of organic and inorganic contaminants. Tree swallows (Tachycineta bicolor), whose diet is mainly aquatic invertebrates, were used to evaluate contaminant exposure in both the dredged and newly created habitat. Organic and inorganic contaminant data were collected from tree swallows in 2007 through 2010 at one study site near the dredging operation, a reference study site upriver from the dredging activity, one study site down river from the dredging activity, and one study site on a newly created island (2009 and 2010 only). Organic and element concentrations were at background levels in all samples. Polychlorinated biphenyl and p,p′-dichlorodiphenyldichloroethylene concentrations in tree swallow nestlings decreased at all study sites over the period 2007 to 2010 including the island study site between 2009 and 2010. Element concentrations in tree swallow livers for the non-island study sites did not show a trend among years in relation to the dredging. Selenium concentrations at the newly created island were higher and cadmium concentrations were lower in 2010 than 2009. Hatching success of eggs in successful nests was not associated with dredging activities.

  7. Dredging and contaminant exposure to tree swallows nesting on the upper Mississippi River.

    PubMed

    Custer, Thomas W; Dummer, Paul M; Custer, Christine M; Warburton, David

    2013-11-01

    In 2008 and 2009, dredge material from the Mississippi River in Pool 8 south of Brownsville, Minnesota was used to construct nearby islands. Chemical analysis of sediment in 2001 and 2002 in the area to be dredged indicated detectable concentrations of organic and inorganic contaminants. Tree swallows (Tachycineta bicolor), whose diet is mainly aquatic invertebrates, were used to evaluate contaminant exposure in both the dredged and newly created habitat. Organic and inorganic contaminant data were collected from tree swallows in 2007 through 2010 at one study site near the dredging operation, a reference study site upriver from the dredging activity, one study site down river from the dredging activity, and one study site on a newly created island (2009 and 2010 only). Organic and element concentrations were at background levels in all samples. Polychlorinated biphenyl and p,p'-dichlorodiphenyldichloroethylene concentrations in tree swallow nestlings decreased at all study sites over the period 2007 to 2010 including the island study site between 2009 and 2010. Element concentrations in tree swallow livers for the non-island study sites did not show a trend among years in relation to the dredging. Selenium concentrations at the newly created island were higher and cadmium concentrations were lower in 2010 than 2009. Hatching success of eggs in successful nests was not associated with dredging activities. PMID:23666121

  8. Swallowing sounds in speech therapy practice: a critical analysis of the literature.

    PubMed

    Ferrucci, Juliana Lopes; Mangilli, Laura Davison; Sassi, Fernanda Chiarion; Limongi, Suelly Cecilia Olivan; Andrade, Claudia Regina Furquim de

    2013-12-01

    This study aimed to investigate international scientific papers published on the subject of cervical auscultation and its use in speech therapy. The study involved a qualitative review of the literature spanning the last 10 years. Articles were selected from the PubMed database using the following keywords: cervical auscultation, swallowing and swallowing disorders. Research was included that was conducted on adult humans (over 18 years of age) and was written in English. Each citation retrieved from the database was analyzed independently by each of the study researchers to ascertain its relevance for inclusion in the study. The methodology involved formulating the research question, locating and selecting studies and critically evaluating the articles according to the precepts of the Cochrane Handbook. As a result, 35 studies were identified; 13 articles were analyzed because they allowed access to the full text and were related directly to the subject. We found that the studies were performed with groups of healthy subjects and subjects with different types of base pathology. Some studies compared the patterns found in the different groups. Some of the research sought to study the pattern of swallowing sounds with different factors - evaluator experience, the specificity and sensitivity of the method and how to improve the technique of cervical auscultation through the use of instruments other than the stethoscope. The conclusion of this critical analysis is that cervical auscultation is an important tool to be used in conjunction with other assessment methods in the routine clinical evaluation of swallowing. PMID:24488399

  9. An energy efficient MAC protocol for multi-hop swallowable body sensor networks.

    PubMed

    Lin, Lin; Yang, Chengfeng; Wong, Kai Juan; Yan, Hao; Shen, Junwen; Phee, Soo Jay

    2014-01-01

    Swallowable body sensor networks (BSNs) are composed of sensors which are swallowed by patients and send the collected data to the outside coordinator. These sensors are energy constraint and the batteries are difficult to be replaced. The medium access control (MAC) protocol plays an important role in energy management. This paper investigates an energy efficient MAC protocol design for swallowable BSNs. Multi-hop communication is analyzed and proved more energy efficient than single-hop communication within the human body when the circuitry power is low. Based on this result, a centrally controlled time slotting schedule is proposed. The major workload is shifted from the sensors to the coordinator. The coordinator collects the path-loss map and calculates the schedules, including routing, slot assignment and transmission power. Sensor nodes follow the schedules to send data in a multi-hop way. The proposed protocol is compared with the IEEE 802.15.6 protocol in terms of energy consumption. The results show that it is more energy efficient than IEEE 802.15.6 for swallowable BSN scenarios. PMID:25330049

  10. Swallowing and Dysphagia Rehabilitation: Translating Principles of Neural Plasticity into Clinically Oriented Evidence

    ERIC Educational Resources Information Center

    Robbins, JoAnne; Butler, Susan G.; Daniels, Stephanie K.; Gross, Roxann Diez; Langmore, Susan; Lazarus, Cathy L.; Martin-Harris, Bonnie; McCabe, Daniel; Musson, Nan; Rosenbek, John

    2008-01-01

    Purpose: This review presents the state of swallowing rehabilitation science as it relates to evidence for neural plastic changes in the brain. The case is made for essential collaboration between clinical and basic scientists to expand the positive influences of dysphagia rehabilitation in synergy with growth in technology and knowledge. The…

  11. Activity of bulbar respiratory neurons during fictive coughing and swallowing in the decerebrate cat.

    PubMed Central

    Oku, Y; Tanaka, I; Ezure, K

    1994-01-01

    1. The behaviour of medullary respiratory neurons was studied during fictive coughing and swallowing evoked by electrical stimulation of the superior laryngeal nerve (SLN) in decerebrate, paralysed and artificially ventilated cats. Fictive coughing, swallowing and respiration were monitored by recording activities of the phrenic, hypoglossal and abdominal nerves. 2. Extracellular recordings were made from respiratory neurons in the ventral respiratory group (VRG) and in the Bötzinger complex (BOT). The neuronal types analysed included decrementing inspiratory neurons (I-DEC), augmenting expiratory neurons (E-AUG) and decrementing expiratory neurons (E-DEC) from the BOT area, and augmenting inspiratory neurons (I-AUG) and augmenting expiratory neurons (E-AUG) from the VRG area. 3. During fictive coughing, all the inspiratory and expiratory neurons were active during the inspiratory and expiratory phases of coughing, respectively. The firing of both I-DEC and I-AUG neurons was increased and prolonged in association with the augmented inspiratory activity of the phrenic nerve. The activity of E-AUG neurons of the VRG did not parallel the abdominal nerve activity, suggesting the existence of additional neurons which participate in the generation of abdominal nerve activity during fictive coughing. 4. During fictive swallowing, half of I-DEC neurons fired transiently at the onset of hypoglossal bursts associated with swallowing; the firing was suppressed during the rest of the hypoglossal bursts. Other I-DEC neurons were silent during hypoglossal bursts. Some I-AUG neurons fired during the initial half of hypoglossal bursts, and others were silent. The brief phrenic activity accompanying the swallowing might have originated from this activity in I-AUG neurons. The discharges of all E-AUG neurons (BOT and VRG) and the majority of E-DEC BOT neurons were suppressed during swallowing. 5. We conclude that these five types of respiratory neurons of the BOT and VRG are

  12. The study on development of easily chewable and swallowable foods for elderly

    PubMed Central

    Kim, Soojeong

    2015-01-01

    BACKGROUND/OBJECTS When the functions involved in the ingestion of food occurs failure, not only loss of enjoyment of eating, it will be faced with protein-energy malnutrition. Dysmasesis and difficulty of swallowing occurs in various diseases, but it may be a major cause of aging, and elderly people with authoring and dysmasesis and difficulty of swallowing in the aging society is expected to increase rapidly. SUBJECTS/METHODS In this study, we carried out a survey targeting nutritionists who work in elderly care facilities, and examined characteristics of offering of foods for elderly and the degree of demand of development of easily chewable and swallowable foods for the elderly who can crush foods and take that by their own tongues, and sometimes have difficulty in drinking water and tea. RESULTS In elderly care facilities, it was found to provide a finely chopped food or ground food that was ground with water in a blender for elderly with dysmasesis. Elderly satisfaction of provided foods is appeared overall low. Results of investigating the applicability of foods for elderly and the reflection will of menus, were showed the highest response rate in a gelification method in molecular gastronomic science technics, and results of investigating the frequent food of the elderly; representative menu of beef, pork, white fish, anchovies and spinach, were showed Korean barbecue beef, hot pepper paste stir fried pork, pan fried white fish, stir fried anchovy, seasoned spinach were the highest offer frequency. CONCLUSIONS This study will provide the fundamentals of the development of easily chewable and swallowable foods, gelification, for the elderly. The study will also illustrate that, in the elderly, food undergone gelification will reduce the risk of swallowing down to the wrong pipe and improve overall food preference. PMID:26244082

  13. Effortful swallowing training combined with electrical stimulation in post-stroke dysphagia: a randomized controlled study.

    PubMed

    Park, Jin-Woo; Kim, Youngsun; Oh, Jong-Chi; Lee, Ho-Jun

    2012-12-01

    We tested the effect of effortful swallow combined with surface electrical stimulation used as a form of resistance training in post-stroke patients with dysphagia. Twenty post-stroke dysphagic patients were randomly divided into two groups: those who underwent effortful swallow with infrahyoid motor electrical stimulation (experimental group, n = 10) and effortful swallow with infrahyoid sensory electrical stimulation (control group, n = 10). In the experimental group, electrical stimulation was applied to the skin above the infrahyoid muscle with the current was adjusted until muscle contraction occurred and the hyoid bone was depressed. In the control group, the stimulation intensity was applied just above the sensory threshold. The patients in both groups were then asked to swallow effortfully in order to elevate their hyolaryngeal complex when the stimulation began. A total of 12 sessions of 20 min of training for 4 weeks were performed. Blinded biomechanical measurements of the extent of hyolaryngeal excursion, the maximal width of the upper esophageal sphincter (UES) opening, and the penetration-aspiration scale before and after training were performed. In the experimental group, the maximal vertical displacement of the larynx was increased significantly after the intervention (p < 0.05). The maximal vertical displacement of the hyoid bone and the maximal width of the UES opening increased but the increase was not found to be significant (p = 0.066). There was no increase in the control group. Effortful swallow training combined with electrical stimulation increased the extent of laryngeal excursion. This intervention can be used as a new treatment method in post-stroke patients with dysphagia. PMID:22447240

  14. Cliff swallows Petrochelidon pyrrhonota as bioindicators of environmental mercury, Cache Creek Watershed, California

    USGS Publications Warehouse

    Hothem, R.L.; Trejo, B.S.; Bauer, M.L.; Crayon, J.J.

    2008-01-01

    To evaluate mercury (Hg) and other element exposure in cliff swallows (Petrochelidon pyrrhonota), eggs were collected from 16 sites within the mining-impacted Cache Creek watershed, Colusa, Lake, and Yolo counties, California, USA, in 1997-1998. Nestlings were collected from seven sites in 1998. Geometric mean total Hg (THg) concentrations ranged from 0.013 to 0.208 ??g/g wet weight (ww) in cliff swallow eggs and from 0.047 to 0.347 ??g/g ww in nestlings. Mercury detected in eggs generally followed the spatial distribution of Hg in the watershed based on proximity to both anthropogenic and natural sources. Mean Hg concentrations in samples of eggs and nestlings collected from sites near Hg sources were up to five and seven times higher, respectively, than in samples from reference sites within the watershed. Concentrations of other detected elements, including aluminum, beryllium, boron, calcium, manganese, strontium, and vanadium, were more frequently elevated at sites near Hg sources. Overall, Hg concentrations in eggs from Cache Creek were lower than those reported in eggs of tree swallows (Tachycineta bicolor) from highly contaminated locations in North America. Total Hg concentrations were lower in all Cache Creek egg samples than adverse effects levels established for other species. Total Hg concentrations in bullfrogs (Rana catesbeiana) and foothill yellow-legged frogs (Rana boylii) collected from 10 of the study sites were both positively correlated with THg concentrations in cliff swallow eggs. Our data suggest that cliff swallows are reliable bioindicators of environmental Hg. ?? Springer Science+Business Media, LLC 2007.

  15. The effects of experimental lake acidification on the reproductive success of tree swallows

    SciTech Connect

    St. Louis, V.L.

    1992-01-01

    The effects of lake acidification on reproductive success of tree swallows (Tachycineta bicolor) breeding near experimentally acidified and unmanipulated reference lakes at the Experimental Lake Area (ELA) were studied. Tree swallows are aerial insectivores that commonly breed near water and forage on emergent insects. Predictions suggest that avian food abundance and quality may be altered due to acidification. Breeding swallows foraged on chironomids emerging at their nest-site lakes before searching for food elsewhere. Among the calcium-rich items consumed by the swallows, fish bones were most numerous, followed by crayfish exoskeleton, clam shell, and bird eggshell. We found significantly fewer calcium-rich items in the stomachs of nestlings from acid lakes than in those from reference lakes. Chironomid species were significantly more abundant in acid lakes, while the Chironominae were less numerous. Biomass of emerging chironomids either increased significantly following acidification, or was not different from that of reference lakes. Concentrations of Al, Ca, Mn, and Zn were on average higher in chironomids from a number of the acid lakes than in chironomids from reference lakes. Calcium concentrations in chironomids from the most acid lake were significantly lower, suggesting that Ca may be difficult to sequester at low pH levels. Hepatic concentrations of metallothioneins in tree swallow nestlings were negatively correlated with pH of the nest-site lake. Additive concentrations of Cu and Zn in the liver were correlated with liver MT concentrations, but Cd was not. Near acidified lakes, eggs were smaller in certain dimensions, hatching success was lower, certain nestling body characters were smaller, nestling wing length was shorter, and growth functions were different than near unmanipulated reference lakes. Clearly even non-aquatic organisms are affected by acidification of freshwater ecosystems.

  16. Biomarkers of exposure and effects of environmental contaminants on swallows nesting along the Rio Grande, Texas, USA

    USGS Publications Warehouse

    Mora, M.A.; Musquiz, D.; Bickham, J.W.; MacKenzie, D.S.; Hooper, M.J.; Szabo, J.K.; Matson, C.W.

    2006-01-01

    We collected adult cave swallows (Petrochelidon fulva) and cliff swallows (P. pyrrhonota) during the breeding seasons in 1999 and 2000 from eight locations along the Rio Grande from Brownsville to El Paso (unless otherwise specified, all locations are Texas, USA) and an out-of-basin reference location. Body mass, spleen mass, hepatosomatic index (HSI), gonadosomatic index (GSI), thyroxine (T4) in plasma, DNA damage measured as the half-peak coefficient of variation of DNA content (HPCV) in blood cells, as well as acetylcholinesterase and butyrylcholinesterase in brain were compared with concentrations of organochlorines, metals, and metalloids in carcasses to determine potential effects of contaminants on swallows during the breeding season. Concentrations of 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (p,p???-DDE) were significantly greater in swallows from El Paso than in those from most locations, except for Pharr and Llano Grande. All swallows from these three locations had p,p???-DDE concentrations of 3 ??g/g wet weight or greater. Swallows from El Paso either had or shared the highest concentrations of p,p???-DDE, polychlorinated biphenyls, and 13 inorganic elements. Swallows from El Paso exhibited greater spleen mass and HPCV values as well as lower T4 values compared with those from other locations. Thyroxine was a potential biomarker of contaminant exposure in swallows of the Rio Grande, because it was negatively correlated with p,p???-DDE and Se. Spleen mass was positively correlated with selenium and HSI and negatively correlated with body mass, GSI, Mn, and Ni. Overall, the present study suggests that insectivorous birds living in areas of high agricultural and industrial activity along the Rio Grande bioaccumulate environmental contaminants. These contaminants, particularly p,p???-DDE, may be among multiple factors that impact endocrine and hematopoietic function in Rio Grande swallows. ?? 2006 SETAC.

  17. Central orexin inhibits reflex swallowing elicited by the superior laryngeal nerve via caudal brainstem in the rat.

    PubMed

    Kobashi, Motoi; Mizutani, Satoshi; Fujita, Masako; Mitoh, Yoshihiro; Shimatani, Yuichi; Matsuo, Ryuji

    2014-05-10

    We examined the effects of orexins on the reflex swallowing using anesthetized rats. Orexins were administered into the fourth ventricle. Swallowing was induced by repeated electrical stimulation of the central cut end of the superior laryngeal nerve (SLN) and was identified by the electromyogram lead penetrated the mylohyoid muscle through bipolar electrodes. The frequency of swallowing during the electrical stimulation of the SLN decreased after the administration of orexin-A in a dose-dependent manner. The latency of the first swallowing tended to be extended after the administration of orexin-A. The administration of orexin-B did not affect swallowing frequency. Pre-administration of SB334867, an orexin-1 receptor antagonist, attenuated the degree of inhibition of swallowing frequency induced by the administration of orexin-A. To identify the effective site of orexin-A, the effect of a microinjection of orexin-A into the dorsal vagal complex (DVC) was evaluated. Orexin-A was injected into one of the lateral DVC, the intermediate DVC, or the medial DVC. Microinjection of orexin-A into the medial DVC but not the other two sites decreased swallowing frequency. Pre-injection of SB334867 into the medial DVC disrupted the inhibitory response induced by fourth ventricular administration of orexin-A. The electrical lesion of the commissural part of the NTS, but not ablation of the AP, abolished the inhibition of reflex swallowing induced by fourth ventricular administration of orexin-A. These results suggest that orexin-A inhibits reflex swallowing via orexin-1 receptors situated in the commissural part of the NTS and/or its vicinity. PMID:24637063

  18. Mobility disability and the urban built environment.

    PubMed

    Clarke, Philippa; Ailshire, Jennifer A; Bader, Michael; Morenoff, Jeffrey D; House, James S

    2008-09-01

    Research on the effects of the built environment in the pathway from impairment to disability has been largely absent. Using data from the Chicago Community Adult Health Study (2001-2003), the authors examined the effect of built environment characteristics on mobility disability among adults aged 45 or more years (n = 1,195) according to their level of lower extremity physical impairment. Built environment characteristics were assessed by using systematic social observation to independently rate street and sidewalk quality in the block surrounding each respondent's residence in the city of Chicago (Illinois). Using multinomial logistic regression, the authors found that street conditions had no effect on outdoor mobility among adults with only mild or no physical impairment. However, among adults with more severe impairment in neuromuscular and movement-related functions, the difference in the odd ratios for reporting severe mobility disability was over four times greater when at least one street was in fair or poor condition (characterized by cracks, potholes, or broken curbs). When all streets were in good condition, the odds of reporting mobility disability were attenuated in those with lower extremity impairment. If street quality could be improved, even somewhat, for those adults at greatest risk for disability in outdoor mobility, the disablement process could be slowed or even reversed. PMID:18667526

  19. What is an Intellectual Disability?

    MedlinePlus

    ... White House Lunch Recipes What Is an Intellectual Disability? KidsHealth > For Kids > What Is an Intellectual Disability? ... becoming an independent person. continue What Causes Intellectual Disabilities? Intellectual disabilities happen because the brain gets injured ...

  20. The violence of disablism.

    PubMed

    Goodley, Dan; Runswick-Cole, Katherine

    2011-05-01

    This article addresses the multi-faceted nature of violence in the lives of disabled people, with a specific focus on the accounts of disabled children and their families. Traditionally, when violence and disability have been considered together, this has emphasised the disabled subject whom inevitably exhibits violent challenging behaviour. Recently, however, more attention has been paid to violence experienced by disabled people, most notably in relation to hate crime. This article embraces theories that do not put the problems of disablism or violence back onto disabled people but magnify and expose processes of disablism that are produced in the relationships between people, which sometimes involve violence. This, we argue, means taking seriously the role of social relationships, institutions and culture in the constitution of violence. Disabled children, we argue, are enculturated by the violence of disablism. We follow Žižek's advice to step back from the obvious signals of violence to 'perceive the contours of the background which generates such outbursts', and identify four elements of the violence of disablism which we define as real, psychoemotional, systemic and cultural. We come to the conclusion that violence experienced by disabled children and their families says more about the dominant culture of disablism than it does of the acts of a few seemingly irrational, unreasonable, mean or violent individuals. We conclude that there is a need for extensive cultural deconstruction and reformation. PMID:21226732

  1. FacingDisability.com

    MedlinePlus

    ... About Blog Facing Disability Jeff Shannon Donate A Spinal Cord Injury Affects the Entire Family FacingDisability was specifically created ... and insights on spinal cord injury issues Interactive Spinal Cord Injury Map Shows what areas are affected by spinal ...

  2. Intellectual and Developmental Disabilities

    MedlinePlus

    ... Clinical Trials Resources and Publications Intellectual and Developmental Disabilities (IDDs): Overview Skip sharing on social media links Share this: Page Content Intellectual and developmental disabilities (IDDs) are a primary focus of the NICHD’s ...

  3. Enabling Disabled Students.

    ERIC Educational Resources Information Center

    Murphy, Diane Makar; Murphy, John T.

    1997-01-01

    The Americans with Disabilities Act requires reasonable accommodations for the disabled in public and private colleges and universities. Faculty must understand the difference between equal opportunity and equal treatment. Specific suggestions are made for teaching learning-disabled, mobility- impaired, visually-impaired, and hearing-impaired…

  4. Disability Accommodation Handbook.

    ERIC Educational Resources Information Center

    Flick-Hruska, Connie, Comp.; Blythe, Gretchen, Comp.

    Designed as a resource for two-year college faculty and staff working with students with disabilities, this handbook contains facts about various disabilities, practical suggestions for improving services, and resource points for further information. Following a brief introduction, legal implications regarding disabled students are discussed for…

  5. Integrating Disabled Children.

    ERIC Educational Resources Information Center

    Hanline, Mary Frances

    1985-01-01

    Discusses research on the effect of integrating disabled children into early childhood programs. Finds fears that nondisabled children will imitate the socially unacceptable behaviors of disabled children or will not make adequate progress to be unfounded. Social integration of disabled children was found to be dependent on the attitudes and…

  6. Work Disability in Appalachia.

    ERIC Educational Resources Information Center

    Greenwood, Judith

    This paper begins by examining the history of disability payments to disabled workers, specifically disability payments to coal workers. Efforts by the United Mine Workers of America made mine health and safety an issue in the 1960s, and continuing liberalization of the law continued through the 1970s. The identification of coal miners with…

  7. Social Psychoanalytic Disability Studies

    ERIC Educational Resources Information Center

    Goodley, Dan

    2011-01-01

    This paper explores connections and tensions between psychoanalysis and disability studies. The first part of the paper considers contemporaneous engagements with the psyche by a number of disability studies writers. These scholars have remained accountable to a politicised disability studies but have pushed for critical encounters with the…

  8. DISABILITY STATISTICS CENTER

    EPA Science Inventory

    The purpose of the Disability Statistics Center is to produce and disseminate statistical information on disability and the status of people with disabilities in American society and to establish and monitor indicators of how conditions are changing over time to meet their health...

  9. Substance Abuse and Disability.

    ERIC Educational Resources Information Center

    Sales, Amos

    A review of the literature provides the conclusion that individuals with a disability versus those without a disability are more likely to have a substance abuse problem and less likely to get effective treatment. Data suggest 10-40% of all individuals in treatment for substance abuse have a coexisting physical or mental disability. Alcohol rates…

  10. Disability and accommodation in the healthcare workplace.

    PubMed

    Niccolini, Robert R; Basu, Nina

    2009-04-01

    Employers in the healthcare industry face unique challenges regarding compliance with the Americans with Disabilities Act (ADA). Healthcare employers must reasonably accommodate employees in complex and often physically challenging positions, while ensuring safe and effective patient care. These challenges have become even more difficult with the recent passage of the ADA Amendments Act of 2008 (ADAAA), which significantly expands the definition and scope of "disability" under the ADA, and legislatively reverses several key Supreme Court decisions favorable to employers. Although the ultimate impact of the ADAAA remains to be determined, this article will help employers and their counsel understand how federal disability discrimination laws may affect their businesses going forward, with an analysis of the language of the ADAAA, case law under the ADA, and guidance from the Equal Employment Opportunity Commission (EEOC). PMID:19485027

  11. Defining Swallowing-Related Quality of Life Profiles in Individuals with Amyotrophic Lateral Sclerosis.

    PubMed

    Tabor, Lauren; Gaziano, Joy; Watts, Stephanie; Robison, Raele; Plowman, Emily K

    2016-06-01

    Although it is known that dysphagia contributes to significant malnutrition, pneumonia, and mortality in amyotrophic lateral sclerosis (ALS), it remains unclear how swallowing impairment impacts quality of life in this vulnerable patient population. The aim of the current study was to (1) delineate swallow-related quality of life (SR-QOL) profiles in individuals with ALS and (2) evaluate relationships between SR-QOL, degree of swallowing impairment, and ALS global disease progression. Eighty-one ALS patients underwent a standardized videofluoroscopic swallow study and completed the swallowing quality of life (SWAL-QOL) instrument and ALS functional rating scale-revised (ALSFRS-R). Penetration Aspiration Scale (PAS) scores were derived by a blinded rater. Correlation analyses and a between groups ANOVA (safe vs. penetrators vs. aspirators) were performed. Mean SWAL-QOL score for this cohort was 75.94 indicating a moderate degree of SR-QOL impairment with fatigue, eating duration, and communication representing the most affected domains. Correlations were revealed between the SWAL-QOL and (1) PAS (r = -0.39, p < 0.001) and (2) ALSFRS-R (r = 0.23, p < 0.05). Mean (SD) SWAL-QOL scores for safe versus penetrator versus aspirator groups were 81.2 (2.3) versus 77 (3.4) versus 58.7 (5.9), respectively, with a main effect observed [F(2,78) = 9.71, p < 0.001]. Post hoc testing revealed lower SWAL-QOL scores for aspirators versus safe swallowers (p < 0.001) and aspirators versus penetrators (p < 0.001). Overall, SR-QOL was moderately reduced in this cohort of ALS patients and profoundly impacted in ALS aspirators and individuals with advanced disease. These findings highlight the importance of early multidisciplinary intervention to not only avoid malnutrition, weight loss, and pulmonary sequelae but also the associated reduced QOL seen in these individuals. PMID:26837611

  12. [Aural Stimulation with Capsaicin Ointment Improved the Swallowing Function in Patients with Dysphagia: Evaluation by the SMRC Scale].

    PubMed

    Kondo, Eiji; Jinnouchi, Osamu; Ohnishi, Hiroki; Kawata, Ikuji; Takeda, Noriaki

    2015-11-01

    Cough and swallowing reflexes are important airway-protective mechanisms against aspiration. Angiotensin-converting enzyme (ACE) inhibitors, one of the side effects of which is cough, have been reported to reduce the incidence of aspiration pneumonia in hypertensive patients with stroke. ACE inhibitors have also been reported to improve the swallowing function in post-stroke patients. On the other hand, stimulation of the Arnold nerve, the auricular branch of the vagus, triggers the cough reflex (Arnold's ear-cough reflex). Capsaicin, an agonist of Transient Receptor Potential Vanilloid 1 (TRPV1), has been shown to activate the peripheral sensory C-fibers. Stimulation of the sensory branches of the vagus in the laryngotracheal mucosa with capsaicin induces the cough reflex and has been reported to improve the swallowing function in patients with dysphagia. In our previous study, we showed that aural stimulation of the Arnold nerve with 0.025% capsaicin ointment improved the swallowing function, as evaluated by the endoscopic swallowing score, in 26 patients with dysphagia. In the present study, the video images of swallowing recorded in the previous study were re-evaluated using the SMRC scale by an independent otolaryngologist who was blinded to the information about the patients and the endoscopic swallowing score. The SMRC scale is used to evaluate four aspects of the swallowing function: 1) Sensory: the initiation of the swallowing reflex as assessed by the white-out timing; 2) Motion: the ability to hold blue-dyed water in the oral cavity and induce laryngeal elevation; 3) Reflex: glottal closure and the cough reflex induced by touching the epiglottis or arytenoid with the endoscope; 4) Clearance: pharyngeal clearance of the blue-dyed water after swallowing. Accordingly, we demonstrated that a single application of capsaicin ointment to the external auditory canal of patients with dysphagia significantly improved the R, but not the S, M or C scores, and this

  13. Adapting Art Instruction for Students with Disabilities.

    ERIC Educational Resources Information Center

    Platt, Jennifer M.; Janeczko, Donna

    1991-01-01

    This article presents adaptations for teaching art to students with disabilities. Various techniques, methods, and materials are described by category of disability, including students with mental disabilities, visual impairments, hearing impairments, learning disabilities, emotional disabilities, and physical disabilities. (JDD)

  14. Effects of neuromuscular electrical stimulation combined with effortful swallowing on post-stroke oropharyngeal dysphagia: a randomised controlled trial.

    PubMed

    Park, J-S; Oh, D-H; Hwang, N-K; Lee, J-H

    2016-06-01

    Neuromuscular electrical stimulation (NMES) has been used as a therapeutic intervention for dysphagia. However, the therapeutic effects of NMES lack supporting evidence. In recent years, NMES combined with traditional swallowing therapy has been used to improve functional recovery in patients with post-stroke dysphagia. This study aimed to investigate the effects of effortful swallowing combined with neuromuscular electrical stimulation on hyoid bone movement and swallowing function in stroke patients. Fifty stroke patients with mild dysphagia who were able to swallow against the resistance applied by using NMES and cooperate actively in training were included. This study was designed as a 6-week single-blind, randomised, controlled study. In the experimental group, two pairs of electrodes were placed horizontally in the infrahyoid region to depress the hyoid bone. The NMES intensity was increased gradually until the participants felt a grabbing sensation in their neck and performed an effortful swallow during the stimulation. In the placebo group, the same procedure was followed except for the intensity, which was increased gradually until the participants felt an electrical sensation. All participants underwent this intervention for 30 min per session, 5 sessions per week, for 6 weeks. Videofluoroscopic swallowing studies (VFSS) were carried out before and after the intervention and kinematics of the hyoid bone and swallowing function were analysed based on the VFSS. The experimental group revealed a significant increase in anterior and superior hyoid bone movement and the pharyngeal phase of the swallowing function. This intervention can be used as a novel remedial approach in dysphagic stroke patients. PMID:26969528

  15. Concordance Between Aspiration Detected on Upper Gastrointestinal Series and Videofluoroscopic Swallow Study in Bottle-Fed Children.

    PubMed

    Flax-Goldenberg, Renee; Kulkarni, Kopal S; Carson, Kathryn A; Pinto, Jeanne M; Martin-Harris, Bonnie; Lefton-Greif, Maureen A

    2016-08-01

    The increasing incidence of pediatric dysphagia has raised questions about how to identify children at risk for aspiration. Multiple investigative imaging modalities are considered in diagnostic algorithms, since dysphagia may involve any or all phases of swallowing. Although upper gastrointestinal (UGI) series and videofluoroscopic swallow study (VFSS) are common procedures, the utility of UGI for detection of aspiration and the impact of oropharyngeal imaging during UGI on radiation exposure have not been well described. We hypothesized that diagnosis of aspiration on UGI would be predictive of aspiration on VFSS and screening swallows during UGI would increase radiation exposure. A retrospective review was completed of bottle-fed children undergoing UGI series within 1 month before/after standardized VFSS. UGI was imaged at 3 frames per second (fps) pulsed and VFSS at 30 fps continuous fluoroscopy. Cumulative radiation dose (CD) and dose area product (DAP) were recorded. VFSS and UGI were performed in 49 patients; however, only 21 (43 %) had documentation of swallow function on an UGI series. All children with aspiration on UGI demonstrated thin liquid aspiration on VFSS; however, 53 % without aspiration on UGI aspirated on VFSS. CD for UGI with versus without swallowing documentation was significantly higher (median = 0.33 vs. 0.21 mGy, p = 0.02) but within variability ranges reported for fluoroscopy equipment. DAP was not significantly higher for UGI with documentation of swallowing compared to without documentation of swallowing (median = 4.11 vs. 3.02 μGy cm(2), p = 0.09). UGI findings are specific but not sensitive markers for aspiration on VFSS. Imaging of swallowing on UGI may have an appreciable increase on radiation exposure. PMID:27048206

  16. Beyond Tracheostomy: Noninvasive Ventilation and Potential Positive Implications for Speaking and Swallowing.

    PubMed

    Britton, Deanna; Benditt, Joshua O; Hoit, Jeannette D

    2016-08-01

    For more than a decade, there has been a trend toward increased use of noninvasive positive pressure ventilation (NPPV) via mask or mouthpiece as a means to provide ventilatory support without the need for tracheostomy. All indications are that use of NPPV will continue to increase over the next decade and beyond. In this article, we review NPPV, describe two common forms of NPPV, and discuss the potential benefits and challenges of NPPV for speaking and swallowing based on the available literature, our collective clinical experience, and interviews with NPPV users. We also speculate on how future research may inform clinical practice on how to best maximize speaking and swallowing abilities in NPPV users over the next decade. PMID:27232093

  17. Effect of visual biofeedback to acquire supraglottic swallow in healthy individuals: a randomized-controlled trial.

    PubMed

    Imada, Miho; Kagaya, Hitoshi; Ishiguro, Yuriko; Kato, Miho; Inamoto, Yoko; Tanaka, Takashi; Shibata, Seiko; Saitoh, Eiichi

    2016-06-01

    The aim of this study is to evaluate the effect of visual biofeedback therapy in acquiring supraglottic swallow (SGS) in a randomized-controlled trial with healthy individuals. Eighteen individuals (mean age, 26 years) who could not close or keep closed the vocal folds before and during the swallow in SGS were allocated randomly to either a visual biofeedback group (eight individuals) or a nonbiofeedback group (10 individuals). A videoendoscope was inserted intranasally and an SGS exercise, using 4 ml of green-colored water, was performed 30 times per day up to 5 days. When the participant failed to perform SGS, the result was provided only to the participants in the visual biofeedback group. The median length of time until acquiring SGS was 1.5 days in the visual biofeedback group and 3.5 days in the nonbiofeedback group (P=0.040). We concluded that visual biofeedback effectively enabled participants to acquire SGS earlier. PMID:26795716

  18. Organochlorine residues and eggshell measurements of tree swallows Tachycineta bicolor in Colorado

    USGS Publications Warehouse

    DeWeese, L.R.; Cohen, R.R.; Stafford, C.J.

    1985-01-01

    Residues of 6 organochlorine compds. were detected in adult carcasses, 4 in eggs, 2 in brains, and one in nestlings of Colorado tree swallows (Tachycineta bicolor). DDE [72-55-9]accounted for 91% of total organochlorine compound residue in each of the 4 sample types. DDE was detected in 30 samples (94%) and DDT [50-29-3] in 2 samples (6%). Carcasses of breeding females and egg clutches had residues of 6 organochlorine compds. not found in nestling samples. Only residues of DDE were found in nestlings. DDT and DDE were the only organochlorine compds. recovered in brain samples. Measurements of tree swallow eggshells showed that unattended eggs were not significantly different from those of attended or historical eggs. The implications of the observed organochlorine compound contamination are discussed.

  19. Image quality and radiation levels in videofluoroscopy for swallowing studies: A review

    SciTech Connect

    Beck, T.J.; Gayler, B.W. )

    1990-01-01

    Inexpensive video recording equipment coupled to conventional x-ray fluoroscopes is now in widespread use by clinicians for the evaluation of patients with swallowing disorders. The prevalence and simplicity of this apparatus have encouraged its use by clinical specialists who are often not specifically trained in the safe use of x-ray equipment, and this may not be in the best interest of either the patient or the examiner. This has prompted an overview of the operating principles of videofluorescopy equipment. The factors governing image quality are discussed as well as potential hazards and protective measures for both patients and operator. A method of estimating the radiation dose to sensitive tissues from a typical swallowing study is included. 6 references.

  20. Multimodal signalling in the North American barn swallow: a phenotype network approach.

    PubMed

    Wilkins, Matthew R; Shizuka, Daizaburo; Joseph, Maxwell B; Hubbard, Joanna K; Safran, Rebecca J

    2015-10-01

    Complex signals, involving multiple components within and across modalities, are common in animal communication. However, decomposing complex signals into traits and their interactions remains a fundamental challenge for studies of phenotype evolution. We apply a novel phenotype network approach for studying complex signal evolution in the North American barn swallow (Hirundo rustica erythrogaster). We integrate model testing with correlation-based phenotype networks to infer the contributions of female mate choice and male-male competition to the evolution of barn swallow communication. Overall, the best predictors of mate choice were distinct from those for competition, while moderate functional overlap suggests males and females use some of the same traits to assess potential mates and rivals. We interpret model results in the context of a network of traits, and suggest this approach allows researchers a more nuanced view of trait clustering patterns that informs new hypotheses about the evolution of communication systems. PMID:26423842

  1. CPAP inhibits non-nutritive swallowing through stimulation of bronchopulmonary receptors.

    PubMed

    Samson, Nathalie; Duvareille, Charles; St-Hilaire, Marie; Clapperton, Véronique; Praud, Jean-Paul

    2008-01-01

    While swallowing and respiratory problems are among the most frequent disorders encountered in neonates, the interrelationships between both functions are not completely understood. This is especially true for non-nutritive swallowing (NNS), which fulfills the important function of clearing upper airways from both local secretions and liquids refluxed from the stomach. Recently, we showed that nasal CPAP inhibits NNS during quiet sleep in the newborn lamb (Samson, St-Hilaire, Nsegbe, Reix, Moreau-Bussière and Praud 2005). The present study was aimed at testing the hypothesis that NNS inhibition is eliminated when CPAP is directly administered through a tracheostomy, thus eliminating reflexes originating from upper airway receptors. Results show that both nasal and tracheal CPAP 6cm H2O similarly inhibit total NNS during quiet sleep, thus suggesting that the inhibiting effect of nasal CPAP on NNS is mainly mediated through bronchopulmonary mechanical receptors with minimal participation of the upper airways. PMID:18085310

  2. Compressive sampling of swallowing accelerometry signals using time-frequency dictionaries based on modulated discrete prolate spheroidal sequences

    NASA Astrophysics Data System (ADS)

    Sejdić, Ervin; Can, Azime; Chaparro, Luis F.; Steele, Catriona M.; Chau, Tom

    2012-12-01

    Monitoring physiological functions such as swallowing often generates large volumes of samples to be stored and processed, which can introduce computational constraints especially if remote monitoring is desired. In this article, we propose a compressive sensing (CS) algorithm to alleviate some of these issues while acquiring dual-axis swallowing accelerometry signals. The proposed CS approach uses a time-frequency dictionary where the members are modulated discrete prolate spheroidal sequences (MDPSS). These waveforms are obtained by modulation and variation of discrete prolate spheroidal sequences (DPSS) in order to reflect the time-varying nature of swallowing acclerometry signals. While the modulated bases permit one to represent the signal behavior accurately, the matching pursuit algorithm is adopted to iteratively decompose the signals into an expansion of the dictionary bases. To test the accuracy of the proposed scheme, we carried out several numerical experiments with synthetic test signals and dual-axis swallowing accelerometry signals. In both cases, the proposed CS approach based on the MDPSS yields more accurate representations than the CS approach based on DPSS. Specifically, we show that dual-axis swallowing accelerometry signals can be accurately reconstructed even when the sampling rate is reduced to half of the Nyquist rate. The results clearly indicate that the MDPSS are suitable bases for swallowing accelerometry signals.

  3. A Timely Intervention: Endoscopic Retrieval of a Swallowed Magnetized Activity Watch

    PubMed Central

    Radowsky, Jason S.; Lee, Joseph S.; Schlussel, Andrew T.

    2016-01-01

    The accidental ingestion of a foreign object often presents a difficult scenario for the clinician. This includes not only the decision to retrieve the material but also the appropriate technique to use. We present the case of a young asymptomatic girl who swallowed a magnetic activity watch, which was then successfully retrieved with an endoscopic snare. To our knowledge, this is the first documented case of salvaging an operational watch from the stomach using an endoscopic technique. PMID:26904319

  4. Central Neural Circuits for Coordination of Swallowing, Breathing, and Coughing: Predictions from Computational Modeling and Simulation

    PubMed Central

    Bolser, Donald C.; Gestreau, Christian; Morris, Kendall F.; Davenport, Paul W.; Pitts, Teresa E.

    2013-01-01

    SYNOPSIS The purpose of this article is to update the otolaryngologic community on recent developments in the basic understanding of how cough, swallow, and breathing are controlled. These behaviors are coordinated to occur at specific times relative to one another to minimize the risk of aspiration. The control system that generates and coordinates these behaviors is complex and advanced computational modeling methods are useful tools to elucidate its function. PMID:24262953

  5. Tongue forces and handgrip strength in normal individuals: association with swallowing

    PubMed Central

    Mendes, Amanda Elias; Nascimento, Liz; Mansur, Letícia Lessa; Callegaro, Dagoberto; Filho, Wilson Jacob

    2015-01-01

    OBJECTIVES: To describe and correlate tongue force and grip strength measures and to verify the association of these measures with water swallowing in different age groups. METHOD: Tongue force was evaluated using the Iowa Oral Performance Instrument and grip strength using the Hand Grip in 90 normal individuals, who were divided into three groups: young (18-39 years old), adult (40-59 years old) and elderly (above 60 years old) individuals. The time and number of swallows required for the continuous ingestion of 200 ml of water were also measured. RESULTS: A reduction in tongue force and grip strength, as well as an increase in the time required to drink 200 ml of water, were observed with increasing participant age. There was no difference in the number of swallows among the three groups. A correlation was observed between reductions in tongue force and grip strength in the groups of young and elderly individuals. CONCLUSION: There were differences in the measures of tongue force in young, adult and elderly individuals. Greater variations within these differences were observed when repeated movements were performed; in addition, a decrease in strength was associated with an increase in age. The decrease in tongue force among the elderly was offset by the increase in time needed to swallow the liquid. There was an association between the measures of tongue force and grip strength in the different age groups. The results of this study can be applied clinically and may act as a basis for guidelines in healthy or vulnerable elderly populations. PMID:25672428

  6. A Timely Intervention: Endoscopic Retrieval of a Swallowed Magnetized Activity Watch.

    PubMed

    Radowsky, Jason S; Lee, Joseph S; Schlussel, Andrew T

    2016-01-01

    The accidental ingestion of a foreign object often presents a difficult scenario for the clinician. This includes not only the decision to retrieve the material but also the appropriate technique to use. We present the case of a young asymptomatic girl who swallowed a magnetic activity watch, which was then successfully retrieved with an endoscopic snare. To our knowledge, this is the first documented case of salvaging an operational watch from the stomach using an endoscopic technique. PMID:26904319

  7. Sound component duration of healthy human pharyngoesophageal swallowing: a gender comparison study.

    PubMed

    Morinière, Sylvain; Beutter, Patrice; Boiron, Michèle

    2006-07-01

    Cervical auscultation is a noninvasive technique for studying swallowing that was first used in the 1960s. The aim of our study was to use the numeric acoustic recording technique for analyzing swallowing sound signals in healthy subjects while they ingested a defined volume and consistency of a specific substance. Twenty males and ten females were included in the study and given 10 ml of a barium suspension to swallow. A microphone was placed on the skin overlying the lateral border of the trachea, directly under the inferior border of the cricoid, and connected to a computer. For each sound recording, the total duration of the sound (td), the number (n) of sound components (SC), the duration of each SC (c1, c2, c3,...), and the intervals (i1, i2,...) between the SCs were measured. For all the recordings, the mean durations of acoustic parameters (TDm, C1m, C2m, C3m, I1m, I2m) were calculated and compared by using Student's t test. In the 20 male subjects, the mean acoustic parameters were calculated (MTDm, MC1m, MC2m, MC3m, MI1m, MI2m) and compared with the mean acoustic parameters (FTDm, FC1m, FC2m, FC3m, FI1m, FI2m) in the ten females by using a Wilcoxon nonparametric statistical test. We were able to interpret 80% of the recordings. The TDm was 710 +/- 28 ms. Three main SCs were detected: C1m = 100 +/- 56, C2m = 150 +/- 90, C3m = 80 +/- 54 ms; I1m = 100 +/- 66, I2m = 190 +/- 120 ms. No significant difference in these parameters was observed with respect to gender. This study enabled us to decompose the swallowing sounds into three main SCs and to quantify their normal durations. These results should prove useful for the assessment of sound variations in pathologic conditions. PMID:16897324

  8. Candidate Dosimetric Predictors of Long-Term Swallowing Dysfunction After Oropharyngeal Intensity-Modulated Radiotherapy

    SciTech Connect

    Schwartz, David L.; Hutcheson, Katherine; Barringer, Denise; Tucker, Susan L.; Kies, Merrill; Ang, K. Kian; Morrison, William H.; Rosenthal, David I.; Garden, Adam S.; Dong Lei; Lewin, Jan S.

    2010-12-01

    Purpose: To investigate long-term swallowing function in oropharyngeal cancer patients treated with intensity-modulated radiotherapy (IMRT), and to identify novel dose-limiting criteria predictive for dysphagia. Methods and Materials: Thirty-one patients with Stage IV oropharyngeal squamous carcinoma enrolled on a Phase II trial were prospectively evaluated by modified barium swallow studies at baseline, and 6, 12, and 24 months post-IMRT treatment. Candidate dysphagia-associated organs at risk were retrospectively contoured into original treatment plans. Twenty-one (68%) cases were base of tongue and 10 (32%) were tonsil. Stage distribution was T1 (12 patients), T2 (10), T3 (4), T4 (2), and TX (3), and N2 (24), N3 (5), and NX (2). Median age was 52.8 years (range, 42-78 years). Thirteen patients (42%) received concurrent chemotherapy during IMRT. Thirteen (42%) were former smokers. Mean dose to glottic larynx for the cohort was limited to 18 Gy (range, 6-39 Gy) by matching IMRT to conventional low-neck fields. Results: Dose-volume constraints (V30 < 65% and V35 < 35% for anterior oral cavity and V55 < 80% and V65 < 30% for high superior pharyngeal constrictors) predictive for objective swallowing dysfunction were identified by univariate and multivariate analyses. Aspiration and feeding tube dependence were observed in only 1 patient at 24 months. Conclusions: In the context of glottic laryngeal shielding, we describe candidate oral cavity and superior pharyngeal constrictor organs at risk and dose-volume constraints associated with preserved long-term swallowing function; these constraints are currently undergoing prospective validation. Strict protection of the glottic larynx via beam-split IMRT techniques promises to make chronic aspiration an uncommon outcome.

  9. Prospective, comparative effectiveness trial of cow's milk elimination and swallowed fluticasone for pediatric eosinophilic esophagitis.

    PubMed

    Kruszewski, P G; Russo, J M; Franciosi, J P; Varni, J W; Platts-Mills, T A E; Erwin, E A

    2016-05-01

    Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disease in which food antigens play a key role. Current therapeutic options are limited to long-term steroid medication and dietary elimination of multiple foods, each of which is challenging. Our objective was to compare single food elimination of cow's milk to swallowed fluticasone in pediatric EoE patients. This is a prospective, comparative effectiveness trial of newly diagnosed EoE patients (ages 2-18 years) treated with swallowed fluticasone (n = 24) or elimination of cow's milk (n = 20). The dual outcome measures of repeat esophageal biopsy (6-8 weeks) and change in Pediatric Quality of Life Inventor (PedsQL) EoE Module and Symptoms Scales were used to assess response to treatment. After 6-8 weeks of treatment, peak esophageal eosinophil counts decreased to below the threshold of 15 eosinophils/high-power field in 64% of patients treated with cow's milk elimination and 80% of patients treated with swallowed fluticasone (P = 0.4). Mean PedsQL EoE Module total scores (69 vs. 82; P < 0.005) and Total Symptoms scores (58 vs. 75; P = 0.001) showed significant improvement with cow's milk elimination. Among children treated with swallowed fluticasone, mean PedsQL EoE Module total scores (64 vs. 75; P < 0.05) and Total Symptoms scores (58 vs. 69; P < 0.01) were also significantly improved after 6-8 weeks of therapy. Removal of cow's milk from the diet is an effective single food elimination treatment for pediatric patients with EoE as assessed by statistically significant histologic and symptomatic improvement. Cow's milk elimination may be more desirable for EoE patients who do not want to take chronic, long-term steroid medications. PMID:25721813

  10. Jaw opening and swallow triggering method for bilateral-brain-damaged patients: K-point stimulation.

    PubMed

    Kojima, Chieko; Fujishima, Ichiro; Ohkuma, Ruri; Maeda, Hiroshi; Shibamoto, Isamu; Hojo, Kyoko; Arai, Motoko

    2002-01-01

    The aim of this study was to confirm the response in patients stimulated at the trigger point (K-point). Since we have already clinically encountered patients with hyperactive bite reflexes who were able to open their mouth and swallow after stimulation of the trigger point, we investigated this response in other brain-damaged patients. The trigger point lies on the mucosa lateral to the palatoglossal arch and medial to the pterygomandibular fold at the height of the postretromolar pad. A total of 57 brain-damaged patients, including patients with pseudobulbar palsy due to bilateral upper motor neuron disease and bulbar palsy due to medulla oblongate. Other supratentorial brain-damaged patients and 20 non-brain-damaged subjects were also examined. The subjects were gently stimulated at the trigger point by a finger or a tongue depressor. We found that the pseudobulbar palsy patients with a hyperactive bite reflex responded by mouth opening and swallowing after a jaw movement similar to mastication elicited by the stimulation. The other pseudobulbar palsy patients, who did not have hyperactive bite reflexes and could open their mouth spontaneously, responded by swallowing with jaw movements similar to mastication after the stimulation. The bulbar palsy patients and the supratentorial brain-damaged patients showed no response to the stimulation. The non-brain-damaged subjects also did not respond, but all of the subjects reported a strange sensation after the stimulation. We concluded that stimulating the trigger point was useful for opening the mouth and facilitating swallowing in pseudobulbar palsy patients and that this technique may be of help in these patients in terms of oral health care and feeding. PMID:12355142

  11. Recapture Heterogeneity in Cliff Swallows: Increased Exposure to Mist Nets Leads to Net Avoidance

    PubMed Central

    Roche, Erin A.; Brown, Charles R.; Brown, Mary Bomberger; Lear, Kristen M.

    2013-01-01

    Ecologists often use mark-recapture to estimate demographic variables such as abundance, growth rate, or survival for samples of wild animal populations. A common assumption underlying mark-recapture is that all animals have an equal probability of detection, and failure to meet or correct for this assumption–as when certain members of the population are either easier or more difficult to capture than other animals–can lead to biased and inaccurate demographic estimates. We built within-year and among-years Cormack-Jolly-Seber recaptures-only models to identify causes of capture heterogeneity for a population of colonially nesting cliff swallows (Petrochelidon pyrrhonota) caught using mist-netting as a part of a 20-year mark-recapture study in southwestern Nebraska, U.S.A. Daily detection of cliff swallows caught in stationary mist nets at their colony sites declined as the birds got older and as the frequency of netting at a site within a season increased. Experienced birds’ avoidance of the net could be countered by sudden disturbances that startled them into a net, such as when we dropped a net over the side of a bridge or flushed nesting cliff swallows into a stationary net positioned at a colony entrance. Our results support the widely held, but seldom tested, belief that birds learn to avoid stationary mist nets over time, but also show that modifications of traditional field methods can reduce this source of recapture heterogeneity. PMID:23472138

  12. Polychlorinated biphenyl exposure and effects in tree swallows (Tachycineta bicolor) residing at eight locations

    USGS Publications Warehouse

    Yorks, A.L.; Rattner, B.A.; Melancon, M.J.

    1998-01-01

    Twelve-day-old Tree Swallow nestlings were studied at eight sites exhibiting a range of polychlorinated biphenyl (PCB) contamination. In addition to determining PCB concentrations in eggs, nestlings, and food items, hepatic cytochromes P450-associated monooxygenase activity quantified as a biomarker of exposure. Nestlings from several of the sites exhibited elevated PCB concentrations and P450 induction compared to a reference site, Furthermore, cytochromes P450 were correlated with PCB concentrations in nestling. Our findings indicate that likely routes of exposure include the direct materna! deposition of PCBs into the egg and the delivery of contaminated emerging aquatic insects to nestlings. We also examined reproductive and morphological parameters to determine if PCB exposure was adversely affecting swallows at these sites. Hatching success did not differ among sites. There were no dramatic effects on gross and histological gonadal morphology of nestlings, and there was complete concordance between phenotypic sex (gonadal morphology) and genotypic sex (as determined by PCR amplification of the sex chromosome). However, where nestling PCB exposure was substantial, clutch size and body weight differed from a reference site. Despite evidence of PCB exposure, only modest effects were observed in nestling swallows.

  13. Bioaccumulation of heavy metals in pre-fledgling tree swallows, Tachycineta bicolor

    SciTech Connect

    Kraus, M.L. )

    1989-09-01

    Wetlands in urbanized areas are frequently degraded by human activity. The Hackensack River Estuary in Northeastern New Jersey is no exception. This estuary contains over 1,600 acres of landfill, and receives various levels of treated effluent from seven different sewage treatment plants. Heavy metals are a common pollutant in the Hackensack River Basin. Bioaccumulation of heavy metals in birds is a well documented phenomenon. Studies have shown that near shore predatory birds have higher mercury levels in their feathers than do pelagic predatory birds. Other studies have shown that insectivorous pied flycatcher nestlings and black-crowned night heron pre-fledglings show heavy metal body burdens that correlate well with the distance of their nests from a heavy metal source. The tree swallow (Tachycineta bicolor) is a common summer resident in the Hackensack Meadowlands. This species readily nests in man-made nest boxes, and has used boxes erected for this purpose in the Hackensack Meadowlands District (HMD). The swallows feed primarily on adult midges (Chironomus decorus) which are prevalent in the region. This relationship makes the tree swallows and midges an ideal model for food chain bioaccumulation studies.

  14. Kinematic analysis of swallowing in the patients with esophagectomy for esophageal cancer.

    PubMed

    Kim, Sang Jun; Cheon, Hee Jung; Lee, Han Nah; Hwang, Ji Hye

    2016-06-01

    The aim of this study is to reveal the mechanism of esophagectomy-mediated swallowing motion disorders. Forty-seven patients who underwent 3-stage esophagectomy with cervical anastomosis and VFSS for esophageal cancer were selected. Twenty-three patients displayed subglottic aspiration (aspiration group) and the other 24 patients did not show any aspiration or penetration in the videofluoroscopic swallowing study after esophagectomy (no aspiration group). For comparison, 27 healthy volunteers (normal group) were included. Maximal anterior displacement of the hyoid (MADH), maximal superior displacement of the hyoid (MSDH), maximal rotation of the epiglottis (MRE) and pharyngeal delay time (PDT) were measured by image J software. MADH, MRE, and PDT in normal group were significantly different from those in aspiration and no aspiration groups (P<0.001). The normal group displayed a significantly different PDT compared to the no aspiration and aspiration groups, and the no aspiration group had a significantly different PDT compared to the aspiration group (P<0.001). The mechanism of swallowing motion disorders caused by the esophagectomy in esophageal cancer includes the decreased anterior movement of the hyoid and rotation of the epiglottis caused by the prolonged operation time and delayed pharyngeal reflex caused by the laryngeal sensory disturbance. Among them, the main mechanism of subglottic aspiration after esophagectomy is the delayed pharyngeal reflex. PMID:26705964

  15. Quality of Life in Swallowing Disorders after Nonsurgical Treatment for Head and Neck Cancer

    PubMed Central

    Silveira, Marta Halina; Dedivitis, Rogerio A.; Queija, Débora Santos; Nascimento, Paulo César

    2014-01-01

    Introduction Radiotherapy or chemoradiotherapy can result in severe swallowing disorders with potential risk for aspiration and can negatively impact the patient's quality of life (QOL). Objective To assess swallowing-related QOL in patients who underwent radiotherapy/chemoradiotherapy for head and neck cancer. Methods We interviewed 110 patients (85 men and 25 women) who had undergone exclusive radiotherapy (25.5%) or concomitant chemoradiotherapy (74.5%) from 6 to 12 months before the study. The Quality of Life in Swallowing Disorders (SWAL-QOL) questionnaire was employed to evaluate dysphagia-related QOL. Results The QOL was reduced in all domains for all patients. The scores were worse among men. There was a relationship between oral cavity as the primary cancer site and the fatigue domain and also between advanced cancer stage and the impact of food selection, communication, and social function domains. Chemoradiotherapy association, the presence of nasogastric tube and tracheotomy, and the persistence of alcoholism and smoking had also a negative effect on the QOL. Conclusions According to the SWAL-QOL questionnaire, the dysphagia-related impact on QOL was observed 6 to 12 months after the treatment ended. PMID:25992151

  16. Assessment of swallowing and masticatory performance in obturator wearers: a clinical study

    PubMed Central

    Vero, Nungotso; Mishra, Niraj; Singh, Kamleshwar; Jurel, Sunit Kumar; Kumar, Vijay

    2015-01-01

    PURPOSE To assess function by identifying changes in swallowing and masticatory performance in maxillary obturator prosthesis wearers. MATERIALS AND METHODS Sixty subjects were recruited for the study, of which 20 were obturator wearers, 20 were completely dentulous and 20 had removable partial/complete dentures with similar Eichner's Index. Swallowing ability was evaluated with and without obturator using the "Water Drinking Test"; Masticatory performance was evaluated with the Sieve test; and maximum occlusal force was recorded with the help of a digital bite sensor. The data was analyzed using the Statistical Package for Social Science version 15.0 with a confidence level at 95%. RESULTS Profile, behavior of drinking and time taken to drink were significantly improved (P<.001) in subjects after wearing obturator. Masticatory performance was not significantly different (P=.252) in obturator wearer when compared with dentulous or removable partial/complete denture wearer, but significantly (P<.001) high inter group difference in maximum occlusal force existed. Correlation between masticatory performance and maximum occlusal force was not significant (P=.124). CONCLUSION Swallowing ability was significantly improved after wearing obturator but masticatory performance was not significantly different from those having similar occlusal support zone in their dentition. PMID:25722831

  17. Ingested foreign bodies and societal wealth: three year observational study of swallowed coins

    PubMed Central

    Zheng, H; Biller, J A

    2009-01-01

    Objective To examine the relation between coins ingested by children and the Dow Jones Industrial Average. Design Observational study. Main outcome measures Total value of coins ingested and number of incidents of coins versus other objects swallowed, measured before and after the stock market crash of October 2008. Results Eighteen objects, including 11 coins, were ingested (NASDAQ (numismatic and sundry detritus acquired) composite of 18). The total value of the 11 coins swallowed was $1.03 (FTSE 100 (fraction of the US$ or 100 cents) index of 103). The pecuniary extraction ratio (PE ratio) was 0.57 (9/16). Comparing values for a period before and after October 2008, the mean monthly NASDAQ composite (0.41 (SD 0.67) v 0.5 (0.85), P=0.75), FTSE 100 index in cents (2.3 (6.8) v 3.1 (7.8), P=0.77), and PE ratio (0.54 (0.52) v 0.66 (0.29), P=0.50) did not change. The mean end-of-month closing value of the Dow Jones, however, decreased significantly (12 537 (841.4) v 8388 (699.8), P<0.001) Conclusion There was no detectable difference in the total value of coins ingested, or ratio of coins to other objects swallowed, before or after a massive stock market crash. PMID:19965938

  18. 'What About Swallowing?' Diagnostic Performance of Daily Clinical Practice Compared with the Eating Assessment Tool-10.

    PubMed

    Heijnen, Bas Joris; Speyer, Renée; Bülow, Margareta; Kuijpers, Laura Mf

    2016-04-01

    In daily clinical practice, patients are frequently asked about their swallowing as part of the patient-clinician interview. This study compares the diagnostic performance of a single open question 'What about swallowing?' (usual care) with the Eating Assessment Tool (EAT-10) as reference test in screening for oropharyngeal dysphagia (OD). 303 outpatients at risk of OD were recruited at three university hospitals: 162 men and 141 women with a mean age of 70 years. All data were retrieved by phone. To identify patients at risk of dysphagia, two different cut-off scores for the EAT-10 total score were retrieved from the literature. The diagnostic performance of the single question was determined by comparing dichotomized answers to the single question (no problems versus difficulties in swallowing) with the EAT-10 as reference test. Sensitivity, specificity, positive and negative predictive values ranged between 0.75-0.76, 0.75-0.84, 0.93-0.97 and 0.38-0.43, respectively. Mostly, the results of this exploratory study indicate a sufficient diagnostic performance of the single question in identifying patients who are at risk of dysphagia when using the EAT-10 questionnaire as a reference test. Further research, is, however, necessary to provide additional psychometric data on Functional Health Status (FHS) questionnaires including the single question using either FEES or VFS as gold standard or reference test. PMID:26753926

  19. The Effect of Bolus Consistency on Hyoid Velocity in Healthy Swallowing

    PubMed Central

    Nagy, Ahmed; Molfenter, Sonja M.; Péladeau-Pigeon, Melanie; Stokely, Shauna; Steele, Catriona M.

    2015-01-01

    The aim of this study was to determine whether measures of hyoid velocity increase when swallowing liquids of thicker consistency at a constant volume. A gender-balanced sample of 20 healthy young participants (mean age 31.5) each swallowed 3 boluses of 5ml volume in 3 consistencies (ultrathin, thin, and nectar-thick barium). Using frame by frame tracking of hyoid position, we identified the onset and peak of the hyoid movement and derived measures of velocity (i.e., distance in anatomically normalized units, i.e., % of the C2–4 vertebral distance, divided by duration in ms) for the X, Y and XY movement directions. Peak hyoid velocity was also identified for each movement direction. Where significant differences were identified, the component measures of hyoid movement distance and duration were further explored to determine the strategies used to alter velocity. The results showed increased velocities and higher peak velocities with the nectar thick stimuli compared to thin and ultrathin stimuli. This was achieved by a primary strategy of larger hyoid movement distances per unit of time when swallowing nectar-thick liquids.. These results point to one mechanism by which thickened liquids may contribute to improved airway protection, by facilitating more-timely laryngeal vestibule closure. PMID:26048615

  20. Influence of repetitive peripheral magnetic stimulation on neural plasticity in the motor cortex related to swallowing.

    PubMed

    Momosaki, Ryo; Kakuda, Wataru; Yamada, Naoki; Abo, Masahiro

    2016-09-01

    The aim of this study was to evaluate the effect of repetitive peripheral magnetic stimulation at two different frequencies (20 and 30 Hz) on cortical excitability in motor areas related to swallowing in healthy individuals. The study participants were 10 healthy normal volunteers (two women and eight men, age range 25-36 years). Repetitive peripheral magnetic stimulation was applied to the submandibular muscle using a parabolic coil at the site where contraction of the suprahyoid muscles was elicited. Stimulation was continued for 10 min (total 1200 pulses) at 20 Hz on 1 day and at 30 Hz on another day, with the stimulation strength set at 90% of the intensity that elicited pain. The motor-evoked potential amplitude of suprahyoid muscles was assessed before, immediately after, and 30 min after stimulation. Stimulations at both 20 and 30 Hz significantly increased motor-evoked potential amplitude (P<0.05), with the increase maintained until 30 min after stimulation. The motor-evoked potential amplitude immediately after stimulation was not significantly different between the 20 and 30 Hz frequencies. The results indicated that repetitive magnetic stimulation increased motor-evoked potential amplitude of swallowing muscles, suggesting facilitation of the motor cortex related to swallowing in healthy individuals. PMID:27262135

  1. Reproductive ecology of tree swallows (Tachycineta bicolor) with high levels of polychlorinated biphenyl contamination

    SciTech Connect

    McCarty, J.P.; Secord, A.L.

    1999-07-01

    Tree swallows(Tachycineta bicolor) breeding along the Hudson River forage extensively on PCB-contaminated insects that emerge from the river. The authors studied the reproductive ecology and behavior of tree swallows breeding at several sites along the Hudson River. Related work has shown that PCB levels in both eggs and chicks were among the highest ever reported in this species, with concentrations comparable to those found in aquatic organisms in the Hudson River. In 1994, reproductive success at PCB-contaminated sites was significantly impaired relative to other sites in New York. Reduced reproductive success was largely due to high levels of nest abandonment during incubation and reduced hatchability of eggs. In 1995, reproductive output was normal, but higher than expected rates of abandonment and supernormal clutches persisted. Growth and development of nestlings was not significantly impaired. Given the levels of contamination in this population, the success of most Hudson River tree swallows reinforces the importance of understanding interspecific differences in the effects of contaminants.

  2. Designing for Safety: Implications of a Fifteen Year Review of Swallowed and Aspirated Dentures

    PubMed Central

    Mackie, James; Macfarlane, Tatiana V.

    2016-01-01

    ABSTRACT Objectives Dentures are worn by around 20% of the population, yet if they become displaced they may enter the gastrointestinal or respiratory system, sometimes with grave consequences. The aim of this study was to review recent published literature in order to identify the epidemiology of patients and characteristics of swallowed and aspirated dental prostheses, and propose strategies to minimise these risks. Material and Methods A fifteen year retrospective of published case series and case reports was carried out. Photographs, radiographs and descriptions of the dental prostheses were gathered, as well as the patient’s presenting complaint, the anatomical site where the denture was caught and the procedure required to remove the denture. Results Ninety one separate events of swallowed or aspirated dentures were identified from 83 case reports and series from 28 countries. Average age was 55 years, and these were 74% male. Photographs were retrieved for 49 of these dentures. Clasps were present in 25 of the dentures. There was no significant difference between clasped and unclasped dentures for perforation rates, need for open surgery and spontaneously passed dentures. Conclusions We discuss the implications of this study regarding denture designs, specifically the importance of using a radiopaque acrylic, using clasps when required even if there is a risk of aspiration, advising patients to return if a denture is loose or damaged, and finally that all patients who wear a denture are at risk of aspiration and swallowing events, and associated morbidity and mortality. PMID:27489607

  3. The effect of weather on morphometric traits of juvenile cliff swallows

    USGS Publications Warehouse

    Roche, Erin A.; Brown, Mary Bomberger; Brown, Charles R.

    2015-01-01

    Episodes of food deprivation may change how nestling birds allocate energy to the growth of skeletal and feather morphological traits during development. Cliff swallows (Petrochelidon pyrrhonota) are colonial, insectivorous birds that regularly experience brief periods of severe weather-induced food deprivation during the nesting season which may affect offspring development. We investigated how annual variation in timing of rearing and weather were associated with length of wing and tail, skeletal traits, and body mass in juvenile cliff swallows reared in southwestern Nebraska during 2001–2006. As predicted under conditions of food deprivation, nestling skeletal and feather measurements were generally smaller in cooler years. However, variability explained by weather was small, suggesting that morphometric traits of juvenile cliff swallows were not highly sensitive to weather conditions experienced during this study. Measurements of juvenile morphological traits were positively correlated with measurements taken as adults, meaning that any variation among juveniles in response to rearing conditions showed evidence of persisting into a bird’s first breeding season. Our results show that body size in this species is phenotypically plastic and influenced, in part, by weather variables.

  4. Contaminant exposure of barn swallows nesting on Bayou d'Inde, Calcasieu Estuary, Louisiana, USA.

    USGS Publications Warehouse

    Custer, T.W.; Custer, Christine M.; Goatcher, B.L.; Melancon, M.J.; Matson, C.W.; Bickham, J.W.

    2006-01-01

    Current and historical point source discharges, storm water runoff, and accidental spills have contaminated the water, sediment, and biota within the Calcasieu Estuary in southwestern Louisiana. In 2003, barn swallow (Hirundo rustica) eggs and nestlings were collected beneath two bridges that cross Bayou d'Inde, the most contaminated waterway within the Calcasieu Estuary. Samples were also collected from a bridge over Bayou Teche, a reference site in south central Louisiana. Polychlorinated biphenyl (PCB) concentrations in barn swallow eggs and nestlings were significantly higher at the downstream site on Bayou d'Inde (2.8 micro g/g PCBs in eggs and 1.5 micro g/g PCBs in nestlings) than at the other two sites (< 0.2 micro g/g PCBs in eggs and nestlings at both sites). Ethoxyresorufin-O-dealkylase activity in nestling livers was significantly higher at the downstream site on Bayou d'Inde (50 pmol/min/mg) compared to the other two locations (24 pmol/min/mg, each), probably because of exposure to PCBs. Polychlorinated dibenzo-p-dioxin and polychlorinated dibenzofuran concentrations in eggs and polycyclic aromatic hydrocarbons in nestlings were at background concentrations at all sites. Trace element concentrations in barn swallow eggs and nestling livers were at background levels and did not differ among the three sites. A biomarker of DNA damage did not differ among sites.

  5. Contaminant exposure of barn swallows nesting on Bayou d'Inde, Calcasieu Estuary, Louisiana, USA

    USGS Publications Warehouse

    Custer, T.W.; Custer, Christine M.; Goatcher, B.L.; Melancon, M.J.; Matson, C.W.; Bickham, J.W.

    2006-01-01

    Current and historical point source discharges, storm water runoff, and accidental spills have contaminated the water, sediment, and biota within the Calcasieu Estuary in southwestern Louisiana. In 2003, barn swallow (Hirundo rustica) eggs and nestlings were collected beneath two bridges that cross Bayou d'Inde, the most contaminated waterway within the Calcasieu Estuary. Samples were also collected from a bridge over Bayou Teche, a reference site in south central Louisiana. Polychlorinated biphenyl (PCB) concentrations in barn swallow eggs and nestlings were significantly higher at the downstream site on Bayou d'Inde (2.8 mu g/g PCBs in eggs and 1.5 mu g/g PCBs in nestlings) than at the other two sites (< 0.2 mu g/g PCBs in eggs and nestlings at both sites). Ethoxyresorufin-O-dealkylase activity in nestling livers was significantly higher at the downstream site on Bayou d'Inde (50 pmol/min/mg) compared to the other two locations (24 pmol/min/mg, each), probably because of exposure to PCBs. Polychlorinated dibenzo-p-dioxin and polychlorinated dibenzofuran concentrations in eggs and polycyclic aromatic hydrocarbons in nestlings were at background concentrations at all sites. Trace element concentrations in barn swallow eggs and nestling livers were at background levels and did not differ among the three sites. A biomarker of DNA damage did not differ among sites.

  6. Contaminant exposure of barn swallows nesting on Bayou d'Inde, Calcasieu Estuary, Louisiana, USA.

    PubMed

    Custer, Thomas W; Custer, Christine M; Goatcher, Buddy L; Melancon, Mark J; Matson, Cole W; Bickham, John W

    2006-10-01

    Current and historical point source discharges, storm water runoff, and accidental spills have contaminated the water, sediment, and biota within the Calcasieu Estuary in southwestern Louisiana. In 2003, barn swallow (Hirundo rustica) eggs and nestlings were collected beneath two bridges that cross Bayou d'Inde, the most contaminated waterway within the Calcasieu Estuary. Samples were also collected from a bridge over Bayou Teche, a reference site in south central Louisiana. Polychlorinated biphenyl (PCB) concentrations in barn swallow eggs and nestlings were significantly higher at the downstream site on Bayou d'Inde (2.8 micro g/g PCBs in eggs and 1.5 micro g/g PCBs in nestlings) than at the other two sites (< 0.2 micro g/g PCBs in eggs and nestlings at both sites). Ethoxyresorufin-O-dealkylase activity in nestling livers was significantly higher at the downstream site on Bayou d'Inde (50 pmol/min/mg) compared to the other two locations (24 pmol/min/mg, each), probably because of exposure to PCBs. Polychlorinated dibenzo-p-dioxin and polychlorinated dibenzofuran concentrations in eggs and polycyclic aromatic hydrocarbons in nestlings were at background concentrations at all sites. Trace element concentrations in barn swallow eggs and nestling livers were at background levels and did not differ among the three sites. A biomarker of DNA damage did not differ among sites. PMID:16779575

  7. A Strategy Intervention to Increase the Reading Comprehension of Junior High School Students with Reading Disabilities

    ERIC Educational Resources Information Center

    Mothus, Trudy G.; Lapadat, Judith C.

    2006-01-01

    A challenge facing educators is to find ways to arrest and reverse the cumulative deficit in reading experienced by many students with learning disabilities. In this study, we evaluated the effect of a strategy intervention to increase the reading comprehension of eighth grade students with reading disabilities in intact junior high school classes…

  8. Injuries and Individuals with Disabilities

    ERIC Educational Resources Information Center

    Waldman, H. Barry; Perlman, Steven P.; Chaudhry, Ramiz A.

    2009-01-01

    Children and adults with disabilities are at an increased risk of injury. Falls are the leading mechanism of injury regardless of the disability status and are even more common in those with moderate or severe disabilities. The setting for the injury differs with the disability status. Compared to individuals with moderate or no disabilities,…

  9. Swallowing Tablets and Capsules Increases the Risk of Penetration and Aspiration in Patients with Stroke-Induced Dysphagia.

    PubMed

    Schiele, Julia T; Penner, Heike; Schneider, Hendrik; Quinzler, Renate; Reich, Gabriele; Wezler, Nikolai; Micol, William; Oster, Peter; Haefeli, Walter E

    2015-10-01

    We evaluated the prevalence of difficulties swallowing solid dosage forms in patients with stroke-induced dysphagia and whether swallowing tablets/capsules increases their risk of penetration and aspiration. Concurrently, we explored whether routinely performed assessment tests help identify patients at risk. Using video endoscopy, we evaluated how 52 patients swallowed four different placebos (round, oval, and oblong tablets and a capsule) with texture-modified water (TMW, pudding consistency) and milk and rated their swallowing performance according to the Penetration Aspiration Scale (PAS). Additionally, Daniels Test, Bogenhausener Dysphagiescore, Scandinavian Stroke Scale, Barthel Index, and Tinetti's Mobility Test were conducted. A substantial proportion of the patients experienced severe difficulties swallowing solid oral dosage forms (TMW: 40.4 %, milk: 43.5 %). Compared to the administration of TMW/milk alone, the placebos increased the PAS values in the majority of the patients (TMW: median PAS from 1.5 to 2.0; milk: median PAS from 1.5 to 2.5, each p value <0.0001) and residue values were significantly higher (p < 0.05). Whereas video-endoscopic examination reliably identified patients with difficulties swallowing medication, neither patients' self-evaluation nor one of the routinely performed bedside tests did. Therefore, before video-endoscopic evaluation, many drugs were modified unnecessarily and 20.8 % of these were crushed inadequately, although switching to another dosage form or drug would have been possible. Hence, safety and effectiveness of swallowing tablets and capsules should be evaluated routinely in video-endoscopic examinations, tablets/capsules should rather be provided with TMW than with milk, and the appropriateness of "non per os except medication" orders for dysphagic stroke patients should be questioned. PMID:26205435

  10. Disability: a welfarist approach

    PubMed Central

    Savulescu, Julian; Kahane, Guy

    2011-01-01

    In this paper, we offer a new account of disability. According to our account, some state of a person's biology or psychology is a disability if that state makes it more likely that a person's life will get worse, in terms of his or her own wellbeing, in a given set of social and environmental circumstances. Unlike the medical model of disability, our welfarist approach does not tie disability to deviation from normal species’ functioning, nor does it understand disability in essentialist terms. Like the social model of disability, the welfarist approach sees disability as a harmful state that results from the interaction between a person's biology and psychology and his or her surrounding environment. However, unlike the social model, it denies that the harm associated with disability is entirely due to social prejudice or injustice. In this paper, we outline and clarify the welfarist approach, answer common objections and illustrate its usefulness in addressing a range of difficult ethical questions involving disability. PMID:22140353

  11. Disability and global development.

    PubMed

    Durocher, Joan; Lord, Janet; Defranco, Allison

    2012-07-01

    The United States invests billions of taxpayer dollars each year into foreign assistance programs that foster international diplomacy and development directed toward improving the quality of life for people around the world. These programs develop economies and combat poverty, promote democracy and governance, build new infrastructure, advance and protect human rights, among other development goals. The United States cannot effectively accomplish the goals of foreign assistance programs unless it undertakes measures to ensure that the programs are accessible to and inclusive of people with disabilities. The United States has been a leader in advancing the rights of people with disabilities and must continue to promote disability rights through its international development work. Overseas economic development will not be successful unless people with disabilities are included. Because of the significant number of people with disabilities in developing countries, if they are not included, the very economic growth the United States is trying to foster will be hindered. The goals of democracy and governance programs cannot be achieved without the inclusion of people with disabilities. In many countries, domestic law contains blatant discriminatory provisions for people with disabilities that undermine access to justice and full participation in society. The provisions that discriminate against people with disabilities include arbitrary exclusions in electoral codes, sweeping plenary guardianship laws with no due-process protections, discriminatory banking practices, and inaccessible court proceedings. National disability legal frameworks remain underdeveloped throughout the world. PMID:22726852

  12. Reversible Thermoset Adhesives

    NASA Technical Reports Server (NTRS)

    Mac Murray, Benjamin C. (Inventor); Tong, Tat H. (Inventor); Hreha, Richard D. (Inventor)

    2016-01-01

    Embodiments of a reversible thermoset adhesive formed by incorporating thermally-reversible cross-linking units and a method for making the reversible thermoset adhesive are provided. One approach to formulating reversible thermoset adhesives includes incorporating dienes, such as furans, and dienophiles, such as maleimides, into a polymer network as reversible covalent cross-links using Diels Alder cross-link formation between the diene and dienophile. The chemical components may be selected based on their compatibility with adhesive chemistry as well as their ability to undergo controlled, reversible cross-linking chemistry.

  13. Relationship between Class III malocclusion and hyoid bone displacement during swallowing: a cine-magnetic resonance imaging study

    PubMed Central

    Gokce, Hasan Suat; Gorgulu, Serkan; Karacay, Seniz; Akca, Eralp; Olmez, Huseyin

    2012-01-01

    Objective The displacement of the hyoid bone (HB) is a critical biomechanical component of the swallowing function. The aim of this study was to evaluate the swallowing-induced vertical and horizontal displacements of the HB in subjects with 2 different magnitudes of skeletal Class III malocclusion, by means of real-time, balanced turbo-field-echo (B-TFE) cine-magnetic resonance imaging. Methods The study population comprised 19 patients with mild skeletal Class III malocclusion, 16 with severe skeletal Class III malocclusion, and 20 with a skeletal Class I relationship. Before the commencement of the study, all subjects underwent cephalometric analysis to identify the nature of skeletal malformations. B-TFE images were obtained for the 4 consecutive stages of deglutition as each patient swallowed 10 mL of water, and the vertical and horizontal displacements of the HB were measured at each stage. Results At all stages of swallowing, the vertical position of the HB in the severe Class III malocclusion group was significantly lower than those in the mild Class III and Class I malocclusion groups. Similarly, the horizontal displacement of the HB was found to be significantly associated with the severity of malocclusion, i.e., the degree of Class III malocclusion, while the amount of anterior displacement of the HB decreased with an increase in the severity of the Class III deformity. Conclusions Our findings indicate the existence of a relationship between the magnitude of Class III malocclusion and HB displacement during swallowing. PMID:23112950

  14. The Reliability of Pharyngeal High Resolution Manometry with Impedance for Derivation of Measures of Swallowing Function in Healthy Volunteers

    PubMed Central

    Omari, Taher I.; Savilampi, Johanna; Kokkinn, Karmen; Schar, Mistyka; Lamvik, Kristin; Doeltgen, Sebastian; Cock, Charles

    2016-01-01

    Purpose. We evaluated the intra- and interrater agreement and test-retest reliability of analyst derivation of swallow function variables based on repeated high resolution manometry with impedance measurements. Methods. Five subjects swallowed 10 × 10 mL saline on two occasions one week apart producing a database of 100 swallows. Swallows were repeat-analysed by six observers using software. Swallow variables were indicative of contractility, intrabolus pressure, and flow timing. Results. The average intraclass correlation coefficients (ICC) for intra- and interrater comparisons of all variable means showed substantial to excellent agreement (intrarater ICC 0.85–1.00; mean interrater ICC 0.77–1.00). Test-retest results were less reliable. ICC for test-retest comparisons ranged from slight to excellent depending on the class of variable. Contractility variables differed most in terms of test-retest reliability. Amongst contractility variables, UES basal pressure showed excellent test-retest agreement (mean ICC 0.94), measures of UES postrelaxation contractile pressure showed moderate to substantial test-retest agreement (mean Interrater ICC 0.47–0.67), and test-retest agreement of pharyngeal contractile pressure ranged from slight to substantial (mean Interrater ICC 0.15–0.61). Conclusions. Test-retest reliability of HRIM measures depends on the class of variable. Measures of bolus distension pressure and flow timing appear to be more test-retest reliable than measures of contractility. PMID:27190520

  15. Comparison of maximal tongue strength and tongue strength used during swallowing in relation to age in healthy adults

    PubMed Central

    Park, Ji-Su; Oh, Dong-Hwan; Chang, Moonyoung

    2016-01-01

    [Purpose] The aim of this study was to measure and compare the maximal tongue strength and tongue strength used during swallowing in young and older adults. [Subjects and Methods] The study recruited 80 healthy young (aged 20 to 39 years) and older adults (aged ≥65 years) in public places. The Iowa Oral Performance Instrument was used to measure maximal tongue strength and tongue strength used during swallowing. For each subject, the peak value of three measurements was recorded and analyzed. [Results] Maximal tongue strength was statistically significantly higher for the young adults group than the older adults group. Conversely, tongue strength used during swallowing was statistically significantly higher for the older adults group than the young adults group. The percentages of tongue strength used during swallowing for the young adults and older adults groups were approximately 38.8% and 53.8%, respectively. [Conclusion] This study confirmed that older adults have a lower maximal tongue strength than young adults, but a higher tongue strength used during swallowing. PMID:27064477

  16. 2005 Disability Awareness Night

    ERIC Educational Resources Information Center

    Exceptional Parent, 2005

    2005-01-01

    The mission of Disability Awareness Night is to expand awareness of the 54 million Americans with disabilities, by highlighting their extraordinary achievements and the perseverance and dedication of the families, caregivers, physicians, nurses, therapists and teachers involved in their care and development. The presentation of the EP Maxwell…

  17. Assessment of Learning Disabilities.

    ERIC Educational Resources Information Center

    Shepard, Lorrie A.

    The assessment and diagnosis of learning disabilities (LD) in the school is problematic. How do educators determine who is learning disabled? What practices are recommended? The main focus of the paper is on specific, relatively technical points that influence the validity of assessment. Since technical concerns are only one of the factors…

  18. Learning Disabilities: Lifelong Issues.

    ERIC Educational Resources Information Center

    Cramer, Shirley C., Ed.; Ellis, William, Ed.

    This book contains papers on learning disabilities based on presentations made at the "Summit on Learning Disabilities: A National Responsibility," held in September 1994. The first section provides an overview and includes "The State of Research" (G. Reid Lyon). The second section focuses on education and includes: "Preventing Early Reading…

  19. Learning Disabilities and Employment.

    ERIC Educational Resources Information Center

    Gerber, Paul J., Ed.; Brown, Dale S., Ed.

    This book provides information on preparing individuals with learning disabilities for the challenges of employment and outlines the rights of those with learning disabilities in the workplace. Introductory chapters in Part 1 include: "Life after School: Challenges in the Workplace" (Paul J. Gerber); "The New Economy in the 21st Century:…

  20. Disability Employment 101

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    Business is about productivity and maintaining a competitive advantage. To do this, business needs qualified workers. Hiring people with disabilities adds value to a business and will attract new customers. Disability is not inability. Employers can make sound business decisions and gain a competitive advantage by using this guide to increase the…

  1. Learning Disabilities. Final Report.

    ERIC Educational Resources Information Center

    Delaware State Dept. of Education, Dover.

    This report responds to Delaware state legislation requiring the development of proposed revised regulations for the classification of students as learning disabled (LD). The report first describes the current system, noting that in 1997 15 percent of the student population were served under the Individuals with Disabilities Education Act and over…

  2. Disability Employment 101

    ERIC Educational Resources Information Center

    US Department of Education, 2005

    2005-01-01

    Business is about productivity and maintaining a competitive advantage. To do this, business needs qualified workers. Hiring people with disabilities adds value to a business and will attract new customers. Disability is not inability. President Bush's position is that he "will not be satisfied until every American who wants a job can find a job,…

  3. Disability Employment 101

    ERIC Educational Resources Information Center

    US Department of Education, 2006

    2006-01-01

    Business is about productivity and maintaining a competitive advantage. To do this, business needs qualified workers. Hiring people with disabilities adds value to a business and will attract new customers. Disability is not inability. President Bush's position is that he "will not be satisfied until every American who wants to work can find a…

  4. Transporting Students with Disabilities.

    ERIC Educational Resources Information Center

    Bluth, Linda F.; Hochberg, Susan N.

    1994-01-01

    Provides a brief description of the U.S. Constitutional provisions and public laws affecting transportation of students with disabilities. Lists suggested inservice training program elements to ensure the provision of adequate training necessary to safely transport students with disabilities. (MLF)

  5. Disciplining Students with Disabilities.

    ERIC Educational Resources Information Center

    Dwyer, Kevin P.

    This report discusses disciplining children with disabilities in schools, in the context of the legal requirements of the Individuals with Disabilities Education Act. Practical concepts are explained in terms of the school's responsibility to: (1) maintain a safe environment; (2) teach a code of discipline to all students; (3) use the…

  6. Disabilities in Written Expression

    ERIC Educational Resources Information Center

    Gardner, Teresa J.

    2011-01-01

    Regular education teachers may have received inadequate preparation to work with the variety of student disabilities encountered in the classroom, or they may have received limited training regarding the full range of learning disabilities and their effects on classroom performance. Along with problems in the area of math, students may also have…

  7. Disabling the SAT.

    ERIC Educational Resources Information Center

    Freedman, Miriam Kurtzig

    2003-01-01

    Argues the College Boards' decision to stop flagging the SAT scores of students with disabilities given extended time to take the test will compromise the test's validity. A civil rights organization urged the College Board to stop flagging SAT scores because the practice violated the rights of students with disabilities. Proposes three…

  8. Beauty and Disability

    ERIC Educational Resources Information Center

    Anderson, David W.

    2015-01-01

    People often hold stereotypical notions about disability, assuming people with significant disabilities offer little in terms of friendship or contribution. Some are even repulsed by that person's physical appearance. Such responses, evident within the Christian community as well, fail to acknowledge the inherent worth of the person as created in…

  9. Biologic Patterns of Disability.

    ERIC Educational Resources Information Center

    Granger, Carl V.; Linn, Richard T.

    2000-01-01

    Describes the use of Rasch analysis to elucidate biological patterns of disability present in the functional ability of persons undergoing medical rehabilitation. Uses two measures, one for inpatients and one for outpatients, to illustrate the approach and provides examples of some biological patterns of disability associated with specific types…

  10. Dads and Disability.

    ERIC Educational Resources Information Center

    Higgins, Cindy, Ed.

    1995-01-01

    This theme issue focuses on the relationship of fathers and their children with disabilities. It reports a study of 86 Kansas fathers of children (ages 5 to 8) with and without disabilities. The study was conducted in order to identify more options for fathers wishing to increase their involvement with their children. The study sent surveys of…

  11. Ghana: Disability and Spirituality

    ERIC Educational Resources Information Center

    Botts, Betsy H.; Evans, William H.

    2010-01-01

    This descriptive study explores the educational system and attitudes toward disability in the Volta Region of Ghana. Traditional, Christian, and Islamic beliefs toward disability are explored. Educators from Accra and three families from the Volta Region with children with special needs are interviewed in an effort to explore the connection…

  12. Voice and swallowing outcomes of an organ-preservation trial for advanced laryngeal cancer

    SciTech Connect

    Fung, Kevin . E-mail: kevin.fung@lhsc.on.ca; Lyden, Teresa H.; Lee, Julia; Urba, Susan G.; Worden, Frank; Eisbruch, Avraham; Tsien, Christina; Bradford, Carol R.; Chepeha, Douglas B.; Hogikyan, Norman D.; Prince, Mark E.P.; Teknos, Theodoros N.; Wolf, Gregory T.

    2005-12-01

    Introduction: Organ-preservation treatment approaches for advanced laryngeal cancer patients that use combination chemoradiotherapy result in cure rates similar to primary laryngectomy with postoperative radiotherapy. In the national VA Larynx Cancer Trial, successful organ preservation was associated with an overall improvement in quality of life but not in subjective speech compared with long-term laryngectomy survivors. As part of a Phase II clinical trial, a prospective study of speech and swallowing results was conducted to determine if larynx preservation is associated with improved voice and swallowing compared with results in patients who require salvage laryngectomy. Subjects: A total of 97 patients with advanced laryngeal cancer (46 Stage III, 51 Stage IV) were given a single course of induction chemotherapy (cisplatin 100 mg/m{sup 2} on Day 1 and 5-FU 1,000 mg/m{sup 2}/day x 5 days), followed by assessment of response. Patients with less than 50% response underwent early salvage laryngectomy, and patients with 50% or better response underwent concurrent chemoradiation (72 Gy and cisplatin 100 mg/m{sup 2} on Days 1, 22, and 43), followed by two cycles of adjuvant chemotherapy (DDP/5-FU). Direct laryngoscopy and biopsy were performed 8 weeks after radiation therapy to determine final tumor response. Late salvage surgery was performed on patients with persistent or recurrent disease. Methods: Completed survey data on voice and swallowing utilizing the Voice-Related Quality of Life Measure (V-RQOL) and the List Performance Status Scale for Head and Neck Cancer Patients (PSS-HN) were obtained from 56 patients who were alive and free of disease at the time of survey, with a minimum follow-up of 8 months. Comparisons were made between patients with an intact larynx (n = 37) vs. laryngectomy (n = 19), as well as early (n = 12) vs. late salvage laryngectomy (n = 7). Multivariate analysis was performed to determine factors predictive of voice and swallowing

  13. Heritable choice of colony size in cliff swallows: does experience trump genetics in older birds?

    PubMed

    Roche, Erin A; Brown, Charles R; Brown, Mary Bomberger

    2011-12-01

    The variation in breeding-colony size seen in populations of most colonial birds may reflect heritable choices made by individuals who are phenotypically specialized for particular social environments. Although a few studies have reported evidence for genetically based choice of group sizes in birds, we know relatively little about the extent to which animals potentially rely on experience versus innate preferences in deciding with how many conspecifics to settle at different times of their lives. We conducted a cross-fostering experiment in 1997-1998 on cliff swallows (Petrochelidon pyrrhonota) in southwestern Nebraska, USA, in which some individuals were reared in colonies different in size from those in which they were born. Breeding-colony sizes chosen by this cohort of birds were monitored by mark-recapture throughout their lives. A multistate mark-recapture analysis revealed that birds in their first breeding year chose colony sizes similar to those of their birth, regardless of their rearing environment, confirming a previous analysis. Beyond the first breeding year, however, cliff swallows' colony choice was less dependent on where they were born. Birds born in small colonies and reared in large colonies showed evidence of a delayed rearing effect, with these birds overwhelmingly choosing large colonies in later years. Heritabilities suggested strong genetic effects on first-year colony choice but not in later years. Cliff swallows' genetically based colony-size preferences their first year could be a way to ensure matching of their phenotype to an appropriate social environment as yearlings. In later years, familiarity with particular colony sites and available information on site quality may override innate group-size preferences when birds choose colonies. PMID:22247565

  14. Swallowing Kinematics and Factors Associated with Laryngeal Penetration and Aspiration in Stroke Survivors with Dysphagia.

    PubMed

    Seo, Han Gil; Oh, Byung-Mo; Han, Tai Ryoon

    2016-04-01

    The purpose of this study was to investigate swallowing kinematics and explore kinematic factors related with penetration-aspiration in patients with post-stroke dysphagia. Videofluoroscopic images of 68 patients with post-stroke dysphagia and 34 sex- and age-matched healthy controls swallowing a thin liquid were quantitatively analyzed using two-dimensional motion digitization. The measurements included the movement distances and velocities of the hyoid and larynx, and the maximal tilt angles and angular velocities of the epiglottis. All velocity variables were significantly decreased in the stroke patients compared to the controls. There was a significant difference in the maximal horizontal displacement of the larynx, but there were no significant differences in other displacements of the larynx, the maximal displacements of the hyoid bone, and the maximum tilt angle of the epiglottis between the two groups. The maximal tilt angle of the epiglottis was lower in the aspiration subgroup than in the no penetration/aspiration and penetration subgroups as well as the controls. The maximal tilt angle from the y axis showed a dichotomous pattern at 90° of the angle, and all 11 patients with an angle <90° showed either penetration or aspiration. In the ROC curve of the angle for prediction of aspiration, the area under the curve was 0.725 (95 % CI 0.557-0.892, P = 0.008). This study suggested that sluggish rather than decreased hyolaryngeal movements during swallowing are a remarkable feature of post-stroke dysphagia. The association of reduced epiglottic movement with the risk of aspiration in patients with post-stroke dysphagia was supported by the quantitative analysis. PMID:26590571

  15. Evaluation of polychlorinated biphenyl remediation at a superfund site using tree swallows (Tachycineta bicolor) as indicators.

    PubMed

    Spears, Brian L; Brown, Michael W; Hester, Cyrus M

    2008-12-01

    We studied tree swallows (Tachycineta bicolor) at the Sangamo National Priorities List (NPL) site and a reference area (Little Grassy) within Crab Orchard National Wildlife Refuge, Illinois, USA, to evaluate the bioavailability of polychlorinated biphenyls (PCBs) at the NPL site following remediation. Tree swallow eggs and 12- to 17-d-old chicks were collected from April to June 2004 and 2005. Total egg PCB concentrations in eggs did not differ between years at Sangamo; mean concentrations at Sangamo in 2004 to 2005 (4,452 ng/g) were higher than those from Little Grassy in 2004 (351 ng/g; p = 0.002) and 2005 (705 ng/g; p = 0.007). A positive PCB dilution in chicks is equivalent to relatively large amounts of exposure and absorption. Total PCB daily dilution in chicks in 2004 and 2005 averaged 92.4 and -203 ng/g/d at Sangamo and -21.8 and -42.7 ng/g/d at Little Grassy. Dioxin toxic equivalents (TEQs) in eggs in 2004 and 2005 were 1,844 and 676 pg/g at Sangamo and 165 and 128 pg/g at Little Grassy. Mean TEQs in chicks in 2004 and 2005 were 117 and 23.8 pg/g body weight at Sangamo and 0.8 and 0.7 pg/g body weight at Little Grassy. Total PCB concentrations in eggs and chicks at Sangamo and Little Grassy appeared to be comparable to other PCB-contaminated and reference sites. Our data demonstrate that tree swallows using the Sangamo site continue to accumulate significant quantities of PCBs seven years after remedial actions. These findings prompted a reevaluation of remediation at the site and underscore the importance of postremediation monitoring of ecological receptors, particularly in cases involving persistent environmental contaminants. PMID:18699698

  16. The Multidisciplinary Swallowing Team Approach Decreases Pneumonia Onset in Acute Stroke Patients

    PubMed Central

    Aoki, Shiro; Hirayama, Junko; Nakamori, Masahiro; Yoshikawa, Mineka; Nezu, Tomohisa; Kubo, Satoshi; Nagano, Yuka; Nagao, Akiko; Yamane, Naoya; Nishikawa, Yuichi; Takamoto, Megumi; Ueno, Hiroki; Ochi, Kazuhide; Maruyama, Hirofumi; Yamamoto, Hiromi; Matsumoto, Masayasu

    2016-01-01

    Dysphagia occurs in acute stroke patients at high rates, and many of them develop aspiration pneumonia. Team approaches with the cooperation of various professionals have the power to improve the quality of medical care, utilizing the specialized knowledge and skills of each professional. In our hospital, a multidisciplinary participatory swallowing team was organized. The aim of this study was to clarify the influence of a team approach on dysphagia by comparing the rates of pneumonia in acute stroke patients prior to and post team organization. All consecutive acute stroke patients who were admitted to our hospital between April 2009 and March 2014 were registered. We analyzed the difference in the rate of pneumonia onset between the periods before team organization (prior period) and after team organization (post period). Univariate and multivariate analyses were performed using a Cox proportional hazards model to determine the predictors of pneumonia. We recruited 132 acute stroke patients from the prior period and 173 patients from the post period. Pneumonia onset was less frequent in the post period compared with the prior period (6.9% vs. 15.9%, respectively; p = 0.01). Based on a multivariate analysis using a Cox proportional hazards model, it was determined that a swallowing team approach was related to pneumonia onset independent from the National Institutes of Health Stroke Scale score on admission (adjusted hazard ratio 0.41, 95% confidence interval 0.19–0.84, p = 0.02). The multidisciplinary participatory swallowing team effectively decreased the pneumonia onset in acute stroke patients. PMID:27138162

  17. Pseudoaneurysm of the Common Carotid Artery in an Infant due to Swallowed Fish Bone

    PubMed Central

    Jean Roger, Moulion Tapouh; Marcus, Fokou; Emmanuel, Fongang; Boniface, Moifo; Alain Georges, Juimo

    2015-01-01

    Carotid artery pseudoaneurysm is a rare condition, particularly in the paediatric population. Only about 30 cases of carotid artery aneurysms in infants have been published until now. This paper reports the case of a giant pseudoaneurysm of the left common carotid artery due to swallowed fish bone by an 8-year-old boy. This pseudoaneurysm was 5.5 cm transverse-diameter and resulted in severe respiratory distress. It was treated by resection and end-to-end anastomosis with satisfactory outcome after one-year follow-up. To the best of our knowledge, this is the largest carotid artery pseudoaneurysm ever described in children. PMID:26783485

  18. A toy MCT model for multiple glass transitions: Double swallow tail singularity

    NASA Astrophysics Data System (ADS)

    Ryzhov, V. N.; Tareyeva, E. E.

    2014-11-01

    We propose a toy model to describe in the frame of Mode Coupling Theory multiple glass transitions. The model is based on the postulated simple form for static structure factor as a sum of two delta-functions. This form makes it possible to solve the MCT equations in almost analytical way. The phase diagram is governed by two swallow tails resulting from two A4 singularities and includes liquid-glass transition and multiple glasses. The diagram has much in common with those of binary and quasibinary systems.

  19. Reverse Correlation in Neurophysiology

    ERIC Educational Resources Information Center

    Ringach, Dario; Shapley, Robert

    2004-01-01

    This article presents a review of reverse correlation in neurophysiology. We discuss the basis of reverse correlation in linear transducers and in spiking neurons. The application of reverse correlation to measure the receptive fields of visual neurons using white noise and m-sequences, and classical findings about spatial and color processing in…

  20. Exposure and effects of perfluoroalkyl compounds on tree swallows nesting at Lake Johanna in east central Minnesota, USA

    USGS Publications Warehouse

    Custer, Christine M.; Custer, Thomas W.; Schoenfuss, Heiko L.; Poganski, Beth H.; Solem, Laura

    2012-01-01

    Tree swallow (Tachycineta bicolor) samples were collected at a reference lake and a nearby lake (Lake Johanna) in east central Minnesota, USA contaminated with perfluorinated carboxylic and sulfonic acids. Tissues were analyzed for a suite of 13 perfluoroalkyl compounds (PFCs) to quantify exposure and to determine if there was an association between egg concentrations of PFCs and reproductive success of tree swallows. Concentrations of perfluoroocatane sulfonate (PFOS) were elevated in all tree swallow tissues from Lake Johanna compared to tissues collected at the reference lake. Other PFCs, except for two, were elevated in blood plasma at Lake Johanna compared to the reference lake. PFOS was the dominant PFC (>75%) at Lake Johanna, but accounted for <50% of total PFCs at the reference lake. There was a negative association between concentrations of PFOS in eggs and hatching success. Reduced hatching success was associated with PFOS levels as low as 150 ng/g wet weight.

  1. Swallow-tailed alkyl and linear alkoxy-substituted dibenzocoronene tetracarboxdiimide derivatives: synthesis, photophysical properties, and thermotropic behaviors.

    PubMed

    Yang, Tengzhou; Pu, Jialing; Zhang, Jun; Wang, Wenguang

    2013-05-17

    A series of dibenzocoronene tetracarboxdiimide derivatives decorated with alkyl swallow-tail and alkoxy moieties were synthesized, and their structures were characterized. 2,3-Dichloro-5,6-dicyano-1,4-benzoquinone (DDQ) as an effective oxidant was first used in the benzannulation of perylene diimides with the almost quantitative yield. The thermotropic behavior was investigated using differential scanning calorimetry (DSC) and polarization optical microscopy (POM). The introduction of alkyl swallow-tail and alkoxy substituents facilitates thermotropic liquid crystalline behavior. The branching site of alkyl swallow-tail units at the α position and the longer alkoxy chains played a similar role in lowering the mesophase transition as well as isotropization transition temperatures. The UV-vis absorption spectra of all compounds appeared as absorption in 425-600 nm region, and POM images of certain compounds exhibited characteristic columnar hexagonal (Col(h)) packing and readily self-assembled into a homeotropic alignment toward the substrate. PMID:23600443

  2. Exposure and effects of perfluoroalkyl compounds on tree swallows nesting at Lake Johanna in east central Minnesota, USA.

    PubMed

    Custer, Christine M; Custer, Thomas W; Schoenfuss, Heiko L; Poganski, Beth H; Solem, Laura

    2012-07-01

    Tree swallow (Tachycineta bicolor) samples were collected at a reference lake and a nearby lake (Lake Johanna) in east central Minnesota, USA contaminated with perfluorinated carboxylic and sulfonic acids. Tissues were analyzed for a suite of 13 perfluoroalkyl compounds (PFCs) to quantify exposure and to determine if there was an association between egg concentrations of PFCs and reproductive success of tree swallows. Concentrations of perfluoroocatane sulfonate (PFOS) were elevated in all tree swallow tissues from Lake Johanna compared to tissues collected at the reference lake. Other PFCs, except for two, were elevated in blood plasma at Lake Johanna compared to the reference lake. PFOS was the dominant PFC (>75%) at Lake Johanna, but accounted for <50% of total PFCs at the reference lake. There was a negative association between concentrations of PFOS in eggs and hatching success. Reduced hatching success was associated with PFOS levels as low as 150ng/g wet weight. PMID:21296656

  3. Preschoolers show less trust in physically disabled or obese informants

    PubMed Central

    Ma, Lili

    2015-01-01

    This research examined whether preschool-aged children show less trust in physically disabled or obese informants. In Study 1, when learning about novel physical activities and facts, 4- and 5-year-olds preferred to endorse the testimony of a physically abled, non-obese informant rather than a physically disabled or obese one. In Study 2, after seeing that the physically disabled or obese informant was previously reliable whereas the physically abled, non-obese one was unreliable, 4- and 5-year-olds did not show a significant preference for either informant. We conclude that in line with the literature on children’s negative stereotypes of physically disabled or obese others, preschoolers are biased against these individuals as potential sources of new knowledge. This bias is robust in that past reliability might undermine its effect on children, but cannot reverse it. PMID:25610413

  4. Emergence and performance of pale and black swallow-wort on two New York soils at three pH levels

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pale swallow-wort (Cynanchum rossicum [Kleopow] Borhidi) and black swallow-wort (Cynanchum louiseae [L.] Kartesz & Gandhi) are two herbaceous, perennial vines which are increasingly problematic invaders in the Great Lakes Basin of the Northeastern U.S. and Southeastern Canada. Although the North Ame...

  5. Influence of the Perceived Taste Intensity of Chemesthetic Stimuli on Swallowing Parameters Given Age and Genetic Taste Differences in Healthy Adult Women

    ERIC Educational Resources Information Center

    Pelletier, Cathy A.; Steele, Catriona M.

    2014-01-01

    Purpose: This study examined whether the perceived taste intensity of liquids with chemesthetic properties influenced lingua-palatal pressures and submental surface electromyography (sEMG) in swallowing, compared with water. Method: Swallowing was studied in 80 healthy women, stratified by age group and genetic taste status. General Labeled…

  6. BIOENERGETICS-BASED MODELING OF INDIVIDUAL PCB CONGENERS IN NESTLING TREE SWALLOWS FROM TWO CONTAMINATED SITES ON THE UPPER 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...

  7. Clinical Experience Using the Mann Assessment of Swallowing Ability for Identification of Patients at Risk for Aspiration in a Mixed-Disease Population

    ERIC Educational Resources Information Center

    Gonzalez-Fernandez, Marlis; Sein, Michael T.; Palmer, Jeffrey B.

    2011-01-01

    Purpose: To determine the clinical performance characteristics of the Mann Assessment of Swallowing Ability (MASA) for predicting aspiration (determined by videofluoroscopic swallowing study [VFSS]) in a mixed population. Method: We selected 133 cases clinically evaluated using MASA and VFSS from January through June 2007. Ordinal risk rating…

  8. [Clinical Analysis of Evaluation of the Swallowing Function before Gastrostomy in an Acute-care Hospital for Elderly People].

    PubMed

    Kimura, Yurika; Ohno, Keiko; Honjyo, Motomu

    2015-12-01

    The Ministry of Health, Labour and Welfare, while defining a significant reduction of the medical fee points for gastrostomy in the medical fee revision of fiscal year 2014, assigned additional fee points for evaluation of the swallowing function by videofluoroscopy (VF) or videoendoscopy (VE) prior to gastrostomy. In addition, for facilities that carried out more than 50 gastrostomy operations, evaluation of the swallowing function was made mandatory in all cases and 35% of oral ingestion recovery rate to require the full amount calculation. Therefore, we evaluated the data on swallowing function evaluation in patients and gastrostomy at our hospital. During a 3-year period from February 2012, 114 patients who underwent gastrostomy at our hospital were enrolled. We evaluated the background disease, indications for gastrostomy, conduct/non-conduct of swallowing function tests prior to gastrostomy, videoendoscopic score (VE score), and the functional oral intake score before and after gastrostomy in the patients. The predominant background diseases were cerebrovascular disease (33%), Parkinson's syndrome (26%), and Alzheimer's disease (11%). The indications for gastrostomy were dysphagia (38%), request for gastrostomy from other hospitals or nursing care home (24%), and malnutrition due to anorexia (18%). The severity of the dysfunction was classified based on the VE score as mild (28%), moderate (47%), or severe (25%). Dysphagia did not reach the majority of reasons for gastrostomy and not few of background diseases were progressive neurological diseases such as Parkinson's disease. Therefore, it remains under debate whether it is necessary to perform swallowing functional evaluation by VE or VF in all cases prior to gastrostomy. In some cases in which gastrostomy was indicated, the VE scores were not so high. Therefore, a comprehensive evaluation based on the pathophysiology and social background is needed to judge the indication for gastrostomy. Leading support

  9. Learning disabilities: an overview.

    PubMed

    Erenberg, G

    1991-03-01

    Children with learning disabilities form a large pool of patients seen by neurologists for help in understanding the disability and deciding which forms of remediation are appropriate. Learning disabilities may accompany a large variety of other neurologic disabilities, but the usual child with such a problem is in excellent health. A thorough office evaluation for possible medical problems is always necessary, but most children do not require laboratory testing. All children with learning disabilities, whether or not they have accompanying neurologic problems, should be seen for psychological and/or educational evaluation. Some children may also benefit from an evaluation by a speech and language pathologist, occupational therapist, or ophthalmologist. The neurologist, alone or in association with a child psychologist, should also investigate the possible association of learning disabilities with attention deficit hyperactivity disorder. It is only for children with this component of learning problems that the possibility of medication arises. Working closely with the family, the child's school system, and other involved professionals becomes an important aspect of providing full and necessary help to children with learning disabilities. A caring physician can be a major help to the child and his family in understanding this disorder and supporting them during a difficult time. PMID:2034911

  10. Quantum Operation Time Reversal

    SciTech Connect

    Crooks, Gavin E.

    2008-03-25

    The dynamics of an open quantum system can be described by a quantum operation: A linear, complete positive map of operators. Here, I exhibit a compact expression for the time reversal of a quantum operation, which is closely analogous to the time reversal of a classical Markov transition matrix. Since open quantum dynamics are stochastic, and not, in general, deterministic, the time reversal is not, in general, an inversion of the dynamics. Rather, the system relaxes toward equilibrium in both the forward and reverse time directions. The probability of a quantum trajectory and the conjugate, time reversed trajectory are related by the heat exchanged with the environment.

  11. The Excessive Appearance of Disability

    ERIC Educational Resources Information Center

    Michalko, Rod

    2009-01-01

    This paper engages the appearance of disability in contemporary Western culture. Rather than taking disability for granted as a biomedical condition, I interrogate how disability is made to appear in our culture, including its appearance as a biomedical condition. Fundamentally, disability appears to us as a trouble and, as such, cultural…

  12. Paralympic Athletes and "Knowing Disability"

    ERIC Educational Resources Information Center

    Fitzgerald, Hayley

    2012-01-01

    This article explores non-disabled young people's understandings of Paralympic athletes and the disability sports they play. The article examines how society has come to know disability by discussing medical and social model views of disability. The conceptual tools offered by Pierre Bourdieu are utilised as a means of understanding the nature and…

  13. Disability Studies. NRC Fact Sheet

    ERIC Educational Resources Information Center

    Harris, Perri

    2010-01-01

    Over the past several decades, what people now refer to as "disability studies" has been a powerful influence on policy and practice in regards to people with disabilities. Disability studies has evolved as a means of addressing how people with disabilities have been treated historically and how they continue to be treated. The field of disability…

  14. The Structure of Disability Perception.

    ERIC Educational Resources Information Center

    Northcraft, Gregory B.

    One of the biggest barriers to a handicapped individual's coping with his or her disability may be reactions of the public. The present study addressed the problem of public reactions to disability by examining the cognitive perceptual structures which underlie attitudes toward the disabled. Thirty-eight different disability types (plus two…

  15. Information Package on Disability Studies.

    ERIC Educational Resources Information Center

    Harris, Perri; Lewin, Lori

    This document is a resource guide to disabilities studies, an approach to disability which seeks to examine the social, economic, and political forces that for years have served to marginalize and oppress people with disabilities. Following an introduction that explains the field of disability studies, Section 1 is an annotated bibliography of 13…

  16. Dickens and disability.

    PubMed

    Wainapel, S F

    1996-12-01

    The novels of Charles Dickens include many vivid portraits of individuals with physical disabilities or deformities, and these conditions are often used symbolically to highlight some of the author's recurring themes. Disabled children are depicted as innocent victims, while their older counterparts are most often viewed as corrupt victimizers whose physical deformities are outward manifestations of their inner depravity. Punishment for moral failings in non-disabled characters frequently takes the form of paralysis and/or aphasia resulting from a cerebrovascular accident. In this context the wheelchair becomes a potent metaphor of imprisonment as a form of retributive justice. PMID:9007422

  17. Construction and validation of indicators and respective definitions for the nursing outcome Swallowing Status1

    PubMed Central

    Oliveira, Ana Railka de Souza; de Araujo, Thelma Leite; de Carvalho, Emilia Campos; Costa, Alice Gabrielle de Sousa; Cavalcante, Tahissa Frota; Lopes, Marcos Venícios de Oliveira

    2015-01-01

    OBJECTIVE: to develop indicators for the nursing outcome Swallowing Status and the respective conceptual and operational definitions validated by experts and in a clinical setting among patients after having experienced a stroke. METHOD: methodological study with concept analysis and content and clinical validations. The Content Validation Index was verified for the scores assigned by 11 experts to indicators. Two pairs of nurses assessed 81 patients during the clinical validation: one pair used an instrument with definitions and the other used an instrument without definitions. The resulting assessments were compared using Intraclass Correlation Coefficient, Friedman's test, and Minimal Important Difference calculation. RESULTS: All the indicators, with the exception of the indicator Ability to bring food to mouth, presented Content Validation Index above 0.80. The pair using the instrument with definitions presented an Intraclass Correlation Coefficient above 0.80 for all the indicators and similarity was found in all the assessments, according to the Minimal Important Difference calculation. The pair using the instrument without definitions presented a low coefficient (ρ<0.75) for all the indicators. CONCLUSION: the results showed that greater uniformity and accuracy was achieved by the pair of nurses using the conceptual and operational definitions for the indicators of the nursing outcome Swallowing Status. PMID:26155008

  18. The complete mitogenome of Japanese swallow angelfish (Genicanthus semifasciatus) and Ornate angelfish (Genicanthus bellus) (Teleostei: Pomacanthidae).

    PubMed

    Hsiao, Chung-Der; Shen, Kang-Ning; Tsai, Shiou-Yi; Wu, Shan-Chun; Chen, Ching-Hung; Chang, Chih-Wei

    2016-07-01

    In this study, we used the next-generation sequencing method to determine the complete mitogenome of Japanese swallow angelfish (Genicanthus semifasciatus) and Ornate angelfish (Genicanthus bellus) for the first time. The assembled mitogenome, 16,722 bp and 16,734 bp in length, shows 95% identity to each other. Both mitogenomes follow the typical vertebrate arrangement, including 13 protein-coding genes, 22 transfer RNAs, 2 ribosomal RNAs genes and a non-coding control region of D-loop. D-loop contains length of 1013 bp in G. semifasciatus and 1030 bp in G. bellus, and is located between tRNA-Pro and tRNA-Phe. The overall GC content is 46.4% for G. semifasciatus and 46.6% for G. bellus. The complete mitogenome of Japanese swallow angelfish and Ornate angelfish determined in this study provides essential and important DNA molecular data for further phylogenetic and evolutionary analyses for marine angelfish. PMID:26024128

  19. A portable self-sensing rheometer for investigation and therapy of swallowing disorders.

    PubMed

    O'Leary, Mark T; Hanson, Ben

    2010-01-01

    Dysphagia is a medical condition in which the safety or efficiency of eating and drinking is compromised. Thin, watery fluids flow too quickly through the oral anatomy during an abnormal swallow, pre-empting airway protective mechanisms, and potentially resulting in fluid entry into the lung. Dysphagia therapy consists of reducing flow speed during swallowing by increasing fluid viscosity using thickeners. Bolus viscosity must be specified and presented to the patient within a well-defined range for effective therapy. Thickeners produce non-Newtonian fluids, rendering current subjective methods for fluid assessment unreliable. Widespread quantification of fluid viscosity is presently impractical as rheometers are costly and complicated to use. Alternative techniques also have disadvantages such as operation at shear rates inappropriate to fluid use. A simple and inexpensive rheometer has been constructed to remedy this situation using a self-sensing electromagnetic actuator. This avoids the need for separate force and displacement sensors, with benefits for simplicity and robustness. The actuator and fluid interface were designed for viscosities consistent with those used for dysphagia therapy. The self-sensing rheometer was found to be able to resolve the different dynamic viscosities obtained from three commonly used therapeutic fluid consistency levels in close agreement with results from a reference laboratory rheometer. Widespread use of the rheometer could remove the subjectivity of fluid assessment, increasing accuracy of fluid specification and therapy across all consistencies and fluid types. PMID:21095673

  20. Surgical resection of cervical schwannoma and paraganglioma: Speech and swallowing outcomes

    PubMed Central

    Parker, Noah P.; Jabbour, Noel; Lassig, Amy Anne; Yueh, Bevan; Khariwala, Samir S.

    2016-01-01

    We conducted a retrospective study (1999 to 2009) at our tertiary care institution to evaluate speech and swallowing outcomes after the resection of cervical schwannoma or paraganglioma. Of 6 patients treated for schwannoma, 5 (83.3%) had immediate dysphonia and dysphagia. All patients with deficits received primary reinnervation (n = 2) or subsequent medialization laryngoplasty (n = 3). At 6 months, 4 patients (66.6%) still had dysphonia and dysphagia. At final follow-up (median: 10 months; range: 8 to 12 months), 4 patients (66.7%) had dysphonia and 2 (33.3%) had dysphagia. Of 10 patients treated for paraganglioma, 6 (60.0%) had immediate dysphonia and dysphagia. Four patients received subsequent medialization laryngoplasty; none had primary reinnervation. At 6 months, 3 (30%) still had dysphonia and dysphagia. At final follow-up (median: 15.5 months; range: 1.25 to 48 months), 2 (20.0%) had dysphonia and dysphagia. All patients with deficits received speech and swallowing therapy. We conclude that cervical schwannoma and paraganglioma resection was associated with high rates of immediate postoperative dysphonia and dysphagia. Schwannoma had higher initial rates and poorer recovery. Primary and/or subsequent laryngeal procedures combined with therapy led to symptom resolution in some patients. PMID:26322453

  1. Water level management and contaminant exposure to tree swallows nesting on the Upper Mississippi River.

    PubMed

    Custer, Thomas W; Dummer, Paul M; Custer, Christine M; Li, Azusa U; Warburton, David; Melancon, Mark J; Hoffman, David J; Matson, Cole W; Bickham, John W

    2007-10-01

    The U.S. Army Corps of Engineers conducted a water drawdown on Navigation Pool 8 of the Upper Mississippi River during the summers of 2001 and 2002 to increase aquatic vegetation production and thereby improve fish and wildlife habitat. Flooding of previously dried wetlands, however, may increase the rate of mercury methylation and make mercury more available to terrestrial vertebrates that feed in aquatic environments. Our objective was to determine if mercury, other elements, and organochlorine contaminants were more available to vertebrates following the 2001 drawdown. Tree swallow (Tachycineta bicolor) eggs and nestlings were collected at two sites on Pool 8 and a nearby Reference site in 2000 (pre-2001 drawdown), 2001 (pre-2001 drawdown) and 2002 (post-2001 drawdown) and tissues were analyzed for mercury, other elements, and organochlorine contaminants. Bioindicator measurements of genetic damage, oxidative stress, ethoxyresorufin-O-dealkylase activity, and the ratio of liver to nestling mass were also measured in nestlings at all sites and all years. Based on a multivariate analysis, the 2001 drawdown of Pool 8 did not influence element concentrations, organochlorine concentrations, or bioindicator response. Concentrations of inorganic and organochlorine contaminants in tree swallow eggs and nestlings were not at toxic levels. Hatching success did not differ among years and was comparable to the nationwide average. PMID:17286172

  2. The maintenance of phenotypic divergence through sexual selection: An experimental study in barn swallows Hirundo rustica.

    PubMed

    Safran, Rebecca J; Vortman, Yoni; Jenkins, Brittany R; Hubbard, Joanna K; Wilkins, Matthew R; Bradley, Rachel J; Lotem, Arnon

    2016-09-01

    Previous studies have shown that sexual signals can rapidly diverge among closely related species. However, we lack experimental studies to demonstrate that differences in trait-associated reproductive performance maintain sexual trait differences between closely related populations, in support for a role of sexual selection in speciation. Populations of Northern Hemisphere distributed barn swallows Hirundo rustica are closely related, yet differ in two plumage-based traits: ventral color and length of the outermost tail feathers (streamers). Here we provide experimental evidence that manipulations of these traits result in different reproductive consequences in two subspecies of barn swallow: (H. r. erythrogaster in North America and H. r. transitiva in the East Mediterranean). Experimental results in Colorado, USA, demonstrate that males with (1) darkened ventral coloration and (2) shortened streamers gained paternity between two successive reproductive bouts. In contrast, exaggeration of both traits improved reproductive performance within H. r. transitiva in Israel: males with a combination treatment of darkened ventral coloration and elongated streamers gained paternity between two successive reproductive bouts. Collectively, these experimental results fill an important gap in our understanding for how divergent sexual selection maintains phenotype differentiation in closely related populations, an important aspect of the speciation process. PMID:27436630

  3. Experimental evidence that brighter males sire more extra-pair young in tree swallows.

    PubMed

    Whittingham, Linda A; Dunn, Peter O

    2016-08-01

    Across taxa, extra-pair mating is widespread among socially monogamous species, but few studies have identified male ornamental traits associated with extra-pair mating success, and even fewer studies have experimentally manipulated male traits to determine whether they are related directly to paternity. As a consequence, there is little experimental evidence to support the widespread hypothesis that females choose more ornamented males as extra-pair mates. Here, we conducted an experimental study of the relationship between male plumage colour and fertilization success in tree swallows (Tachycineta bicolor), which have one of the highest levels of extra-pair mating in birds. In this study, we experimentally dulled the bright blue plumage on the back of males (with nontoxic ink markers) early in the breeding season prior to most mating. Compared with control males, dulled males sired fewer extra-pair young, and, as a result, fewer young overall. Among untreated males, brighter blue males also sired more extra-pair young, and in paired comparisons, extra-pair sires had brighter blue plumage than the within-pair male they cuckolded. These results, together with previous work on tree swallows, suggest that extra-pair mating behaviour is driven by benefits to both males and females. PMID:27105297

  4. Mercury and growth of tree swallows at Acadia National Park, and at Orono, Maine, USA

    USGS Publications Warehouse

    Longcore, J.R.; Dineli, R.; Haines, T.A.

    2007-01-01

    In 1997 and 1998 we weighed nestling tree swallows (Tachycineta bicolor) and measured selected body components at two colonies: Acadia National Park on Mt. Desert Island, and at Orono, ME. We used differences in mean growth variables among individual nestlings to evaluate differences between colonies, years, and amount of total mercury (THg) in carcasses and methyl mercury (MeHg) in feathers. We marked nestlings on the day hatched and measured body components every day in 1997 and every other day in 1998 until nestlings fledged. We calculated linear growth rates and asymptotic means as appropriate. In 1998, linear growth rate of weight was higher at Acadia than at Orono, but not different in 1997. We detected no mean differences in asymptotic mean weight of nestlings between colonies or years. In 1997, mean linear growth rates of the wing (chord), tail, tarsus, and mandible were higher at Acadia than at Orono. The amount of MeHg in feathers was associated with a lower linear growth rate of weight during early age (2?10 days), but asymptotic mean weight during days 11?16 was not different. No effect on linear growth of tail feathers or wing was associated with the amount of MeHg in feathers or THg in carcasses. Fledgling tree swallows that survive to migrate, however, will leave Maine with substantial concentrations of Hg in their tissues.

  5. Water level management and contaminant exposure to tree swallows nesting on the Upper Mississippi River

    USGS Publications Warehouse

    Custer, T.W.; Dummer, P.M.; Custer, Christine M.; Li, A.U.; Warburton, D.; Melancon, M.J.; Hoffman, D.J.; Matson, C.W.; Bickham, J.W.

    2007-01-01

    The U.S. Army Corps of Engineers conducted a water drawdown on Navigation Pool 8 of the Upper Mississippi River during the summers of 2001 and 2002 to increase aquatic vegetation production and thereby improve fish and wildlife habitat. Flooding of previously dried wetlands, however, may increase the rate of mercury methylation and make mercury more available to terrestrial vertebrates that feed in aquatic environments. Our objective was to determine if mercury, other elements, and organochlorine contaminants were more available to vertebrates following the 2001 drawdown. Tree swallow (Tachycineta bicolor) eggs and nestlings were collected at two sites on Pool 8 and a nearby Reference site in 2000 (pre-2001 drawdown), 2001 (pre-2001 drawdown) and 2002 (post-2001 drawdown) and tissues were analyzed for mercury, other elements, and organochlorine contaminants. Bioindicator measurements of genetic damage, oxidative stress, ethoxyresorufin-O-dealkylase activity, and the ratio of liver to nestling mass were also measured in nestlings at all sites and all years. Based on a multivariate analysis, the 2001 drawdown of Pool 8 did not influence element concentrations, organochlorine concentrations, or bioindicator response. Concentrations of inorganic and organochlorine contaminants in tree swallow eggs and nestlings were not at toxic levels. Hatching success did not differ among years and was comparable to the nationwide average.

  6. Effects of reflux laryngitis on non-nutritive swallowing in newborn lambs.

    PubMed

    Brisebois, Simon; Samson, Nathalie; Fortier, Pierre-Hugues; Doueik, Alexandre A; Carreau, Anne-Marie; Praud, Jean-Paul

    2014-08-15

    Reflux laryngitis in infants may be involved not only in laryngeal disorders, but also in disorders of cardiorespiratory control through its impact on laryngeal function. Our objective was to study the effect of reflux laryngitis on non-nutritive swallowing (NNS) and NNS-breathing coordination. Two groups of six newborn lambs, randomized into laryngitis and control groups, were surgically instrumented for recording states of alertness, swallowing and cardiorespiratory variables without sedation. A mild to moderate reflux laryngitis was induced in lambs from the experimental group. A significant decrease in the number of NNS bursts and apneas was observed in the laryngitis group in active sleep (p=0.03). In addition, lower heart and respiratory rates, as well as prolonged apnea duration (p<0.0001) were observed. No physiologically significant alterations in NNS-breathing coordination were observed in the laryngitis group. We conclude that a mild to moderate reflux laryngitis alters NNS burst frequency and autonomous control of cardiac activity and respiration in lambs. PMID:24893350

  7. Sequential Coordination between Lingual and Pharyngeal Pressures Produced during Dry Swallowing

    PubMed Central

    Yano, Jitsuro; Aoyagi, Yoichiro; Ono, Takahiro; Hori, Kazuhiro; Yamaguchi, Wakami; Fujiwara, Shigehiro; Kumakura, Isami; Minagi, Shogo; Tsubahara, Akio

    2014-01-01

    The aim of this study was to investigate oropharyngeal pressure flow dynamics during dry swallowing in ten healthy subjects. Tongue pressure (TP) was measured using a sensor sheet system with five measuring points on the hard palate, and pharyngeal pressure (PP) was measured using a manometric catheter with four measuring points. The order and correlations of sequential events, such as onset, peak, and offset times of pressure production, at each pressure measuring point were analyzed on the synchronized waveforms. Onset of TP was earlier than that of PP. The peak of TP did not show significant differences with the onset of PP, and it was earlier than that of PP. There was no significant difference between the offset of TP and PP. The onset of PP was temporally time-locked to the peak of TP, and there was an especially strong correlation between the onset of PP and TP at the posterior-median part on the hard palate. The offset of PP was temporally time-locked to that of TP. These results could be interpreted as providing an explanation for the generation of oropharyngeal pressure flow to ensure efficient bolus transport and safe swallowing. PMID:25580436

  8. Aspiration Pneumonia in Children with Cerebral Palsy after Videofluoroscopic Swallowing Study

    PubMed Central

    Lagos-Guimarães, Hellen Nataly Correia; Teive, Hélio Afonso Ghizoni; Celli, Adriane; Santos, Rosane Sampaio; Abdulmassih, Edna Marcia da Silva; Hirata, Gisela Carmona; Gallinea, Liliane Friedrich

    2015-01-01

    Introduction Dysphagia is a common symptom in children with cerebral palsy, either in oral or pharyngeal phases. Children who face such difficulties tend to show health problems such as food aspiration, malnutrition and respiratory infections. Videofluoroscopic swallowing study is the most recommended for these cases, as it reveals the real situation during swallowing. Objective The study aimed to verify the occurrence of aspiration pneumonia in children with cerebral palsy after videofluoroscopy. Methods The population for this prospective cross-sectional study involved 103 children with cerebral palsy, referred for videofluoroscopic who had returned for medical examination after a week to search for signs and symptoms of pneumonia. Results The study involved 46 girls (44.66%) and 57 boys (55.34%), aged between 0 and 14 years of age. Of the total, 84 (81.5%) had dysphagia, of which 24 (23.3%) were severe, 8 (7.7%) were moderate and 52 (50.4%) were mild dysphagia. None of the children presented aspiration pneumonia or infectious complications during the course of videofluoroscopy or after the procedure. Conclusion In the population studied, the authors found no cases of aspiration pneumonia, even with tracheal aspiration present in 32 (31.07%) cases. PMID:27096017

  9. Innate immunity is not related to the sex of adult Tree Swallows during the nestling period

    USGS Publications Warehouse

    Houdek, Bradley J.; Lombardo, Michael P.; Thorpe, Patrick A.; Hahn, D. Caldwell

    2011-01-01

    Evolutionary theory predicts that exposure to more diverse pathogens will result in the evolution of a more robust immune response. We predicted that during the breeding season the innate immune function of female Tree Swallows (Tachycineta bicolor) should be more effective than that of males because (1) the transmission of sexually transmitted microbes during copulation puts females at greater risk because ejaculates move from males to females, (2) females copulate with multiple males, exposing them to the potentially pathogenic microbes in semen, and (3) females spend more time in the nest than do males so may be more exposed to nest microbes and ectoparasites that can be vectors of bacterial and viral pathogens. In addition, elevated testosterone in males may suppress immune function. We tested our prediction during the 2009 breeding season with microbicidal assays in vitro to assess the ability of the innate immune system to kill Escherichia coli. The sexes did not differ in the ability of their whole blood to kill E. coli. We also found no significant relationships between the ability of whole blood to kill E. coli and the reproductive performance or the physical condition of males or females. These results indicate that during the nestling period there are no sexual differences in this component of the innate immune system. In addition, they suggest that there is little association between this component of innate immunity and the reproductive performance and physical condition during the nestling period of adult Tree Swallows.

  10. Innate immunity is not related to the sex of adult Tree Swallows during the nestling period

    USGS Publications Warehouse

    Houdek, B.J.; Lombardo, M.P.; Thorpe, P.A.; Hahn, D.C.

    2011-01-01

    Evolutionary theory predicts that exposure to more diverse pathogens will result in the evolution of a more robust immune response. We predicted that during the breeding season the innate immune function of female Tree Swallows (Tachycineta bicolor) should be more effective than that of males because (1) the transmission of sexually transmitted microbes during copulation puts females at greater risk because ejaculates move from males to females, (2) females copulate with multiple males, exposing them to the potentially pathogenic microbes in semen, and (3) females spend more time in the nest than do males so may be more exposed to nest microbes and ectoparasites that can be vectors of bacterial and viral pathogens. In addition, elevated testosterone in males may suppress immune function. We tested our prediction during the 2009 breeding season with microbicidal assays in vitro to assess the ability of the innate immune system to kill Escherichia coli. The sexes did not differ in the ability of their whole blood to kill E. coli. We also found no significant relationships between the ability of whole blood to kill E. coli and the reproductive performance or the physical condition of males or females. These results indicate that during the nestling period there are no sexual differences in this component of the innate immune system. In addition, they suggest that there is little association between this component of innate immunity and the reproductive performance and physical condition during the nestling period of adult Tree Swallows. ?? The Cooper Ornithological Society 2011.

  11. Reproductive and behavioral abnormalities in tree swallows with high levels of PCB contamination

    SciTech Connect

    McCarty, J.; Secord, A.; Tillitt, D.

    1995-12-31

    Tree Swallows (Tachycineta bicolor) breeding along the Hudson River forage extensively on PCB contaminated insects that emerge from the river. The authors studied the reproductive ecology and behavior of tree swallows breeding at several sites along the Hudson River. These sites vary in the severity of PCB contamination. PCB levels in both eggs and chicks were found to be among the highest ever reported in this species, with concentrations comparable to those found in aquatic organisms in the Hudson River. In 1994 reproductive success at PCB contaminated sites was significantly impaired, relative to other sites in New York. Reduced reproductive success was largely attributed to high levels of nest abandonment during incubation and reduced hatchability of eggs. Growth and development of nestlings was not significantly impaired. Abnormal nest building behavior was also noted in 1994, and this was studied in detail in 1995. Nests from contaminated areas are significantly smaller than those at a nearby reference site and at other sites in New York. The authors suggest that the reduced reproductive outputs at these sites are, in large part, a result of effects on the behavior of incubating females. The population-level implications of these patterns are unknown.

  12. Clock gene polymorphism and scheduling of migration: a geolocator study of the barn swallow Hirundo rustica

    PubMed Central

    Bazzi, Gaia; Ambrosini, Roberto; Caprioli, Manuela; Costanzo, Alessandra; Liechti, Felix; Gatti, Emanuele; Gianfranceschi, Luca; Podofillini, Stefano; Romano, Andrea; Romano, Maria; Scandolara, Chiara; Saino, Nicola; Rubolini, Diego

    2015-01-01

    Circannual rhythms often rely on endogenous seasonal photoperiodic timers involving ‘clock’ genes, and Clock gene polymorphism has been associated to variation in phenology in some bird species. In the long-distance migratory barn swallow Hirundo rustica, individuals bearing the rare Clock allele with the largest number of C-terminal polyglutamine repeats found in this species (Q8) show a delayed reproduction and moult later. We explored the association between Clock polymorphism and migration scheduling, as gauged by light-level geolocators, in two barn swallow populations (Switzerland; Po Plain, Italy). Genetic polymorphism was low: 91% of the 64 individuals tracked year-round were Q7/Q7 homozygotes. We compared the phenology of the rare genotypes with the phenotypic distribution of Q7/Q7 homozygotes within each population. In Switzerland, compared to Q7/Q7, two Q6/Q7 males departed earlier from the wintering grounds and arrived earlier to their colony in spring, while a single Q7/Q8 female was delayed for both phenophases. On the other hand, in the Po Plain, three Q6/Q7 individuals had a similar phenology compared to Q7/Q7. The Swiss data are suggestive for a role of genetic polymorphism at a candidate phenological gene in shaping migration traits, and support the idea that Clock polymorphism underlies phenological variation in birds. PMID:26197782

  13. Clock gene polymorphism and scheduling of migration: a geolocator study of the barn swallow Hirundo rustica.

    PubMed

    Bazzi, Gaia; Ambrosini, Roberto; Caprioli, Manuela; Costanzo, Alessandra; Liechti, Felix; Gatti, Emanuele; Gianfranceschi, Luca; Podofillini, Stefano; Romano, Andrea; Romano, Maria; Scandolara, Chiara; Saino, Nicola; Rubolini, Diego

    2015-01-01

    Circannual rhythms often rely on endogenous seasonal photoperiodic timers involving 'clock' genes, and Clock gene polymorphism has been associated to variation in phenology in some bird species. In the long-distance migratory barn swallow Hirundo rustica, individuals bearing the rare Clock allele with the largest number of C-terminal polyglutamine repeats found in this species (Q8) show a delayed reproduction and moult later. We explored the association between Clock polymorphism and migration scheduling, as gauged by light-level geolocators, in two barn swallow populations (Switzerland; Po Plain, Italy). Genetic polymorphism was low: 91% of the 64 individuals tracked year-round were Q7/Q7 homozygotes. We compared the phenology of the rare genotypes with the phenotypic distribution of Q7/Q7 homozygotes within each population. In Switzerland, compared to Q7/Q7, two Q6/Q7 males departed earlier from the wintering grounds and arrived earlier to their colony in spring, while a single Q7/Q8 female was delayed for both phenophases. On the other hand, in the Po Plain, three Q6/Q7 individuals had a similar phenology compared to Q7/Q7. The Swiss data are suggestive for a role of genetic polymorphism at a candidate phenological gene in shaping migration traits, and support the idea that Clock polymorphism underlies phenological variation in birds. PMID:26197782

  14. Better-surviving barn swallow mothers produce more and better-surviving sons.

    PubMed

    Romano, Andrea; Costanzo, Alessandra; Caprioli, Manuela; Parolini, Marco; Ambrosini, Roberto; Rubolini, Diego; Saino, Nicola

    2016-05-01

    Sex allocation theory predicts that parents are selected to bias their progeny sex ratio (SR) toward the sex that will benefit the most from parental quality. Because parental quality may differentially affect survival of sons and daughters, a pivotal test of the adaptive value of SR adjustment is whether parents overproduce offspring of the sex that accrues larger fitness advantages from high parental quality. However, this crucial test of the long-term fitness consequences of sex allocation decisions has seldom been performed. In this study of the barn swallow (Hirundo rustica), we showed a positive correlation between the proportion of sons and maternal annual survival. We then experimentally demonstrated that this association did not depend on the differential costs of rearing offspring of either sex. Finally, we showed that maternal lifespan positively predicted lifespan of sons but not of daughters. Because in barn swallows lifespan is a strong determinant of lifetime reproductive success, the results suggest that mothers overproduce offspring of the sex that benefits the most from maternal quality. Hence, irrespective of mechanisms causing the SR bias and mother-son covariation in lifespan, we provide strong evidence that sex allocation decisions of mothers can highly impact on their lifetime fitness. PMID:26990898

  15. Kinematics of intraoral transport and swallowing in the herbivorous lizard uromastix acanthinurus

    PubMed

    Herrel; Vree

    1999-05-01

    The kinematics of intraoral transport and swallowing in lizards of the species Uromastix acanthinurus (Chamaeleonidae, Leiolepidinae) were investigated using cineradiography (50 frames s-1). Additional recordings were also made using high-speed (500 frames s-1) and conventional video systems (25 frames s-1). Small metal markers were inserted into different parts of the upper and lower jaw and the tongue. Cineradiographic images were digitised, and displacements of the body, head, upper and lower jaw and the tongue were quantified. Twenty additional variables depicting displacements and the timing of events were calculated. Multivariate analyses of variance indicated significant differences between feeding stages. Remarkably, only very few food-type-dependent differences were observed during intraoral transport, and no such differences could be demonstrated during swallowing. Using previously published data for the closely related insectivorous lizard Plocederma stellio, the effect of dietary specialisation in U. acanthinurus on the kinematic variables while eating locusts was examined. Species differed in a number of gape- and tongue-related variables. These differences may be related to differences in tongue structure between the species. Clearly, U. acanthinurus possesses a specialised gut and dental structure that allows them efficiently to cut pieces from whole leaves. However, a decrease in modulatory capacity seems to be a consequence of dietary specialisation in Uromastix acanthinurus. PMID:10101110

  16. Aspiration Pneumonia in Children with Cerebral Palsy after Videofluoroscopic Swallowing Study.

    PubMed

    Lagos-Guimarães, Hellen Nataly Correia; Teive, Hélio Afonso Ghizoni; Celli, Adriane; Santos, Rosane Sampaio; Abdulmassih, Edna Marcia da Silva; Hirata, Gisela Carmona; Gallinea, Liliane Friedrich

    2016-04-01

    Introduction Dysphagia is a common symptom in children with cerebral palsy, either in oral or pharyngeal phases. Children who face such difficulties tend to show health problems such as food aspiration, malnutrition and respiratory infections. Videofluoroscopic swallowing study is the most recommended for these cases, as it reveals the real situation during swallowing. Objective The study aimed to verify the occurrence of aspiration pneumonia in children with cerebral palsy after videofluoroscopy. Methods The population for this prospective cross-sectional study involved 103 children with cerebral palsy, referred for videofluoroscopic who had returned for medical examination after a week to search for signs and symptoms of pneumonia. Results The study involved 46 girls (44.66%) and 57 boys (55.34%), aged between 0 and 14 years of age. Of the total, 84 (81.5%) had dysphagia, of which 24 (23.3%) were severe, 8 (7.7%) were moderate and 52 (50.4%) were mild dysphagia. None of the children presented aspiration pneumonia or infectious complications during the course of videofluoroscopy or after the procedure. Conclusion In the population studied, the authors found no cases of aspiration pneumonia, even with tracheal aspiration present in 32 (31.07%) cases. PMID:27096017

  17. The Accuracy of the Swallowing Kinematic Analysis at Various Movement Velocities of the Hyoid and Epiglottis

    PubMed Central

    Lee, Seung Hak; Chun, Seong Min; Lee, Jung Chan; Min, Yusun; Bang, Sang-Heum; Kim, Hee Chan; Han, Tai Ryoon

    2013-01-01

    Objective To evaluate the accuracy of the swallowing kinematic analysis. Methods To evaluate the accuracy at various velocities of movement, we developed an instrumental model of linear and rotational movement, representing the physiologic movement of the hyoid and epiglottis, respectively. A still image of 8 objects was also used for measuring the length of the objects as a basic screening, and 18 movie files of the instrumental model, taken from videofluoroscopy with different velocities. The images and movie files were digitized and analyzed by an experienced examiner, who was blinded to the study. Results The Pearson correlation coefficients between the measured and instrumental reference values were over 0.99 (p<0.001) for all of the analyses. Bland-Altman plots showed narrow ranges of the 95% confidence interval of agreement between the measured and reference values as follows: 0.14 to 0.94 mm for distances in a still image, -0.14 to 1.09 mm/s for linear velocities, and -1.02 to 3.81 degree/s for angular velocities. Conclusion Our findings demonstrate that the distance and velocity measurements obtained by swallowing kinematic analysis are highly valid in a wide range of movement velocity. PMID:23869329

  18. [Strategy on dealing with noisy NIRS data: implications on functional neuroimaging on swallowing].

    PubMed

    Dan, Ippeita; Sano, Toshifumi; Dan, Haruka; Watanabe, Eiju

    2012-01-01

    Functional near-infrared spectroscopy (fNIRS) may be suited for functional monitoring during swallowing as it is comparatively immune to body movement. However, still fNIRS measurement on swallowing poses a technical problem that it may often involve motion artifacts. Although there is no single way to solve this problem, technical insights have been available form related studies in the past. Here we introduce two examples for analyzing data rich in motion artifacts putting emphasis on temporal structures of the data. The first is about fNIRS assessment of language function during overt naming tasks. Since data were temporally continuous, we adopted a general linear model with regression to a canonical hemodynamic response function to extract cortical activations related to overt naming tasks. The second example is about fNIRS assessment on go/no-go task performance with or without methylphenidate administration in Attention Deficit Hyperactivity Disorder (ADHD) children. Since data were disrupted by unexpected motion artifacts, we simplified temporal data structures by averaging to extract only robust signals. Thus, we indicated that the optimum analytical strategy varies depending on the temporal structures of the data. PMID:23196558

  19. Exposure and effects of perfluoroalkyl substances in tree swallows nesting in Minnesota and Wisconsin, USA

    USGS Publications Warehouse

    Custer, Christine M.; Custer, Thomas W.; Dummer, Paul; Etterson, Matthew A.; Thogmartin, Wayne E.; Wu, Qian; Kannan, Kurunthachalam; Trowbridge, Annette; McKann, Patrick C.

    2013-01-01

    The exposure and effects of perfluoroalkyl substances (PFASs) were studied at eight locations in Minnesota and Wisconsin between 2007 and 2011 using tree swallows (Tachycineta bicolor). Concentrations of PFASs were quantified as were reproductive success end points. The sample egg method was used wherein an egg sample is collected, and the hatching success of the remaining eggs in the nest is assessed. The association between PFAS exposure and reproductive success was assessed by site comparisons, logistic regression analysis, and multistate modeling, a technique not previously used in this context. There was a negative association between concentrations of perfluorooctane sulfonate (PFOS) in eggs and hatching success. The concentration at which effects became evident (150–200 ng/g wet weight) was far lower than effect levels found in laboratory feeding trials or egg-injection studies of other avian species. This discrepancy was likely because behavioral effects and other extrinsic factors are not accounted for in these laboratory studies and the possibility that tree swallows are unusually sensitive to PFASs. The results from multistate modeling and simple logistic regression analyses were nearly identical. Multistate modeling provides a better method to examine possible effects of additional covariates and assessment of models using Akaike information criteria analyses. There was a credible association between PFOS concentrations in plasma and eggs, so extrapolation between these two commonly sampled tissues can be performed.

  20. Exposure and effects of perfluoroalkyl substances in tree swallows nesting in Minnesota and Wisconsin, USA.

    PubMed

    Custer, Christine M; Custer, Thomas W; Dummer, Paul M; Etterson, Matthew A; Thogmartin, Wayne E; Wu, Qian; Kannan, Kurunthachalam; Trowbridge, Annette; McKann, Patrick C

    2014-01-01

    The exposure and effects of perfluoroalkyl substances (PFASs) were studied at eight locations in Minnesota and Wisconsin between 2007 and 2011 using tree swallows (Tachycineta bicolor). Concentrations of PFASs were quantified as were reproductive success end points. The sample egg method was used wherein an egg sample is collected, and the hatching success of the remaining eggs in the nest is assessed. The association between PFAS exposure and reproductive success was assessed by site comparisons, logistic regression analysis, and multistate modeling, a technique not previously used in this context. There was a negative association between concentrations of perfluorooctane sulfonate (PFOS) in eggs and hatching success. The concentration at which effects became evident (150-200 ng/g wet weight) was far lower than effect levels found in laboratory feeding trials or egg-injection studies of other avian species. This discrepancy was likely because behavioral effects and other extrinsic factors are not accounted for in these laboratory studies and the possibility that tree swallows are unusually sensitive to PFASs. The results from multistate modeling and simple logistic regression analyses were nearly identical. Multistate modeling provides a better method to examine possible effects of additional covariates and assessment of models using Akaike information criteria analyses. There was a credible association between PFOS concentrations in plasma and eggs, so extrapolation between these two commonly sampled tissues can be performed. PMID:23860575

  1. Optimization of parameter settings in cine-MR imaging for diagnosis of swallowing.

    PubMed

    Ohkubo, Mai; Higaki, Takuo; Nishikawa, Keiichi; Otonari-Yamamoto, Mika; Sugiyama, Tetsuya; Ishida, Ryo; Wako, Mamoru; Sano, Tsukasa

    2014-01-01

    Videofluorography is frequently used to evaluate swallowing and is considered the "gold standard" among imaging modalities. This modality, however, has several disadvantages, including radiation exposure and limitations in the detection of soft tissues. Conversely, magnetic resonance imaging (MRI) offers excellent contrast resolution in soft tissue without radiation exposure. A major drawback of MRI in evaluating swallowing, however, is that temporal resolution is poor. The aim of this study was to investigate a new cine-MRI modality. Imaging parameters were optimized and the efficacy of this new technique is discussed. Three techniques for speeding up MRI were combined: true fast imaging with steady state precession, generalized auto-calibrating partially parallel acquisition, and key-hole imaging. The effects of the receiver coils used, receiving bandwidth, slice thickness, and flip angle on each image were determined. The optimal imaging parameters obtained comprised a reduction factor of 2, receiving bandwidth of 1,000 Hz/pixel (repetition time of 151.7 milliseconds and echo time of 1.4 milliseconds), flip angle of 50°, and slice thickness of 6 mm. Neck and spine coils were used. Under these conditions, the new cine-MR imaging technique investigated showed a temporal resolution of 0.1 sec/slice (10 frames/sec). Even with optimized parameter settings, this technique did not allow a true temporal resolution of 30 frames/sec by a large margin. Motion artifacts persisted. Further study is needed on how to speed up this technique. PMID:25212558

  2. Evaluating respiratory patient disability.

    PubMed

    Ruiz Manzano, Juan; Alfageme Michavila, Inmaculada; Chiner Vives, Eusebi; Martínez González, Cristina

    2012-08-01

    The evaluation of the disabilities of patients with respiratory disease is regulated by the Spanish Ministry of Labor and Social Security, as are disabilities of any other type. We believe, however, that in respiratory pathologies this evaluation is especially complicated because, as they are chronic processes, they inter-relate with other systems. Furthermore, they tend to have occasional exacerbations; therefore, normal periods may alternate with other periods of important functional limitations. The present document arises from the desire of SEPAR to update this topic and to respond to the requests of respiratory disease patient associations who have asked us to do so. In this paper, we analyze the current situation of work disability legislation as well as the determination of degrees and percentages, including the current criteria for assigning disabilities due to respiratory tract deficiencies. Lastly, we propose work guidelines that would improve the existing scenario and outline this evaluation for specific pathologies. PMID:22341300

  3. Cognition and Learning Disabilities.

    ERIC Educational Resources Information Center

    Jacobs, Linda

    1984-01-01

    The cognitive approach to education is briefly summarized, and its implications for learning disabilities considered. The approach, which includes the genetic epistemology espoused by J. Piaget and information processing theory, proposes the importance of active involvement and control processes. (CL)

  4. Disability and Obesity

    MedlinePlus

    ... Findings Disability-Related Documents Resources & Materials Multimedia & Tools Free Materials Grantee Information Information for ... and obesity are both labels for ranges of weight that are greater than what is ...

  5. Approach to learning disability.

    PubMed

    Kulkarni, M; Kalantre, S; Upadhye, S; Karande, S; Ahuja, S

    2001-06-01

    Learning disabilities (LD) is one of the important causes of poor academic performance in school going children. Learning disabilities are developmental disorders that usually manifest during the period of normal education. These disabilities create a significant gap between the true potential and day to day performance of an individual. Dyslexia, dysgraphia and dyscalculia denote the problem related to reading, writing and mathematics. Perinatal problems are certain neurological conditions, known to be associated with LD; however, genetic predisposition seems to be the most probable etiological factors. Evaluation of a child suspected to be having LD consists of medical examination, vision and hearing test analysis of school performance. The psycho-behaviour assessment and education testing are essential in the process of diagnosis. The experienced persons in the field of LD should interpret the results of such tests. With Individualized Remedial Education Plan (IEP) most children learn to cope up with disability and may get integrated in a regular steam. PMID:11450386

  6. Ethics in neurodevelopmental disability.

    PubMed

    Racine, Eric; Bell, Emily; Shevell, Michael

    2013-01-01

    Neurodevelopmental disabilities, like autism spectrum disorders and cerebral palsy are a common health problem in children. Given the impact of these conditions on children, families, and healthcare and social systems, the care of developmentally challenged children raises questions related to values and ethical principles. We review the common features of neurodevelopmental disorders that help understand the associated ethical questions. We focus on three major areas where ethical questions arise for clinicians and those involved in making decisions for or caring for these children: (1) the principles of decision-making and autonomy as they relate to developmental disability; (2) the issues related to quality of life that have long intersected with developmental disability; and (3) the use of unproven therapies and diagnostics that are particularly controversial given the extent that neurodevelopmental disabilities impact children and their families, yet active treatments options are limited. PMID:24182383

  7. Difficulty Swallowing

    MedlinePlus

    ... decisions about when and where they should receive healthcare. Unfortunately, most people lack the medical knowledge needed to make these decisions safely. FreeMD.com is powered by a computer program that performs symptom triage. The goal of ...

  8. Swallowing Problems

    MedlinePlus

    ... such as citrus fruits and drinks and fizzy soft drinks. Avoid hard, dry foods such as crackers, pretzels, nuts, and chips. Sit upright to eat and drink, and stay that way for a ... caregivers can do Offer soft, moist foods. Baked egg dishes, tuna salads, and ...

  9. Swallowing Trouble

    MedlinePlus

    ... that slow stomach acid production, muscle relaxants, and antacids are a few of the many medicines available. ... bed at night. If these don’t help, antacids between meals and at bedtime may provide relief. ...

  10. Swallowing problems

    MedlinePlus

    ... the home Dry mouth during cancer treatment Enteral nutrition - child - managing problems Gastrostomy feeding tube - bolus Jejunostomy feeding tube Mouth and neck radiation - discharge Multiple sclerosis - discharge Stroke - discharge Update Date 5/15/2014 ...

  11. Pencil swallowing

    MedlinePlus

    Take the container with you to the hospital, if possible. The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate.

  12. Shampoo - swallowing

    MedlinePlus

    ... reaction may need: Airway and breathing support, including oxygen. In extreme cases, a tube may be passed through the mouth into the lungs to prevent aspiration. Chest x-ray EKG (electrocardiogram, or heart tracing)

  13. Drugs, discrimination and disability.

    PubMed

    Gibson, Frances

    2009-12-01

    Whether addiction to prohibited drugs should be classified as a disability for the purposes of disability discrimination is a controversial question in Australia. The leading Australian case of Marsden v Human Rights Equal Opportunity Commission & Coffs Harbour & District Ex-Servicemen & Women's Memorial Club Ltd (HREOC, No H98/51, 30 August 1999); [2000] FCA 1619 concerned a disability discrimination complaint brought by Mr Marsden as a result of his treatment by the club. The case was brought as a public interest test case by the New South Wales Legal Aid Commission. Mr Marsden was on a methadone program at the time. The reasoning of the decision at the Federal Court opened the way for a finding that dependence on illegal drugs constituted a disability under disability discrimination legislation. The media reaction to the court's decision led to State and federal governments proposing legislation limiting legal protection from discrimination for people addicted to illegal drugs on the basis of their drug use. While the proposed federal legislation lapsed after objections from a coalition of medical, legal and other advocacy groups, the New South Wales legislation still provides that, in employment matters, it is not unlawful to discriminate against a person on the ground of disability if the disability relates to the person's addiction to a prohibited drug and the person is actually addicted to a prohibited drug at the time of the discrimination. The article details the sequence of events in the Marsden case, reflects on the role of public interest litigation in achieving social justice outcomes and suggests that Australia's recent ratification of the Convention on the Rights of Persons with Disabilities on 17 July 2008 should encourage legislators to review legislation which may have a discriminatory effect on people suffering from addictions. PMID:20169800

  14. May I Take a Message? Using General Case Programming to Teach Students with Disabilities to Take and Give Phone Messages

    ERIC Educational Resources Information Center

    Bicard, David F.; Horan, James; Plank, Esther; Covington, Tina

    2010-01-01

    Research has shown general case programming to be an effective method for teaching a wide range of skills to students with disabilities. The authors used a multiple probe nested in an ABA reversal design to test (a) the effectiveness of general case programming for teaching 4 students with mild to moderate disabilities to take and give telephone…

  15. Dysphagia After Chemoradiotherapy for Head-and-Neck Squamous Cell Carcinoma: Dose-Effect Relationships for the Swallowing Structures

    SciTech Connect

    Dirix, Piet Abbeel, Sarah; Vanstraelen, Bianca; Hermans, Robert; Nuyts, Sandra

    2009-10-01

    Purpose: To evaluate late dysphagia after chemoradiotherapy for locally advanced head-and-neck squamous cell carcinoma, and to examine its correlation with clinical and dosimetric parameters. Methods and Materials: Consecutive patients, treated with radiotherapy (70-72 Gy) and concomitant chemotherapy (cisplatinum 100 mg/m{sup 2} every 3 weeks) between 2004 and 2007, were examined. Swallowing was evaluated by four quality-of-life questionnaires: EORTC C30 and H and N35, the Performance Status Scale of List, and the MD Anderson Dysphagia Inventory. Clinical and dosimetric parameters were correlated with late dysphagia. Results: A total of 53 disease-free patients were evaluated; mean follow-up was 20.4 months (range, 6-45 months). The volume of the middle pharyngeal constrictor muscle receiving {>=}50 Gy (p = 0.04), the mean dose to this structure (p = 0.02) and to the supraglottic larynx (p = 0.04) were significantly associated with late swallowing problems at univariate analysis, along with tumor localization (p = 0.008), T-classification (p = 0.02), and pretreatment swallowing problems (p = 0.01). Only this last factor significantly correlated with late dysphagia at multivariate analysis. Conclusion: These findings motivate further efforts to reduce the dose to the swallowing structures, especially to the pharyngeal constrictor muscles and the larynx. However, clinical parameters are also important and should be included in future prospective trials.

  16. Legal and Financial Issues Associated with Providing Services in Schools to Children with Swallowing and Feeding Disorders

    ERIC Educational Resources Information Center

    Power-deFur, Lissa; Alley, Nancy S. N.

    2008-01-01

    Purpose: This review of federal statutes and regulations, state and federal administrative and case law, and policy documents is designed to provide information regarding the treatment of children with swallowing and feeding disorders in the law for the purpose of identifying best practice procedures for school personnel serving children with…

  17. Abrostola clarissa (Lepidoptera, Noctuidae), a new potential biocontrol agent for invasive swallow-worts, Vincetoxicum rossicum and V. nigrum

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pale and black swallow-worts (Vincetoxicum rossicum and V. nigrum; Apocynaceae, subfamily Asclepiadoideae), perennial vines native to Eurasia, are now invading natural and anthropogenic habitats in the northeastern U.S.A. and southeastern Canada, threatening natural biodiversity and increasing contr...

  18. Adult tree swallow survival on the polychlorinated biphenyl-contaminated Hudson River, New York, USA, between 2006 and 2010

    USGS Publications Warehouse

    Custer, Christine M.; Custer, Thomas W.; Hines, James E.

    2012-01-01

    The upper Hudson River basin in east central New York, USA, is highly contaminated, primarily with polychlorinated biphenyls (PCBs). Reduced adult survival has been documented in tree swallows (Tachycineta bicolor) at a similarly PCB-contaminated river system in western Massachusetts. The purpose of the present study was to assess whether adult survival of tree swallows was likewise affected in the Hudson River basin. Between 2006 and 2010, a total of 521 female tree swallows were banded, of which 148 were retrapped at least once. The authors used Program MARK and an information theoretic approach to test the hypothesis that PCB contamination reduced annual survival of female tree swallows. The model that best described the processes that generated the capture history data included covariate effects of year and female plumage coloration on survival but not PCB/river. Annual survival rates of brown-plumaged females (mostly one year old) were generally lower (mean phi = 0.39) than those of blue-plumaged females (mean phi = 0.50, one year or older). Poor early spring weather in 2007 was associated with reduced survival in both plumage-color groups compared to later years. Models with the effects of PCB exposure on survival (all ΔAICc values >5.0) received little support.

  19. Response of the invasive vine pale swallow-wort following two years of mowing and herbicide application

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pale swallow-wort [PSW] (Vincetoxicum rossicum) is an invasive non-native perennial vine that is increasing in many regions of the NE U.S. and southern Canada. It thrives in old fields but can also establish in shaded forest understories. Control of PSW has been difficult and limited information is ...

  20. 76 FR 45602 - Proposed Safe Harbor Agreement for California Red-Legged Frog, at Swallow Creek Ranch, San Luis...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-29

    ... Service's Safe Harbor Policy published in the Federal Register on June 17, 1999 (64 FR 32717), the Service... Fish and Wildlife Service Proposed Safe Harbor Agreement for California Red-Legged Frog, at Swallow... the Federally threatened California red-legged frog (Rana draytonii), under the Endangered Species...

  1. Adult tree swallow survival on the polychlorinated biphenyl-contaminated Hudson River, New York, USA, between 2006 and 2010.

    PubMed

    Custer, Christine M; Custer, Thomas W; Hines, James E

    2012-08-01

    The upper Hudson River basin in east central New York, USA, is highly contaminated, primarily with polychlorinated biphenyls (PCBs). Reduced adult survival has been documented in tree swallows (Tachycineta bicolor) at a similarly PCB-contaminated river system in western Massachusetts. The purpose of the present study was to assess whether adult survival of tree swallows was likewise affected in the Hudson River basin. Between 2006 and 2010, a total of 521 female tree swallows were banded, of which 148 were retrapped at least once. The authors used Program MARK and an information theoretic approach to test the hypothesis that PCB contamination reduced annual survival of female tree swallows. The model that best described the processes that generated the capture history data included covariate effects of year and female plumage coloration on survival but not PCB/river. Annual survival rates of brown-plumaged females (mostly one year old) were generally lower (mean phi=0.39) than those of blue-plumaged females (mean phi=0.50, one year or older). Poor early spring weather in 2007 was associated with reduced survival in both plumage-color groups compared to later years. Models with the effects of PCB exposure on survival (all ΔAICc values >5.0) received little support. PMID:22639085

  2. Foraging at the edge of the world: low-altitude, high-speed manoeuvering in barn swallows.

    PubMed

    Warrick, Douglas R; Hedrick, Tyson L; Biewener, Andrew A; Crandell, Kristen E; Tobalske, Bret W

    2016-09-26

    While prior studies of swallow manoeuvering have focused on slow-speed flight and obstacle avoidance in still air, swallows survive by foraging at high speeds in windy environments. Recent advances in field-portable, high-speed video systems, coupled with precise anemometry, permit measures of high-speed aerial performance of birds in a natural state. We undertook the present study to test: (i) the manner in which barn swallows (Hirundo rustica) may exploit wind dynamics and ground effect while foraging and (ii) the relative importance of flapping versus gliding for accomplishing high-speed manoeuvers. Using multi-camera videography synchronized with wind-velocity measurements, we tracked coursing manoeuvers in pursuit of prey. Wind speed averaged 1.3-2.0 m s(-1) across the atmospheric boundary layer, exhibiting a shear gradient greater than expected, with instantaneous speeds of 0.02-6.1 m s(-1) While barn swallows tended to flap throughout turns, they exhibited reduced wingbeat frequency, relying on glides and partial bounds during maximal manoeuvers. Further, the birds capitalized on the near-earth wind speed gradient to gain kinetic and potential energy during both flapping and gliding turns; providing evidence that such behaviour is not limited to large, fixed-wing soaring seabirds and that exploitation of wind gradients by small aerial insectivores may be a significant aspect of their aeroecology.This article is part of the themed issue 'Moving in a moving medium: new perspectives on flight'. PMID:27528781

  3. Metals and metalloids in nestling tree swallows and their dietary items near oilsands mine operations in Northern Alberta.

    PubMed

    Godwin, Christine M; Smits, Judit E G; Barclay, Robert M R

    2016-08-15

    Tree swallows (Tachycineta bicolor) nesting near oilsands development in northern Alberta are potentially exposed to elevated levels of metals. The objective of this study was to determine whether levels of metals and metalloid elements in dietary items and tissues of nestling tree swallows inhabiting areas near oilsands mine operations were higher compared to those of reference sites. We hypothesized that if there was increased, industry-related exposure to metals, it would be via the diet. We identified the invertebrate prey in the stomach contents of nestlings. We also collected invertebrates using Malaise traps near nest boxes, and analyzed those taxa found in the nestling diet to understand potential variability in metal exposure. For most elements, we found no significant differences in concentrations in the liver, kidney, or stomach contents between sites near to and far from oilsands operations. Concentrations of five elements were positively correlated among tissues and stomach contents. For invertebrates collected from Malaise traps, location differences occurred in some absolute elemental concentrations, which were most often highest at reference sites away from mining operations. We found no evidence that nestling tree swallows accumulated metals approaching toxic levels. Tree swallows consumed relatively high quantities of terrestrial insects, possibly limiting exposure to water borne, food-web-related contaminants. We suggest that annual variability associated with elemental exposure and dietary levels of elements be considered when interpreting concentrations in bird tissues. PMID:27110982

  4. Evidence-Based Systematic Review: Effects of Oral Motor Interventions on Feeding and Swallowing in Preterm Infants

    ERIC Educational Resources Information Center

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

    2010-01-01

    Purpose: To conduct an evidence-based systematic review and provide an estimate of the effects of oral motor interventions (OMIs) on feeding/swallowing outcomes (both physiological and functional) and pulmonary health in preterm infants. Method: A systematic search of the literature published from 1960 to 2007 was conducted. Articles meeting the…

  5. Emergence and performance of two invasive Swallow-worts (Vincetoxicum spp.) in contrasting soil types and soil pH

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The alien invasive vines black and pale swallow-wort are currently spreading across eastern North America, invading parklands, old fields, restored forest sites, and other natural areas. These plants spread by wind-borne seed and can form dense stands where they become established. Although their cu...

  6. Dose to Larynx Predicts for Swallowing Complications After Intensity-Modulated Radiotherapy

    SciTech Connect

    Caglar, Hale B.; Tishler, Roy B.; Burke, Elaine; Li Yi; Goguen, Laura; Norris, Carl M.; Allen, Aaron M.

    2008-11-15

    Purpose: To evaluate early swallowing after intensity-modulated radiotherapy for head and neck squamous cell carcinoma and determine factors correlating with aspiration and/or stricture. Methods and Materials: Consecutive patients treated with intensity-modulated radiotherapy with or without chemotherapy between September 2004 and August 2006 at the Dana Farber Cancer Institute/Brigham and Women's Hospital were evaluated with institutional review board approval. Patients underwent swallowing evaluation after completion of therapy; including video swallow studies. The clinical- and treatment-related variables were examined for correlation with aspiration or strictures, as well as doses to the larynx, pharyngeal constrictor muscles, and cervical esophagus. The correlation was assessed with logistic regression analysis. Results: A total of 96 patients were evaluated. Their median age was 55 years, and 79 (82%) were men. The primary site of cancer was the oropharynx in 43, hypopharynx/larynx in 17, oral cavity in 13, nasopharynx in 11, maxillary sinus in 2, and unknown primary in 10. Of the 96 patients, 85% underwent definitive RT and 15% postoperative RT. Also, 28 patients underwent induction chemotherapy followed by concurrent chemotherapy, 59 received concurrent chemotherapy, and 9 patients underwent RT alone. The median follow-up was 10 months. Of the 96 patients, 31 (32%) had clinically significant aspiration and 36 (37%) developed a stricture. The radiation dose-volume metrics, including the volume of the larynx receiving {>=}50 Gy (p = 0.04 and p = 0.03, respectively) and volume of the inferior constrictor receiving {>=}50 Gy (p = 0.05 and p = 0.02, respectively) were significantly associated with both aspiration and stricture. The mean larynx dose correlated with aspiration (p = 0.003). Smoking history was the only clinical factor to correlate with stricture (p = 0.05) but not aspiration. Conclusion: Aspiration and stricture are common side effects after

  7. The influence of food texture and liquid consistency modification on swallowing physiology and function: a systematic review.

    PubMed

    Steele, Catriona M; Alsanei, Woroud Abdulrahman; Ayanikalath, Sona; Barbon, Carly E A; Chen, Jianshe; Cichero, Julie A Y; Coutts, Kim; Dantas, Roberto O; Duivestein, Janice; Giosa, Lidia; Hanson, Ben; Lam, Peter; Lecko, Caroline; Leigh, Chelsea; Nagy, Ahmed; Namasivayam, Ashwini M; Nascimento, Weslania V; Odendaal, Inge; Smith, Christina H; Wang, Helen

    2015-02-01

    Texture modification has become one of the most common forms of intervention for dysphagia, and is widely considered important for promoting safe and efficient swallowing. However, to date, there is no single convention with respect to the terminology used to describe levels of liquid thickening or food texture modification for clinical use. As a first step toward building a common taxonomy, a systematic review was undertaken to identify empirical evidence describing the impact of liquid consistency and food texture on swallowing behavior. A multi-engine search yielded 10,147 non-duplicate articles, which were screened for relevance. A team of ten international researchers collaborated to conduct full-text reviews for 488 of these articles, which met the study inclusion criteria. Of these, 36 articles were found to contain specific information comparing oral processing or swallowing behaviors for at least two liquid consistencies or food textures. Qualitative synthesis revealed two key trends with respect to the impact of thickening liquids on swallowing: thicker liquids reduce the risk of penetration-aspiration, but also increase the risk of post-swallow residue in the pharynx. The literature was insufficient to support the delineation of specific viscosity boundaries or other quantifiable material properties related to these clinical outcomes. With respect to food texture, the literature pointed to properties of hardness, cohesiveness, and slipperiness as being relevant both for physiological behaviors and bolus flow patterns. The literature suggests a need to classify food and fluid behavior in the context of the physiological processes involved in oral transport and flow initiation. PMID:25343878

  8. Potential effects of environmental contaminants on P450 aromatase activity and DNA damage in swallows from the Rio Grande and Somerville, Texas

    USGS Publications Warehouse

    Sitzlar, M.A.; Mora, M.A.; Fleming, J.G.W.; Bazer, F.W.; Bickham, J.W.; Matson, C.W.

    2009-01-01

    Cliff swallows (Petrochelidon pyrrhonota) and cave swallows (P. fulva) were sampled during the breeding season at several locations in the Rio Grande, Texas, to evaluate the potential effects of environmental contaminants on P450 aromatase activity in brain and gonads and DNA damage in blood cells. The tritiated water-release aromatase assay was used to measure aromatase activity and flow cytometry was used to measure DNA damage in nucleated blood cells. There were no significant differences in brain and gonadal aromatase activities or in estimates of DNA damage (HPCV values) among cave swallow colonies from the Lower Rio Grande Valley (LRGV) and Somerville. However, both brain and gonadal aromatase activities were significantly higher (P < 0.05) in male cliff swallows from Laredo than in those from Somerville. Also, DNA damage estimates were significantly higher (P < 0.05) in cliff swallows (males and females combined) from Laredo than in those from Somerville. Contaminants of current high use in the LRGV, such as atrazine, and some of the highly persistent organochlorines, such as toxaphene and DDE, could be potentially associated with modulation of aromatase activity in avian tissues. Previous studies have indicated possible DNA damage in cliff swallows. We did not observe any differences in aromatase activity or DNA damage in cave swallows that could be associated with contaminant exposure. Also, the differences in aromatase activity and DNA damage between male cliff swallows from Laredo and Somerville could not be explained by contaminants measured at each site in previous studies. Our study provides baseline information on brain and gonadal aromatase activity in swallows that could be useful in future studies. ?? 2008 Springer Science+Business Media, LLC.

  9. Hemodynamic Signal Changes Accompanying Execution and Imagery of Swallowing in Patients with Dysphagia: A Multiple Single-Case Near-Infrared Spectroscopy Study

    PubMed Central

    Kober, Silvia Erika; Bauernfeind, Günther; Woller, Carina; Sampl, Magdalena; Grieshofer, Peter; Neuper, Christa; Wood, Guilherme

    2015-01-01

    In the present multiple case study, we examined hemodynamic changes in the brain in response to motor execution (ME) and motor imagery (MI) of swallowing in dysphagia patients compared to healthy matched controls using near-infrared spectroscopy (NIRS). Two stroke patients with cerebral lesions in the right hemisphere, two stroke patients with lesions in the brainstem, and two neurologically healthy control subjects actively swallowed saliva (ME) and mentally imagined to swallow saliva (MI) in a randomized order while changes in concentration of oxygenated hemoglobin (oxy-Hb) and deoxygenated hemoglobin (deoxy-Hb) were assessed. In line with recent findings in healthy young adults, MI and ME of swallowing led to the strongest NIRS signal change in the inferior frontal gyrus in stroke patients as well as in healthy elderly. We found differences in the topographical distribution and time course of the hemodynamic response in dependence on lesion location. Dysphagia patients with lesions in the brainstem showed bilateral hemodynamic signal changes in the inferior frontal gyrus during active swallowing comparable to healthy controls. In contrast, dysphagia patients with cerebral lesions in the right hemisphere showed more unilateral activation patterns during swallowing. Furthermore, patients with cerebral lesions showed a prolonged time course of the hemodynamic response during MI and ME of swallowing compared to healthy controls and patients with brainstem lesions. Brain activation patterns associated with ME and MI of swallowing were largely comparable, especially for changes in deoxy-Hb. Hence, the present results provide new evidence regarding timing and topographical distribution of the hemodynamic response during ME and MI of swallowing in dysphagia patients and may have practical impact on future dysphagia treatment. PMID:26217298

  10. Reverse Transfer in Australia

    ERIC Educational Resources Information Center

    Moodie, Gavin

    2004-01-01

    This article considers national Australian data on reverse transfer--the transfer of students from bachelor programs or higher to sub baccalaureate programs, institutions and sectors. It finds that previous studies have overstated the prevalence and perhaps also the significance of reverse transfer. The data are not good, but the best conclusion…

  11. Quantum reverse hypercontractivity

    SciTech Connect

    Cubitt, Toby; Kastoryano, Michael; Montanaro, Ashley; Temme, Kristan

    2015-10-15

    We develop reverse versions of hypercontractive inequalities for quantum channels. By generalizing classical techniques, we prove a reverse hypercontractive inequality for tensor products of qubit depolarizing channels. We apply this to obtain a rapid mixing result for depolarizing noise applied to large subspaces and to prove bounds on a quantum generalization of non-interactive correlation distillation.

  12. Justice and Reverse Discrimination.

    ERIC Educational Resources Information Center

    Goldman, Alan H.

    Defining reverse discrimination as hiring or admissions decisions based on normally irrelevant criteria, this book develops principles of rights, compensation, and equal opportunity applicable to the reverse discrimination issue. The introduction defines the issue and discusses deductive and inductive methodology as applied to reverse…

  13. Reverse Discrimination: Recent Cases.

    ERIC Educational Resources Information Center

    Steinhilber, August W.

    This paper discusses reverse discrimination cases with particular emphasis on Bakke v. Regents of University of California and those cases which preceded it. A brief history is given of court cases used by opponents and proponents in the discussion of reverse discrimination. Legal theory and a discussion of court cases that preceded Bakke follow.…

  14. Ultrasonic Time Reversal Mirrors

    NASA Astrophysics Data System (ADS)

    Fink, Mathias; Montaldo, Gabriel; Tanter, Mickael

    2004-11-01

    For more than ten years, time reversal techniques have been developed in many different fields of applications including detection of defects in solids, underwater acoustics, room acoustics and also ultrasound medical imaging and therapy. The essential property that makes time reversed acoustics possible is that the underlying physical process of wave propagation would be unchanged if time were reversed. In a non dissipative medium, the equations governing the waves guarantee that for every burst of sound that diverges from a source there exists in theory a set of waves that would precisely retrace the path of the sound back to the source. If the source is pointlike, this allows focusing back on the source whatever the medium complexity. For this reason, time reversal represents a very powerful adaptive focusing technique for complex media. The generation of this reconverging wave can be achieved by using Time Reversal Mirrors (TRM). It is made of arrays of ultrasonic reversible piezoelectric transducers that can record the wavefield coming from the sources and send back its time-reversed version in the medium. It relies on the use of fully programmable multi-channel electronics. In this paper we present some applications of iterative time reversal mirrors to target detection in medical applications.

  15. Disability in multiple sclerosis

    PubMed Central

    Chamot, Eric; Salter, Amber R.; Cutter, Gary R.; Bacon, Tamar E.; Herbert, Joseph

    2013-01-01

    Objective: To create a reference table of disability outcomes in multiple sclerosis (MS) that would enable patients to rank their disability relative to others' with similar disease duration and to develop a cost-effective research tool for comparing MS severity across patient populations and time periods. Methods: The North American Research Committee on Multiple Sclerosis (NARCOMS) Registry collects disability data from patients with MS on a validated, 9-point Patient-Determined Disease Steps (PDDS) scale. We compiled the Disability Expectancy Table, which displays cumulative frequencies of PDDS scores for each year of disease duration, from 0 to 45 years. We also tabulated disease duration–adjusted mean ranks of PDDS scores, referred to as Patient-derived MS Severity Scores (P-MSSS). Results: The cohort consisted of 27,918 NARCOMS enrollees, 72.7% of whom were female and 90.1% of whom were white. Mean age at symptom onset was 30.1 ± 10.1 years, and age at enrollment was 47.1 ± 11.0 years. The Disability Expectancy Table and P-MSSS afford a detailed overview of disability outcomes in a large MS cohort over a 45-year period. In the first year of disease, 15% of patients reported need of ambulatory aid, and 4% needed bilateral assistance or worse; after 45 years of disease, 76% of patients required ambulatory aid, and 52% bilateral assistance or worse. Proportion of patients who reported minimal or no interference in daily activities (PDDS ≤ 1) declined from 63% in the first year to 8% after 45 years of disease. Conclusion: The Disability Expectancy Table allows individual patients to determine how their disability ranks relative to NARCOMS enrollees with the same disease duration. P-MSSS may be used to compare disability across patient populations and to track disease progression in patient cohorts. P-MSSS does not require a formal neurologic examination and may therefore find wide applicability as a practical and cost-effective outcome measure in

  16. Differentiation of normal and abnormal airway protection during swallowing using the penetration-aspiration scale.

    PubMed

    Robbins, J; Coyle, J; Rosenbek, J; Roecker, E; Wood, J

    1999-01-01

    Accidental loss of food or liquids into the airway while eating or drinking is perhaps the most clinically significant consequence of dysphagia. Although videofluoroscopic recording of swallowing is the current gold standard for identifying and determining remediation for aspiration, results are generally described in descriptive terms, thus limiting information and lending to errors of interpretation. We previously published an 8-point scale to quantitate selected aspects of penetration and aspiration conveying depth of airway invasion and whether or not material entering the airway is expelled (Rosenbek et al., 1996, Dysphagia 11:93-98). The present study defines the distribution of the Penetration-Aspiration Scale scores in healthy normal subjects of different genders and ages. The scale was also used with two groups of patients known to have significant dysphagia relative to stroke or head and neck cancer. Significant differences found among groups are discussed. PMID:10467048

  17. Reproductive effort reduces long-term immune function in breeding tree swallows (Tachycineta bicolor).

    PubMed Central

    Ardia, Daniel R; Schat, Karel A; Winkler, David W

    2003-01-01

    We examined whether strategies of reproductive allocation may reduce long-term immunocompetence through the effects of manipulated effort on secondary or acquired immunity. We tested whether increased reproductive effort leads to reduced immune function and survival by manipulating brood size in tree swallows (Tachycineta bicolor) and exposing breeding females to a primary and secondary exposure of sheep red blood cells to elicit a humoral immune response. Females raising enlarged broods produced fewer secondary antibodies than did females raising control or reduced broods. Most importantly, individuals with high secondary responses were more likely to survive to breed 3 years after brood manipulations, suggesting that differences in disease susceptibility may be caused by trade-offs in reproductive allocation. We also found that individual quality, measured by clutch initiation date, mediated the effects of brood manipulations, with higher-quality birds showing a greater ability to deal with increases in effort. PMID:12964994

  18. Reversible Shape Memory

    NASA Astrophysics Data System (ADS)

    Zhou, Jing; Li, Qiaoxi; Turner, Sara; Brosnan, Sarah; Tippets, Cary; Carrillo, Jan-Michael; Nykypnachuk, Dmytro; Gang, Oleg; Dobrynin, Andrey; Lopez, Rene; Ashby, Valerie; Sheiko, Sergei

    2014-03-01

    Reversible shape memory has been achieved on various shapes, e.g. hairpin, origami, coil, robotic gripper and flow rate control device, allowing for multiple switching between encoded shapes without applying any external force. Also, the reversible photonic structure molded in dielectric elastomers has been designed. Maximum reversibility can be achieved by tuning the crosslinking density and the degree of crystallinity of semi-crystalline elastomers. Different crystallization protocols including isothermal and cooling crystallization have been applied to develop a universal picture integrating different shape memory (SM) behaviors: conventional one-way SM, two-way reversible SM, and one-way reversible SM. Acknowledge financial support from the NSF DMR-1122483, DMR- 1004576, and DMR-1206957.

  19. Mercury contamination in bank swallows and double-crested cormorants from the Carson River, Nevada

    SciTech Connect

    Kim, R.; Brewer, R.; Peterson, S.C.; Mach, C.

    1995-12-31

    An ecological risk assessment was performed in conjunction with a remedial investigation at the Carson River Mercury Site (CRMS) in northwestern Nevada. Large quantities of mercury used in the processing of gold and silver during mining operations in the mid to late 1800s are distributed throughout the Carson River ecosystem. Previous investigations indicated elevated levels of mercury in soil, sediment, water, and the aquatic food chain. Bird exposure to mercury was determined by measuring total mercury and monomethyl mercury in blood and feather samples from 15 unfledged double-crested cormorants (Phalacrocorax auritus), and in blood, feather, and liver samples from 18 juvenile bank swallows (Riparia riparia) at both the CRMS and uncontaminated background locations. Monomethyl mercury accounted for 90 to 98% of the total mercury in the samples. Total mercury concentrations in bird tissues collected at the CRMS were significantly higher than at background locations. Average total mercury concentrations (wet weight) for the swallow blood, liver, and feather samples collected at the CRMS were 2.63, 3.96, and 2.01 mg/kg, respectively; compared with 0.74, 1,03, and 1.84 mg/kg, respectively at the background area. Average total mercury concentrations for cormorant samples collected at the CRMS were 17.07 mg/kg for blood, and 105.1 1 mg/kg for feathers. Cormorant samples collected at the background location had average total mercury concentrations of 0.49 mg/kg for blood and 8.99 mg/kg for feathers. Results are compared with published residue-effects levels to evaluate avian risks.

  20. Comparison of Methods to Reduce Dose to Swallowing-Related Structures in Head and Neck Cancer

    SciTech Connect

    Caudell, Jimmy J.; Burnett, Omer L.; Schaner, Philip E.; Bonner, James A.; Duan Jun

    2010-06-01

    Introduction: Emerging data suggest that reduction of dose to the larynx and pharyngeal constrictor may lower the risk of swallowing complications such as long-term gastrostomy dependence and aspiration. Organ avoidance becomes difficult when the primary tumor or involved nodes are present at the level of the larynx. Materials and Methods: Fifteen patients with Stage III-IV squamous cell carcinoma of the head and neck with high-dose target volume at the level of the larynx (but not involving the glottic larynx) were planned with whole-field IMRT (WF-IMRT), as well as a low anterior neck field dynamically matched to an IMRT plan (D-SCLV). Plans were compared with respect to coverage of targets and sparing of normal tissues including the larynx, inferior pharyngeal constrictor (IPC), parotid, and cord. Results: There was no significant difference between the two techniques in coverage of the high- or intermediate-dose planning target volumes (PTVs). Coverage of the elective nodal PTV was inferior with the D-SCLV technique, with a mean of 96.5% vs. 86.3% of the volume receiving the prescription dose (p = 0.001) compared with WF-IMRT plans. However, the D-SCLV technique significantly reduced mean dose to the larynx (43.7 vs. 46.7 Gy, p = 0.05) and IPC (39.1 vs. 46.1 Gy, p = 0.002). There was no significant difference in dose to the parotid or cord. Conclusion: Given the steep dose responses seen in studies examining the association between swallowing toxicity and dose to the larynx and IPC, dose reductions using the D-SCLV technique may be clinically significant.

  1. Estimation of the Dose of Radiation Received by Patient and Physician During a Videofluoroscopic Swallowing Study.

    PubMed

    Morishima, Yoshiaki; Chida, Koichi; Watanabe, Hiroshi

    2016-08-01

    Videofluoroscopic swallowing study (VFSS) is considered the standard diagnostic imaging technique to investigate swallowing disorders and dysphagia. Few studies have been reported concerning the dose of radiation a patient receives and the scattering radiation dose received by a physician during VFSS. In this study, we investigated the dose of radiation (entrance skin dose, ESD) estimated to be received by a patient during VFSS using a human phantom (via a skin-dose monitor sensor placed on the neck of the human phantom). We also investigated the effective dose (ED) and dose equivalent (DE) received by a physician (wearing two personal dosimeters) during an actual patient procedure. One dosimeter (whole body) was worn under a lead apron at the chest, and the other (specially placed to measure doses received by the lens of the eye) outside the lead apron on the neck collar to monitor radiation doses in parts of the body not protected by the lead apron. The ESD for the patient was 7.8 mGy in 5 min. We estimated the average patient dose at 12.79 mGy per VFSS procedure. The physician ED and DE during VFSS were 0.9 mSv/year and 2.3 mSv/year, respectively. The dose of radiation received by the physician in this study was lower than regulatory dose limits. However, in accordance with the principle that radiation exposure should be as low as reasonably achievable, every effort should be made (e.g., wearing lead glasses) to reduce exposure doses. PMID:27318941

  2. Geographic Variation in Hirundo pyrrhonota (Cliff Swallow) from Northern North America

    USGS Publications Warehouse

    Browning, M. Ralph

    1992-01-01

    The number of subspecies recognized in Hirundo pyrrhonota Vieillot (Cliff Swallow) from Alaska, Canada, and the northern contiguous United States ranges from one (Peters 1960) to three (e.g., Jewett et al. 1953, Oberholser, 1920, breeding from central Alaska to the central Great Basin, and two disjunct populations of nominate pyrrhonota, breeding on the west coast and east of the Rocky Mountains. Although various authors have reported measurements of wing chord, they have not provided quantitative data for other plumage characters, and they disagree in the characterizations and ranges of the subspecies they recognize. Because of this, I reviewed the geographic variation among the northern populations. My study is confined to specimens from Alaska, Canada, and the contigeous United States south to Merced County in California, both slopes of the Rocky Mountains from Montana and Colorado, and northern half of the eastern United States from Kansas east to Virginia (Figure 1). The A.O.U. (1957) gave the breeding range of hypopolia as extending from Alaska and Mackenzie to southeastern British Columbia, the eastern parts of Washington, Oregon, and central-eastern California, central Nevada, northern Utah, Montana, and northwestern Wyoming, and the range of nominate pyrhonota as from southwestern British Columbia, western Oregon and Washington to southern California, southern Nevada, southern and eastern Utag, and east of the Rocky Mountains. I excluded specimens of H. p. ganieri Phillips, 1986, a subspecies (Browning 1990) that breeds from at least west-central Tennessee to Texas, and H. p. tachina Oberholser, 1903 (sensu Phillips 1986), which breeds north to central California, Utah, Arizona, and new Mexico. I follow Phillips (1973) for the use of the generic name Hirundo for the Cliff Swallow, Hellmayr (1935) for the use of the specific name pyrrhonota.

  3. Development of A MEMS Based Manometric Catheter for Diagnosis of Functional Swallowing Disorders.

    NASA Astrophysics Data System (ADS)

    Hsu, H. Y.; Hariz, A. J.; Omari, T.; Teng, M. F.; Sii, D.; Chan, S.; Lau, L.; Tan, S.; Lin, G.; Haskard, M.; Mulcahy, D.; Bakewell, M.

    2006-04-01

    Silicon pressure sensors based on micro-electro-mechanical-systems (MEMS) technologies are gaining popularity for applications in bio-medical devices. In this study, a silicon piezo-resistive pressure sensor die is used in a feasibility study of developing a manometric catheter for functional swallowing disorders diagnosis. The function of a manometric catheter is to measure the peak and intrabolus pressures along the esophageal segment during the swallowing action. Previous manometric catheters used the water perfusion technique to measure the pressure changes. This type of catheter is reusable, large in size and the pressure reading is recorded by an external transducer. Current manometric catheters use a solid state pressure sensor on the catheter itself to measure the pressure changes. This type of catheter reduces the discomfort to the patient but it is reusable and is very expensive. We carried out several studies and experiments on the MEMS-based pressure sensor die, and the results show the MEMS-based pressure sensors have a good stability and a good linearity output response, together with the advantage of low excitation biasing voltage and extremely small size. The MEMS-based sensor is the best device to use in the new generation of manometric catheters. The concept of the new MEMS-based manometric catheter consists of a pressure sensing sensor, supporting ring, the catheter tube and a data connector. Laboratory testing shows that the new calibrated catheter is capable of measuring pressure in the range from 0 to 100mmHg and maintaining stable condition on the zero baseline setting when no pressure is applied. In-vivo tests are carried out to compare the new MEMS based catheter with the current version of catheters used in the hospital.

  4. Density and habitat of breeding Swallow-tailed Kites in the lower Suwannee ecosystem, Florida

    USGS Publications Warehouse

    Sykes, P.W., Jr.; Kepler, C.B.; Litzenberger, K.L.; Sansing, H.R.; Lewis, E.T.R.; Hatfield, J.S.

    1999-01-01

    Historically the Swallow-tailed Kite (Elanoides forficatus) bred in the United States in at least 16 eastern states. Currently it is restricted to seven southeastern states, with most of its breeding range in Florida. Breeding Bird Surveys indicate a declining trend for this Neotropical migrant in most of Florida. Using a rapid survey technique at the Lower Suwannee NWR on 25-27 Mar. 1997, we scanned for kites from 16 sampling stations above the forest canopy, using 10X binoculars for 45 min per station. An effective detection distance of 2.4 km provided almost complete coverage of kite habitat (excluding salt marsh) on the refuge (14,620 ha) and in a 1.6-km buffer (13,526 ha). A mobile observation platform, extended to heights of 30-34 m provided an unobstructed view above the forest canopy where foraging bouts, feeding, courtship displays, and other activities by this species occur. This technique was found to be efficient in obtaining an estimate of potential breeding pairs. An estimated 19 breeding pairs were observed, with possibly five additional pairs, a density of at least one pair per 1173-1407 ha. There was no opportunity to search for nests so we were unable to correlate number of active nests with the number of kites observed, and linear nature of study area might concentrate birds, including nonbreeders, so our density of kites may or may not be typical for other areas. The refuge has a mosaic of 11 different habitats (7 forest types, freshwater and salt marshes, open water and urban/suburban) providing much linear edge to the matrix of different plant communities that range in height from less than 1 m to greater than 30 m. Such structure provides quality habitat for Swallow-tailed Kites.

  5. Adult tree swallow (Tachycineta bicolor) survival on the polychlorinated biphenyl-contaminated Housatonic River, Massachusetts, USA

    USGS Publications Warehouse

    Custer, Christine M.; Custer, T.W.; Hines, J.E.; Nichols, J.D.; Dummer, P.M.

    2007-01-01

    Tree swallows (Tachycineta bicolor) were captured and banded at six sites that differed in polychlorinated biphenyl (PCB) contamination levels in the Housatonic River watershed, western Massachusetts, USA, from 2000 through 2004 to test the prediction that apparent survival rates of females in more contaminated areas were lower than those from less contaminated areas. We also tested whether plumage coloration affected over-winter survival and whether concentrations of PCBs in eggs differed between birds that did and that did not return the following year. Apparent survival rates were calculated using mark?recapture methods and compared using Akaike's Information Criterion. Model-adjusted survival rates ranged from 0.365 to 0.467 for PCB-contaminated females and between 0.404 and 0.476 for reference females. Models with either survival or capture probability modeled as functions of treatment (degree of PCB contamination), year, and age received some support. The model-averaged parameter estimate reflecting a treatment effect for high-PCB birds was negative ( = -0.046, SE() = 0.0939). Fifty-four percent of the total model weights involved models in which survival was a function of PCB treatment. Eggs were collected for contaminant analyses from a random sample of females that did and that did not return the following year. Concentrations of total PCBs were the same or higher in the eggs of females that returned compared to the eggs of those that did not return at both the highly and the moderately contaminated PCB sites. This may have resulted from higher-quality females with higher lipid reserves being more likely than lower-quality females to return the following year. Percentage lipid was positively correlated with total PCBs in eggs. Survival rates were similar among swallows with brown versus blue plumage.

  6. Voluntary Cough Airflow Differentiates Safe Versus Unsafe Swallowing in Amyotrophic Lateral Sclerosis.

    PubMed

    Plowman, Emily K; Watts, Stephanie A; Robison, Raele; Tabor, Lauren; Dion, Charles; Gaziano, Joy; Vu, Tuan; Gooch, Clifton

    2016-06-01

    Dysphagia and aspiration are prevalent in amyotrophic lateral sclerosis (ALS) and contribute to malnutrition, aspiration pneumonia, and death. Early detection of at risk individuals is critical to ensure maintenance of safe oral intake and optimal pulmonary function. We therefore aimed to determine the discriminant ability of voluntary cough airflow measures in detecting penetration/aspiration status in ALS patients. Seventy individuals with ALS (El-Escorial criteria) completed voluntary cough spirometry testing and underwent a standardized videofluoroscopic swallowing evaluation (VFSE). A rater blinded to aspiration status derived six objective measures of voluntary cough airflow and evaluated airway safety using the penetration-aspiration scale (PAS). A between groups ANOVA (safe vs. unsafe swallowers) was conducted and sensitivity, specificity, area under the curve (AUC) and likelihood ratios were calculated. VFSE analysis revealed 24 penetrator/aspirators (PAS ≥3) and 46 non-penetrator/aspirators (PAS ≤2). Cough volume acceleration (CVA), peak expiratory flow rise time (PEFRT), and peak expiratory flow rate (PEFR) were significantly different between airway safety groups (p < 0.05) and demonstrated significant discriminant ability to detect the presence of penetration/aspiration with AUC values of: 0.85, 0.81, and 0.78, respectively. CVA <45.28 L/s/s, PEFR <3.97 L/s, and PEFRT >76 ms had sensitivities of 91.3, 82.6, and 73.9 %, respectively, and specificities of 82.2, 73.9, and 78.3 % for identifying ALS penetrator/aspirators. Voluntary cough airflow measures identified ALS patients at risk for penetration/aspiration and may be a valuable screening tool with high clinical utility. PMID:26803772

  7. Familiarity with breeding habitat improves daily survival in colonial cliff swallows

    PubMed Central

    BROWN, CHARLES R.; BROWN, MARY BOMBERGER; BRAZEAL, KATHLEEN R.

    2008-01-01

    One probable cost of dispersing to a new breeding habitat is unfamiliarity with local conditions such as the whereabouts of food or the habits of local predators, and consequently immigrants may have lower probabilities of survival than more experienced residents. Within a breeding season, estimated daily survival probabilities of cliff swallows (Petrochelidon pyrrhonota) at colonies in southwestern Nebraska were highest for birds that had always nested at the same site, followed by those for birds that had nested there in some (but not all) past years. Daily survival probabilities were lowest for birds that were naïve immigrants to a colony site and for yearling birds that were nesting for the first time. Birds with past experience at a colony site had monthly survival 8.6% greater than that of naïve immigrants. All colonies where experienced residents did better than immigrants were smaller than 750 nests in size, and in colonies greater than 750 nests, naïve immigrants paid no survival costs relative to experienced residents. Removal of nest ectoparasites by fumigation resulted in higher survival probabilities for all birds, on average, and diminished the differences between immigrants and past residents, probably by improving bird condition to the extent that effects of past experience were relatively less important and harder to detect. The greater survival of experienced residents could not be explained by condition or territory quality, suggesting that familiarity with a local area confers survival advantages during the breeding season for cliff swallows. Colonial nesting may help to moderate the cost of unfamiliarity with an area, likely through social transfer of information about food sources and enhanced vigilance in large groups. PMID:19802326

  8. Fusimotor influence on jaw muscle spindle activity during swallowing-related movements in the cat.

    PubMed Central

    Taylor, A; Hidaka, O; Durbaba, R; Ellaway, P H

    1997-01-01

    1. The activity patterns of muscle spindle afferents in jaw-closer muscles were studied during reflex swallowing movements in anaesthetized cats. Simultaneous records were made of the electromyogram (EMG) in masseter and anterior digastric muscles and of the unloaded jaw movements. The underlying patterns of fusimotor activity were deduced by comparing afferent discharges occurring during active swallowing with those occurring when exactly the same movements were imposed passively. The interpretation of spindle behaviour was greatly facilitated by characterizing the afferents according to the evidence for their contact with the various intrafusal muscle fibres, derived from testing with succinylcholine. It was also valuable to have two different types of afferent recorded simultaneously. 2. There was clear evidence of fusimotor activity occurring during active jaw closing so as to oppose the spindle silencing. This effect was most marked in b2c-type afferents (probably secondaries) and was therefore attributed to a modulation of static fusimotor discharge approximately in parallel with alpha-activity. 3. Afferents with evidence of bag1 fibre contacts (primaries) showed much greater sensitivity to muscle lengthening during active movement than when the movement was imposed. This difference was exaggerated when anaesthesia was deepened for the passive movements. This was interpreted as evidence for a higher level of dynamic fusimotor activity maintained during active movements than at rest. 4. The results support the view that for a variety of active jaw movements, static fusimotor neurone firing is modulated roughly in parallel with alpha-activity but leading it so as to counteract spindle unloading. Dynamic fusimotor neurone firing appears to be set at a raised level during active movements. Anaesthesia appears to depress activity in the alpha-motoneurones more than in gamma-motoneurones. PMID:9288683

  9. Conducting Real-Time Videofluoroscopic Swallow Study via Telepractice: A Preliminary Feasibility and Reliability Study.

    PubMed

    Burns, Clare L; Ward, Elizabeth C; Hill, Anne J; Phillips, Nick; Porter, Linda

    2016-06-01

    A small number of studies have examined the feasibility of conducting videofluoroscopic swallow studies (VFSS) via telepractice. While the results have confirmed this potential, the systems tested to date have either reported issues that impacted the ability to analyze/interpret the VFSS recordings in real time, or they were not designed to enable real-time interpretation. Further system design is needed to establish a telepractice model that enables the VFSS assessment to be both guided and interpreted live in real time. The aim of this study was to test the feasibility and reliability of using a telepractice system to enable live VFSS assessment. Twenty adult patients underwent a VFSS assessment directed by a telepractice SLP with competency in VFSS located in another room of the hospital. The telepractice clinician led the sessions using a C20 Cisco TelePresence System. This was linked in real time via a secure telehealth network (at 4 megabits per second (Mbit/s)) to a C60 Cisco TelePresence System located in a fluoroscopy suite, connected to the digital fluoroscopy system. Levels of agreement were calculated between the telepractice clinician and a face-to-face clinician who simultaneously rated the VFSS in real time. High levels of agreement for swallowing parameters (range = 75-100 %; k = -0.34 to 1.0) and management decisions (range = 70-100 %, k = 0.64-1.0) were found. A post-session questionnaire revealed clinicians agreed that the telepractice system enabled successful remote assessment of VFSS. The findings support the potential to conduct live VFSS assessment via a telepractice model. PMID:26979971

  10. Instrumental and sensory quantification of oral coatings retained after swallowing semi-solid foods.

    PubMed

    Prinz, J F; Huntjens, L; de Wijk, R A

    2006-12-01

    After a mouthful of food has been swallowed, some food material is always retained in the mouth. With semi-solid foods this is in the form of a coating that adheres to the oral mucosa. The amount and location of this material may play an important role in food sensations. In this study two quantitative methods of describing the coatings, generated by a set of 16 model custards varying in degree of lubrication (fat content) and degree of viscosity (starch concentration) are investigated. In the first method, a trained quantitative descriptive analysis panel (N=8) was instructed to take single mouthfuls of semi-solid foods, swallow and then rinse twice for 5s with water and spit out. The turbidity of the rinse water was then measured. During the same session, sensory assessments of the products were obtained. In the second method the thickness of the coating on the anterior and middle one-thirds of the tongue was quantified using a pair of opto-electronic reflectance sensors mounted on a probe which was placed on the tongue, one sensor measuring the anterior part of the tongue the other the posterior (middle third) of the tongue. Turbidity of the first rinse related strongly to the food's viscosity, as well as to sensory attributes associated with the food's fat content and viscosity, such as perceived thickness, creaminess and fattiness. Turbidity of subsequent rinses related primarily to fat content. These results indicate that turbidity of rinse water is a useful tool in fundamental (e.g., food texture research) as well as applied research (e.g., product development and quality assurance in food industry). Reflectance varied primarily with fat content and did not relate well to sensory attributes. PMID:17045954

  11. Timing of molt of barn swallows is delayed in a rare Clock genotype

    PubMed Central

    Romano, Maria; Caprioli, Manuela; Fasola, Mauro; Lardelli, Roberto; Micheloni, Pierfrancesco; Scandolara, Chiara; Rubolini, Diego; Gianfranceschi, Luca

    2013-01-01

    Photoperiodic responses are major factors entraining circannual life-cycles, functioning to adaptively synchronize annual routines to seasonal fluctuations in ecological conditions. Photoperiodism in physiology and behaviour is enforced by genes, including the vertebrate Clock orthologues, which are associated, for example, with phenology of migration in fish and breeding in birds. However, the role of Clock in photoperiodic plumage molt processes is unknown. We analyzed variation in molt schedules in relation to Clock genotype, using the long-distance migratory barn swallow (Hirundo rustica) as a model and by identifying males and females using molecular sexing techniques. Consistently with previous studies, we found one very common (Q7) and two rare (Q6, Q8) variants of a functionally significant Clock polyglutamine repeat. Molt schedules of primary wing feathers of swallows during their wintering period in Nigeria differed among Clock genotypes: rare (1.1%) Q7/Q8 heterozygotes had significantly delayed molt compared to the other genotypes. Molt schedules did not differ between males and females, and no differential association between molt and Clock in relation to sex emerged. The same rare Clock genotype that exhibited delayed breeding in Europe was here found to delay molt in Africa. Though based on a limited number of Q7/Q8 individuals from an otherwise very large sample, these novel results suggest that Clock is involved in the photoperiodic control of both molt and breeding, potentially also via reciprocal carry-over effects. If confirmed in species with higher Clock polymorphism, present results may have far-reaching consequences for the study of photoperiodic control of molt and expression of annual routines. PMID:23638351

  12. Corticosterone stress response in tree swallows nesting near polychlorinated biphenyl- and dioxin-contaminated rivers

    USGS Publications Warehouse

    Franceschini, M.D.; Custer, Christine M.; Custer, T.W.; Reed, J.M.; Romero, L.M.

    2008-01-01

    We assayed baseline and stress-induced corticosterone concentrations from adult female and nestling tree swallows, Tachycineta bicolor, from New England, USA, sites with different levels of contamination with polychlorinated biphenyls (PCBs) and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Corticosterone was compared over 2 years from a highly contaminated PCB site along the Housatonic River (Berkshire County, MA, USA), a midrange contaminated site upstream, and a reference site. Adult females (n = 29), sampled only in 2003, showed an inverted-U association with PCBs, with higher stress-induced corticosterone with midrange contamination than at the high-contamination site. In nestlings, stress-induced corticosterone was highest for the highly contaminated site compared with the other sites in 2003 (n = 53, 29 nests), with no difference among sites in 2004 (n = 93, 27 nests). In 2004, we began testing mechanisms underlying these changes in nestlings at the high- and low-PCB sites. Corticosterone response to dexamethasone injection (used to test negative feedback) was not different between sites, but stress-induced corticosterone was reduced at the contaminated site after adrenocorticotropin hormone injection (used to test adrenal responsiveness), suggesting an inhibited ability to mount a stress response. We also compared nestlings from a stretch of the Woonasquatucket River, Rhode Island, USA, heavily contaminated with TCDD (n = 80, 43 nests) with nestlings from an upstream site that had lower levels of TCDD and the Berkshire County reference site. Although there were no stress-induced differences, baseline corticosterone was lower at the higher TCDD site than at the reference site. Altogether these findings suggest that tree swallows chronically exposed to high PCB and TCDD levels exhibit altered baseline and stress-induced corticosterone responses, but the patterns of alteration might not be predictable. ?? 2008 SETAC.

  13. Corticosterone stress response in tree swallows nesting near polychlorinated biphenyl- and dioxin-contaminated rivers.

    PubMed

    Franceschini, Melinda D; Custer, Christine M; Custer, Thomas W; Reed, J Michael; Romero, L Michael

    2008-11-01

    We assayed baseline and stress-induced corticosterone concentrations from adult female and nestling tree swallows, Tachycineta bicolor, from New England, U.S.A., sites with different levels of contamination with polychlorinated biphenyls (PCBs) and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Corticosterone was compared over 2 years from a highly contaminated PCB site along the Housatonic River (Berkshire County, MA, USA), a midrange contaminated site upstream, and a reference site. Adult females (n=29), sampled only in 2003, showed an inverted-U association with PCBs, with higher stress-induced corticosterone with midrange contamination than at the high-contamination site. In nestlings, stress-induced corticosterone was highest for the highly contaminated site compared with the other sites in 2003 (n=53, 29 nests), with no difference among sites in 2004 (n=93, 27 nests). In 2004, we began testing mechanisms underlying these changes in nestlings at the high- and low-PCB sites. Corticosterone response to dexamethasone injection (used to test negative feedback) was not different between sites, but stress-induced corticosterone was reduced at the contaminated site after adrenocorticotropin hormone injection (used to test adrenal responsiveness), suggesting an inhibited ability to mount a stress response. We also compared nestlings from a stretch of the Woonasquatucket River, Rhode Island, U.S.A., heavily contaminated with TCDD (n=80, 43 nests) with nestlings from an upstream site that had lower levels of TCDD and the Berkshire County reference site. Although there were no stress-induced differences, baseline corticosterone was lower at the higher TCDD site than at the reference site. Altogether these findings suggest that tree swallows chronically exposed to high PCB and TCDD levels exhibit altered baseline and stress-induced corticosterone responses, but the patterns of alteration might not be predictable. PMID:18476749

  14. Adult tree swallow (Tachycineta bicolor) survival on the polychlorinated biphenyl-contaminated Housatonic River, Massachusetts, USA.

    PubMed

    Custer, Christine M; Custer, Thomas W; Hines, James E; Nichols, James D; Dummer, Paul M

    2007-05-01

    Tree swallows (Tachycineta bicolor) were captured and banded at six sites that differed in polychlorinated biphenyl (PCB) contamination levels in the Housatonic River watershed, western Massachusetts, USA, from 2000 through 2004 to test the prediction that apparent survival rates of females in more contaminated areas were lower than those from less contaminated areas. We also tested whether plumage coloration affected over-winter survival and whether concentrations of PCBs in eggs differed between birds that did and that did not return the following year. Apparent survival rates were calculated using mark-recapture methods and compared using Akaike's Information Criterion. Model-adjusted survival rates ranged from 0.365 to 0.467 for PCB-contaminated females and between 0.404 and 0.476 for reference females. Models with either survival or capture probability modeled as functions of treatment (degree of PCB contamination), year, and age received some support. The model-averaged parameter estimate reflecting a treatment effect for high-PCB birds was negative (beta = -0.046, SE(beta) = 0.0939). Fifty-four percent of the total model weights involved models in which survival was a function of PCB treatment. Eggs were collected for contaminant analyses from a random sample of females that did and that did not return the following year. Concentrations of total PCBs were the same or higher in the eggs of females that returned compared to the eggs of those that did not return at both the highly and the moderately contaminated PCB sites. This may have resulted from higher-quality females with higher lipid reserves being more likely than lower-quality females to return the following year. Percentage lipid was positively correlated with total PCBs in eggs. Survival rates were similar among swallows with brown versus blue plumage. PMID:17521155

  15. Encouraging the Development of Disability Allies

    ERIC Educational Resources Information Center

    Evans, Nancy J.; Assadi, Jennifer L.; Herriott, Todd K.

    2005-01-01

    The authors advocate for a constructionist interpretation of disability, grounded in a social justice perspective, by discussing disability paradigms, factors that influence attitudes and attitude change regarding disability, and disability ally development and behaviors.

  16. 20 CFR 718.204 - Total disability and disability causation defined; criteria for determining total disability and...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Total disability and disability causation defined; criteria for determining total disability and total disability due to pneumoconiosis. 718.204... DISABILITY OR DEATH DUE TO PNEUMOCONIOSIS Determining Entitlement to Benefits § 718.204 Total disability...

  17. 20 CFR 718.204 - Total disability and disability causation defined; criteria for determining total disability and...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Total disability and disability causation defined; criteria for determining total disability and total disability due to pneumoconiosis. 718.204... DISABILITY OR DEATH DUE TO PNEUMOCONIOSIS Determining Entitlement to Benefits § 718.204 Total disability...

  18. Disability Studies, Disabled People and the Struggle for Inclusion

    ERIC Educational Resources Information Center

    Oliver, Mike; Barnes, Colin

    2010-01-01

    This paper traces the relationship between the emergence of disability studies and the struggle for meaningful inclusion for disabled people with particular reference to the work of a pivotal figure in these developments: Len Barton. It is argued that the links between disability activism and the academy were responsible for the emergence of…

  19. Thrice Disabling Disability: Enabling Inclusive, Socially Just Teacher Education

    ERIC Educational Resources Information Center

    Thompson, S. Anthony

    2012-01-01

    The goal of this inquiry was to create a social justice-oriented inclusive and enabling pedagogy by situating traditional individualised views of disability alongside three alternative understandings: a disability studies in education perspective, a First Nations view of disability and one based upon the autism pride/autism-as-culture movement.…

  20. Disability Services Offices for Students with Disabilities: A Campus Resource

    ERIC Educational Resources Information Center

    Cory, Rebecca C.

    2011-01-01

    Section 504 of the 1973 Rehabilitation Act and the Americans with Disabilities Act (ADA) are often the starting places for conversations about students with disabilities in higher education. Section 504 and the ADA provide mandates for protection from discrimination and provision of reasonable disability accommodations (e.g., sign language…