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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. Can the subaltern speak? Visibility of international migrants with communication and swallowing disabilities in the World Report on Disability.

    PubMed

    Pillay, Mershen

    2013-02-01

    Wylie, McAllister, Davidson, and Marshal (2013) argued that the speech-language pathology profession must be encouraged to consider novel ways to deliver equitable services to people with communication disorders. People with communication disorders include the world's 215 million international migrants who deserve unique commentary when considering disability in the world. Hence, this paper focuses on invisibility of international migrants with communication or swallowing disorders in the World Report on Disability. The analysis of people with disabilities is biased towards citizenship. What of those who are non-citizens? Three issues are highlighted: (a) the demographic construction of migrants; (b) management of communication disability within the migrant patient-speech language pathologist dyad; and (c) strategic re-prioritization of dysphagia as a disability. While relevant to all people, re-prioritization of dysphagia as an impairment (of eating or drinking) resulting in restricted mealtime participation is especially relevant to the healthcare of international migrants. This issue is discussed in terms of how safe or adequate eating and drinking ought to constitute essential discharge criteria in medical settings where discharge (often resulting in deportation) may be decided on one's ability to walk or talk.

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

    PubMed

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

    2014-02-15

    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.

  4. 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

  5. Swallowing Problems

    MedlinePlus

    ... such as cream-based soups, pudding, ice cream, yogurt, and milkshakes). Take small bites, and swallow each ... dishes, tuna salads, and thick liquids such as yogurt may be easier to swallow. Sauces and gravies ...

  6. Shampoo - swallowing

    MedlinePlus

    ... The time it was swallowed The 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 ...

  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. Dirt - swallowing

    MedlinePlus

    ... About MedlinePlus Site Map FAQs Customer Support Health Topics Drugs & Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Dirt - swallowing URL of this page: //medlineplus.gov/ency/article/002840.htm Dirt - swallowing ...

  9. Painful swallowing

    MedlinePlus

    ... Ulcer in the esophagus, especially due to the antibiotic doxycycline Other causes of swallowing problems include: Mouth or throat ulcers Something stuck in the throat (for example, fish or chicken bones) Tooth infection or abscess

  10. Swallowing sunscreen

    MedlinePlus

    ... will be treated. The person may receive: Activated charcoal Blood and urine tests Breathing support, including a ... alcohol called ethanol. Children who swallow a large amount of sunscreen that contains ethanol may become drunk ( ...

  11. Enhancing Services for Toddlers with Disabilities: A Reverse Mainstreaming Inclusion Approach.

    ERIC Educational Resources Information Center

    Cormany, Ernestine E.

    This practicum designed and developed a program to implement a reverse mainstreaming model of inclusion for 7 toddlers (ages 1 to 3) with disabilities (Down syndrome, profound mental retardation, cerebral palsy, neurofibromatosis, stroke, and hearing impairment) and 3 of their typically developing peers. Emphasis was on the provision of…

  12. Neurophysiology of swallowing

    PubMed Central

    Humbert, Ianessa A.; Fitzgerald, Michelle E.; McLaren, Donald G.; Johnson, Sterling; Porcaro, Eva; Kosmatka, Kris; Hind, Jacqueline; Robbins, JoAnne

    2009-01-01

    This study examined age-related changes in swallowing from an integrated biomechanical and functional imaging perspective in order to more comprehensively characterize changes in swallowing associated with age. We examined swallowing-related fMRI brain activity and videoflouroscopic biomechanics of three bolus types (saliva, water and barium) in 12 young and 11 older adults. We found that age-related neurophysiological changes in swallowing are evident. The group of older adults recruited more cortical regions than young adults, including the pericentral gyri and inferior frontal gyrus pars opercularis and pars triangularis (primarily right-sided). Saliva swallows elicited significantly higher BOLD responses in regions important for swallowing compared to water and barium. In separate videofluoroscopy sessions, we obtained durational measures of supine swallowing. The older cohort had significantly longer delays before the onset of the pharyngeal swallow response and increased residue of ingested material in the pharynx. These findings suggest that older adults without neurological insult elicit more cortical involvement to complete the same swallowing tasks as younger adults. PMID:19010424

  13. 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

  14. The Videofluorographic Swallowing Study

    PubMed Central

    Martin-Harris, Bonnie; Jones, Bronwyn

    2008-01-01

    SYNOPSIS The evidence for the physiologic foundation and interpretation of the videofluorographic swallowing study (VFSS) is described. The purpose and clinical utility of VFSS are explained. Standardization of the VFSS procedure, protocol, interpretation and reporting is highlighted as a critical step in future clinical practice and in clinical research. Individualized, evidenced –based rehabilitation strategies are presented as key components that are systematically applied during the VFSS procedure and integrated into the swallowing management plan. A new tool that has been developed and tested for the quantification of swallowing impairment is introduced. PMID:18940640

  15. [Dysphagia and swallowing rehabilitation].

    PubMed

    Shigematsu, Takashi; Fujishima, Ichiro

    2015-02-01

    Dysphagia is a life-threatening disorder caused by many medical conditions such as stroke, neurological disorders, tumors, etc. The symptoms of dysphagia are quite variable and diagnosed by observation or through screening involving instrumental swallowing examinations such as video-fluoroscopy and video-endoscopy, to determine functional severity and treatment-prognosis. Direct- and indirect-therapy is used with and without food, respectively. Swallowing rehabilitation is very effective, and could be used in conjunction with compensatory techniques. Here we present an overview of dysphagia and swallowing rehabilitation.

  16. Dysphagia (Difficulty Swallowing)

    MedlinePlus

    ... your breathing tube. A visual examination of your esophagus (endoscopy). A thin, flexible lighted instrument (endoscope) is passed down your throat so your doctor can see your esophagus. Fiber-optic endoscopic swallowing evaluation (FEES). Your may ...

  17. [Arrhythmias from swallowing].

    PubMed

    Palazzuoli, V; Mondillo, S; Faglia, S; D'Aprile, N; De Luca, G; Kristodhullu, A; Corba, E

    1992-01-01

    We describe the case of a 51-year old, non cardiopathic patient, with recurrent attacks of supraventricular tachycardia induced by swallowing. In the existing literature we found several descriptions of hypokinetic arrhythmias, easily explained by a mechanism of vagal inhibition. The cases of predominantly hyperkinetic arrhythmias, however, are much less common. In these patients the origin of the disease seems to be due to sympathetic oesophageal fibers and superior and medium cardiac nerves. In the present case, as in the others reported in the literature, the drug of choice seems to be Amiodarone which appears to be the most effective in preventing tachyarrhythmias caused by swallowing.

  18. Jordan-3: measuring visual reversals in children as symptoms of learning disability and attention-deficit/hyperactivity disorder.

    PubMed

    Jordan, Brian T; Martin, Nancy; Austin, J Sue

    2012-12-01

    The purpose of this research was to establish new norms for the Jordan-3 for children ages 5 to 18 years. The research also investigated the frequency of visual reversals in children previously identified as having reading disability, attention-deficit/hyperactivity disorder, and broader learning disabilities. Participants were regular education students, ages 5 through 18 years, and special education students previously diagnosed with attention-deficit/hyperactivity disorder, reading disability, or broader learning disability. Jordan-3 Accuracy and Error raw scores were compared to assess if there was a significant difference between the two groups. Mean Accuracy and Error scores were compared for males and females. Children with learning disability and attention-deficit/hyperactivity disorder had higher reversals when compared to regular education children, which lends continued support to the Jordan-3 as a valid and reliable measure of visual reversals in children and adolescents. This study illustrates the utility of the Jordan-3 when assessing children who may require remediation to reach their academic potential.

  19. Disabilities

    MedlinePlus

    ... it isn't a sickness. Most people with disabilities can - and do - work, play, learn, and enjoy full, healthy lives. Mobility aids and assistive devices can make daily tasks easier. About one in every five people in the United States has a disability. Some people are born with one. Others have ...

  20. 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…

  1. Difficulty Swallowing After Stroke (Dysphagia)

    MedlinePlus

    ... Stories Stroke Heroes Among Us Difficulty Swallowing After Stroke (Dysphagia) Updated:Nov 15,2016 Excerpted and adapted ... stiffness (spasticity), fatigue and more. Let's Talk About Stroke Fact Sheets Our stroke fact sheets cover treatments, ...

  2. Swallowing dysfunction following endotracheal intubation

    PubMed Central

    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

    2016-01-01

    Abstract 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. Reversals.

    ERIC Educational Resources Information Center

    National Center on Educational Media and Materials for the Handicapped, Columbus, OH.

    Selected from the National Instructional Materials Information System (NIMIS)--a computer based on-line interactive retrieval system on special education materials--the bibliography covers nine materials for remediating reversals in handicapped students at the early childhood and elementary levels. Entries are presented in order of NIMIS accession…

  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. Temporal Sequence of Swallow Events during the Oropharyngeal Swallow

    ERIC Educational Resources Information Center

    Mendell, Dorie A.; Logemann, Jeri A.

    2007-01-01

    Purpose: To (a) identify and characterize the temporal relation of selected structural movements during the oropharyngeal swallow across participants, (b) determine whether patterns of movement could be identified, and (c) determine whether the temporal relations were affected by aging and bolus characteristics. Method: Retrospective analysis of…

  6. 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…

  7. 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…

  8. Two Techniques to Make Swallowing Pills Easier

    PubMed Central

    Schiele, Julia T.; Schneider, Hendrik; Quinzler, Renate; Reich, Gabriele; Haefeli, Walter E.

    2014-01-01

    To evaluate whether 2 techniques (the pop-bottle method for tablets and the lean-forward technique for capsules) ease swallowing of tablets and capsules, we conducted a cross-sectional study including 151 adults of the general German population. Participants swallowed 16 differently shaped placebos, rated their ease of swallowing on an 8-point Likert scale, and swallowed the 2 dosage forms that they had rated most difficult again using the appropriate technique. The pop-bottle method substantially improved swallowing of tablets in 59.7% (169/283) and the lean-forward technique for capsules in 88.6% (31/35). Both techniques were remarkably effective in participants with and without reported difficulties swallowing pills and should be recommended regularly. PMID:25384817

  9. Two techniques to make swallowing pills easier.

    PubMed

    Schiele, Julia T; Schneider, Hendrik; Quinzler, Renate; Reich, Gabriele; Haefeli, Walter E

    2014-01-01

    To evaluate whether 2 techniques (the pop-bottle method for tablets and the lean-forward technique for capsules) ease swallowing of tablets and capsules, we conducted a cross-sectional study including 151 adults of the general German population. Participants swallowed 16 differently shaped placebos, rated their ease of swallowing on an 8-point Likert scale, and swallowed the 2 dosage forms that they had rated most difficult again using the appropriate technique. The pop-bottle method substantially improved swallowing of tablets in 59.7% (169/283) and the lean-forward technique for capsules in 88.6% (31/35). Both techniques were remarkably effective in participants with and without reported difficulties swallowing pills and should be recommended regularly.

  10. Surface Electromyographic Assessment of Swallowing Function

    PubMed Central

    Poorjavad, Marziyeh; Talebian, Saeed; Ansari, Noureddin Nakhostin; Soleymani, Zahra

    2017-01-01

    The reliability of surface electromyographic (sEMG) variables during swallowing determines the potential usefulness of these measures in swallowing assessment and treatment. This study aimed to establish the reliability of the sEMG measures of the swallowing function of muscles during different swallowing conditions in healthy young and old volunteers. Two groups of volunteers (24 older adults, 10 younger adults) participated in this cross-sectional study during 2014. The activity of masseter, submental, and infrahyoid groups were measured using sEMG during three repetitions of different swallowing tasks. Both the relative and absolute reliability (characterized respectively by ICC, SEM%, and SRD%) were calculated for the sEMG indices of muscle activity during swallowing events. Statistical analyses were performed by the SPSS 19.0 and Microsoft Excel 2007 software packages. Statistical significance was set at P≤0.05. The relative reliability calculations showed significant agreements between repetitions for the mean and peak amplitude and the average of median frequency (MDF) of the studied muscles function during most swallowing types in both groups. However, the duration and particularly the time to peak of muscle activity showed significant agreements during fewer swallowing conditions. Excluding MDF, we found high SEM% and SRD% for the studied measures (particularly timing measures) of muscles function during most swallowing types in both groups. The reliability of sEMG measures was influenced by the age and swallowing types. Our findings suggest that the MDF of muscle function during almost all studied swallowing types can be a reliable measure for the sEMG assessment of swallowing function in both younger and older adults. PMID:28360446

  11. Ovine fetal swallowing responses to polyhydramnios

    PubMed Central

    Brace, Robert A.; Anderson, Debra F.; Cheung, Cecilia Y.

    2014-01-01

    Abstract Swallowing of amniotic fluid by late gestation fetuses increases when amniotic fluid volume (AFV) is elevated. Our objectives were to quantitatively characterize fetal swallowing when AFV is elevated above normal to polyhydramniotic levels and to explore the mechanisms that mediate these changes. Late gestation fetal sheep were studied under basal conditions and during intra‐amniotic infusion of lactated Ringer's solution. Control AFV averaged 631 ± 214 mL (SE, n = 6), swallowed volume was 299 ± 94 mL/day, and there were 5.7 ± 1.8 bouts/day of rapid swallowing. During intra‐amniotic infusion, AFV (3065 ± 894 mL) and daily swallowed volume (699 ± 148 mL/day) increased (P < 0.05) and the number of bouts reached a maximum of 13.7 ± 2.0 bouts/day when AFV exceeded 1500 mL. Unexpectedly, the volume swallowed per bout (57.3 ± 5.8 mL, n = 102) did not vary with AFV (r = 0.023, P = 0.81). Neither the number of swallows/day nor the volume/swallow changed consistently with elevated AFV. Daily swallowed volume increases and reaches a maximum of twice normal as AFV approaches polyhydramniotic levels. Mechanistically, the increase in swallowing was achieved primarily by an increase in the number of bouts of swallowing per day rather than the expected passive increase in volume per bout. This implies changes in fetal behavior as AFV was elevated. Furthermore, swallowed volume was four times more sensitive to increases in AFV than reported previously. PMID:24760530

  12. Cliff swallows, swallow bugs, and West Nile virus: an unlikely transmission mechanism.

    PubMed

    Oesterle, Paul; Nemeth, Nicole; Young, Ginger; Mooers, Nicole; Elmore, Stacey; Bowen, Richard; Doherty, Paul; Hall, Jeffrey; McLean, Robert; Clark, Larry

    2010-06-01

    The cliff swallow (Petrochelidon pyrrhonota) could play an important role in the transmission of West Nile virus (WNV) because of its breeding ecology, reservoir competence status, and potentially high natural exposure rates. Cliff swallows nest within colonies and their nests are occupied year-round by swallow bugs (Oeciacus vicarius), hematophagus ectoparasites that feed primarily on cliff swallows. These parasites are likely exposed to WNV while feeding on infectious blood of nesting cliff swallow adults and nestlings and thus, if competent vectors, could contribute to seasonal elevations in WNV transmission. In addition, swallow bugs remain within nests year-round and therefore could provide a potential overwintering mechanism for WNV if persistently infected. To test the hypotheses that swallow bugs are competent vectors and become persistently infected with WNV, we experimentally inoculated cliff swallow nestlings, allowed swallow bugs to feed on these birds during the acute phase of infection, and then exposed naive cliff swallow nestlings to the same swallow bugs. In addition, a subset of swallow bugs that fed on infectious swallow nestlings was maintained through a simulated overwintering period. Although swallow bugs ingested infectious blood (up to 10(6.8) plaque-forming units of WNV/mL serum) and subsequently blood-fed on naive swallows, no WNV transmission was detected, and all bugs tested WNV negative after the simulated overwintering period. Although many ecologic scenarios exist beyond the present study, our results suggest that swallow bugs may be unlikely to serve as competent biological vectors for WNV during active transmission periods or to reinitiate seasonal transmission.

  13. 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…

  14. 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…

  15. Videomanometric analysis of supraglottic swallow, effortful swallow, and chin tuck in healthy volunteers.

    PubMed

    Bülow, M; Olsson, R; Ekberg, O

    1999-01-01

    Simultaneous videoradiography and solid-state manometry (videomanometry) was applied in eight healthy volunteers (four women, four men; age range 25-64 years, mean age 41 years) without swallowing problems. Three different swallowing techniques were tested; supraglottic swallow, effortful swallow, and chin tuck. Seven videoradiographic variables and six manometric variables were analyzed. The supraglottic swallowing technique did not differ significantly from that of the control swallows. The effortful swallow had a significantly (p = 0.0001) reduced hyoid-mandibular distance preswallow due to an elevation of the hyoid and the larynx, which caused a significantly (p = 0.007) reduced maximal hyoid movement and a significantly (p = 0.009) reduced laryngeal elevation during swallow. The chin tuck swallow had a significantly (p = 0. 001) reduced laryngohyoid distance and also a significantly (p = 0. 004) reduced hyoid-mandibular distance. The chin tuck swallow also displayed significantly (p = 0.003) weaker pharyngeal contractions. Videomanometry allows for analysis of bolus transport, movement of anatomical structures, and measurement of intraluminal pressures. These variables are important when evaluating swallowing techniques. In the present study, we made a few observations that never have been reported before. When healthy volunteers performed supraglottic swallow, they performed the technique somewhat differently. Therefore, we assume dysphagic patients would need a substantial period of training to perform a technique efficiently. Chin tuck could impair protection of the airways in dysphagic patients with weak pharyngeal constrictor muscles.

  16. 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…

  17. Electrophysiological association of spontaneous yawning and swallowing.

    PubMed

    Ertekin, Cumhur; Bulbul, Nazlı Gamze; Uludag, Irem Fatma; Tiftikcioglu, Bedile Irem; Arici, Sehnaz; Gurgor, Nevin

    2015-07-01

    Yawning and swallowing are fundamental physiological processes that are present from fetal stages throughout life and that involve sequential motor activities in the oropharyngo-larynx making it likely that they may share neuroanatomical pathways. We postulate that yawning and swallowing are controlled by a distributed network of brainstem regions including the central pattern generator of swallowing, and therefore spontaneous swallowing is frequently associated with spontaneous yawning. In this study, we sought to test this hypothesis by evaluating the elementary features of yawning in the facial, masseter and submental muscles, together with laryngeal movement sensor and respiratory recordings for spontaneous swallowing. We investigated 15 healthy, normal control subjects, 10 patients with Parkinson's disease (PD) and 10 patients with brainstem stroke (BSS). Apart from four subjects with PD and two with BSS, who had dysphagia, none of the other study subjects were dysphagic by published criteria. Twenty-five subjects (10 control, 10 BSS, 5 PD) were evaluated by 1-h polygraphic recording, and 10 (5 control, 5 PD) underwent whole-night sleep recordings. One hundred thirty-two yawns were collected, 113 of which were associated with spontaneous swallows, a clear excess of what would be considered as coincidence. The yawns related with swallows could be classified into the following three categories. The characteristics or the duration of swallows and yawns were similar between controls and disease subjects, with the exception of increased duration of yawning in subjects with BSS. Our findings support the presence of common neuroanatomico-physiological pathways for spontaneous swallows and yawning.

  18. Pharyngeal swallowing phase and chronic cough

    PubMed Central

    Drozdz, Daniela Rejane Constantino; Costa, Cintia Conceição; Jesus, Paulo Roberto de Oliveira; Trindade, Mateus Silva; Weiss, Guilherme; Neto, Abdias Baptista M.; da Silva, Ana Maria T.; Mancopes, Renata

    2012-01-01

    Summary Introduction: The act of swallowing depends on a complex and dynamic process which uses common structures to the act of breathing; respiratory problems can cause swallowing difficulties. Aim: To assess the swallowing pharyngeal phase in patients with chronic cough. Method: Retrospective study with 15 patients of both genders, patients with chronic cough and risk factors for aspiration defined by the pneumologic diagnosis. The patients were submitted to anamnesis on complaints related to swallowing, chewing and breathing, or related to food and to videofluoroscopic examination. Results: It was observed that 33.3% had normal and functional swallowing, being the last one of most prevalence. The mild dysphagia was observed in 20% of the patients, the mild to moderate dysphagia in 6.7% of them. In relation to the Rosenbek scale, 73.3% of patients presented degree 1, 6.7% presented degrees 2 and 3, and 13.3% presented degree 8. The most found pathology was the chronic cough with 40%, followed by asthma with 20%; 69.2% of patients presented stasis and of these, five used protection maneuvers, of these, seven were effective and only three were used in the presence of stasis. The most used maneuver was the multiple swallowing, being effective in 100%. Conclusion: There are peculiarities in the patients' swallowing with chronic cough that, although not presenting complaints relating to swallowing, it presents an important aspiration risk due to the presence of changes in breathing pattern that can intervene in the coordination between breathing and swallowing, which is essential to protect the lower airway. PMID:25991980

  19. 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…

  20. Stuttered swallowing: Electric stimulation of the right insula interferes with water swallowing. A case report

    PubMed Central

    2011-01-01

    Background Various functional resonance imaging, magnetoencephalographic and lesion studies suggest the involvement of the insular cortex in the control of swallowing. However, the exact location of insular activation during swallowing and its functional significance remain unclear. Case presentation Invasive electroencephalographic monitoring was performed in a 24-year-old man with medically intractable stereotyped nocturnal hypermotor seizures due to a ganglioglioma. During stimulation of the right inferior posterior insular cortex with depth electrodes the patient spontaneously reported a perception of a "stutter in swallowing". Stimulation of the inferior posterior insular cortex at highest intensity (4 mA) was also associated with irregular and delayed swallows. Swallowing was not impaired during stimulation of the superior posterior insular cortex, regardless of stimulation intensity. Conclusions These results indicate that the right inferior posterior insular cortex is involved in the neural circuitry underlying the control of swallowing. PMID:21294905

  1. Huntington's Disease: Speech, Language and Swallowing

    MedlinePlus

    ... devices and techniques that can supplement the individual's verbal communication. The SLP can evaluate a person's swallowing function ... available, people with HD generally prefer to attempt verbal communication for as long as possible, even if their ...

  2. 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.

  3. 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

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

    PubMed

    Jayatilake, Dushyantha; 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.

  5. Swallowing assessment in myotonic dystrophy type 1 using fiberoptic endoscopic evaluation of swallowing (FEES).

    PubMed

    Pilz, Walmari; Baijens, Laura W J; Passos, Valéria Lima; Verdonschot, Rob; Wesseling, Frederik; Roodenburg, Nel; Faber, Catharina G; Kremer, Bernd

    2014-12-01

    This study describes the swallowing function of patients with myotonic dystrophy type 1 (DM1) and the effect of bolus consistency on swallowing in this group. The aim of the study is twofold: (a) to identify which (and to what extent) swallowing variables change for DM1 patients relative to healthy control subjects and (b) to examine whether the degree of oropharyngeal dysphagia is associated with disease severity. Forty-five consecutive DM1 patients and ten healthy subjects underwent a swallowing assessment, at Maastricht University medical Center in the Netherlands. The assessment included a standardized fiberoptic endoscopic evaluation of swallowing (FEES) protocol using different bolus consistencies. Clinical severity of the disease was assessed using the muscular impairment rating scale (MIRS). Significant differences were found between patients and controls for all FEES variables. The magnitude of these differences depended on the bolus consistency. The odds of a more pathological swallowing outcome increased significantly with higher MIRS levels. In conclusion, swallowing function is found to be significantly altered in DM1 patients. The results emphasize the importance of conducting a detailed swallowing assessment in all patients, even those with mild muscle weakness.

  6. Influences of swallowing volume and viscosity on regulation of levator veli palatini muscle activity during swallowing.

    PubMed

    Okuno, K; Tachimura, T; Sakai, T

    2013-09-01

    This study examined the aspect of the regulation of velum movement in the transition from the oral to pharyngeal phases of swallowing in relation to changes in the swallowing volume and viscosity by means of measurment of levator veli palatini muscle activity. The subjects were nine normal adults, ranging in age from 24 to 30 years. The swallowing volume was set at 1/4, 1/2 and 1 volume of the optimum volume of green tea for swallowing determined in each subject, and the viscosity was adjusted to 0, 2·0 and 4·6 Pa·s by mixing with thickener. Nine test foods were prepared in total. The electromyographic activity of the levator veli palatini muscle was monitored using bipolar hooked wire electrodes. The levator veli palatini muscle activity was defined as the integrated electromyographic wave. The mean in swallowing each test food was determined in each subject. The levator veli palatini muscle activity increased with the swallowing volume for all subjects (P < 0·05) and decreased inversely with the viscosity for six subjects (P < 0·05), but no change with the increase in the viscosity was noted for three subjects. This study clarified the aspect of the regulation of velar movement with regard to the involvement of the levator veli palatini muscle in swallowing activity with changes in the swallowing volume and viscosity.

  7. The interaction between breathing and swallowing in amyotrophic lateral sclerosis.

    PubMed

    Erdem, Nazan Simsek; Karaali, Kamil; Ünal, Ali; Kızılay, Ferah; Öğüş, Candan; Uysal, Hilmi

    2016-12-01

    The aim of the study is to determine the association between respiratory swallow patterns in amyotrophic lateral sclerosis (ALS) patients. Furthermore, it aims to clarify the role of the dysphagia limit in defining the relationship between swallowing disorders and respiratory disorders. Functional rating scales were used to describe swallowing and respiratory function. Swallowing was observed using the dysphagia limit. Dysphagia limit is the volume at which a second or more swallows are required to swallow the whole bolus. Laryngeal and chest movement sensors, pulmonary function tests, submental, and diaphragm electromyography activity were used to evaluate the relationship between swallowing and respiratory phase. Of the 27 patients included in the study, 14 were dysphagic and 13 were non-dysphagic. Tests showed normal respiratory function in 11 of the non-dysphagic patients and 3 of the dysphagic patients. There was a high correlation between the dysphagia limit and Amyotrophic Lateral Sclerosis Functional Rating Scale swallowing parameters. Non-dysphagic patients were able to swallow during inspiration but only six patients in the dysphagic group were able to swallow during inspiration. The occurrence of dysphagia in ALS is related to piecemeal deglutition and respiration consistency during swallowing. Detecting the timing of disturbances in the relationship between swallowing and respiration may be a way of identifying dysphagia. Dysphagia limit may be a useful, complementary test for assessing swallowing disturbances in amyotrophic lateral sclerosis.

  8. 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.

  9. Rehabilitation of swallowing and communication following glossectomy.

    PubMed

    LaBlance, G R; Kraus, K; Steckol, K F

    1991-01-01

    Patients who have had surgical removal of part or all of the tongue are left with varying degrees of swallowing and speech deficiencies. The extent of resection, mobility of the residual tongue segment, and adequacy of the remaining structures determine the amount and type of deficiency. While communicative impairment and dysphagia commonly are seen in a rehabilitation setting, the problems of the glossectomy patient often are unique. This article reviews the anatomy and physiology of the oral and pharyngeal musculature, discusses the speech and swallowing of the glossectomy patient, and presents nursing considerations for successful rehabilitation.

  10. Development of a swallowing frequency meter using a laryngeal microphone.

    PubMed

    Tanaka, N; Nohara, K; Okuno, K; Kotani, Y; Okazaki, H; Matsumura, M; Sakai, T

    2012-06-01

    Disuse atrophy of swallowing-related organs is suspected when decreased swallowing frequency is seen in the elderly. However, swallowing frequency has not been examined in elderly people during daily life. We developed a swallowing frequency meter containing a laryngeal microphone that does not restrict the subject's ability to perform daily activities. In this study, the utility of the meter was assessed. Experiment 1: The ability of the meter to detect swallowing was examined. The subject was instructed to swallow saliva or foods at a voluntarily pace. During these procedures, swallowing events were simultaneously recorded by the meter, self-enumeration and videofluorography. As a result, all of the swallowing events identified by the meter coincided with the swallowing events identified by self-enumeration and videofluorography. Experiment 2: Swallowing sounds display various patterns both between and within individuals. Therefore, we examined the concordance rate between the number of swallowing events counted by the meter and that counted by self-enumeration in 15 subjects over a longer period than in experiment 1. The concordance rates calculated by two examiners between the meter and self-enumeration were 96·8 ± 4·5% and 98·9 ± 3·3% at rest and 95·2 ± 4·5% and 96·1 ± 4·1% during meals, respectively. Our findings indicate that this meter is useful for measuring the frequency of swallowing during daily situations.

  11. 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…

  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. Symptomatic swallowing-induced paroxysmal supraventricular tachycardia.

    PubMed

    Mirvis, D M; Bandura, J P; Brody, D A

    1977-05-04

    A 55 year old woman with palpitations during ingestion of food or drink was evaluated with surface, esophageal and dynamic electrocardiographic techniques. Recordings documented the consistent induction of supraventricular tachycardia by swallowing; no definable gastrointestinal or other cardiac abnormality was present. Nine previously reported cases are reviewed, with special reference to the role of vagovagal reflexes in the pathogenesis of this unusual clinical syndrome.

  14. 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…

  15. 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

  16. 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.

  17. Towards automated ingestion detection: swallow sounds.

    PubMed

    Walker, William P; Bhatia, Dinesh

    2011-01-01

    Obesity is a worldwide epidemic and is a cause of many major chronic diseases. In most cases, obesity is a result of an imbalance between food intake and calories burned. Steps toward automated ingestion detection are being made. In order to automate the process of capturing ingestion, a method for detecting, analyzing, and recording sounds related to ingestion is being developed. In this paper, preliminary swallow sound analysis is presented and compared with various other noises captured from a throat mounted microphone. Initial frequency analysis indicates a stronger presence at high frequency intervals for swallow sounds in relation to other captured sounds such as voice. Comparisons show that a single high-pass filter can offer similar results as wavelet decomposition. Two simple methods for event detection are given.

  18. 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.

  19. Swallowing Disorders - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Arabic (العربية) 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 ...

  20. Gastrointestinal damage caused by swallowing multiple magnets.

    PubMed

    Liu, Shiqi; Li, Jianhui; Lv, Yi

    2012-09-01

    Swallowing multiple magnets is not uncommon worldwide and it frequently leads to serious consequences. However, most patients fail to receive timely and correct diagnosis and treatment. A literature search was performed to establish an algorithm for these accidents by the authors to identify relevant articles published from June 1987 to October 2010 in Google, Medline, ISI Web of Knowledge Ovid, CNKI, Korea Med and library document delivery, using search terms "magnet ingestion, " "fistula," and "perforation." A total of 149 patients with ingestion of magnetic foreign bodies from 20 countries and areas were identified. 22 of them were companioned with neurological and psychiatric disorders. Swallowing magnets occurred throughout childhood and adolescent, mostly ranging 2 to 4 years in age. Various gastrointestinal damages such as necrosis and intestinal perforation or fistula were encountered. Damage from swallowing multiple magnets carries a significant risk of morbidity and even mortality throughout childhood to adolescent worldwide. Older children and adults with neurological and psychiatric problems may be at high risk for such accidents. Early intervention is crucial.

  1. Psychosocial effects of reverse-integrated basketball activity compared to separate and no physical activity in young people with physical disability.

    PubMed

    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 separate physical activity (RESPA), reverse-integrated basketball activity (RIBA), and no physical activity (NOPA). QOL and PSC questionnaires were administered at the beginning and the end of the study's duration of six months. ANCOVA corrected for functional independence and gender revealed significant group effects for pre to post change values of QOL and PSC, with greater positive change in the RIBA compared to all other groups. In addition, one-way ANOVA on pre to post change values with LSD post hoc revealed significant differences. RIBA change values for QOL with 8.77%, and for PSC with 9.98% change were significantly higher (p<.001) than in all other groups (ranges -0.18 through 1.36% for QOL, and -2.31 through 2.34% for PSC). These outcomes demonstrate a favorable outcome of the RIBA on participants. Low functional ability did not constrain the effects of sport participation.

  2. Examination of swallowing maneuver training and transfer of practiced behaviors to laryngeal vestibule kinematics in functional swallowing of healthy adults.

    PubMed

    Guedes, Renata; Azola, Alba; Macrae, Phoebe; Sunday, Kirstyn; Mejia, Veerley; Vose, Alicia; Humbert, Ianessa A

    2017-03-18

    Swallowing maneuvers are routinely trained in dysphagia rehabilitation with the assumption that practiced behaviors transfer to functional swallowing, however transfer is rarely examined in the deglutition literature. The goal of this study was to train the volitional laryngeal vestibule closure (vLVC) maneuver, which is a swallowing maneuver that targets prolonged laryngeal vestibule closure (LVC). In two different training experiments, 69 healthy adults underwent Long-hold (hold vLVC as long as possible) or Short-hold vLVC training (hold vLVC for 2s). Before and after vLVC training, natural swallows (swallowing without a therapeutic technique) were completed. The outcome variables included laryngeal vestibule closure reaction time and the duration of laryngeal vestibule closure. Results indicate that during both Long-hold and Short-hold vLVC trainings, vLVC swallows had faster laryngeal vestibule closure reaction times and longer durations of laryngeal vestibule closure than in pre-training 5ml liquid swallows. However, only faster laryngeal vestibule closure reaction times transferred to post-training 5ml liquid swallows (20-24% faster), but not prolonged durations of laryngeal vestibule closure. Our findings suggest that swallowing maneuver training has the potential to induce transfer of what was practiced to functional swallowing behavior, although not all practiced behaviors may generalize. These findings are significant for bolstering the effectiveness of dysphagia management in medical settings and should be tested in individuals with dysphagia.

  3. Diagnosis of spasmodic dysphonia manifested by swallowing difficulty in videofluoroscopic swallowing study.

    PubMed

    Yeo, Han Gyeol; Lee, Seong Jae; Hyun, Jung Keun; Kim, Tae Uk

    2015-04-01

    Spasmodic dysphonia is defined as a focal laryngeal disorder characterized by dystonic spasms of the vocal cord during speech. We described a case of a 22-year-old male patient who presented complaining of idiopathic difficulty swallowing that suddenly developed 6 months ago. The patient also reported pharyngolaryngeal pain, throat discomfort, dyspnea, and voice change. Because laryngoscopy found no specific problems, an electrodiagnostic study and videofluoroscopic swallowing study (VFSS) were performed to find the cause of dysphagia. The VFSS revealed continuous twitch-like involuntary movement of the laryngeal muscle around the vocal folds. Then, he was diagnosed with spasmodic dysphonia by VFSS, auditory-perceptual voice analysis, and physical examination. So, we report the first case of spasmodic dysphonia accompanied with difficulty swallowing that was confirmed by VFSS.

  4. Coordinate mapping of hyolaryngeal mechanics in swallowing.

    PubMed

    Thompson, Thomas Z; Obeidin, Farres; Davidoff, Alisa A; Hightower, Cody L; Johnson, Christohper Z; Rice, Sonya L; Sokolove, Rebecca-Lyn; Taylor, Brandon K; Tuck, John M; Pearson, William G

    2014-05-06

    Characterizing hyolaryngeal movement is important to dysphagia research. Prior methods require multiple measurements to obtain one kinematic measurement whereas coordinate mapping of hyolaryngeal mechanics using Modified Barium Swallow (MBS) uses one set of coordinates to calculate multiple variables of interest. For demonstration purposes, ten kinematic measurements were generated from one set of coordinates to determine differences in swallowing two different bolus types. Calculations of hyoid excursion against the vertebrae and mandible are correlated to determine the importance of axes of reference. To demonstrate coordinate mapping methodology, 40 MBS studies were randomly selected from a dataset of healthy normal subjects with no known swallowing impairment. A 5 ml thin-liquid bolus and a 5 ml pudding swallows were measured from each subject. Nine coordinates, mapping the cranial base, mandible, vertebrae and elements of the hyolaryngeal complex, were recorded at the frames of minimum and maximum hyolaryngeal excursion. Coordinates were mathematically converted into ten variables of hyolaryngeal mechanics. Inter-rater reliability was evaluated by Intraclass correlation coefficients (ICC). Two-tailed t-tests were used to evaluate differences in kinematics by bolus viscosity. Hyoid excursion measurements against different axes of reference were correlated. Inter-rater reliability among six raters for the 18 coordinates ranged from ICC = 0.90 - 0.97. A slate of ten kinematic measurements was compared by subject between the six raters. One outlier was rejected, and the mean of the remaining reliability scores was ICC = 0.91, 0.84 - 0.96, 95% CI. Two-tailed t-tests with Bonferroni corrections comparing ten kinematic variables (5 ml thin-liquid vs. 5 ml pudding swallows) showed statistically significant differences in hyoid excursion, superior laryngeal movement, and pharyngeal shortening (p < 0.005). Pearson correlations of hyoid excursion measurements from two

  5. A systematic review of self-reported swallowing assessments in progressive neurological disorders.

    PubMed

    Keage, Megan; Delatycki, Martin; Corben, Louise; Vogel, Adam

    2015-02-01

    Dysphagia experienced as a consequence of neurodegenerative disease can have severe consequences on a patient's health and well-being. Regular assessment of swallowing function can assist to achieve adequate nutrition and hydration. Here we review subjective swallowing assessments currently available are suitable for use in people with neurodegenerative disease. Measurement properties were reviewed for each tool and coverage of the World Health Organization's International Classification of Functioning, Disability and Health (WHO ICF) was considered. Assessments were identified following a review of the published literature Instruments were reviewed on the basis of reliability and validity, as well as administrative properties, such an interpretability, acceptability, and feasibility. Tools were also evaluated according to the WHO ICF framework. In total, 19 studies were identified for full-text review from 13,315 abstracts. Nine self-reported dysphagia assessment tools suitable for use in progressive neurological disorders were identified. The Swallowing Quality of Life Questionnaire (SWAL-QOL) yields the strongest combination of reliability (including internal consistency and test-retest reliability) and convergent validity while simultaneously covering all WHO ICF domains. Lengthy administration time was identified as a limitation of the SWAL-QOL. The review highlights a relative lack of well-validated self-report questionnaires in dysphagia for people with progressive neurological disease. Additional validation and evaluation of the clinical utility of the tools currently available is required to further promote an informed selection of available assessments.

  6. 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…

  7. 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

  8. 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

  9. 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

  10. 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…

  11. Therapy for Children with Swallowing Disorders in the Educational Setting.

    ERIC Educational Resources Information Center

    Logemann, Jeri A.

    2000-01-01

    This article presents the various types of swallowing therapy available, including postural changes, sensory enhancements, changes in feeding processes, and exercise programs. Other therapy issues discussed include the relationship of the feeding process to swallowing therapy, the schedule of therapy, and maintenance programs as compared to…

  12. 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...

  13. 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…

  14. 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…

  15. 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…

  16. Swallowing disorders in patients with blepharospasm.

    PubMed

    Cersósimo, María G; Juri, Silvia; Suárez de Chandler, Silvia; Clerici, Roxana; Micheli, Federico E

    2005-01-01

    Blepharospasm is a focal dystonia characterized by involuntary eye closure due to abnormal contraction of orbicular eyelid muscles. When blepharospasm is associated to the presence of involuntary oromandibular movements, it is termed Meige syndrome. The aim of this study was to investigate the presence of deglutition alterations in patients with concurrent blepharospasm and Meige syndrome. Twenty consecutive patients were studied by video fluoroscopy using a barium technique. The 4 stages of deglutition were investigated. Ninety percent of patients (18 cases) presented deglutition disorders. The more commonly found alterations were premature food drop, 15 cases (83%) and vallecuale residuals, 14 cases (78%). Sixty seven percent of abnormal findings occurred in the third stage of deglutition. Eighty-nine percent of patients (16) presented more than one swallowing alteration. There was a positive and significant correlation between the number of alterations and patient's age or disease duration. Prevalence of swallowing disorders in the healthy elderly population is reported to be 44%. In our series it reached 90%, suggesting that our findings might be related not only with age but also with a more widespread dystonia exceeding the orofacial muscles.

  17. Cervical auscultation synchronized with images from endoscopy swallow evaluations.

    PubMed

    Leslie, Paula; Drinnan, Michael J; Zammit-Maempel, Ivan; Coyle, James L; Ford, Gary A; Wilson, Janet A

    2007-10-01

    Cervical auscultation is the use of a listening device, typically a stethoscope in clinical practice, to assess swallow sounds and by some definitions airway sounds. Judgments are then made on the normality or degree of impairment of the sounds. Listeners interpret the sounds and suggest what might be happening with the swallow or causing impairment. A major criticism of cervical auscultation is that there is no evidence on what causes the sounds or whether the sounds correspond to physiologically important, health-threatening events. We sought to determine in healthy volunteers (1) if a definitive set of swallow sounds could be identified, (2) the order in which swallow sounds and physiologic events occur, and (3) if swallow sounds could be matched to the observed physiologic events. Swallow sounds were computer recorded via a Littmann stethoscope from 19 healthy volunteers (8 males, 11 females, age range = 18-73 years) during simultaneous fiberoptic laryngoscopy and respiration monitoring. Six sound components could be distinguished but none of these occurred in all swallows. There was a wide spread and a large degree of overlap of the timings of swallow sounds and physiologic events. No individual sound component was consistently associated with a physiologic event, which is a clinically significant finding. Comparisons of groups of sounds and events suggest associations between the preclick and the onset of apnea; the preclick and the start of epiglottic excursion; the click and the epiglottis returning to rest; the click and the end of the swallow apnea. There is no evidence of a causal link. The absence of a swallow sound in itself is not a definite sign of pathologic swallowing, but a repeated abnormal pattern may indicate impairment. At present there is no robust evidence that cervical auscultation of swallow sounds should be adopted in routine clinical practice. There are no data to support the inclusion of the technique into clinical guidelines or

  18. Swallowing Function Defined by Videofluoroscopic Swallowing Studies after Anterior Cervical Discectomy and Fusion: a Prospective Study

    PubMed Central

    2016-01-01

    This study evaluated factors related to swallowing dysfunction after anterior cervical discectomy and fusion (ACDF) using videofluoroscopic swallowing studies (VFSS). Preoperative and postoperative VFSSs were done with 5 mL diluted barium. Oral transit time, pharyngeal delay time, pharyngeal response time (PRT), and pharyngeal transit time were measured. Hyoid bone movement and upper esophageal sphincter (UES) diameter were measured serially. Thickness of prevertebral soft tissue was measured from digitized VFSS images. In results, 12 of 20 patients showed abnormal postoperative VFSS findings. PRT decreased significantly after surgery. Hyoid bone movement did not change significantly after surgery. The maximal distance of UES opening decreased significantly after surgery, and the higher the level of surgery (C3 > C4 > C5 > C6), the greater the decrease in maximal distance of the UES opening after surgery. The time to widest opening of the UES was prolonged significantly. At the C3 and C4 levels, the change in prevertebral soft tissue thickness of patients with VFSS abnormalities was significantly greater than those without abnormalities. In conclusion, patients after ADCF with their highest surgery level at C3 and C4 showed more abnormal VFSS findings, significantly increased soft tissue thickness, and decreased maximal distance of UES opening. VFSS provided objective data related with swallowing dysfunction after ACDF. PMID:27822944

  19. 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.

  20. Fabrication of Artificial Food Bolus for Evaluation of Swallowing.

    PubMed

    Hosotsubo, Miyu; Magota, Tetsuro; Egusa, Masahiko; Miyawaki, Takuya; Matsumoto, Takuya

    2016-01-01

    Simple and easy methods to evaluate swallowing are required because of the recently increased need of rehabilitation for dysphagia. "Artificial food bolus", but not "artificial food", would be a valuable tool for swallowing evaluation without considering the mastication effect which is altered according to the individual's oral condition. Thus, this study was carried out to fabricate artificial bolus resembling natural food bolus. The mechanical property and the volume change of food bolus in normal people were firstly investigated. Thirty healthy adults without dysphagia were selected and asked to chew four sample foods (rice cake, peanut, burdock, and gummy candy). The results indicated that Young's modulus of bolus before swallowing was below 150 kPa. The bolus volume before swallowing was below 400 mm3. In addition, the saliva component ratio of each bolus was approximately 30wt%, and the average saliva viscosity of research participants was approximately 10 mPa•s. Based on the obtained data, artificial food bolus was designed and fabricated by using alginate hydrogel as a visco-elastic material and gelatin solution as a viscotic material with a ratio of 7:3 based on weight. Consequently, the swallowing time of fabricated artificial food bolus was measured among the same participants. The results indicated the participants swallowed fabricated food bolus with similar manner reflecting their mechanical property and volume. Thus, this artificial food bolus would be a promising tool for evaluation of swallowing.

  1. Characteristics of Dry Chin-Tuck Swallowing Vibrations and Sounds

    PubMed Central

    Dudik, Joshua M; Jestrović, Iva; Luan, Bo; Coyle, James L.; Sejdić, Ervin

    2015-01-01

    Objective The effects of the chin-tuck maneuver, a technique commonly employed to compensate for dysphagia, on cervical auscultation are not fully understood. Characterizing a technique that is known to affect swallowing function is an important step on the way to developing a new instrumentation-based swallowing screening tool. Methods In this study, we recorded data from 55 adult participants who each completed five saliva swallows in a chin-tuck position. The resulting data was processed using previously designed filtering and segmentation algorithms. We then calculated 9 time, frequency, and time-frequency domain features for each independent signal. Results We found that multiple frequency and time domain features varied significantly between male and female subjects as well as between swallowing sounds and vibrations. However, our analysis showed that participant age did not play a significant role on the values of the extracted features. Finally, we found that various frequency features corresponding to swallowing vibrations did demonstrate statistically significant variation between the neutral and chin-tuck positions but sounds showed no changes between these two positions. Conclusion The chin-tuck maneuver affects many facets of swallowing vibrations and sounds and its effects can be monitored via cervical auscultation. Significance These results suggest that a subject’s swallowing technique does need to be accounted for when monitoring their performance with cervical auscultation based instrumentation. PMID:25974926

  2. Fabrication of Artificial Food Bolus for Evaluation of Swallowing

    PubMed Central

    Hosotsubo, Miyu; Magota, Tetsuro; Egusa, Masahiko; Miyawaki, Takuya; Matsumoto, Takuya

    2016-01-01

    Simple and easy methods to evaluate swallowing are required because of the recently increased need of rehabilitation for dysphagia. "Artificial food bolus", but not "artificial food", would be a valuable tool for swallowing evaluation without considering the mastication effect which is altered according to the individual's oral condition. Thus, this study was carried out to fabricate artificial bolus resembling natural food bolus. The mechanical property and the volume change of food bolus in normal people were firstly investigated. Thirty healthy adults without dysphagia were selected and asked to chew four sample foods (rice cake, peanut, burdock, and gummy candy). The results indicated that Young’s modulus of bolus before swallowing was below 150 kPa. The bolus volume before swallowing was below 400 mm3. In addition, the saliva component ratio of each bolus was approximately 30wt%, and the average saliva viscosity of research participants was approximately 10 mPa•s. Based on the obtained data, artificial food bolus was designed and fabricated by using alginate hydrogel as a visco-elastic material and gelatin solution as a viscotic material with a ratio of 7:3 based on weight. Consequently, the swallowing time of fabricated artificial food bolus was measured among the same participants. The results indicated the participants swallowed fabricated food bolus with similar manner reflecting their mechanical property and volume. Thus, this artificial food bolus would be a promising tool for evaluation of swallowing. PMID:27977775

  3. Electrophysiological evaluation of oropharyngeal swallowing in myotonic dystrophy

    PubMed Central

    Ertekin, C; Yuceyar, N; Aydogdu, I; Karasoy, H

    2001-01-01

    OBJECTIVE—Oropharyngeal dysphagia is a common feature of patients with myotonic dystrophy and is not usually perceived due to their emotional deficits and lack of interest. The aim was to show the existence and frequency of subclinical electrophysiological abnormalities in oropharyngeal swallowing and to clarify the mechanisms of dysphagia in myotonic dystrophy.
METHODS—Eighteen patients with myotonic dystrophy were examined for oropharyngeal phase of swallowing by clinical and electrophysiological methods. Ten patients had dysphagia whereas 11 patients had signs and symptoms reflecting CNS involvement. Four patients with myotonia congenita and 30 healthy volunteers served as controls. Laryngeal movements were detected by means of a piezoelectric sensor. EMG activities of the submental muscle (SM-EMG) and needle EMG of the cricopharyngeal muscle of the upper eosophageal sphincter (CP-EMG) were also recorded during swallowing.
RESULTS—In about 70% of the patients with myotonic dystrophy, the existence of oropharyngeal dysphagia was indicated objectively by means of the technique of "dysphagia limit" and by clinical evaluation. Duration of the swallowing reflex as defined by the laryngeal relocation time (0-2 time interval) and submental muscle excitation as a part of the swallowing reflex (A-C interval) were significantly prolonged in patients with myotonic dystrophy, especially in dysphagic patients. Triggering time of the swallowing reflex (A-0 interval) also showed significant prolongation, especially in the patients having both dysphagia and CNS involvement. During swallowing, CP muscle activity was abnormal in 40% of the patients with myotonic dystrophy.
CONCLUSION—Both myopathic weakness and myotonia encountered in oropharyngeal muscles play an important part in the oral and the pharyngeal phases of swallowing dysfunction in myotonic dystrophy. It was also suggested that CNS involvement might contribute to the delay of the triggering of the

  4. Characterization of Swallowing Sound: Preliminary Investigation of Normal Subjects

    PubMed Central

    Honda, Tsuyoshi; Baba, Takuro; Fujimoto, Keiko; Goto, Takaharu; Nagao, Kan; Harada, Masafumi; Honda, Eiichi; Ichikawa, Tetsuo

    2016-01-01

    Objective The purpose of this study was to characterize the swallowing sound and identify the process of sound generation during swallowing in young healthy adults. Methods Thirty-three healthy volunteers were enrolled and allocated into three experimental groups. In experiment 1, a microphone was attached to one of eight cervical sites in 20 subjects, participants swallowed 5 ml water, and the sound waveform was recorded. In experiment 2, 10 subjects swallowed either 0, 5, 10, or 15 ml water during audio recording. In addition, participants consumed the 5 ml bolus in two different cervical postures. In experiment 3, the sound waveform and videofluoroscopy were simultaneously recorded while the three participants consumed 5 ml iopamidol solution. The duration and peak intensity ratio of the waveform were analyzed in all experimental groups. Results The acoustic analysis of the waveforms and videofluoroscopy suggested that the swallowing sound could be divided into three periods, each associated with a stage of the swallowing movement: the oral phase comprising posterior tongue and hyoid bone movement; the pharyngeal phase comprising larynx movement, hyoid bone elevation, epiglottis closure, and passage of the bolus through the esophagus orifice; and the repositioning phase comprising the return of the hyoid bone and larynx to their resting positions, and reopening of the epiglottis. Conclusion Acoustic analysis of swallowing sounds and videofluoroscopy suggests that the swallowing sound could be divided into three periods associated with each process of the swallowing movement: the oral phase comprising the posterior movement of the tongue and hyoid bone; the pharyngeal phase comprising the laryngeal movement, hyoid bone elevation, epiglottis closure, and the bolus passage to the esophagus orifice; and the repositioning phase comprising the repositioning of the hyoid bone and larynx, and reopening of the epiglottis. PMID:27959902

  5. 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

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

    PubMed Central

    Jestrović, Iva; Coyle, James L.

    2015-01-01

    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. PMID:26372528

  7. 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.

  8. 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.

  9. Gelfoam-induced Swallowing Difficulty after Anterior Cervical Spine Surgery.

    PubMed

    Yang, Joo Chul; Kim, Tae Wan; Park, Kwan Ho

    2013-06-01

    Symptomatic diffuse idiopathic skeletal hyperostosis (DISH) is not common. Gelfoam is one of the most commonly used topical hemostatic agents. But, in the partially moistened state, air retained in its pores may result in excessive expansion on contact with liquid. The onset of swallowing difficulty after anterior cervical spine surgery due to appling gelfoam is a rare complication. A 77-year-old man with swallowing difficulty was admitted to our hospital and we diagnosed him as DISH confirmed by radiological study. After removing the DISH, patient's symptom was relieved gradually. However, on postoperative day (POD) 7, the symptom recurred but lesser than the preoperative state. We confirmed no hematoma and esophageal perforation on the operation site. We observed him closely and controlled the diet. Three months later, he had no symptom of swallowing difficulty, and was able to be back on a regular diet, including solid foods. We present a complication case of swallowing difficulty occurring by gelfoam application.

  10. 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...

  11. Swallowed magnets and batteries: a dangerous but not unexpected attraction.

    PubMed

    Teague, Warwick Jonathan; Vaughan, Elizabeth Mary; McHoney, Merrill; McCabe, Amanda Jayne

    2013-04-10

    An 18-month-old boy was witnessed swallowing a cluster of five magnetic toy balls. He was coincidentally noted on plain x-rays to have also recently swallowed a watch battery and a small screw. Initial outpatient management with serial review and x-rays was unsuccessful, and delayed inpatient surgical care by 9 days. Although the child never manifested features of systemic or gastrointestinal upset, emergency laparotomy confirmed a resultant jejunocolic fistula. This case demonstrates how clinical assessment of children who have swallowed magnets separately from each other can be falsely reassuring, and highlights the potential dangers of outpatient management. We recommend children who have swallowed separately >1 magnetic objects (or >1 objects capable of magnetic attraction) be managed as inpatients with active observation and timely foreign body removal.

  12. 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.

  13. 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.

  14. Role of tongue pressure production in oropharyngeal swallow biomechanics

    PubMed Central

    Hori, Kazuhiro; Taniguchi, Hiroshige; Hayashi, Hirokazu; Magara, Jin; Minagi, Yoshitomo; Li, Qiang; Ono, Takahiro; Inoue, Makoto

    2013-01-01

    The tongue is important for orofacial movements, including swallowing. Although numerous studies have focused on tongue pressure against the palate, its physiological role has not been fully evaluated. The tongue pressure generation may have the temporal coordination with the swallowing relational organs. The aim of this study was to clarify the physiological mechanisms of tongue pressure and to investigate the temporal relationship among tongue pressure, supra-hyoid muscle activity, and videofluorographic (VF) images during swallowing. Fifteen healthy young subjects participated. Tongue pressure measured using a sensor sheet with five channels, electromyographic EMG, and VF was recorded synchronously during 4-ml barium swallowing. Swallowing behavior in VF images with and without the sensor sheet was compared. Furthermore, the temporal relationship between events measured from tongue pressure, EMG, and VF was evaluated. Swallowing behavior on VF images was not affected by placement of the sensor sheet. Tongue pressure at the posterio-lateral point of the hard palate tended to have biphasic peaks. Tongue pressure production with a monophasic pattern appeared during the same period as the second peak in the biphasic pattern. The onset of tongue pressure was later than the start of hyoid movement and onset of EMG, and offset was observed between the hyoid at the up-forward position and reposition. Onset of tongue pressure at the anterior area was correlated with the start of slight hyoid elevation. Offset of tongue pressure at the posterio-lateral points was strongly time locked with the hyoid at the up-forward position. The present results suggested the temporal coordination of tongue pressure generation with the swallowing-related organs. That is, the tongue pressure was produced for bolus propulsion, and was closely related to hyoid movement temporally during swallowing. These results may contribute to clarify the clinical state with the disorder of tongue

  15. A swallowed fishbone penetrating the oesophagus into the sternomastoid muscle.

    PubMed

    Al-Shukry, Sabah M

    2003-08-01

    A 40-year-old woman presented with the history of swallowing a fishbone one hour earlier. Since the patient was swallowing normally and the X-ray results were negative, she was reassured and sent home. Twenty days later, when the patient again presented with pain and tenderness in her neck, the fishbone was detected in the left sternomastoid muscle, and removed under local anaesthesia.

  16. 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.

  17. Quality of life related to swallowing in Parkinson's disease.

    PubMed

    Carneiro, Danielle; das Graças Wanderley de Sales Coriolano, Maria; Belo, Luciana Rodrigues; de Marcos Rabelo, Aneide Rocha; Asano, Amdore Guescel; Lins, Otávio Gomes

    2014-10-01

    Swallowing difficulties in Parkinson's disease can result in decreased quality of life. The swallowing quality of life questionnaire (SWAL-QOL) is an instrument for specifically assessing quality of life with respect to swallowing, which has been little explored in patients with Parkinson's disease (PD). The goal of this study was to evaluate the quality of life with respect to swallowing in persons with PD compared to controls and at several stages of the disease using the SWAL-QOL. The experimental group was composed of 62 persons with PD at stages 1-4. Forty-one age-matched healthy subjects constituted the control group. The SWAL-QOL scores were significantly lower for the patients with PD than for the controls in all SWAL-QOL domains. Eating duration had the largest difference in score between persons with PD and the controls and the lowest mean score, followed by communication, fatigue, fear, sleep, and food selection. The scores of most domains were lower at later stages of the disease. The scores for eating duration, symptom frequency, and sleep were significantly lower at stage 4 than stages 1 and 2. In conclusion, patients with PD have significantly lower scores in all domains of the SWAL-QOL than normal controls. This means swallowing difficulties occurring in patients with PD negatively affect their QOL. Progression of the disease worsens swallowing QOL, more specifically in the domains of eating duration, symptom frequency, and sleep. This occurs mostly at later stages of the disease.

  18. Human hyolaryngeal movements show adaptive motor learning during swallowing.

    PubMed

    Humbert, Ianessa A; Christopherson, Heather; Lokhande, Akshay; German, Rebecca; Gonzalez-Fernandez, Marlis; Celnik, Pablo

    2013-06-01

    The hyoid bone and larynx elevate to protect the airway during swallowing. However, it is unknown whether hyolaryngeal movements during swallowing can adjust and adapt to predict the presence of a persistent perturbation in a feed-forward manner (adaptive motor learning). We investigated adaptive motor learning in nine healthy adults. Electrical stimulation was administered to the anterior neck to reduce hyolaryngeal elevation, requiring more strength to swallow during the perturbation period of this study. We assessed peak hyoid bone and laryngeal movements using videofluoroscopy across thirty-five 5-ml water swallows. Evidence of adaptive motor learning of hyolaryngeal movements was found when (1) participants showed systematic gradual increases in elevation against the force of electrical stimulation and (2) hyolaryngeal elevation overshot the baseline (preperturbation) range of motion, showing behavioral aftereffects, when the perturbation was unexpectedly removed. Hyolaryngeal kinematics demonstrates adaptive, error-reducing movements in the presence of changing and unexpected demands. This is significant because individuals with dysphagia often aspirate due to disordered hyolaryngeal movements. Thus, if rapid motor learning is accessible during swallowing in healthy adults, patients may be taught to predict the presence of perturbations and reduce errors in swallowing before they occur.

  19. Silent aspiration detection by breath and swallowing sound analysis.

    PubMed

    Sarraf Shirazi, Samaneh; Moussavi, Zahra

    2012-01-01

    Detecting aspiration after swallows (the entry of bolus into trachea) is often a difficult task particularly when the patient does not cough; those are called silent aspiration. In this study, the application of acoustical analysis in detecting silent aspiration is investigated. We recorded the swallowing and the breath sounds of 10 individuals with swallowing disorders, who demonstrated silent aspiration during the fiberoptic endoscopic evaluation of swallowing (FEES) assessment. We analyzed the power spectral density (PSD) of the breath sound signals following each swallow; the PSD showed higher magnitude at low frequencies for the breath sounds following an aspiration. Therefore, we divided the frequency range below 300 Hz into 3 sub-bands, over which we calculated the average power as the characteristic features for the classification purpose. Then, the fuzzy k-means unsupervised classification method was deployed to find the two clusters in the data set: the aspirated and non-aspirated groups. The results were evaluated using the FEES assessments provided by the speech language pathologists. The results show 82.3% accuracy in detecting swallows with silent aspiration. Although the proposed method should be verified on a larger dataset, the results are promising for the use of acoustical analysis as a clinical tool to detect silent aspiration.

  20. 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…

  1. 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…

  2. The Relationship Between Pharyngeal Constriction and Post-swallow Residue.

    PubMed

    Stokely, Shauna L; Peladeau-Pigeon, Melanie; Leigh, Chelsea; Molfenter, Sonja M; Steele, Catriona M

    2015-06-01

    Pharyngeal constriction has been proposed as a parameter that may distinguish functional from impaired swallows. We employed anatomically normalized pixel-based measures of pharyngeal area at maximum constriction, and the ratio of this measure to area at rest, and explored the association between these measures and post-swallow residue using the normalized residue ratio scale (NRRS). Videofluoroscopy data for 5 ml boluses of 22 % (w/v) liquid barium were analyzed from 20 healthy young adults and 40 patients with suspected neurogenic dysphagia. The frames of maximum pharyngeal constriction and post-swallow hyoid rest were extracted. Pixel-based measures of pharyngeal area were made using ImageJ and size-normalized using the squared C2-C4 vertebral distance as a reference scalar. Post-swallow residue and the areas of the vallecular and pyriform sinus spaces were measured on the hyoid rest frame to calculate the NRRSv and NRRSp. The dataset was divided into swallows with residue within or exceeding the upper confidence interval boundary seen in the healthy participants. Mixed model repeated measures ANOVAs were used to compare pharyngeal area (rest, constriction) and the pharyngeal constriction ratio, between individuals with and without residue. Measures of pharyngeal area at maximum constriction were significantly larger (i.e., less constricted, p = 0.000) in individuals with post-swallow residue in either the valleculae or the pyriform sinus. These results support the idea that interventions targeted toward improving pharyngeal constriction have the potential to be effective in reducing post-swallow residue.

  3. Sensorimotor modulation of human cortical swallowing pathways

    PubMed Central

    Hamdy, Shaheen; Aziz, Qasim; Rothwell, John C; Hobson, Anthony; Thompson, David G

    1998-01-01

    Transcranial magnetic stimulation over motor areas of cerebral cortex in man can activate short latency bilateral cortical projections to the pharynx and oesophagus. In the present paper we investigate the interaction between pathways from each hemisphere and explore how activity in these pathways is modulated by afferent feedback from the face, pharynx and oesophagus.Comparison of unilateral and bilateral stimulation (using interstimulus intervals (ISIs) of 1, 5 or 10 ms between shocks) showed spatial summation of responses from each hemisphere at an ISI of 1 ms, indicating that cortical efferents project onto a shared population of target neurones. Such summation was not evident at ISIs of 5 or 10 ms. There was little evidence for transcallosal inhibition of responses from each hemisphere, as described for limb muscles.Single stimuli applied to the vagus nerve in the neck or the supraorbital nerve, which alone produce intermediate (onset 20-30 ms) and long (50-70 ms) latency reflex responses in the pharynx and oesophagus, were used to condition the cortical responses. Compared with rest, responses evoked by cortical stimulation were facilitated when they were timed to coincide with the late part of the reflex. The onset latency was reduced during both parts of the reflex response. No facilitation was observed with subthreshold reflex stimuli.Single electrical stimuli applied to the pharynx or oesophagus had no effect on the response to cortical stimulation. However, trains of stimuli at frequencies varying from 0.2 to 10 Hz decreased the latency of the cortically evoked responses without consistently influencing their amplitudes. The effect was site specific: pharyngeal stimulation shortened both pharyngeal and oesophageal response latencies, whereas oesophageal stimulation shortened only the oesophageal response latencies.Cortical swallowing motor pathways from each hemisphere interact and their excitability is modulated in a site-specific manner by sensory

  4. The generation of pharyngeal phase of swallow and its coordination with breathing: interaction between the swallow and respiratory central pattern generators.

    PubMed

    Bautista, Tara G; Sun, Qi-Jian; Pilowsky, Paul M

    2014-01-01

    Swallowing and breathing utilize common muscles and an anatomical passage: the pharynx. The risk of aspiration of ingested material is minimized not only by the laryngeal adduction of the vocal folds and laryngeal elevation but also by the precise coordination of swallows with breathing. Namely, swallows: (1) are preferentially initiated in the postinspiratory/expiratory phase, (2) are accompanied by a brief apnea, and (3) are often followed by an expiration and delay of the next breath. This review summarizes the expiratory evidence on the brainstem regions comprising the central pattern generator (CPG) that produces the pharyngeal stage of swallow, how the motor acts of swallowing and breathing are coordinated, and lastly, brainstem regions where the swallowing and respiratory CPGs may interact in order to ensure "safe" swallows.

  5. Hard to Swallow: Developmental Biological Insights into Pediatric Dysphagia

    PubMed Central

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

    2015-01-01

    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. Altered hindbrain patterning, neural crest migration, 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 reflect disrupted hindbrain patterning and its impact on 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

  6. 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

  7. 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

  8. Swallowing problems in the nursing home: a novel training response.

    PubMed

    O'Loughlin, G; Shanley, C

    1998-01-01

    Various studies suggest that between 50% and 75% of nursing home residents have some difficulty in swallowing. Some of these residents are assessed and treated by speech pathologists, but many are managed by nursing staff without specialist input. A training program called Swallowing ... on a Plate (SOAP) has been developed by the Centre for Education and Research on Ageing and the Inner West Geriatrics and Rehabilitation Service to help address swallowing-related problems in local nursing homes (Inner West of Sydney, Australia). The training program teaches nursing staff how to identify, assess, and manage swallowing problems, including making appropriate referrals. Several new instruments were developed specifically for this program including two assessment checklists, a set of management guidelines, and a swallowing care plan. Evaluation of the program--including 3 months follow-up--showed it to be highly successful. A stand-alone training resource has been produced for wide distribution to help staff implement the program as a permanent aspect of their nursing care. This paper describes the development, content, presentation, resource, and evaluation of the above program.

  9. Swallowing in patients with Parkinson's disease: a surface electromyography study.

    PubMed

    Ws Coriolano, Maria das Graças; R Belo, Luciana; Carneiro, Danielle; G Asano, Amdore; Al Oliveira, Paulo José; da Silva, Douglas Monteiro; G Lins, Otávio

    2012-12-01

    Our goal was to study deglutition of Parkinson's disease (PD) patients and normal controls (NC) using surface electromyography (sEMG). The study included 15 patients with idiopathic PD and 15 age-matched normal controls. Surface electromyography was collected over the suprahyoid muscle group. Conditions were the following: swallow at once 10 and 20 ml of water and 5 and 10 ml of yogurt of firm consistency, and freely drink 100 ml of water. During swallowing, durations of sEMG were significantly longer in PD patients than in normal controls but no significant differences of amplitudes were found. Eighty percent of the PD patients and 20 % of the NC needed more than one swallow to consume 20 ml of water, while 70 % of the PD patients and none of the NC needed more than one swallow to consume 5 ml of yogurt. PD patients took significantly more time and needed significantly more swallows to drink 100 ml of water than normal controls. We conclude that sEMG might be a simple and useful tool to study and monitor deglutition in PD patients.

  10. Prevalence of swallowing dysfunction screened in Swedish cohort of COPD patients

    PubMed Central

    Gonzalez Lindh, Margareta; Blom Johansson, Monica; Jennische, Margareta; Koyi, Hirsh

    2017-01-01

    Background COPD is a common problem associated with morbidity and mortality. COPD may also affect the dynamics and coordination of functions such as swallowing. A misdirected swallow may, in turn, result in the bolus entering the airway. A growing body of evidence suggests that a subgroup of people with COPD is prone to oropharyngeal dysphagia. The aim of this study was to evaluate swallowing dysfunction in patients with stable COPD and to determine the relation between signs and symptoms of swallowing dysfunction and lung function (forced expiratory volume in 1 second percent predicted). Methods Fifty-one patients with COPD in a stable phase participated in a questionnaire survey, swallowing tests, and spirometry. A post-bronchodilator ratio of the forced expiratory volume in 1 second/best of forced vital capacity and vital capacity <0.7 was used to define COPD. Swallowing function was assessed by a questionnaire and two swallowing tests (water and cookie swallow tests). Results Sixty-five percent of the patients reported subjective signs and symptoms of swallowing dysfunction in the questionnaire and 49% showed measurable ones in the swallowing tests. For the combined subjective and objective findings, 78% had a coexisting swallowing dysfunction. No significant difference was found between male and female patients. Conclusion Swallowing function is affected in COPD patients with moderate to severe airflow limitation, and the signs and symptoms of this swallowing dysfunction were subjective, objective, or both. PMID:28176891

  11. Validation and demonstration of an isolated acoustic recording technique to estimate spontaneous swallow frequency.

    PubMed

    Crary, Michael A; Sura, Livia; Carnaby, Giselle

    2013-03-01

    Spontaneous swallowing is considered a reflexive, pharyngeal clearance mechanism. Reductions in spontaneous swallow frequency may be a sensitive index for dysphagia and related morbidities. This study evaluated an acoustic recording technique as a measure to estimate spontaneous swallow frequency. Initially, a multichannel physiologic (surface electromyography, swallow apnea, cervical auscultation) recording technique was validated and subsequently compared to an isolated acoustic (microphone) recording technique on a sample of younger (25 ± 2.8 years) and older (68 ± 5.3 years) healthy adult participants. Sensitivity (94 %), specificity (99 %), and classification accuracy (98 %) were high for swallow identification from the multichannel physiologic recording technique. Interjudge reliability was high (k = 0.94, 95 % CI = 0.92-0.96). No significant differences in spontaneous swallow frequency were observed between the multichannel physiologic recordings and the acoustic recordings (0.85 vs. 0.81 swallows per minute). Furthermore, these two techniques were highly correlated (r = 0.95). Interjudge reliability for swallow identification via acoustic recordings was high (k = 0.96, 95 % CI = 0.94-0.99). Preliminary evaluation of the temporal stability of spontaneous swallow frequency measured from acoustic recordings indicated that time samples as short as 5 min produce viable results. Age differences were identified in spontaneous swallow frequency rates, with older participants swallowing less frequently than younger participants (0.47 vs. 1.02 swallows per minute). Collectively, these results indicate that an isolated acoustic recording technique is a valid approach to estimate spontaneous swallow frequency.

  12. Evaluation of swallowing by Sydney Swallow Questionnaire (SSQ) in oral and oropharyngeal cancer patients treated with primary surgery.

    PubMed

    Dwivedi, Raghav C; St Rose, Suzanne; Chisholm, Edward J; Georgalas, Christos; Bisase, Brian; Amen, Furrat; Kerawala, Cyrus J; Clarke, Peter M; Nutting, Christopher M; Rhys-Evans, Peter H; Harrington, Kevin J; Kazi, Rehan

    2012-12-01

    This work aimed at evaluating patients' swallowing functions by a newly validated swallow-specific questionnaire, the Sydney Swallow Questionnaire (SSQ), in a cohort of oral and oropharyngeal cancer patients. Mean/median SSQ scores were calculated and compared with study variables using the Mann-Whitney U test and Kruskal-Wallis test. The mean composite SSQ scores (SD) for the base of tongue, oral tongue, and tonsillar cancer patients were 663.8 (382.8), 456.2 (407.6), and 283.0 (243.1), respectively (p = 0.005); for advanced vs. early T stage disease they were 918.1 (319.5) vs. 344.8 (292.1) (p ≤ 0.001); for patients <60 years vs. ≥60 years they were 549.3 (415.1) vs. 314.0 (247.3) (p = 0.02); and for patients with reconstruction vs. without reconstruction they were 676.5 (410.5) vs. 331.9 (286.5) (p = 0.002). SSQ is a useful tool for evaluation of swallowing in head and neck cancer patients. Site of cancer, T stage, patient's age, and reconstruction directly affect post-treatment swallow outcome.

  13. Analysis of pressure generation and bolus transit during pharyngeal swallowing.

    PubMed

    McConnel, F M

    1988-01-01

    Current pharyngeal deglutition theory has stressed the role of the pharyngeal constrictors as producing a peristaltic wave responsible for bolus propulsion through the pharynx. This thesis presents data obtained using manofluorography which supports the significance of tongue and laryngeal motion in swallowing. The usage of the term peristalsis to describe the constrictor contraction is challenged. The results of this quantitative study of swallowing in normal subjects, laryngectomized patients, and patients with restricted tongue motion show that tongue driving pressure and the negative pressure developed in the pharyngeal esophageal segment appear more important than the peristaltic-like pressure of the constrictors. Bolus transit is really dependent upon these two pressures. This model for analysis has clinical significance because it permits quantification of the pharyngeal swallowing mechanism.

  14. 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.

  15. Swallow-related cerebral cortical activity maps are not specific to deglutition.

    PubMed

    Kern, M; Birn, R; Jaradeh, S; Jesmanowicz, A; Cox, R; Hyde, J; Shaker, R

    2001-04-01

    Cortical representation of swallow-related motor tasks has not been systematically investigated. In this study, we elucidated and compared these cortical representations to those of volitional swallow using block-trial and single-trial methods. Fourteen volunteers were studied by functional magnetic resonance imaging. Cortical activation during both swallowing and swallow-related motor tasks that can be performed independent of swallowing, such as jaw clenching, lip pursing, and tongue rolling, was found in four general areas: the anterior cingulate, motor/premotor cortex, insula, and occipital/parietal region corresponding to Brodmann's areas 7, 19, and 31. Regions of activity, volume of activated voxels, and increases in signal intensity were found to be similar between volitional swallow and swallow-related motor tasks. These findings, using both block-trial and single-trial techniques, suggest that cerebral cortical regions activated during swallowing may not be specific to deglutitive function.

  16. Segmentation of dual-axis swallowing accelerometry signals in healthy subjects with analysis of anthropometric effects on duration of swallowing activities.

    PubMed

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

    2009-04-01

    Dysphagia (swallowing difficulty) is a serious and debilitating condition that often accompanies stroke, acquired brain injury, and neurodegenerative illnesses. Individuals with dysphagia are prone to aspiration (the entry of foreign material into the airway), which directly increases the risk of serious respiratory consequences such as pneumonia. Swallowing accelerometry is a promising noninvasive tool for the detection of aspiration and the evaluation of swallowing. In this paper, dual-axis accelerometry was implemented since the motion of the hyolaryngeal complex occurs in both anterior-posterior and superior-inferior directions during swallowing. Dual-axis cervical accelerometry signals were acquired from 408 healthy subjects during dry, wet, and wet chin tuck swallowing tasks. The proposed segmentation algorithm is based on the idea of sequential fuzzy partitioning of the signal and is well suited for long signals with nonstationary variance. The algorithm was validated with simulated signals with known swallowing locations and a subset of 295 real swallows manually segmented by an experienced speech language pathologist. In both cases, the algorithm extracted individual swallows with over 90% accuracy. The time duration analysis was carried out with respect to gender, body mass index (BMI), and age. Demographic and anthropometric variables influenced the duration of these segmented signals. Male participants exhibited longer swallows than female participants (p=0.05). Older participants and participants with higher BMIs exhibited swallows with significantly longer (p=0.05) duration than younger participants and those with lower BMIs, respectively.

  17. 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.

  18. 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...

  19. Use of a metal detector in the location of a swallowed razor blade in the oesophagus.

    PubMed

    Kessler, A; Yellin, A; Kessler, A; Kronenberg, J

    1990-05-01

    A case describing the use of a metal detector to locate a metallic foreign body swallowed by a prisoner. Initial work up included plain thoracic X-rays and a gastrografin swallow which were negative. A metal detector was used to confirm the presence of a metal body in the oesophagus which was verified by a barium swallow.

  20. 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:…

  1. [Characteristics and limitation of portable bedside swallowing test in elderly with dementia: comparison between the repetitive saliva swallowing test and the simple swallowing provocation test].

    PubMed

    Baba, Yuki; Teramoto, Shinji; Hasegawa, Hiroshi; Machida, Ayako; Akishita, Masahiro; Toba, Kenji

    2005-05-01

    Several bedside portable swallowing tests have been advocated for screening for dysphagia. However, the clinical usefulness and limitation of these tests have not been examined in elderly patients with dementia. We performed the repetitive saliva swallowing test (RSST) and the simple swallowing provocation test (SSPT) in 37 elderly inpatients (81.8 +/- 1.2 years old). Simultaneously, cognitive and verbal communication ability were assessed by the Hasegawa Dementia Scale revised version (HDSR) and the Mini-Communication Test (MCT). RSST was completed only in 22 patients (59%), whereas SSPT was successfully completed in all cases. Scores of HDSR and MCT were significantly lower in patients who were unable to cooperate with RSST compared to successful examinees (HDSR: 7 +/- 1 vs 15 +/- 3, p < 0.0; MCT: 47 +/- 8 vs 81 +/- 5, p < 0.01). Dysphagia was detected in 14 patients (64%) by RSST and 5 (14%) by SSPT. Patients with dysphagia showed significantly lower cognitive function (p < 0.05) and verbal communication ability (p < 0.05). In conclusion, RSST is more sensitive to detect dysphagia in elderly patients; however, compliance with RSST is strongly influenced by the patient's cognitive function and verbal communication ability. Comprehensive geriatric assessment will help to choose an alternative test for dysphagia such as SSPT which is more specific test for aspiration pneumonia.

  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. 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…

  4. 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…

  5. Abundance and genetic damage of barn swallows from Fukushima

    PubMed Central

    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

  6. 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.

  7. 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…

  8. 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…

  9. [A case of swallowing a lower partial denture].

    PubMed

    Carbery, A; Provençal, M

    1993-10-01

    This paper reports on the case of an elderly person who accidentally swallowed his partial denture. The ingestion did not result in any signs or symptoms and the denture was found totally by chance. A major surgical procedure was required to remove the prosthesis.

  10. 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…

  11. Teaching children with attention deficit hyperactivity disorder (ADHD) and autistic disorder (AD) how to swallow pills.

    PubMed

    Beck, Melissa H; Cataldo, Marilyn; Slifer, Keith J; Pulbrook, Valerie; Guhman, Jaswinder K

    2005-01-01

    One barrier to medication adherence in pediatric populations is difficulty swallowing pills. Some children may not have prerequisite skills for pill swallowing, while others may have developed conditioned anxiety from repeated negative experiences. Eight children with attention deficit hyperactivity disorder or autistic disorder participated in behavioral training to increase cooperation with pill swallowing. A pill-swallowing protocol was utilized during practice sessions with placebo "pills" of increasing size to implement systematic desensitization. Seven of the 8 children swallowed medication with a therapist. Six of the 8 children maintained treatment gains over time. Interventions used to succeed with these children are presented along with methods to reduce conditioned behavioral distress.

  12. Sensory stimulation to improve swallowing reflex and prevent aspiration pneumonia in elderly dysphagic people.

    PubMed

    Ebihara, Satoru; Kohzuki, Masahiro; Sumi, Yasunori; Ebihara, Takae

    2011-01-01

    Morbidity and mortality from aspiration pneumonia continues to be a major health problem in the elderly. A swallowing disorder, such as a delayed triggering of the swallowing reflex, exists in patients with aspiration pneumonia. We found that the swallowing reflex in elderly people was temperature-sensitive. The swallowing reflex was delayed when the temperature of the food was close to body temperature. The actual swallowing time shortened when the temperature difference increases. The improvement of swallowing reflex by temperature stimuli could be mediated by the temperature-sensitive transient receptor potential (TRP) channel. The administration of a pastille with capsaicin as an agonist stimulus of TRPV1, a warm-temperature receptor, decreased the delay in swallowing reflex. Food with menthol, an agonist of TRPM8, a cold-temperature receptor, also decreased the delay in swallowing reflex. Olfactory stimulation such as black pepper was useful to improve the swallowing reflex for people with low activity of daily living (ADL) levels or with decreased consciousness. Oral care also shortened the latent time of swallowing reflex presumably due to stimulating the nociception of the oral cavity. A combination of these sensory stimuli may improve the swallowing disorders and prevent aspiration pneumonia.

  13. Soft-robotic esophageal swallowing as a clinically-inspired bolus rheometry technique

    NASA Astrophysics Data System (ADS)

    Dirven, Steven; Allen, Jacqueline; (Peter Xu, Weiliang; Cheng, Leo K.

    2017-03-01

    To investigate the impact of viscosity and peristaltic transport parameters on manometric pressure signatures, a reproducible swallowing process is required. Due to inter- and intra-subject variability from swallow to swallow, the human body does not represent an optimal mechanism for such an investigation. A smooth and continuous swallowing soft-robot has been developed to produce biomimetic swallowing trajectories, and is proposed to operate as a bench-top bolus rheometric investigation method. The method compares conventional viscometry and pressure signature findings from robotic swallowing experiments. The robotic aspect of experimentation involved 450 biomimetic swallows (10 repetitions of 45 unique experiments). The method examined swallowing transport in three dimensions: bolus formulation, peristaltic wavelength, and peristaltic velocity, each of which are known to contribute to safe and effective swallowing in vivo. It is found that the pressure gradients and magnitudes are commensurate with clinical reports on biological swallowing, on the order of 100 mmHg peak, however, the relationship between viscosity and pressure signatures is less clear. Bolus transport cannot be predicted as a function of bolus viscosity alone. Traditional viscometric data at 50 s-1, as used in clinical practice, may not be a strong indicator of swallow effort, safety, or efficacy in vivo.

  14. 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.

  15. 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.

  16. 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…

  17. The timing of administration, dose dependence and efficacy of dopa decarboxylase inhibitors on the reversal of motor disability produced by L-DOPA in the MPTP-treated common marmoset.

    PubMed

    Tayarani-Binazir, Kayhan A; Jackson, Michael J; Fisher, Ria; Zoubiane, Ghada; Rose, Sarah; Jenner, Peter

    2010-06-10

    Dopa decarboxylase inhibitors are routinely used to potentiate the effects of L-DOPA in the treatment of Parkinson's disease. However, neither in clinical use nor in experimental models of Parkinson's disease have the timing and dose of dopa decarboxylase inhibitors been thoroughly explored. We now report on the choice of dopa decarboxylase inhibitors, dose and the time of dosing relationships of carbidopa, benserazide and L-alpha-methyl dopa (L-AMD) in potentiating the effects of L-DOPA in the 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP)-treated common marmoset. Pre-treatment with benserazide for up to 3h did not alter the motor response to L-DOPA compared to simultaneous administration with L-DOPA. There was some evidence of a relationship between carbidopa and benserazide dose and increased locomotor activity and the reversal of motor disability. But in general, commonly used dose levels of dopa decarboxylase inhibitors appeared to produce a maximal motor response to L-DOPA. In contrast, dyskinesia intensity and duration continued to increase with both carbidopa and benserazide dose. The novel dopa decarboxylase inhibitor, L-AMD, increased locomotor activity and improved motor disability to the same extent as carbidopa or benserazide but importantly this was accompanied by significantly less dyskinesia. This study shows that currently, dopa decarboxylase inhibitors may be routinely employed in the MPTP-treated primate at doses which are higher than those necessary to produce a maximal potentiation of the anti-parkinsonian effect of L-DOPA. This may lead to excessive expression of dyskinesia in this model of Parkinson's disease and attention should be given to the dose regimens currently employed.

  18. 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.

  19. Successful endoscopic removal of a swallowed toothbrush: case report.

    PubMed

    Tonkic, Ante; Bogdanovic, Zoran; Grandić, Leo

    2011-04-06

    Most ingested foreign bodies will pass uneventfully through the gastrointestinal tract. Nevertheless, long and rigid foreign bodies are associated with an increased risk of gastrointestinal impaction, perforation and bleeding. Moreover, there has been no case of spontaneous passage of a toothbrush reported. Therefore, the prompt removal of such ingested foreign objects is recommended before complications develop. This case report describes a case of an 18-year-old woman who accidentally swallowed her toothbrush. The toothbrush was successfully removed via flexible endoscopy using a polypectomy snare. A swallowed toothbrush is a special clinical challenge. Early endoscopic retrieval of the toothbrush is critical for reducing morbidity and mortality. In cases when endoscopic removal fails, a laparoscopic surgical approach may be an alternative.

  20. Activation of upper airway muscles during breathing and swallowing

    PubMed Central

    Ludlow, Christy L.

    2013-01-01

    The upper airway is a complex muscular tube that is used by the respiratory and digestive systems. The upper airway is invested with several small and anatomically peculiar muscles. The muscle fiber orientations and their nervous innervation are both extremely complex, and how the activity of the muscles is initiated and adjusted during complex behaviors is poorly understood. The bulk of the evidence suggests that the entire assembly of tongue and laryngeal muscles operate together but differently during breathing and swallowing, like a ballet rather than a solo performance. Here we review the functional anatomy of the tongue and laryngeal muscles, and their neural innervation. We also consider how muscular activity is altered as respiratory drive changes, and briefly address upper airway muscle control during swallowing. PMID:24092695

  1. Validation of the optimal site in the neck region for detecting swallowing sounds.

    PubMed

    Pan, Q; Maeda, N; Manda, Y; Kodama, N; Minagi, S

    2016-11-01

    Recently, the swallowing sound has been used to detect swallowing events non-invasively. A previous study, using an accelerometer, showed that the site over the lateral border of the trachea immediately inferior to the cricoid cartilage was the optimal site for detecting swallowing sounds. However, the optimal site for detection of the swallowing sound using a microphone remains undetermined. To validate the optimal site in the neck region for detecting swallowing sounds. Fourteen healthy subjects (mean age, 27·6 ± 2·2 years; seven male and seven female) participated in this study. Twenty condenser microphones were attached to 20 sites on the left neck surface to detect swallowing sounds. Participants were instructed to swallow five different stimuli three times as follows: Resting saliva, 1 and 5 mL of Japanese tea, and 1 and 5 mL of yoghurt. Mean relative peak intensity was used to indicate the magnitude of the swallowing sound. Sound spectrograms were used to illustrate differences in the properties of swallowing sounds. Mean relative peak intensity number was highest in sites at the inferior border of the mandible just above the sternocleidomastoid muscle (site 11) and sites over the lateral border of the trachea immediately inferior to the cricoid cartilage (site 8). Comparison of spectrograms showed a greater density distribution of higher frequency components at site 11 compared with site 8. These results indicate that the inferior border of the mandible just above the sternocleidomastoid muscle is the optimal site for the detection of swallowing sounds.

  2. 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.

  3. Using a metal detector to locate a swallowed ring pull.

    PubMed

    Ryan, J; Perez-Avila, C A; Cherukuri, A; Tidey, B

    1995-03-01

    A 48-year-old man accidently swallowed the ring pull from a soft drink can. He complained of pain in his chest. Chest radiographs were normal. A metal detector emitted a strong response when passed across the front of his chest. Oesophagoscopy was carried out and the ring pull was successfully removed. We recommend the wider use of metal detectors by accident and emergency (A&E) department staff particularly when dealing with patients who have ingested metals of low radiodensity.

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

    PubMed Central

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

    2007-01-01

    Summary 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

  5. Enhancing effects of flavored nutritive stimuli on cortical swallowing network activity

    PubMed Central

    Babaei, Arash; Kern, Mark; Antonik, Stephen; Mepani, Rachel; Ward, B. Douglas; Li, Shi-Jiang; Hyde, James

    2010-01-01

    A better understanding of the central control of the physiology of deglutition is necessary for devising interventions aimed at correcting pathophysiological conditions of swallowing. Positive modulation of the cortical swallowing network can have clinical ramifications in dysphagia due to central nervous system deficits. Our aim was to determine the effect of nutritive sensory input on the cortical swallowing network. In 14 healthy right-handed volunteers, we utilized a paradigm-driven protocol to quantify the number of activated voxels and their signal intensity within the left hemispheric cortical swallowing network by high-resolution functional MRI (fMRI) during five different swallowing conditions. Swallowing conditions included a dry swallow (saliva) and natural water-, lemon-, popcorn-, and chocolate-flavored liquid swallows. Each flavored liquid was presented simultaneously by its image, scent, and taste in random order and tested over three runs. fMRIs were analyzed in a blinded fashion. Average fMRI blood oxygenation level-dependent signal intensity and number of activated voxels during swallowing concurrent with nutritive gustatory, olfactory, and visual stimulations were significantly increased compared with dry/natural water swallows throughout the cortical swallowing network (P < 0.001 and P < 0.05, respectively). Subregion analysis showed the increased activity for flavored liquids in prefrontal, cingulate gyrus, and sensory/motor cortex, but not in precuneus and insula. Concurrent gustatory, olfactory, and visual nutritive stimulation enhances the activity of the cortical swallowing network. This finding may have clinical implications in management of swallowing disorders due to cortical lesions. PMID:20508154

  6. Cryptococcus neoformans isolation from swallow (Hirundo rustica) excreta in Iran.

    PubMed

    Hedayati, Mohammad T; Mayahi, Sabah; Fakhar, Mahdi; Shokohi, Tahereh; Majidi, Mohammad

    2011-01-01

    Cryptococcus neoformans is an encapsulated yeast that can cause cryptococcosis, a life-threatening infection that mainly occurs in immunocompromised patients. The major environmental sources of C. neoformans have been shown to be soil contaminated with avian droppings. In the present study, we evaluated the isolation of C. neoformans from swallow (Hirundo rustica) excreta in two northern cities of Iran. Ninety-seven swallow droppings were evaluated and 498 yeast-like colonies were isolated and identified as Rhodotorula spp. (62.8%), Candida spp. (28.5%)and C. neoformans (8.7%). Cryptococcus neoformans was isolated from 5/97 (5.2%) of collected samples. Min-Max colony forming units (CFU) per one gram for the positive samples were 3-10 C. neoformans colonies. The total mean CFU per one gram for the positive samples was 4.8. The results of this study demonstrate that excreta of swallow may harbor different species of potentially pathogenic yeasts, mainly C. neoformans, and may be capable of disseminating these fungi in the environment.

  7. Tongue-surface movement patterns during speech and swallowing.

    PubMed

    Green, Jordan R; Wang, Yu-Tsai

    2003-05-01

    The tongue has been frequently characterized as being composed of several functionally independent articulators. The question of functional regionality within the tongue was examined by quantifying the strength of coupling among four different tongue locations across a large number of consonantal contexts and participants. Tongue behavior during swallowing was also described. Vertical displacements of pellets affixed to the tongue were extracted from the x-ray microbeam database. Forty-six participants recited 20 vowel-consonant-vowel (VCV) combinations and swallowed 10 ccs of water. Tongue-surface movement patterns were quantitatively described by computing the covariance between the vertical time-histories of all possible pellet pairs. Phonemic differentiation in vertical tongue motions was observed as coupling varied predictably across pellet pairs with place of articulation. Moreover, tongue displacements for speech and swallowing clustered into distinct groups based on their coupling profiles. Functional independence of anterior tongue regions was evidenced by a wide range of movement coupling relations between anterior tongue pellets. The strengths and weaknesses of the covariance-based analysis for characterizing tongue movement are considered.

  8. 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

  9. Pathologic Aerophagia: A Rare but Important Medical Condition in People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Wong, Wendy; Sajith, Sreedharan Geetha

    2017-01-01

    Background: Pathologic aerophagia (PA) is characterised by excessive swallowing of air resulting in significant abdominal distension or belching. This is a relatively rare condition in general population but has been reported in up to 8.8% of institutionalised patients with intellectual disability. In severe cases, this can cause volvulus and…

  10. 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.

  11. Learning Disabilities

    MedlinePlus

    ... be able to go to college and study engineering as he'd hoped? What Are Learning Disabilities? ... some theories as to why they develop, including: Genetic influences. Experts have noticed that learning disabilities tend ...

  12. 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.

  13. Adaptation of swallowing hyo-laryngeal kinematics is distinct in oral vs. pharyngeal sensory processing

    PubMed Central

    Lokhande, Akshay; Christopherson, Heather; German, Rebecca; Stone, Alice

    2012-01-01

    Before a bolus is pushed into the pharynx, oral sensory processing is critical for planning movements of the subsequent pharyngeal swallow, including hyoid bone and laryngeal (hyo-laryngeal) kinematics. However, oral and pharyngeal sensory processing for hyo-laryngeal kinematics is not fully understood. In 11 healthy adults, we examined changes in kinematics with sensory adaptation, sensitivity shifting, with oropharyngeal swallows vs. pharyngeal swallows (no oral processing), and with various bolus volumes and tastes. Only pharyngeal swallows showed sensory adaptation (gradual changes in kinematics with repeated exposure to the same bolus). Conversely, only oropharyngeal swallows distinguished volume differences, whereas pharyngeal swallows did not. No taste effects were observed for either swallow type. The hyo-laryngeal kinematics were very similar between oropharyngeal swallows and pharyngeal swallows with a comparable bolus. Sensitivity shifting (changing sensory threshold for a small bolus when it immediately follows several very large boluses) was not observed in pharyngeal or oropharyngeal swallowing. These findings indicate that once oral sensory processing has set a motor program for a specific kind of bolus (i.e., 5 ml water), hyo-laryngeal movements are already highly standardized and optimized, showing no shifting or adaptation regardless of repeated exposure (sensory adaptation) or previous sensory experiences (sensitivity shifting). Also, the oral cavity is highly specialized for differentiating certain properties of a bolus (volume) that might require a specific motor plan to ensure swallowing safety, whereas the pharyngeal cavity does not make the same distinctions. Pharyngeal sensory processing might not be able to adjust motor plans created by the oral cavity once the swallow has already been triggered. PMID:22403349

  14. Pharyngeal swallowing elicited by fluid infusion: role of volition and vallecular containment.

    PubMed

    Pouderoux, P; Logemann, J A; Kahrilas, P J

    1996-02-01

    Nonalimentary swallows minimize aspiration by clearing accumulated fluid from the pharynx. This study aimed to define 1) the pharyngeal sensory field to elicit swallowing and 2) the effect of infusion rate, volition, taste, and temperature on pharyngeal swallows. Test solutions were directed into the valleculae at 6.5, 11.5, and 32 ml/min through a catheter in eight healthy volunteers. Deglutition was signaled with electromyography and electroglottography. Spatial distribution of infusate before swallowing was studied using videofluoroscopy coupled with a video timer. Volitional control was assessed with rapid or restrained swallows. Pharyngeal swallow latency decreased as the instillation rate increased, was potently modified with volition, and was unchanged by infusate taste or temperature. Water infusion into the valleculae did not trigger pharyngeal swallowing until liquids overflowed and reached the aryepiglottic folds or pyriform sinuses. The variation in swallow latency among flow rates was mainly due to the duration of liquid containment within the valleculae. This suggests that the valleculae act to contain pharyngeal secretions and residue and prevent aspiration by diverting their contents around the larynx before swallowing.

  15. Feeding and Swallowing Disorders in Pediatric Neuromuscular Diseases: An Overview

    PubMed Central

    van den Engel-Hoek, Lenie; de Groot, Imelda J.M.; de Swart, Bert J.M.; Erasmus, Corrie E.

    2015-01-01

    Feeding and swallowing problems in infants and children have a great impact on health and wellbeing. The aim of this study was to provide an overview of recognized feeding and swallowing problems in different groups of children with neuromuscular diseases, based on relevant literature and expert opinion, and to propose recommendations for the assessment and treatment of these problems. Almost all pediatric neuromuscular diseases are accompanied by feeding and swallowing problems during the different phases of deglutition, problems that give rise to a wide variety of signs and symptoms, which emphasizes the importance of a comprehensive feeding and swallowing assessment by a speech and language therapist. PMID:27858755

  16. The relationship between limit of Dysphagia and average volume per swallow in patients with Parkinson's disease.

    PubMed

    Belo, Luciana Rodrigues; Gomes, Nathália Angelina Costa; Coriolano, Maria das Graças Wanderley de Sales; de Souza, Elizabete Santos; Moura, Danielle Albuquerque Alves; Asano, Amdore Guescel; Lins, Otávio Gomes

    2014-08-01

    The goal of this study was to obtain the limit of dysphagia and the average volume per swallow in patients with mild to moderate Parkinson's disease (PD) but without swallowing complaints and in normal subjects, and to investigate the relationship between them. We hypothesize there is a direct relationship between these two measurements. The study included 10 patients with idiopathic PD and 10 age-matched normal controls. Surface electromyography was recorded over the suprahyoid muscle group. The limit of dysphagia was obtained by offering increasing volumes of water until piecemeal deglutition occurred. The average volume per swallow was calculated by dividing the time taken by the number of swallows used to drink 100 ml of water. The PD group showed a significantly lower dysphagia limit and lower average volume per swallow. There was a significantly moderate direct correlation and association between the two measurements. About half of the PD patients had an abnormally low dysphagia limit and average volume per swallow, although none had spontaneously related swallowing problems. Both measurements may be used as a quick objective screening test for the early identification of swallowing alterations that may lead to dysphagia in PD patients, but the determination of the average volume per swallow is much quicker and simpler.

  17. Experimental exposure of swallow bugs (Hemiptera: Cimicidae) to West Nile virus.

    PubMed

    Oesterle, Paul; Nemeth, Nicole; Doherty, Paul; McLean, Robert; Clark, Larry

    2010-09-01

    The cliff swallow (Petrochelidon pyrrhonota, Vieillot) could potentially play an important role in the transmission of West Nile virus (WNV) because of its breeding ecology, reservoir competence status, and potentially high natural exposure rates. These birds nest in colonies and their nests are occupied year round by swallow bugs (Oeciacus vicarius, Hovarth), hematophagus ectoparasites that feed primarily on cliff swallows. Swallow bugs are most likely exposed to WNV while feeding on infectious blood of cliff swallows and, thus, if competent vectors, could contribute to initiation and maintenance of seasonal WNV transmission. In addition, swallow bugs remain within nests year round and, therefore, if persistently infected and competent vectors, they could provide an overwintering mechanism for WNV. We tested the hypothesis that swallow bugs become infected with WNV through direct abdominal inoculation or ingestion of infectious blood meals. We observed that swallow bugs did not maintain or amplify WNV, and infectious virus titers within bugs declined over 15 d postexposure. These results suggest that swallow bugs may not be competent vectors of WNV, and therefore are unlikely to play a significant role in transmission.

  18. 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

  19. Development of Suck and Swallow Mechanisms in Infants.

    PubMed

    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-care 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 infants' readiness for 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.

  20. 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.

  1. 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.

  2. Switching Hemispheres: A New Migration Strategy for the Disjunct Argentinean Breeding Population of Barn Swallow (Hirundo rustica)

    PubMed Central

    Garcia-Perez, Belen; Hobson, Keith A.; Powell, Rebecca L.; Still, Christopher J.; Huber, Gernot H.

    2013-01-01

    Background Barn Swallows (Hirundo rustica) breed almost exclusively in the Northern Hemisphere. However, since the early 1980's, a small disjunct breeding population has become established in eastern Argentina, presumably by birds previously derived from those breeding in North America. Currently, it is unknown where these individuals go following breeding and how they have adjusted to a reversal in phenology. Their austral wintering period corresponds to the breeding period of the northern ancestral population and so they can potentially return to these more traditional breeding sites or they may occupy other South American wintering regions left vacant by conspecifics returning to the Northern Hemisphere. Principal Findings We used a three-isotope (δ13C, δ15N, δ2H) approach to investigate potential wintering areas in Central and South America of individuals breeding in Argentina. Feather isotope values differed from those expected and measured at local breeding sites in Argentina indicating molt after the austral breeding period and away from the breeding grounds. Potential molting origins were identified applying likelihood-based assignment methods to a δ2H isoscape for South America and dichotomous prior information on the distribution of C3 and C4 vegetation types based on modeled vegetation-δ13C values. Barn Swallows now breeding in Argentina have changed their migratory behavior but presumably use the same cues as those used by the ancestral population, molting their feathers during the austral winter, likely in north-eastern South America. PMID:23383257

  3. [Videofluoroscopic Examination of Swallowing Using the AsR Score for Postoperative Swallowing Function in Oral Cancer Patients].

    PubMed

    Suzuki, Motoyuki; Fujii, Takashi; Yoshii, Tadashi; Otozai, Shinji; Kida, Kohta; Sugawa, Toshimitsu; Kitamura, Koji; Kanamura, Ryo; Koike, Ryosuke

    2015-07-01

    To evaluate the postoperative swallowing function in head and neck cancer patients, videofluoroscopic examination of swallowing (VF) proved useful as a qualitative evaluation, but was complex as a quantitative evaluation. We made use of the AsR score which consisted of a 10-point scale as a quantitative evaluation of VF. To identify the usefulness of the AsR score, 146 patients who had undergone extensive resection and reconstruction with free flaps or pedicle grafts were reviewed. The AsR score of VF for the first time after surgery was defined as "first score", and at the last time in the hospital was defined as "last score". The correlations between the first score and continuity of direct therapy, and between the last score and way of nutrition at the time of discharge were examined. Using the ROC (receiver operator characteristic) analysis and the AUC (area under the curve) the cut-off values of the AsR score were estimated. One hundred and thirty one patients could continue direct therapy after the first time of VF. The first score detected continuity of direct therapy with high accuracy (AUC = 0.946), furthermore using a cut-off of 5, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were about 96.2%, 86.6%, 98.4%, and 72.2%, respectively. At the time of discharge, 138 patients had no limitation of oral intake and 8 patients had a limitation e.g. PEG (n = 7) and a total laryngectomy for preventing aspiration (n = 1). The last score detected oral intake ability with no limitation with high accuracy (AUC = 0.925). Using a cut-off of 6, the sensitivity, specificity, PPV and NPV were about 82.6%, 87.5%, 99.1% and 22.6%, respectively. The AsR score is useful as a quantitative evaluation of postoperative swallowing function in oral cancer patients.

  4. 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...

  5. [Effect of Bolus Volume on Pharyngeal Swallowing Dynamics Evaluated with Small High-Resolution Manometry Catheters].

    PubMed

    Jungheim, Michael; Kallusky, Johanna; Ptok, Martin

    2017-02-01

    The bolus volume has a modulating effect on the swallowing dynamics, but previously reported adaptations of the pharyngeal function have been inconsistent. Therefore, the aim of this study was to comprehensively evaluate changes of pressure and time parameters in the pharynx and upper esophageal sphincter (UES) in relation to the swallowed bolus volume with high-resolution manometry (HRM). To examine the normal swallowing physiology, particularly thin HRM probes were used, which were expected to influence the investigated structures only minimally.10 healthy volunteers accomplished 10 swallows with 2 and 10 ml water respectively in an upright position, while an HRM-examination was performed. Pressure and time parameters of the velopharynx, the tongue base region and the UES were determined and analyzed for statistical differences with respect to the bolus volume.Swallowing larger bolus volumes resulted in both, a longer closure of the velopharynx and in a longer opening of the UES. Volume dependent pressure changes in the pharyngeal swallowing sequence were not detectable.Under the chosen test conditions, bolus volume had an impact on the time parameters of the pharyngeal phase, thus, temporal adaptations of the automated swallowing dynamics were detected. Changes in pharyngeal pressure parameters as shown in other studies cannot be confirmed. They may be due to HRM probes with a larger diameter, which take an effect on the pharyngeal structures themselves. With regard to diagnostic aspects, HRM studies should always be conducted with different bolus volumes in order to investigate the swallowing process completely.

  6. 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…

  7. 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...

  8. 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…

  9. 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...

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  11. Identifying Patterns of FEES-Derived Swallowing Trajectories Using Group-Based Trajectory Model.

    PubMed

    Baijens, Laura W J; Pilz, Walmari; Kremer, Bernd; Passos, Valeria Lima

    2015-10-01

    The present study delineates and visualizes swallowing trajectories along seven swallow trials in dysphagic patients using group-based trajectory modeling (GBTM). This model facilitates the recognition of swallowing functional categories, estimates their frequency of occurrence, and enhances the understanding of swallowing dynamics. Two hundred and five dysphagic patients underwent a standardized FEES examination protocol. Five ordinal variables were blindly assessed for each swallow by two observers independently. GBTM analysis was conducted to find and characterize trajectories of FEES responses. For most FEES outcome variables, trajectories were qualitatively distinct in degree and kind (level of impairment and how this changed over the seven swallow trials). Two FEES outcome variables-delayed initiation of the pharyngeal reflex and postswallow pyriform sinus pooling-showed the highest prevalence of severe swallowing impairment. Highly impaired categories were more stable throughout the different swallow trials. Intermediate trajectories, by contrast, were erratic, responding more sensitively to shifts in bolus consistency. GBTM can identify distinct developmental trajectories of measured FEES variables in patients with oropharyngeal dysphagia. In clinical practice, classification into distinct groups would help to identify the subgroup of dysphagic patients who may need specific medical attention.

  12. Functional outcome in acute stroke patients with oropharyngeal Dysphagia after swallowing therapy.

    PubMed

    Huang, Kun-Ling; Liu, Ting-Yuan; Huang, Yu-Chi; Leong, Chau-Peng; Lin, Wei-Che; Pong, Ya-Ping

    2014-01-01

    Dysphagia after stroke is associated with mortality and increased pulmonary complications. Swallowing therapies may decrease pulmonary complications and improve patients' quality of life after stroke. This study used clinical swallowing assessments and videofluoroscopy (VFS) to assess the functional recovery of acute stroke patients with dysphagia after different swallowing therapies. We enrolled 29 acute stroke patients with dysphagia and randomly divided them into 3 therapy groups: traditional swallowing (TS), oropharyngeal neuromuscular electrical stimulation (NMES), and combined NMES/TS. All patients were assessed using the clinical functional oral intake scale (FOIS), 8-point penetration-aspiration scale (PAS), and functional dysphagia scale (FDS) of VFS before and after treatment. There were no differences in the clinical parameters and swallowing results of the FOIS and VFS before swallowing treatment among the 3 groups (P > .05). TS therapy and combined therapy both had significant swallowing improvement after therapy according to the FOIS and 8-point PAS (P < .05). When comparing the results of the VFS among the 3 groups, we found significant improvements in patients eating cookies and thick liquid after combined NMES/TS therapy (P < .05). In acute stroke patients with dysphagia, combined NMES/TS therapy is the most effective swallowing therapy in taking solid diets and thick liquids.

  13. Both head extension and mouth opening impair the ability to swallow in the supine position.

    PubMed

    Hanamoto, H; Kadono, K; Boku, A; Kudo, C; Morimoto, Y; Sugimura, M; Niwa, H

    2014-08-01

    Head position and mouth opening in the supine position may impair the ability to swallow. If this does occur, it would lead to retention of intra-oral fluids during dental treatment, which would lead to stimulation of the cough reflex. This study was conducted to investigate how head position and mouth opening affect swallowing ability. The water swallowing test was performed in 13 healthy adult subjects in the supine position. The subjects were asked to swallow 10 mL of water that was injected into the mouth in a single attempt. After swallowing, the residual intra-oral water was suctioned and its volume was measured. An electromyogram (EMG) of the suprahyoid (SH) muscles was also recorded during the test. The duration of SH muscle activity and peak amplitude of SH EMG were examined. The water swallowing test was performed under three head positions (neutral, extended and flexed) and four mouth opening patterns (interincisal distances of 0, 20, 30 and 40 mm). The wider the subject opened the mouth, the more the water remained in the mouth after swallowing. The residual volume of water was more in the extended position compared with that in the neutral and flexed positions. Peak amplitude of SH EMG decreased with mouth opening. Duration of SH muscle activity was longer in the extended position than in the neutral and flexed positions. Head extension and mouth opening can induce difficulty in swallowing in the supine position by extending the duration of SH muscle activity while reducing its intensity.

  14. 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…

  15. 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…

  16. 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,…

  17. 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…

  18. 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.…

  19. Invasive Swallow-worts: An allelopathic role for -(-) antofine remains unclear

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pale swallow-wort (Vincetoxicum rossicum) and black swallow-wort (V. nigrum) are two invasive plant species in the northeastern United States and eastern Canada that have undergone rapidly expanding ranges over the past 30 years. Both species possess a highly bioactive phytotoxin -(-) antofine in r...

  20. 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…

  1. Preliminary studies on seed dispersal of swallow-wort (Vincetoxicum spp.)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Vincetoxicum rossicum (pale swallow-wort) and V. nigrum (black swallow-wort) are invasive, perennial vines that have become problematic in natural areas in the northeastern United States and neighboring southeastern Canada. Both species reproduce primarily via wind-dispersed seeds in the form of ac...

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2015-01-01

    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.

  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. 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...

  6. Normal swallowing acoustics across age, gender, bolus viscosity, and bolus volume.

    PubMed

    Youmans, Scott R; Stierwalt, Julie A G

    2011-12-01

    Cervical auscultation has been proposed as an augmentative procedure for the subjective clinical swallowing examination due to the tangible differences between normal and dysphagic swallowing sounds. However, the research is incomplete regarding cervical auscultation and swallowing acoustics in that the differences between the sounds of normal versus dysphagic swallowing have yet to be fully understood or quantified. The swallows of 96 reportedly healthy adults, balanced for gender and divided into younger, middle, and older age groups, were audio-recorded while ingesting several boluses of varying viscosity and volume. The audio signals were then analyzed to determine their temporal and acoustic characteristics. Results indicated increasing pharyngeal swallowing duration with increasing age, bolus viscosity, and bolus volume. In addition, an increased duration to peak intensity with increasing age was found in one of our two analyses, as well as with some of the more viscous versus less viscous boluses. Men and older persons produced higher peak intensities and peak frequencies than women and younger persons. Thin liquids were produced with more intensity than honey or more viscous boluses, and with greater frequency than mechanical soft solids. Larger volumes resulted in greater peak frequency values. Some of the acoustic measurements appear to be more useful than others, including the duration of the acoustic swallowing signal and the within-subjects peak intensity variable. We noted that differences in swallowing acoustics were more related to changes in viscosity rather than volume. Finally, within-participant observations were more useful than between-participant observations.

  7. Function of upper esophageal sphincter during swallowing: the grabbing effect.

    PubMed

    Pouderoux, P; Kahrilas, P J

    1997-05-01

    This study investigated deglutitive axial force developed within the pharynx, upper esophageal sphincter (UES), and cervical esophagus. Position and deglutitive excursion of the UES were determined using combined manometry and videofluoroscopy in eight healthy volunteers. Deglutitive clearing force was quantified with a force transducer to which nylon balls of 6- or 8-mm diameter were tethered and positioned within the oropharynx, hypopharynx, UES, and cervical esophagus. Axial force recordings were synchronized with videofluoroscopic imaging. Clearing force was dependent on both sphere diameter (P < 0.05) and location, with greater force exhibited in the hypopharynx and UES compared with the oropharynx and esophagus (P < 0.05). Within the UES, the onset of traction force coincided with passage of the pharyngeal clearing wave but persisted well beyond this. On videofluoroscopy, the persistent force was associated with the aboral motion of the ball caught within the UES. Force abated with gradual slippage of the UES around the ball. The force attributable to the combination of UES contraction and laryngeal descent was named the grabbing effect. The grabbing effect functions to transfer luminal contents distal to the laryngeal inlet at the end of the pharyngeal swallow, presumably acting to prevent regurgitation and/or aspiration of swallowed material.

  8. Neuropharmacologic correlates of deglutition: lessons from fictive swallowing.

    PubMed

    Bieger, D

    1991-01-01

    Pharmacologic investigations into the transmission processes underlying fictive swallowing in the rat have disclosed the potential diversity of chemical signals used in central deglutitive pathways. Monoaminergic mechanisms appear to serve as links between subcortical structures and the medullary pattern generator of swallowing (PGS), and may play a critical role in maintaining internal facilitatory drive, required by the PGS for optimal responsivity to peripheral sensory input. Cholinergic bulbar interneurons form an integral component of the PGS subnetwork controlling esophageal peristalsis. Local GABA neurons exert a tonic inhibition of the buccopharyngeal stage, may regulate buccopharyngeal-esophageal coupling, and may contribute to peristaltic rhythmic generation at both the premotoneuronal and motoneuronal level. Receptor subtypes for excitatory amino acids (glutamate, aspartate) are differentially associated with deglutitive premotoneurons for both the buccopharyngeal and esophageal stage, as well as with ambiguus motoneurons. Preliminary evidence suggests the existence of excitatory peptidergic mechanisms involving thyrotropin-releasing hormone, vasopressin, oxytocin, and somatostatin, a probable candidate for excitatory transmitter in the solitarioambigual internuncial projection to motoneurons innervating esophageal striated musculature. Further validation of this experimental model may ultimately help to establish a framework for the clinical recognition, management, and exploitation of drug actions on central deglutitive neuroeffectors.

  9. 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.

  10. Fiberoptic endoscopic evaluation of swallowing (FEES): proposal for informed consent

    PubMed Central

    Nacci, A; Ursino, F; La Vela, R; Matteucci, F; Mallardi, V; Fattori, B

    2008-01-01

    Summary Fiberoptic endoscopic evaluation of swallowing (FEES) is now a first choice method for studying swallowing disorders on account of the various advantages it offers: easy to use, very well tolerated, allows bedside examination and is economic. Nevertheless, this diagnostic procedure is not without risks, the most probable consequences of which include discomfort, gagging and/or vomiting, vasovagal syncope, epistaxis, mucosal perforation, adverse reactions to topical anaesthetics and laryngospasm. The risks involved with FEES stress the importance of informing the patient of these; this is an important aspect in medicine that necessarily and immediately implies receiving the patient’s so-called “informed consent”. Informed consent should be obtained not only by means of specific printed forms but also after the patient has had an interview with the physician who will be performing the procedure and who will offer information according to the personal clinical, psychological, cultural and linguistic situation of the patient and in keeping with the type of procedure proposed. In the case of FEES, as with other invasive or non-invasive diagnostic procedures, therefore, routine written and signed consent, together with a patient/physician interview should fulfil what is known as “complete information”. In this report, a specific form for informed consent to FEES procedures, is proposed. PMID:18939710

  11. 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

  12. Incidence of Pneumonia After Videofluoroscopic Swallowing Study and Associated Factors.

    PubMed

    Jo, Hannae; Park, Jung-Gyoo; Min, David; Park, Hee-Won; Kang, Eun Kyoung; Lee, Kun-Jai; Baek, Sora

    2016-02-01

    Pneumonia after videofluoroscopic swallow study (VFSS) is sometimes considered to be caused by aspiration during VFSS; however, to our knowledge, a relationship between these events has not been clearly investigated. The aim of this study was to assess the incidence of VFSS-related pneumonia and related factors. Overall, 696 VFSS cases were retrospectively reviewed. Cases in which blood culture was performed within 3 days after VFSS due to newly developed infectious signs were considered as post-VFSS infection cases. Pneumonia was suspected when there was some evidence of respiratory infectious signs in clinical, radiological, and laboratory findings. The underlying disease, clinical signs, and VFSS findings of the pneumonia group were assessed. Among 696 cases, pneumonia was diagnosed in 15 patients. The patients in the pneumonia group tended to be older and had higher aspiration rate on VFSS than those in the non-pneumonia group. In the pneumonia group, 2 patients showed no aspiration during VFSS. In 6 patients, pneumonia developed after massive aspiration of gastric content in 5 patients and inappropriate oral feeding with risk of aspiration before VFSS in 1 patient. Only 7 patients (1.0 %) were finally determined as having VFSS-related pneumonia. In conclusion, the 72-h incidence of VFSS-related pneumonia was 1.0 %. Old age and severity of swallowing difficulty are associated with occurrence of pneumonia.

  13. Combined neuromuscular electrical stimulation (NMES) with fiberoptic endoscopic evaluation of swallowing (FEES) and traditional swallowing rehabilitation in the treatment of stroke-related dysphagia.

    PubMed

    Sun, Shu-Fen; Hsu, Chien-Wei; Lin, Huey-Shyan; Sun, Hsien-Pin; Chang, Ping-Hsin; Hsieh, Wan-Ling; Wang, Jue-Long

    2013-12-01

    Dysphagia is common after stroke. Neuromuscular electrical stimulation (NMES) and fiberoptic endoscopic evaluation of swallowing (FEES) for the treatment of dysphagia have gained in popularity, but the combined application of these promising modalities has rarely been studied. We aimed to evaluate whether combined NMES, FEES, and traditional swallowing rehabilitation can improve swallowing functions in stroke patients with moderate to severe dysphagia. Thirty-two patients with moderate to severe dysphagia poststroke (≥3 weeks) were recruited. Patients received 12 sessions of NMES for 1 h/day, 5 days/week within a period of 2-3 weeks. FEES was done before and after NMES for evaluation and to guide dysphagic therapy. All patients subsequently received 12 sessions of traditional swallowing rehabilitation (50 min/day, 3 days/week) for 4 weeks. Primary outcome measure was the Functional Oral Intake Scale (FOIS). Secondary outcome measures included clinical degree of dysphagia, the patient's self-perception of swallowing ability, and the patient's global satisfaction with therapy. Patients were assessed at baseline, after NMES, at 6-month follow-up, and at 2-year follow-up. Twenty-nine patients completed the study. FOIS, degree of dysphagia, and patient's self-perception of swallowing improved significantly after NMES, at the 6-month follow-up, and at the 2-year follow-up (p < 0.001, each compared with baseline). Most patients reported considerable satisfaction with no serious adverse events. Twenty-three of the 29 (79.3 %) patients maintained oral diet with no pulmonary complications at 2-year follow-up. This preliminary case series demonstrated that combined NMES, FEES, and traditional swallowing rehabilitation showed promise for improving swallowing functions in stroke patients with moderate-to-severe dysphagia. The benefits were maintained for up to 2 years. The results are promising enough to justify further studies.

  14. 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.

  15. Ultrasound of oral and masticatory muscles: Why every neuromuscular swallow team should have an ultrasound machine.

    PubMed

    Van Den Engel-Hoek, Lenie; Lagarde, Marloes; Van Alfen, Nens

    2017-03-01

    Patients with neuromuscular disorders often present with swallowing difficulties due to oral phase problems and pharyngeal residue after swallow. It is important to assess the underlying pathology and cause of the swallowing disturbance in this patient group, such as dystrophic changes in oral and masticatory muscles. This allows for more patient-tailored recommendations, for example optimal compensation strategies to maintain function for longer. Ultrasound can show structural changes caused by dystrophy or denervation of muscles, detect involuntary movements such as fasciculations, and provide dynamic video images of tongue motion during swallowing attempts. This article, based on the authors' extensive experience with ultrasound in neuromuscular disease, explains the concepts of oral muscle ultrasound and its proven value in assessing neuromuscular mastication and swallowing problems. As a patient-friendly and portable technique, we advocate its use as a standard tool for analyzing neuromuscular dysphagia. Clin. Anat. 30:183-193, 2017. © 2017 Wiley Periodicals, Inc.

  16. 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.

  17. 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.

  18. 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…

  19. 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

  20. 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…

  1. 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

  2. Multiple Disabilities. NICHCY Disability Fact Sheet #10

    ERIC Educational Resources Information Center

    National Dissemination Center for Children with Disabilities, 2013

    2013-01-01

    The term "multiple disabilities" is general and broad. From the term, you cannot tell how many disabilities a child has; which disabilities are involved; or how severe each disability is. Many combinations of disabilities are possible. The different disabilities will also have a combined impact. That is why it is also important to ask:…

  3. Monarch butterfly oviposition on swallow-worts (Vincetoxicum spp.).

    PubMed

    Casagrande, R A; Dacey, J E

    2007-06-01

    As black swallow-wort, Vincetoxicum nigrum L. Moench, and pale swallow-wort, V. rossicum (Kleopow) Barbar., spread throughout the northeastern United States and southern Canada, there is concern about the impact of these invasive plants on populations of the native North American monarch butterfly Danaus plexippus L. Recent laboratory studies in New York and Ontario, Canada, have found little or no oviposition by monarch butterflies on the two Vincetoxicum species. In Rhode Island, we found 10.5-21.7% oviposition on Vincetoxicum species relative to common milkweed Asclepias syriaca L. in choice tests and 11.9-20.3% in no-choice tests in 2 yr of laboratory testing. These results were supported by field cage trials where monarchs given a choice between V. nigrum and A. syriaca laid 24.5% of their eggs on V. nigrum. In surveys of three pasture fields in Rhode Island where relative coverage of A. syriaca exceeded that of V. nigrum by a 0.77:0.23 ratio, 15.4% of monarch eggs were found on V. nigrum plants. In V. nigrum stands with very little A. syriaca (6.25 stems/ha), monarch egg density on V. nigrum was found to be over five times greater than in the three mixed pasture fields. In none of our laboratory or field evaluations was there any survival of monarch larvae on Vincetoxicum species. It seems that in Rhode Island, Vincetoxicum species serve as an oviposition sink for monarch butterflies. These findings suggest that East Coast butterflies may differ in host selection from those in central New York and southern Ontario, Canada.

  4. The mandible advancement may alter the coordination between breathing and the non-nutritive swallowing reflex.

    PubMed

    Ayuse, T; Ayuse, T; Ishitobi, S; Yoshida, H; Nogami, T; Kurata, S; Hoshino, Y; Oi, K

    2010-05-01

    The coordination between nasal breathing and non-nutritive swallowing serves as a protective reflex against potentially asphyxiating material, i.e. saliva and secretions, entering the respiratory tract. Although this protective reflex is influenced by positional changes in the head and body, the effect of mandible position on this reflex is not fully understood. We examined the effect of mandible advancement associated with mouth opening on the coordination between nasal breathing and non-nutritive swallowing induced by continuous infusion of distilled water into the pharyngeal cavity. The combination of mandible advancement and mouth opening increased the duration of swallowing apnoea and submental electromyographic burst duration. When the mandible was advanced with the mouth open, the duration of swallowing apnoea increased significantly compared with the centric position (0.79 +/- 0.23 vs. 0.64 +/- 0.12 s, P < 0.05, n = 12), and the duration of submental electromyographic activity increased significantly (2.11 +/- 0.63 vs. 1.46 +/- 0.25 s, P < 0.05, n = 12). Mandible advancement with mouth opening altered the respiratory phase resetting during swallowing and the timing of swallow in relation to respiratory cycle phase. We conclude that mandible re-positioning may strongly influence the coordination between nasal breathing and non-nutritive swallowing by altering respiratory parameters and by inhibiting movement of the tongue-jaw complex.

  5. Routine Use of Contrast Swallow After Total Gastrectomy and Esophagectomy: Is it Justified?

    PubMed Central

    El-Sourani, Nader; Bruns, Helge; Troja, Achim; Raab, Hans-Rudolf; Antolovic, Dalibor

    2017-01-01

    Summary Background After gastrectomy or esophagectomy, esophagogastrostomy and esophagojejunostomy are commonly used for reconstruction. Water-soluble contrast swallow is often used as a routine screening to exclude anastomotic leakage during the first postoperative week. In this retrospective study, the sensitivity and specificity of oral water-soluble contrast swallow for the detection of anastomotic leakage and its clinical symptoms were analysed. Material/Methods Records of 104 consecutive total gastrectomies and distal esophagectomies were analysed. In all cases, upper gastrointestinal contrast swallow with the use of a water-soluble contrast agent was performed on the 5th postoperative day. Extravasation of the contrast agent was defined as anastomotic leakage. When anastomotic insufficiency was suspected but no extravasation was present, a computed tomography (CT) scan and upper endoscopy were performed. Results Oral contrast swallow detected 7 anastomotic leaks. Based on CT-scans and upper endoscopy, the true number of anastomotic leakage was 15. The findings of the oral contrast swallow were falsely positive in 4 and falsely negative in 12 patients, respectively. The sensitivity and specificity of the oral contrast swallow was 20% and 96%, respectively. Conclusions Routine radiological contrast swallow following total gastrectomy or distal esophagectomy cannot be recommended. When symptoms of anastomotic leakage are present, a CT-scan and endoscopy are currently the methods of choice.

  6. 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.

  7. An evaluation of the University of Washington Quality of Life swallowing domain following oropharyngeal cancer.

    PubMed

    Thomas, L; Jones, T M; Tandon, S; Katre, C; Lowe, D; Rogers, S N

    2008-07-01

    Oropharyngeal cancer and its treatment have debilitating effect on swallowing function which can impact on quality of life. The aims of this study were to assess swallowing dysfunction in patients treated for oropharyngeal cancer by both patient and observer assessed tools and to assess the suitability of University of Washington Quality of Life (UW-QOL) swallowing domain as a potential screening tool in routine clinic practice. This was a cross-sectional study of disease free survivors following radical treatment for oropharyngeal squamous cell carcinoma at a tertiary care centre between 1999 and May 2005. Evaluation included three questionnaires--the M. D. Anderson Dysphagia Inventory (MDADI), the SWALQOL, the University of Washington Quality of Life (UWQOL) and Fibreoptic Endoscopic Evaluation of Swallowing (FEES). Of 117 patients 77 (66%) participated. On the UW-QOL, 18% could only swallow liquids whilst 11% could not swallow at all. There is a clear demarcation between UW-QOL levels and food consistency and texture as measured by the SWALQOL (r= -0.86, P<0.001). There was a graduation in respect to function with correlations of r=0.61 with overall MDADI and SWALQOL and r= -0.45 for FEES. Patients scoring 70 or better in the UW-QOL were notably better in MDADI and the SWALQOL hence a cut off of below 70 could be regarded as a quick screening tool for swallowing dysfunction.

  8. Behavioural and neurophysiological disruption of corticobulbar motor systems and their effects on sequential pharyngeal swallowing.

    PubMed

    Al-Toubi, Aamir; Daniels, Stephanie K; Huckabee, Maggie-Lee; Corey, David M; Doeltgen, Sebastian H

    2016-10-15

    Primary motor networks are known to be involved in the control of voluntary oral movements as well as the modulation of pharyngeal movements during experimentally controlled single swallows performed on command. The role of these networks in the more typical task of sequential swallowing remains unexplored. This study evaluated the hypothesis that experimental disruption of motor cortical activation would reduce the rate and regularity of repeatedly performed volitional or volitionally initiated motor tasks controlled by corticospinal (finger tapping) and corticobulbar (eyebrow movement, jaw opening, volitional sequential swallowing) motor systems, but would not influence a more reflexive corticobulbar task (reflexive sequential swallowing to pharyngeal water infusion). This premise was investigated in 24 healthy participants using two techniques: a dual task paradigm and a transcranial magnetic stimulation paradigm. Disruption effects were quantified by changes in rate and regularity of performance for each tested motor task. In summary, volitional motor tasks controlled by corticospinal motor networks (finger tapping) are more susceptible to behavioural and neurophysiological disruption than tasks controlled by cortiobulbar motor networks containing a reflexive component (both volitional and experimentally initiated consecutive swallowing). Purely volitional motor tasks controlled by the corticobulbar motor system (eyebrow raising or jaw opening) were affected in similar ways as the volitional corticospinal motor tasks. In summary, tasks involving sequential pharyngeal swallowing - whether volitionally or experimentally initiated - are largely robust against disruption of primary cortical motor networks, supporting a key role of medullary CPGs in the motor control of sequential pharyngeal swallowing.

  9. Kinematic and temporal factors associated with penetration-aspiration in swallowing liquids.

    PubMed

    Molfenter, Sonja M; Steele, Catriona M

    2014-04-01

    In this study we undertook careful analysis of 13 quantitative physiological variables related to oropharyngeal swallowing from a sample of 42 subacute patients referred for dysphagia assessment. Each patient underwent a videofluoroscopic swallowing examination in which they swallowed up to five boluses of 22 % w/v ultrathin liquid barium suspension administered by teaspoon. Our goal was to determine whether scores on 13 kinematic or temporal parameters of interest were independently associated with the presence of penetration-aspiration in the final compiled dataset of 178 swallows. Participants were classified as aspirators based on the presence of at least one swallow that demonstrated a Penetration-Aspiration Scale score of ≥3. The parameters of interest included six kinematic parameters for capturing hyoid position, three swallow durations [laryngeal closure duration, hyoid movement duration, and upper esophageal sphincter (UES) opening duration], and four swallow intervals (laryngeal closure to UES opening, bolus dwell time in the pharynx prior to laryngeal closure, stage transition duration, and pharyngeal transit time). Mixed-model repeated-measures ANOVAs were conducted to determine the association between each parameter and aspiration status. Only 1 of the 13 parameters tested distinguished aspirators from nonaspirators: aspirators demonstrated significantly shorter UES opening duration. In addition, a trend toward reduced maximum superior position of the hyoid was seen in aspirators. Limitations and future considerations are discussed.

  10. 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

  11. 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

  12. Dysphagia and swallowing-related quality of life in Friedreich ataxia.

    PubMed

    Vogel, Adam P; Brown, Sophie E; Folker, Joanne E; Corben, Louise A; Delatycki, Martin B

    2014-02-01

    Dysphagia in Friedreich ataxia (FRDA) and its impact on quality of life is not adequately understood. The objective of this study was to characterise dysphagia in FRDA and to determine the impact of swallowing dysfunction on activities, participation, and sense of well-being. Thirty-six individuals with a confirmed diagnosis of FRDA were assessed via a clinical bedside examination (CBE), the Royal Brisbane Hospital outcome measure for swallowing, an oral-motor examination and the Australian therapy outcome measures for speech and swallowing (AusTOMS). Data on swallowing function, diet modification and swallowing strategies were collated. Thirty-three (91.67 %) participants exhibited clinical signs of dysphagia according to the CBE, and all participants received ratings indicating swallowing difficulties on at least one other measure. Dysphagia in FRDA is characterised by oral and pharyngeal stage impairment relating to incoordination, weakness and spasticity. A significant positive correlation was found between the severity of impairment, activity, participation and distress/well-being on the AusTOMS, suggesting that swallowing function decreases with overall reductions in quality of life. A significant correlation was found between activity on the AusTOMS and disease duration (r = -0.283, p = 0.012). No significant correlations were found between dysphagia severity and GAA repeat length, age of onset or disease severity. Participants employing diet modification and swallowing strategies demonstrated higher dysphagia severity, activity limitations and participation restrictions. These data advocate a holistic approach to dysphagia management in FRDA. Early detection of swallowing impairment and consideration of the potential impact dysphagia has on quality of life should be key aspects in disease management.

  13. 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.

  14. '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.

  15. Swallowing Disorders in Sjögren's Syndrome: Prevalence, Risk Factors, and Effects on Quality of Life.

    PubMed

    Pierce, Jenny L; Tanner, Kristine; Merrill, Ray M; Miller, Karla L; Kendall, Katherine A; Roy, Nelson

    2016-02-01

    This epidemiological investigation examined the prevalence, risk factors, and quality-of-life effects of swallowing disorders in Sjögren's syndrome (SS). One hundred and one individuals with primary or secondary SS (94 females, 7 males; mean age 59.4, SD = 14.1) were interviewed regarding the presence, nature, and impact of swallowing disorders and symptoms. Associations among swallowing disorders and symptoms, select medical and social history factors, SS disease severity, and the M.D. Anderson Dysphagia Inventory (MDADI) and Short Form 36 Health Survey (SF-36) were examined. The prevalence of a current self-reported swallowing disorder was 64.4 %. SS disease severity was the strongest predictor of swallowing disorders, including significant associations with the following swallow symptoms: taking smaller bites, thick mucus in the throat, difficulty placing food in the mouth, and wheezing while eating (p < .05). Additional swallowing disorder risk factors included the presence of a self-reported voice disorder, esophageal reflux, current exposure to secondary tobacco smoke, frequent neck or throat tension, frequent throat clearing, chronic post-nasal drip, and stomach or duodenal ulcers. Swallowing disorders did not differ on the basis of primary or secondary SS. Swallowing disorders and specific swallowing symptoms were uniquely associated with reduced quality of life. Among those with swallowing disorders, 42 % sought treatment, with approximately half reporting improvement. Patient-perceived swallowing disorders are relatively common in SS and increase with disease severity. Specific swallowing symptoms uniquely and significantly reduce swallow and health-related quality of life, indicating the need for increased identification and management of dysphagia in this population.

  16. Intellectual disability

    MedlinePlus

    ... Failure to grow intellectually or continued infant-like behavior Lack of curiosity Problems keeping up in school Failure to adapt (adjust to new situations) Difficulty understanding and following social rules Signs of intellectual disability can range from ...

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

    USGS Publications Warehouse

    Custer, Christine M.; Elliott, John G.; Bishop, Christine Annette; Morrissey, Christy A.

    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.

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

    USGS Publications Warehouse

    Echols, Kathy R.; Tillitt, Donald E.; Nichols, John W.; Secord, Anne L.; McCarty, John 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.

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

    PubMed

    Echols, Kathy R; Tillitt, Donald E; Nichols, John W; Secord, Anne L; McCarty, John P

    2004-12-01

    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.

  20. Using the gugging swallowing screen (GUSS) for dysphagia screening in acute stroke patients.

    PubMed

    John, Jennilee St; Berger, Linley

    2015-03-01

    Aspiration pneumonia from dysphagia following stroke presents significant morbidity and mortality in that population. Dysphagia screening before oral intake has been a standard of care for years, but there is a lack of consensus on the best screening tool. The Gugging Swallowing Screen (GUSS) is presented as a potentially better alternative to other dysphagia screens due to its safer progression of oral intake, more thorough evaluation of swallowing, and ability to enable earlier nutrition.

  1. Modulation of activity in swallowing motor cortex following esophageal acidification: a functional magnetic resonance imaging study.

    PubMed

    Paine, Peter A; Hamdy, Shaheen; Chitnis, Xavier; Gregory, Lloyd J; Giampietro, Vincent; Brammer, Mick; Williams, Steve; Aziz, Qasim

    2008-06-01

    Esophageal acid exposure induces sensory and motility changes in the upper gastrointestinal tract; however, the mechanisms involved and the effects on activity in the brain regions that control swallowing are unknown. The aim of this study was to examine functional changes in the cortical swallowing network as a result of esophageal acidification using functional magnetic resonance imaging (fMRI). Seven healthy volunteers (3 female, age range=20-30 years) were randomized to receive either a 0.1 M hydrochloric acid or (control) saline infusion for 30 min into the distal esophagus. Postinfusion, subjects underwent four 8 min blocks of fMRI over 1 h. These alternated between 1 min swallowing water boluses and 1 min rest. Three-dimensional cluster analysis for group brain activation during swallowing was performed together with repeated-measures ANOVA for differences between acid and saline. After acid infusion, swallowing-induced activation was seen predominantly in postcentral gyrus (p<0.004). ANOVA comparison of acid with saline showed a significant relative reduction in activation during swallowing of the precentral gyrus (M1) BA 4 (p<0.008) in response to acid infusion. No areas of increased cortical activation were identified with acid vs. saline during swallowing. Esophageal acidification inhibits motor and association cortical areas during a swallowing task, probably via changes in vagal afferent or nociceptive input from the esophagus. This mechanism may play a protective role, facilitating acid clearance by reduced descending central motor inhibition of enteric/spinal reflexes, or by preventing further ingestion of injurious agents.

  2. Endoscopic removal of throat-packing gauze swallowed during general anesthesia.

    PubMed

    Iwai, Toshinori; Goto, Takahisa; Matsui, Yoshiro; Tohnai, Iwai

    2012-09-01

    Throat packing is commonly placed in the pharynx before starting oral and maxillofacial surgery under general anesthesia to protect the airway from aspiration of blood and surgical debris. Complications such as airway obstruction may arise if any of the throat packing is retained after extubation, and less commonly, swallowing of the throat packing has been reported. We report endoscopic removal of throat packing gauze swallowed during general anesthesia.

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

    USGS Publications Warehouse

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

    2006-01-01

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

  4. Learning about the dynamic swallowing process using an interactive multimedia program.

    PubMed

    Scholten, I; Russell, A

    2000-01-01

    The management of dysphagia is the largest recognized subspecialty in the field of speech-language pathology. Practicing speech-language pathologists require a comprehensive theoretical and functional knowledge base to underpin the safe and effective management of people with dysphagia. Students need to develop an understanding of the normal integrated swallow and how it can be affected to appreciate the assessment or treatment of dysphagia. Although students are well motivated to learn this material, assimilating knowledge of the dynamic nature of the swallow has typically been problematic because of its complex character. The limitations of currently available teaching resources have been addressed by the production of an interactive multimedia program that includes integrated presentation of text, graphics, voice-overs, and video and animation sequences to highlight various aspects of the swallowing process. Students can selectively manipulate parts of this process to understand the normal swallow and to simulate different aspects of dysfunction and the consequent effects on swallow safety and efficiency. Feedback from students, faculty, and experts has demonstrated that The Dynamic Swallow would be a valued tool in the teaching of dysphagia.

  5. Relationships Among Rheological, Sensory Texture, and Swallowing Pressure Measurements of Hydrocolloid-Thickened Fluids.

    PubMed

    Vickers, Z; Damodhar, H; Grummer, C; Mendenhall, H; Banaszynski, K; Hartel, R; Hind, J; Joyce, A; Kaufman, A; Robbins, J

    2015-12-01

    The objective of this study was to examine the relationships among three categories of measurements (rheological, sensory texture, and swallowing pressure) from fluids thickened to two different viscosities with 15 different hydrocolloids. Fluids at viscosities of 300 and 1500 cP (at 30 s(-1)) were targeted because these are the viscosities corresponding to the barium standards used in radiographic dysphagia diagnosis. Within the low viscosity (nectar) fluids (300 cP), the sensory properties thickness, stickiness, adhesiveness, mouth coating, and number of swallows were highly positively correlated with each other and highly positively correlated with the flow behavior index, n value (an indicator of shear-thinning behavior). Within the higher viscosity (thin honey) fluids (1500 cP), the sensory textures of adhesiveness, stickiness, mouth coating, and number of swallows correlated positively with rheological measures of n value. Swallowing pressures measured in the anterior oral cavity correlated negatively with the consistency coefficient k [shear stress/(shear rate) (n) ]. Samples that were more shear thinning (lower n values, higher k values) were generally perceived as less thick, with less adhesive properties (stickiness, adhesiveness, mouthcoating, and number of swallows). This information can be useful for selecting thickeners for people with dysphagia. A desirable thickener for many dysphagic patients would be one that allowed for a safe swallow by being viscous enough to reduce airway penetration, yet pleasant to drink, having the minimal perceived thickness and mouthcoating associated with greater shear thinning.

  6. Effects of mercury exposure on the reproductive success of tree swallows (Tachycineta bicolor).

    PubMed

    Brasso, Rebecka L; Cristol, Daniel A

    2008-02-01

    An experimental tree swallow population was established in the headwaters of the Shenandoah River, Virginia, USA to assess the accumulation and effects of mercury contamination on birds that eat emergent aquatic insects. One tributary, the South River, was contaminated with mercury before 1950. Reproductive success of swallows nesting within 50 m of this river was compared to that of three uncontaminated reference tributaries in 2005 and 2006. Female swallows on the contaminated stretch of river had significantly elevated blood and feather total mercury (blood: 3.56 +/- 2.41 ppm ww vs. 0.17 +/- 0.15 ppm reference; feather: 13.55 +/- 6.94 ppm vs. 2.34 +/- 0.87 ppm reference), possibly the highest ever reported for an insectivorous songbird. Insects collected by the swallows to be fed to nestlings averaged 0.97 +/- 1.11 ppm dw total mercury, significantly higher than on reference sites. Swallows in the contaminated area produced fewer fledglings than those in reference areas. The effect of mercury contamination on productivity was detectable only for young females in the contaminated area that were breeding for the first time in 2006, a segment of the population that may already have been stressed by inexperience. Tree swallows served as practical and effective biomonitors for mercury levels and effects and have great potential as proxy biomonitors for more logistically challenging birds such as loons or eagles.

  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.

  8. Thyroid Resection Improves Perception of Swallowing Function in Patients with Thyroid Disease

    PubMed Central

    Greenblatt, David Yü; Sippel, Rebecca; Leverson, Glen; Frydman, James; Schaefer, Sarah; Chen, Herbert

    2010-01-01

    Background Patients with thyroid disease frequently complain of dysphagia. To date, there have been no prospective studies evaluating swallowing function before and after thyroid surgery. We used the swallowing quality of life (SWAL-QOL) validated outcomes assessment tool to measure changes in swallowing-related quality-of-life in patients undergoing thyroid surgery. Methods Patients undergoing thyroid surgery from May 2002 to December 2004 completed the SWAL-QOL questionnaire before and one year after surgery. Data were collected on demographic and clinicopathologic variables, and comparisons were made to determine the effect of surgery on patients’ perceptions of swallowing function. Results Of 146 eligible patients, 116 (79%) completed the study. The mean patient age was 49 years, and 81% were female. Sixty-four patients (55%) underwent total thyroidectomy and the remainder received thyroid lobectomy. Thirty patients (26%) had thyroid cancer. The most frequent benign thyroid conditions were multinodular goiter (28%) and Hashimoto’s thyroiditis (27%). Mean pre-operative SWAL-QOL scores were below 90 for nine of the eleven domains, indicating the perception of impaired swallowing and imperfect quality of life. After surgery, significant improvements were seen in eight SWAL-QOL domains. Recurrent laryngeal nerve injury was associated with dramatic score decreases in multiple domains. Conclusions In patients with thyroid disease, uncomplicated thyroidectomy leads to significant improvements in many aspects of patient-reported swallowing-related quality-of-life measured by the SWAL-QOL instrument. PMID:19034567

  9. Physiology of oropharyngeal swallow in the cat: a videofluoroscopic and electromyographic study.

    PubMed

    Kobara-Mates, M; Logemann, J A; Larson, C; Kahrilas, P J

    1995-02-01

    The majority of animal studies of deglutition have examined electrically stimulated swallows in sedated animals. This present investigation examined oropharyngeal and cervical esophageal swallow physiology in three awake normal domestic cats using concurrent electromyography (EMG) and videofluorography (VFG). Hooked wire electrodes were surgically implanted into six oropharyngeal muscles in each cat. During collection of VFG and EMG data, each cat ate barium-impregnated cat food while the fluorography tube focused on a lateral view of the oral cavity, pharynx, and cervical esophagus. A number of significant differences in the physiology of swallowing were found between the cat and human adult. The oral stage of swallow is much longer in the cat with bolus accumulation in the valleculae. Duration and components of the pharyngeal stage of swallow are much faster, and the pharyngeal stage occurs earlier in relation to bolus passage through the cricopharyngeus. In addition, the cat exhibits a marked superior constrictor bulge at the onset of the pharyngeal contractile wave and summation of the peristaltic waves in the esophagus, whereas the human adult does not. Feline swallow physiology is more similar to that of the human infant than that of human adults.

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

    PubMed Central

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

    2015-01-01

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

  11. Effect of aging on cough and swallowing reflexes: implications for preventing aspiration pneumonia.

    PubMed

    Ebihara, Satoru; Ebihara, Takae; Kohzuki, Masahiro

    2012-02-01

    The impairment of airway protective reflexes, i.e., swallowing and cough reflexes, is thought to be one of the major causes for aspiration pneumonia in older people. Restoration of cough and swallowing reflexes in the elderly is key to preventing aspiration pneumonia in the elderly. Although, the medical literature has asserted that cough and swallowing are controlled primarily by the brainstem, recent advances in human brain imaging has provided evidence that cortical and subcortical structures play critical roles in cough and swallowing control. Because of their nature, reflexive cough and swallowing activate both sensory and motor areas in the cortex. In both protective reflexes, the sensory component, including sensory cortex in reflexive circuits, seems to be more vulnerable to aging than the motor component, including the motor cortex. Therefore, the strategy to restore cough and swallowing reflexes should be focused on compensations of sensory components in these reflexive circuits. Remedies to enhance sensory nerve terminals and sensory cortical areas related to these reflexes might be useful to prevent aspiration pneumonia in the elderly.

  12. Swallowing disorder and inhibition of cough reflex induced by atropine sulfate in conscious dogs.

    PubMed

    Tsubouchi, Tadashi; Tsujimoto, Shinji; Sugimoto, Shinichi; Katsura, Yasunori; Mino, Terumasa; Seki, Takaki

    2008-03-01

    In this study, the effects of atropine sulfate (atropine) on swallowing and cough reflex were evaluated in the two experimental models in conscious dogs. To evaluate the effects of atropine on swallowing, 1 mL of marker (contrast medium) was injected into the pharynx under X-ray exposure to induce swallowing. Baclofen, used as a positive control, caused marker congestion in the upper esophagus. In our experimental model, atropine (0.02 and 0.1 mg/kg, i.v.) dose-dependently increased not only the number of marker congestions but also that of the swallows. In addition, atropine significantly shortened the onset of first swallowing. In the evaluation of atropine effects on electrically evoked cough reflex induced by two electrodes implanted into the trachea, atropine strongly inhibited the number of coughs at 0.01 or 0.05 mg/kg accompanied with 0.01 or 0.05 mg/kg per hour (i.v.), respectively. These findings indicate that atropine has the potential of causing aspiration pneumonia through induction of swallowing disorder and inhibition of the cough reflex.

  13. Cine MRI of swallowing in patients with advanced oral or oropharyngeal carcinoma: a feasibility study.

    PubMed

    Kreeft, Anne Marijn; Rasch, Coen R N; Muller, Sara H; Pameijer, Frank A; Hallo, Eeke; Balm, Alfons J M

    2012-06-01

    Treatment of oral and oropharyngeal cancer may cause dysphagia. Purpose is to examine whether cine magnetic resonance imaging (MRI) yields additional information compared to standard examination in the evaluation of posttreatment dysphagia and mobility of oral and oropharyngeal structures. Thirty-four cine MRIs were made in 23 patients with advanced oral and oropharyngeal cancer, consisting of an MR image every 800 ms during swallowing which is compared to videofluoroscopy and quality of life questionnaires. A scoring system was applied to assess mobility on cine MR and videofluoroscopy leading to a score ranging from 9 to 17. Cine MRI of the swallowing in a midsagittal plane visualized the tumor (if located in the same plane), important anatomic structures and surgical reconstructions. Posttreatment mobility on cine MRI and videofluoroscopy was significantly diminished compared to pretreatment, mean pretreatment cine MRI score was 10.8 and posttreatment 12.4 (p = 0.017). Impaired mobility on cine MRI was significantly correlated to more swallowing problems (Spearman's correlation coefficient 0.73, p = 0.04), on videofluoroscopy not. Cine MRI is a promising new technique as an adjunct to standard examinations for evaluation of swallowing in patients with oral and oropharyngeal cancer. Cine MRI directly visualizes the dynamics of swallowing and allows evaluation of pre- and posttreatment differences. Abnormal findings are significantly correlated with subjective swallowing complaints of patients.

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

    PubMed

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

    2015-12-07

    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.

  15. 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.

  16. 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)

  17. 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

  18. Disability Insurance

    PubMed Central

    Williamson, Elliot A.

    1985-01-01

    A disability insurance policy provides specified income benefits when the insured person becomes unable to work because of illness or accident. With an individual policy, the insured person is generally the policy holder. With a group plan, the employer is the policy holder. An individual policy can provide several optional benefits in addition to disability benefits, which are not available in a group plan. In assessing risk, the insurer uses the application, the agent's report, a physical examination, the attending physician's report, and sometimes a consumer investigation company's inspection report. Records from the Medical Information Bureau, an association of American and Canadian life insurance companies, may also be used. The process of claims adjudication is described, as are differences between short-term and long-term disability claims. Many group policies have a rehabilitation provision; payments may continue while the claimant undergoes rehabilitation or retraining. Imagesp1928-a PMID:21274206

  19. 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.

  20. [Cervicogenic dysphagia: swallowing difficulties caused by functional and organic disorders of the cervical spine].

    PubMed

    Grgić, Vjekoslav

    2013-01-01

    Cervical spine disorders which can cause swallowing difficulties (cervicogenic dysphagia; CD) are: chronic multisegmental/MS dysfunction (dysfunction=functional blockade) of the facet joints, changes in physiological curvature of the cervical spine, degenerative changes (anterior osteophytes, anterior disc herniation, osteochondrosis, osteoarthritis), inflammatory rheumatic diseases, diffuse idiopathic skeletal hyperostosis, injuries, conditions after anterior cervical spine surgery, congenital malformations and tumors. According to our clinical observations, degenerative changes in the cervical discs and facet joints and chronic MS dysfunction of the cervical spine facet joints are disorders which can cause swallowing difficulties. However, these disorders have not been recognized enough as the causes of dysphagia and they are not even mentioned in differential diagnosis. Because of the close anatomical relationship of cervical spine with the pharynx and cervical part of esophagus, the consequences of the degenerative changes in the cervical discs and facet joints and chronic MS dysfunction of the cervical spine facet joints such as the changes in the physiological curvature of the cervical spine, changes in elasticity and contractility in the neck muscles and decreased mobility of the cervical spine, adversely affect the dimensions of the pharynx and cervical part of esophagus, that is, swallowing capacity which can result in dysphagia. Degenerative changes in the cervical discs and facet joints are common additional cause of dysphagia in elderly people with disorders of the central control of swallowing (stroke, Parkinson's disease, senile dementia etc). The most important therapeutic options in patients with CD are: medicamentous therapy, physical therapy, manual therapy, kinesiotherapy and surgical treatment. The aim of the conservative therapy in patients with CD is to improve the swallowing capacity (for example, soft tissue techniques, stretching of the

  1. 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

  2. Measuring Competency Development in Objective Evaluation of Videofluoroscopic Swallowing Studies.

    PubMed

    Nordin, Natrah Ahmad; Miles, Anna; Allen, Jacqui

    2017-01-11

    Clinical interpretation of videofluoroscopic swallow study (VFSS) has often been criticized for its poor objectivity and inter-rater agreement. In order to address this, objective VFSS measures have been developed, reported and demonstrated to be valid and reliable. However, widespread clinical implementation is lacking. Reasons cited include lack of training and excessive time taken to perform measures. This study investigated competency development in selected standardized objective VFSS measures among speech-language pathologists (SLPs) naive to quantitative measurement. Six novice (no VFSS experience) and four experienced (2-10 years of VFSS experience) SLPs participated in 4 h of training in how to perform selected objective VFSS measures including pharyngeal constriction ratio, maximum pharyngoesophageal opening, pharyngoesophageal opening duration, airway closure duration and total pharyngeal transit time. Each week for eight weeks, participants were asked to independently measure and report three VFSS of patients affected by stroke. By week 8, all SLPs, irrespective of prior experience level, were able to achieve 80% accuracy in measures in comparison to the consensus of three expert clinicians. SLPs' mean time for completion reduced from 50 min in week 1-25 min in week 8. Inter-rater agreement for measures improved across the eight-week period (range ICC = -31.05 to .60 in week 1 to ICC = .71 to .98 in week 8). There was high agreement in location of impairment and consequent management recommendations by week 8. In conclusion, SLPs can reliably learn and incorporate objective VFSS measures within a reasonable time frame. Level of experience has limited influence on the learning curve.

  3. Use of Videofluoroscopic Swallowing Study in Patients with Aspiration Pneumonia

    PubMed Central

    Park, Seunglee; Lee, Jin-Youn; Jung, Heeyoune; Koh, Seong-Eun; Lee, In-Sik; Yoo, Kwang Ha; Lee, Seung Ah

    2012-01-01

    Objective To investigate the clinical characteristics of dysphagic elderly Korean patients diagnosed with aspiration pneumonia as well as to examine the necessity of performing a videofluoroscopic swallowing study (VFSS) in order to confirm the presence of dysphagia in such patients. Method The medical records of dysphagic elderly Korean subjects diagnosed with aspiration pneumonia were retrospectively reviewed for demographic and clinical characteristics as well as for VFSS findings. Results In total, medical records of 105 elderly patients (81 men and 24 women) were reviewed in this study. Of the 105 patients, 82.9% (n=87) were admitted via the emergency department, and 41.0% (n=43) were confined to a bed. Eighty percent (n=84) of the 105 patients were diagnosed with brain disorders, and 68.6% (n=72) involved more than one systemic disease, such as diabetes mellitus, cancers, chronic cardiopulmonary disorders, chronic renal disorders, and chronic liver disorders. Only 66.7% (n=70) of the 105 patients underwent VFSS, all of which showed abnormal findings during the oral or pharyngeal phase, or both. Conclusion In this study, among 105 dysphagic elderly patients with aspiration pneumonia, only 66.7% (n=70) underwent VFSS in order to confirm the presence of dysphagia. As observed in this study, the evaluation of dysphagia is essential in order to consider elderly patients with aspiration pneumonia, particularly in patients with poor functional status, brain disorders, or more than one systemic disease. A greater awareness of dysphagia in the elderly, as well as the diagnostic procedures thereof, particularly VFSS, is needed among medical professionals in Korea. PMID:23342310

  4. Understanding Disabilities.

    ERIC Educational Resources Information Center

    Hartwell, Richard D.

    2001-01-01

    A language arts teacher at a California middle school describes an exercise he developed to help students understand disabilities through virtual, firsthand experience. As students simulate being blind, unable to walk, they learn how to adjust, innovate, compensate, cooperate, and empathize with one another. (MLH)

  5. 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 surveyed and…

  6. Swallowing disorders in nursing home residents: how can the problem be explained?

    PubMed Central

    Nogueira, Dália; Reis, Elizabeth

    2013-01-01

    Background The swallowing mechanism changes significantly as people age, even in the absence of chronic diseases. Presbyphagia, a term that refers to aging-related changes in the swallowing mechanism, may be linked to many health conditions and presents itself in distinct ways. Swallowing disorders are also identified as a major problem amongst the elderly population living in nursing homes. Methods The study sought to determine the prevalence of swallowing disorders in nursing home residents, to identify the relationship between self-perceived swallowing disorders, cognitive functions, autonomy, and depression, and also to analyze which variables explain the score of the Dysphagia Self-Test (DST). For this purpose, the researchers chose to apply a survey conveying questions on demographic aspects, general health, eating and feeding, as well as instruments to assess functional performance and the 3 ounce Water Swallow Test. Results The sample consisted of 272 elderly people living in eight nursing homes in Portugal. Six did not sign the informed consent form. Of the total, 29% were totally dependent, 33% were depressed, 45% had cognitive impairment, and 38% needed help with feeding. About 43% of the individuals reported having problems related to eating. Regarding the DST, 40% showed signs of dysphagia. With respect to the 3 ounce Water Swallow Test, 38% revealed at least one of the symptoms, wet voice being the most prevalent. Correlation measures showed that age had no linear association with the DST score although correlation with the Barthel Index and Mini Mental State Examination was found to be significant. A linear regression model was estimated with the DST score as the dependent variable and the MMSE and BI scores, gender, age, education, the Geriatric Depression Scale score, 3 ounce Water Swallow Test, and diagnosed conditions (such as neurological disorder, dementia, and cardiorespiratory problems) as explaining variables. Conclusion Results showed a

  7. MBS measurement tool for swallow impairment--MBSImp: establishing a standard.

    PubMed

    Martin-Harris, Bonnie; Brodsky, Martin B; Michel, Yvonne; Castell, Donald O; Schleicher, Melanie; Sandidge, John; Maxwell, Rebekah; Blair, Julie

    2008-12-01

    The aim of this study was to test reliability, content, construct, and external validity of a new modified barium swallowing study (MBSS) tool (MBSImp) that is used to quantify swallowing impairment. Multiple regression, confirmatory factor, and correlation analyses were used to analyze 300 in- and outpatients with heterogeneous medical and surgical diagnoses who were sequentially referred for MBS exams at a university medical center and private tertiary care community hospital. Main outcome measures were the MBSImp and index scores of aspiration, health status, and quality of life. Inter- and intrarater concordance were 80% or greater for blinded scoring of MBSSs. Regression analysis revealed contributions of eight of nine swallow types to impressions of overall swallowing impairment (p < or = 0.05). Factor analysis revealed 13 significant components (loadings >/= 0.5) that formed two impairment groupings (oral and pharyngeal). Significant correlations were found between Oral and Pharyngeal Impairment scores and Penetration-Aspiration Scale scores, and indexes of intake status, nutrition, health status, and quality of life. The MBSImp demonstrated clinical practicality, favorable inter- and intrarater reliability following standardized training, content, and external validity. This study reflects potential for establishment of a new standard for quantification and comparison of oropharyngeal swallowing impairment across patient diagnoses as measured on MBSS.

  8. 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, Jeffrey 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.

  9. 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.

  10. MBS Measurement Tool for Swallow Impairment—MBSImp: Establishing a Standard

    PubMed Central

    Martin-Harris, Bonnie; Brodsky, Martin B.; Michel, Yvonne; Castell, Donald O.; Schleicher, Melanie; Sandidge, John; Maxwell, Rebekah; Blair, Julie

    2014-01-01

    The aim of this study was to test reliability, content, construct, and external validity of a new modified barium swallowing study (MBSS) tool (MBSImp) that is used to quantify swallowing impairment. Multiple regression, confirmatory factor, and correlation analyses were used to analyze 300 in- and outpatients with heterogeneous medical and surgical diagnoses who were sequentially referred for MBS exams at a university medical center and private tertiary care community hospital. Main outcome measures were the MBSImp and index scores of aspiration, health status, and quality of life. Inter- and intrarater concordance were 80% or greater for blinded scoring of MBSSs. Regression analysis revealed contributions of eight of nine swallow types to impressions of overall swallowing impairment (p ≤ 0.05). Factor analysis revealed 13 significant components (loadings ≥ 0.5) that formed two impairment groupings (oral and pharyngeal). Significant correlations were found between Oral and Pharyngeal Impairment scores and Penetration-Aspiration Scale scores, and indexes of intake status, nutrition, health status, and quality of life. The MBSImp demonstrated clinical practicality, favorable inter- and intrarater reliability following standardized training, content, and external validity. This study reflects potential for establishment of a new standard for quantification and comparison of oropharyngeal swallowing impairment across patient diagnoses as measured on MBSS. PMID:18855050

  11. Swallowing rehabilitation of dysphagic tracheostomized patients under mechanical ventilation in intensive care units: a feasibility study

    PubMed Central

    Rodrigues, Katia Alonso; Machado, Flávia Ribeiro; Chiari, Brasília Maria; Rosseti, Heloísa Baccaro; Lorenzon, Paula; Gonçalves, Maria Inês Rebelo

    2015-01-01

    Objective The aim of the present study was to assess the feasibility of the early implementation of a swallowing rehabilitation program in tracheostomized patients under mechanical ventilation with dysphagia. Methods This prospective study was conducted in the intensive care units of a university hospital. We included hemodynamically stable patients under mechanical ventilation for at least 48 hours following 48 hours of tracheostomy and with an appropriate level of consciousness. The exclusion criteria were previous surgery in the oral cavity, pharynx, larynx and/or esophagus, the presence of degenerative diseases or a past history of oropharyngeal dysphagia. All patients were submitted to a swallowing rehabilitation program. An oropharyngeal structural score, a swallowing functional score and an otorhinolaryngological structural and functional score were determined before and after swallowing therapy. Results We included 14 patients. The mean duration of the rehabilitation program was 12.4 ± 9.4 days, with 5.0 ± 5.2 days under mechanical ventilation. Eleven patients could receive oral feeding while still in the intensive care unit after 4 (2 - 13) days of therapy. All scores significantly improved after therapy. Conclusion In this small group of patients, we demonstrated that the early implementation of a swallowing rehabilitation program is feasible even in patients under mechanical ventilation. PMID:25909315

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

    PubMed

    Hothem, Roger L; Trejo, Bonnie S; Bauer, Marissa L; Crayon, John J

    2008-07-01

    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 microg/g wet weight (ww) in cliff swallow eggs and from 0.047 to 0.347 microg/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.

  13. Multisensor Classification System for Triggering FES in Order to Support Voluntary Swallowing

    PubMed Central

    Riebold, Benjamin; Nahrstaedt, Holger; Schultheiss, Corinna; Seidl, Rainer O.; Schauer, Thomas

    2016-01-01

    In dysphagia the ability of elevating the larynx and hyoid is usually impaired. Electromyography (EMG) and Bioimpedance (BI) measurements at the neck can be used to trigger functional electrical stimulation (FES) of swallowing related muscles. Nahrstaedt et al.1 introduced an algorithm to trigger the stimulation in phase with the voluntary swallowing to improve the airway closure and elevation speed of the larynx and hyoid. However, due to non-swallow related movements like speaking, chewing or head turning, stimulations might be unintentionally triggered. So far a switch was used to enable the BI/EMG-triggering of FES when the subject was ready to swallow, which is inconvenient for practical use. In this contribution, a range image camera system is introduced to obtain data of head, mouth, and jaw movements. This data is used to apply a second classification step to reduce the number of false stimulations. In experiments with healthy subjects, the amount of potential false stimulations could be reduced by 47% while 83% of swallowing intentions would have been correctely supported by FES. PMID:28078072

  14. Multifunctional laryngeal premotor neurons: their activities during breathing, coughing, sneezing, and swallowing.

    PubMed

    Shiba, Keisuke; Nakazawa, Ken; Ono, Kenichi; Umezaki, Toshiro

    2007-05-09

    To examine whether motor commands of two or more distinct laryngeal motor patterns converge onto a common premotor network, we conducted dual recordings from the laryngeal adductor motoneuron and its premotor neuron within the brainstem respiratory circuitry during fictive breathing, coughing, sneezing, and swallowing in decerebrate paralyzed cats. Expiratory neurons with an augmenting firing pattern (EAUG), whose action potentials evoked monosynaptic IPSPs in the adductor motoneurons, sharply fired during the expulsive phases of fictive coughing and sneezing, during which the adductor motoneurons transiently repolarized. In contrast, these premotor neurons were silent during the swallow-related hyperpolarization in adductor motoneurons. These results show that one class of medullary respiratory neuron, EAUG, is multifunctional and shared among the central pattern generators (CPGs) for breathing, coughing, and sneezing. In addition, although the CPGs underlying these three behaviors and the swallowing CPG do overlap, EAUG neurons are not part of the swallowing CPG and, in contrast to the other three behaviors, are not a source of inhibitory input to adductor motoneurons during swallowing.

  15. 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

  16. Swallowing appliance: intraoral reshaping prosthesis for dysphagia secondary to oral floor cancer: a pilot study.

    PubMed

    Koyama, Yuji; Ota, Yoshihide; Sakaizumi, Kazuo; Simoda, Naoshi; Kodama, Mitsuhiko; Toyokura, Minoru; Masakado, Yoshihisa

    2014-11-01

    Patients with oral floor cancer often have difficulty swallowing solid foods. The aim of this study was to improve the propulsion of solid foods using a swallowing appliance (SW-A). Subjects comprised three patients with oral floor cancer who had undergone curative surgery. Each participant was asked to swallow gelatin under three conditions: without an SW-A, with a maxillary SW-A, and with both maxillary and mandibular SW-As. This procedure was repeated thrice with three volumes of gelatin (2.5, 5, and 7.5 ml), with videofluorographic swallowing study. Swallowing was assessed on the basis of whether the participant could propel the gelatin from the oral cavity to the pharynx. No subject could propel 2.5 ml of gelatin to the pharynx without an SW-A or with only a maxillary SW-A in place. When both SW-As were used, all subjects could propel all three volumes of gelatin. The mandibular SW-A complemented the compensatory effects of the maxillary SW-A.

  17. 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

  18. Sensory and instrumental analysis for slipperiness and compliance of food during swallowing.

    PubMed

    Seo, H-S; Hwang, I K; Han, T R; Kim, I S

    2007-11-01

    In spite of its importance, there have been few attempts to evaluate the sensory attributes of the food bolus during swallowing. In the current study, the slipperiness, the degree of slide for the food bolus through the mucosal surface of the oro-pharynx, and the compliance, how easily the shape of a food bolus can be transformed for automatic and comfortable swallowing, were derived among several sensory attributes related to the swallowing. Therefore, the study aims were twofold: (1) to develop the methods of sensory and instrumental analyses for determining the slipperiness and compliance of the food bolus during swallowing and (2) to examine the appropriateness of the newly designed devices by correlating the data between the sensory and instrumental analyses. Six commercial food products were evaluated by 10 trained panelists for each attribute. The devices for assessing each attribute were developed in consideration of the oro-pharyngeal movements. The sensory and instrumental analyses showed high correlation and regression coefficients as well as intensity differences of the 6 samples for each attribute. In conclusion, the slipperiness and the compliance were suitable for acquiring a better understanding of the sensory attributes of the food bolus during swallowing, and the newly developed devices showed a high potential for determining those attributes.

  19. 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.

  20. Reversible Computing

    DTIC Science & Technology

    1980-02-01

    will have been introduced. 9. Reversible celular autemata We shall assume the reader to have some familiarity with the concept of cel- lular...10003 Mr. Kin B. Thcmpson 1 copy Technical Director Information Systems Divisia.i Naval Research Laboratory (OP-91T) Technical Information Division

  1. REVERSE OSMOSIS,

    DTIC Science & Technology

    acetate membranes. Mechanisms of the process and porous cellulose acetate membrane technology are briefly reviewed. Based on a general capillary...The reverse osmosis process is discussed with particular reference to systems involving aqueous solutions and Loeb-Sourirajan-type porous cellulose

  2. Polychlorinated biphenyl contamination and minisatellite DNA mutation rates of tree swallows.

    PubMed

    Stapleton, M; Dunn, P O; McCarty, J; Secord, A; Whittingham, L A

    2001-10-01

    The evidence that exposure to polychlorinated biphenyls (PCBs) leads to mutations is equivocal and controversial. Using multilocus DNA fingerprinting, we compared the mutation rate of tree swallows (Tachycineta bicolor) nesting at sites with high and low levels of contamination with PCBs. The upper Hudson River, USA, is highly contaminated with PCBs as a result of releases from two capacitor manufacturing plants in Hudson Falls and Fort Edward, New York, USA. Tree swallows nesting nearby have some of the highest known concentrations of PCBs in their tissues of any contemporary bird population (up to 114,000 ng PCB/g tissue). We found no difference in mutation rates between sites in New York with high PCB contamination and reference sites in Wisconsin, USA, and Ontario and Alberta, Canada, with known or presumably low levels of contamination. Thus, the mechanism behind altered reproductive behavior of tree swallows along the upper Hudson River is most likely physiological impairment, such as endocrine disruption, rather than mutation.

  3. 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

  4. Cricothyroid approximation for voice and swallowing rehabilitation of high vagal paralysis secondary to skull base neoplasms.

    PubMed

    Thakar, Alok; Sikka, Kapil; Verma, Rohit; Preetam, C

    2011-11-01

    This study documents the speech and swallowing outcomes of isolated ipsilateral cricothyroid approximation (aka tensioning thyroplasty; Type IV thyroplasty) for the treatment of high vagal paralysis (combined superior laryngeal nerve and recurrent laryngeal nerve paralysis). This is a pilot study of five cases with high vagal paralysis consequent to skull base neoplasms. Unilateral cricothyroid tensioning sutures were used. In all cases, vocal fold tensioning and vertical realignment of lax vocal folds were achieved. A partial, but acceptable medialization of vocal cord position was achieved. In all cases, aspiration was minimized and normal swallow function was restored by 6 weeks. The voice outcome was excellent in four cases and acceptable in one. Cricothyroid approximation restores vocal fold tension; in addition, it restores vertical vocal fold position and partially restores horizontal vocal fold position. Good voice and swallowing outcomes have been achieved. The procedure is quick, safe, and convenient when combined with a skull-base excision procedure. Further evaluation is merited.

  5. Climate change has affected the breeding date of tree swallows throughout North America

    PubMed

    Dunn; Winkler

    1999-12-22

    Increasing evidence suggests that climate change has affected the breeding and distribution of wildlife. If such changes are due to global warming, then we should expect to see large-scale effects. To explore for such effects on avian reproduction, we examined 3450 nest records of tree swallows from across North America. The egg-laying date in tree swallows advanced by up to nine days during 1959-1991. This advance in phenology was associated with increasing surface air temperatures at the time of breeding. Our analysis controlled for several potentially confounding variables such as latitude, longitude, breeding density and elevation. We conclude that tree swallows across North America are breeding earlier and that the most likely cause is a long-term increase in spring temperature.

  6. Measurement of hyoid and laryngeal displacement in video fluoroscopic swallowing studies: variability, reliability, and measurement error.

    PubMed

    Sia, Isaac; Carvajal, Pamela; Carnaby-Mann, Giselle D; Crary, Michael A

    2012-06-01

    Video fluoroscopy is commonly used in the study of swallowing kinematics. However, various procedures used in linear measurements obtained from video fluoroscopy may contribute to increased variability or measurement error. This study evaluated the influence of calibration referent and image rotation on measurement variability for hyoid and laryngeal displacement during swallowing. Inter- and intrarater reliabilities were also estimated for hyoid and laryngeal displacement measurements across conditions. The use of different calibration referents did not contribute significantly to variability in measures of hyoid and laryngeal displacement but image rotation affected horizontal measures for both structures. Inter- and intrarater reliabilities were high. Using the 95% confidence interval as the error index, measurement error was estimated to range from 2.48 to 3.06 mm. These results address procedural decisions for measuring hyoid and laryngeal displacement in video fluoroscopic swallowing studies.

  7. 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.

  8. Simulation of swallowing dysfunction and mechanical ventilation after a Montgomery T-tube insertion.

    PubMed

    Trabelsi, O; Malvè, M; Mena Tobar, A; Doblaré, M

    2015-01-01

    The Montgomery T-tube is used as a combined tracheal stent and airway after laryngotracheoplasty, to keep the lumen open and prevent mucosal laceration from scarring. It is valuable in the management of upper and mid-tracheal lesions, while invaluable in long and multisegmental stenting lesions. Numerical simulations based on real-patient-tracheal geometry, experimental tissue characterization, and previous numerical estimation of the physiological swallowing force are performed to estimate the consequences of Montgomery T-tube implantation on swallowing and assisted ventilation: structural analysis of swallowing is performed to evaluate patient swallowing capacity, and computational fluid dynamics simulation is carried out to analyze related mechanical ventilation. With an inserted Montgomery T-tube, vertical displacement (Z-axis) reaches 8.01 mm, whereas in the Y-axis, it reaches 6.63 mm. The maximal principal stress obtained during swallowing was 1.6 MPa surrounding the hole and in the upper contact with the tracheal wall. Fluid flow simulation of the mechanical ventilation revealed positive pressure for both inhalation and exhalation, being higher for inspiration. The muscular deflections, considerable during normal breathing, are nonphysiological, and this aspect results in a constant overload of the tracheal muscle. During swallowing, the trachea ascends producing a nonhomogeneous elongation. This movement can be compromised when prosthesis is inserted, which explains the high incidence of glottis close inefficiency. Fluid simulations showed that nonphysiological pressure is established inside the trachea due to mechanical ventilation. This may lead to an overload of the tracheal muscle, explaining several related problems as muscle thinning or decrease in contractile function.

  9. A Novel Imaging Analysis Method for Capturing Pharyngeal Constriction During Swallowing

    PubMed Central

    Schwertner, Ryan W.; Garand, Kendrea L.; Pearson, William G.

    2016-01-01

    Videofluoroscopic imaging of swallowing known as the Modified Barium Study (MBS) is the standard of care for assessing swallowing difficulty. While the clinical purpose of this radiographic imaging is to primarily assess aspiration risk, valuable biomechanical data is embedded in these studies. Computational analysis of swallowing mechanics (CASM) is an established research methodology for assessing multiple interactions of swallowing mechanics based on coordinates mapping muscle function including hyolaryngeal movement, pharyngeal shortening, tongue base retraction, and extension of the head and neck, however coordinates characterizing pharyngeal constriction is undeveloped. The aim of this study was to establish a method for locating the superior and middle pharyngeal constrictors using hard landmarks as guides on MBS videofluoroscopic imaging, and to test the reliability of this new method. Twenty de-identified, normal, MBS videos were randomly selected from a database. Two raters annotated landmarks for the superior and middle pharyngeal constrictors frame-by-frame using a semi-automated MATLAB tracker tool at two time points. Intraclass correlation coefficients were used to assess test-retest reliability between two raters with an ICC = 0.99 or greater for all coordinates for the retest measurement. MorphoJ integrated software was used to perform a discriminate function analysis to visualize how all 12 coordinates interact with each other in normal swallowing. The addition of the superior and middle pharyngeal constrictor coordinates to CASM allows for a robust analysis of the multiple components of swallowing mechanics interacting with a wide range of variables in both patient specific and cohort studies derived from common use imaging data.

  10. A Novel Imaging Analysis Method for Capturing Pharyngeal Constriction During Swallowing.

    PubMed

    Schwertner, Ryan W; Garand, Kendrea L; Pearson, William G

    2016-01-01

    Videofluoroscopic imaging of swallowing known as the Modified Barium Study (MBS) is the standard of care for assessing swallowing difficulty. While the clinical purpose of this radiographic imaging is to primarily assess aspiration risk, valuable biomechanical data is embedded in these studies. Computational analysis of swallowing mechanics (CASM) is an established research methodology for assessing multiple interactions of swallowing mechanics based on coordinates mapping muscle function including hyolaryngeal movement, pharyngeal shortening, tongue base retraction, and extension of the head and neck, however coordinates characterizing pharyngeal constriction is undeveloped. The aim of this study was to establish a method for locating the superior and middle pharyngeal constrictors using hard landmarks as guides on MBS videofluoroscopic imaging, and to test the reliability of this new method. Twenty de-identified, normal, MBS videos were randomly selected from a database. Two raters annotated landmarks for the superior and middle pharyngeal constrictors frame-by-frame using a semi-automated MATLAB tracker tool at two time points. Intraclass correlation coefficients were used to assess test-retest reliability between two raters with an ICC = 0.99 or greater for all coordinates for the retest measurement. MorphoJ integrated software was used to perform a discriminate function analysis to visualize how all 12 coordinates interact with each other in normal swallowing. The addition of the superior and middle pharyngeal constrictor coordinates to CASM allows for a robust analysis of the multiple components of swallowing mechanics interacting with a wide range of variables in both patient specific and cohort studies derived from common use imaging data.

  11. 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

  12. Speech and swallow rehabilitation in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.

    PubMed

    Clarke, P; Radford, K; Coffey, M; Stewart, M

    2016-05-01

    This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. The disease itself and the treatment can have far reaching effects on speech and swallow function, which are consistently prioritised by survivors as an area of concern. This paper provides recommendations on the assessments and interventions for speech and swallow rehabilitation in this patient group. Recommendations • All multidisciplinary teams should have rehabilitation patient pathways covering all stages of the patient's journey including multidisciplinary and pre-treatment clinics. (G) • Clinicians treating head and neck cancer patients should consult the National Cancer Rehabilitation Pathway for head and neck cancers. (G) • All head and neck cancer patients should have a pre-treatment assessment of speech and swallowing. (G) • A programme of prophylactic exercises and the teaching of swallowing manoeuvres can reduce impairments, maintain function and enable a speedier recovery. (R) • Continued speech and language therapist input is important in maintaining voice and safe and effective swallow function following head and neck cancer treatment. (R) • Disease recurrence must be ruled out in the management of stricture and/or stenosis. (R) • Continuous radial expansion balloons offer a safe, effective dilation method with advantages over gum elastic bougies. (R) • Site, length and completeness of strictures as well as whether they are in the presence of the larynx or not, need to be assessed when establishing the likelihood of surgically improved outcome. (G) • Primary surgical voice restoration should be offered to all patients undergoing laryngectomy. (R) • Attention to surgical detail and long-term speech and language therapist input is required to optimise speech and swallowing after laryngectomy. (G) • Patients should commence wearing heat and moisture exchange devices as soon as possible after

  13. 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.

  14. 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…

  15. Auditory verbal cues alter the perceived flavor of beverages and ease of swallowing: a psychometric and electrophysiological analysis.

    PubMed

    Nakamura, Aya; Imaizumi, Satoshi

    2013-01-01

    We investigated the possible effects of auditory verbal cues on flavor perception and swallow physiology for younger and elder participants. Apple juice, aojiru (grass) juice, and water were ingested with or without auditory verbal cues. Flavor perception and ease of swallowing were measured using a visual analog scale and swallow physiology by surface electromyography and cervical auscultation. The auditory verbal cues had significant positive effects on flavor and ease of swallowing as well as on swallow physiology. The taste score and the ease of swallowing score significantly increased when the participant's anticipation was primed by accurate auditory verbal cues. There was no significant effect of auditory verbal cues on distaste score. Regardless of age, the maximum suprahyoid muscle activity significantly decreased when a beverage was ingested without auditory verbal cues. The interval between the onset of swallowing sounds and the peak timing point of the infrahyoid muscle activity significantly shortened when the anticipation induced by the cue was contradicted in the elderly participant group. These results suggest that auditory verbal cues can improve the perceived flavor of beverages and swallow physiology.

  16. Multi-year survival, growth and maturation of invasive swallow-wort juveniles (Vincetoxicum spp.) across a habitat gradient

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Vincetoxicum rossicum, pale swallow-wort [PSW], and V. nigrum, black swallow-wort [BSW] are two non-native perennial vines that are increasingly problematic in many regions of the northeastern US and southern Canada. The two species can grow in full sun or shaded forest understories, and infest a v...

  17. 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.

  18. Incoordination of sucking, swallowing, and breathing as an etiology for breastfeeding difficulty.

    PubMed

    Glass, R P; Wolf, L S

    1994-09-01

    This case report describes an infant who presented with coughing and choking during breastfeeding. Comprehensive clinical evaluation of these difficulties included assessment of sucking, swallowing, and breathing. Stridor and difficulty interspersing breaths during sucking bursts were observed, although sucking mechanics were normal. Further evaluation of airway structure revealed asymmetric laryngomalacia. This structural problem, exacerbated by the breastfeeding position, impeded respiration and resulted in poor coordination of sucking, swallowing, and breathing. This case underscores the need to include respiratory function and coordination in the evaluation of breastfeeding difficulties.

  19. Comprehensive swallowing exercises to treat complicated dysphagia caused by esophageal replacement with colon

    PubMed Central

    Jiang, Li; Wang, Yujue; Li, Na; Qiu, Weihong; Wu, Huixiang; Huo, Jianshan; Dai, Meng; Yu, Yong; Wan, Guifang; Dou, Zulin; Guo, Weiping

    2017-01-01

    Abstract Introduction: Surgical procedures for colonic replacement of the esophagus are most commonly associated with anastomotic stricture which cause dysphagia. In this report, we describe a rare case of a patient who demonstrated dysphagia resulting from an anastomotic stricture following esophageal replacement with the colon. All the treatments to dilate the anastomotic stricture were ineffective. To investigate the new treatment strategy for a case with complicated dysphagia, clinical dysphagia evaluations, functional oral intake scale (FOIS), videofluoroscopic swallowing study as well as high-resolution manometry were used to evaluate the swallowing function of the patient before and after treatments. Interventions: Comprehensive swallowing exercises included the protective airway maneuver, tongue pressure resistance feedback exercise, Masako Maneuver swallowing exercise, and the effortful swallowing exercise. Outcomes: Comprehensive swallowing exercises showed good effect in the patient. The FOIS score increased from level 1 to level 7. The videofluoroscopy digital analysis showed that the pharynx constriction rate was 23% and 50%, before and after treatment, respectively. The data from the high-resolution manometry displayed that: the value of the velopharyngeal pressure peak was 82.8 mmHg before treatment and 156.9 mmHg after treatment; the velopharyngeal contraction duration time was 310 milliseconds before treatment and 525 milliseconds after treatment; the value of the hypopharynx pressure peak was 53.7 mmHg before treatment and 103.2 mmHg after treatment; and the hypopharynx contraction duration time was 390 milliseconds before treatment and 1030 milliseconds after treatment. The swallowing visualization illustrated that a bolus could normally pass through the anastomotic stoma, and the bolus leakage was no longer present. The patient was able to eat various consistencies of food independently, and we were able to remove the jejunum nutrient

  20. Duodenal perforation because of swallowed ballpoint pen and its laparoscopic management: report of a case.

    PubMed

    Golffier, Claudio; Holguin, Francia; Kobayashi, Akihiko

    2009-03-01

    Accidental ingestion of foreign objects by teenagers or young adults without mental impairment is a rare event. We present a case of a patient who unintentionally swallowed a ballpoint pen several days before seeking medical attention. She concealed the event until abdominal radiographs revealed the foreign object. Because swallowed foreign objects can be potentially harmful, they should be removed endoscopically as soon as possible to prevent development of complications. At times, they need to be removed operatively. This report describes the laparoscopic removal of a ballpoint pen that perforated the duodenum.

  1. 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.

  2. A videofluoroscopic study comparing severe swallowing disorders in patients treated surgically or with radiation for oropharyngeal cancer.

    PubMed

    Santini, L; Robert, D; Lagier, A; Giovanni, A; Dessi, P; Fakhry, N

    2015-06-01

    The aim of this study was to analyze the causal mechanisms of severe swallowing disorders after the treatment of oropharyngeal cancer. Twenty-six patients with severe swallowing disorders at ≥12 months after treatment for oropharyngeal cancer were analyzed retrospectively using videofluoroscopy. Fourteen patients (54%) had been treated with surgery (±postoperative radiotherapy), while 12 patients (46%) had been treated with (chemo)radiotherapy. Videofluoroscopy analysis showed a localized alteration in the surgical excision area resulting in impaired tongue root retraction in the surgical group (P=0.012), while general impairment of the pharyngeal, laryngeal, and upper oesophagus sphincter was found in the non-surgical group. Aspirations in the surgical group most often occurred after swallowing, while in the non-surgical group, they occurred during and after swallowing (P=0.039). This analysis by videofluoroscopy provides important insights into the mechanisms giving rise to swallowing disorders after the treatment of oropharyngeal cancer.

  3. Non-Disabled Children's Ideas about Disability and Disabled People

    ERIC Educational Resources Information Center

    Beckett, Angharad E.

    2014-01-01

    This article discusses findings from an Economic and Social Research Council-funded study exploring non-disabled children's ideas about disability. This represents the first in-depth sociological investigation of children's ideas about disabled people as members of wider society. Data are presented from focus group discussions with children aged…

  4. 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

  5. Reflections on the brainstem dysfunction in neurologically disabled children.

    PubMed

    Saito, Yoshiaki

    2009-08-01

    This article deals with the neurological basis of brainstem-related symptoms in disabled children. Synaptic interactions of respiratory and swallowing centers, which are briefly reviewed in this study, highlight the significance of the nucleus of solitary tract (NTS) in the stereotyped motor events. Coordination mechanisms between these two central pattern generators are also studied with a focus on the inhibitory action of decrementing expiratory neurons that terminate the inspiratory activity and become activated during swallowing. Dorsal brainstem lesions in hypoxic-ischemic encephalopathy (HIE) affect the area including NTS, and result in symptoms of apneusis, facial nerve paresis, dysphagia, gastroesophageal reflux, and laryngeal stridor. Leigh syndrome patients with similar distributions of medullary lesions show increased sighs, post-sigh apnea, hiccups, and vomiting in addition to the symptoms of HIE, suggesting pathologically augmented vagal reflex pathways. The present article also discusses the pathophysiology of laryngeal dystonia in xeroderma pigmentosum group A, self-mutilation in Lesch-Nyhan syndrome, and sudden unexpected death in Fukuyama congenital muscular dystrophy. Close observation and logical assessment of brainstem dysfunction symptoms should be encouraged in order to achieve better understanding and management of these symptoms in disabled children.

  6. Learning Disabilities in Campers.

    ERIC Educational Resources Information Center

    Peniston, Lorraine C.

    1999-01-01

    Notes that camp directors and counselors should be familiar with learning disabilities. Defines learning disabilities and explains accommodations of materials, procedures, and equipment; modification of activities; individuals' learned compensation strategies; and communication issues. Sidebar defines types of learning disabilities. (SAS)

  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. 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. 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.…

  10. 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…

  11. 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.

  12. 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...

  13. 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...

  14. 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…

  15. Effects of club soda and ginger brew on linguapalatal pressures in healthy swallowing.

    PubMed

    Krival, Kate; Bates, Crystal

    2012-06-01

    Oral chemesthesis is the detection of chemicals that activate temperature and pain receptors in the oral mucosa. Presentation of orally chemesthetic input has been theorized to stimulate a faster, stronger swallow. We measured differences in peak linguapalatal swallowing pressures, pressure durations, and pressure adjustments in response to two volumes of water and carbonation (in Schweppes® Club Soda) and carbonation + gingerol (in Reed's Extra Ginger Brew) in 20 young adult women. There was a main effect of stimulus on linguapalatal swallowing pressure, F(6,74) = 6.247, p = 0.000, hp(2) = 0.536 (Reed's Extra Ginger Brew > Schweppes Club Soda > water). Rising and releasing linguapalatal pressure durations were greater for carbonation + gingerol and carbonation than for water. Our results add to the evidence that orally chemesthetic beverages influence greater neuromotor activity compared to water during the oral stage of swallowing. Our findings also suggest that there may be some benefit to the cumulative addition of chemosensory agents in a beverage. Clinically, this provides a theoretical basis for considering the use of these or chemically similar beverages as facilitating stimuli in patients who aspirate thin liquids.

  16. Pharyngeal swallow adaptations to bolus volume measured with high resolution manometry

    PubMed Central

    Hoffman, Matthew R.; Ciucci, Michelle R.; Mielens, Jason D.; Jiang, Jack J.; McCulloch, Timothy M.

    2012-01-01

    Objective To determine the effect of bolus volume on pharyngeal swallowing using high resolution manometry (HRM). Study design Repeated measures with subjects serving as own controls. Methods Twelve subjects swallowed four bolus volumes in the neutral head position: saliva; 5 ml water; 10 ml water; and 20 ml water. Pressure measurements were taken along the length of the pharynx using a high resolution manometer, with emphasis placed on the velopharynx, tongue base, and upper esophageal sphincter (UES). Variables were analyzed across bolus volumes using three-way repeated measures analysis of co-variance (ANCOVA) investigating the effect of sex, bolus volume, and pharynx length. Pearson’s product moment tests were performed to evaluate how pharyngeal pressure and timing events changed across bolus volume. Results Velopharyngeal duration, maximum tongue base pressure, tongue base pressure rise rate, UES opening duration, and total swallow duration varied significantly across bolus volume. Sex did not have an effect, while pharynx length appeared to affect tongue base pressure duration. Maximum velopharyngeal pressure and minimum UES pressure had a direct relationship with bolus volume, while maximum tongue base pressure had an inverse relationship. Velopharyngeal pressure duration, UES opening duration, and total swallow duration increased as bolus volume increased. Conclusions Differences in pharyngeal pressures and timing of key pressure events were detected across varying bolus volumes. Knowing the relationships between bolus volume and pharyngeal pressure activity can be valuable when diagnosing and treating dysphagic patients. Level of evidence N/A. PMID:21108425

  17. 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).

  18. 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).

  19. 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.; Adams, N.J.; Slotow, R.H.

    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.

  20. 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

    2014-10-17

    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.

  1. Development of a System to Monitor Laryngeal Movement during Swallowing Using a Bend Sensor

    PubMed Central

    Li, Qiang; Hori, Kazuhiro; Minagi, Yoshitomo; Ono, Takahiro; Chen, Yong-jin; Kondo, Jyugo; Fujiwara, Shigehiro; Tamine, Kenichi; Hayashi, Hirokazu; Inoue, Makoto; Maeda, Yoshinobu

    2013-01-01

    Background Swallowing dysfunction (also known as dysphagia), which results in a deterioration of nutritional intake, slows rehabilitation and causes aspiration pneumonia, is very common following neurological impairments. Although videofluorographic (VF) examination is widely used for detecting aspiration, an objective and non-invasive method for assessing swallowing function has yet to be established because of a lack of adequate devices and protocols. In this paper, a bend sensor whose resistance is altered by bending was introduced to monitor swallowing-related laryngeal movement. Methods Six healthy male volunteers were recruited in the present study. Specific time points on the signal waveform produced by the bend sensor were defined to describe laryngeal movement by differential analysis. Additionally, the physiological significance of the obtained waveform was confirmed by analyzing the sequential correlations between the signal waveform from the bend sensor and hyoid bone kinetics simultaneously recorded by VF. Results Seven time points were successfully defined on the signal waveform to reference laryngeal movement. Each time point was well correlated with certain VF events, with evidence of no significant time lags, and there were positive correlations between waveform time points and matched VF events. Furthermore, obvious similarities were noticed between the duration of each phase on the signal waveform and the duration of the matched hyoid bone activity. Conclusions The present monitoring system using a bend sensor might be useful for observing the temporal aspects of laryngeal movement during swallowing, and it was well coordinated with hyoid bone movement. PMID:23940652

  2. 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)

  3. 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…

  4. Swallowing disorders, pneumonia and respiratory tract infectious disease in the elderly.

    PubMed

    Puisieux, F; D'Andrea, C; Baconnier, P; Bui-Dinh, D; Castaings-Pelet, S; Crestani, B; Desrues, B; Ferron, C; Franco, A; Gaillat, J; Guenard, H; Housset, B; Jeandel, C; Jebrak, G; Leymarie-Saddles, A; Orvoen-Frija, E; Piette, F; Pinganaud, G; Salle, J-Y; Strubel, D; Vernejoux, J-M; de Wazières, B; Weil-Engerer, S

    2011-10-01

    Swallowing disorders (or dysphagia) are common in the elderly and their prevalence is often underestimated. They may result in serious complications including dehydration, malnutrition, airway obstruction, aspiration pneumonia (infectious process) or pneumonitis (chemical injury caused by the inhalation of sterile gastric contents). Moreover the repercussions of dysphagia are not only physical but also emotional and social, leading to depression, altered quality of life, and social isolation. While some changes in swallowing may be a natural result of aging, dysphagia in the elderly is mainly due to central nervous system diseases such as stroke, parkinsonism, dementia, medications, local oral and oesophageal factors. To be effective, management requires a multidisciplinary team approach and a careful assessment of the patient's oropharyngeal anatomy and physiology, medical and nutritional status, cognition, language and behaviour. Clinical evaluation can be completed by a videofluoroscopic study which enables observation of bolus movement and movements of the oral cavity, pharynx and larynx throughout the swallow. The treatment depends on the underlying cause, extent of dysphagia and prognosis. Various categories of treatment are available, including compensatory strategies (postural changes and dietary modification), direct or indirect therapy techniques (swallow manoeuvres, medication and surgical procedures).

  5. 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…

  6. 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…

  7. 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…

  8. 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.; Adams, N.J.; Slotow, R.H.

    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.

  9. Numerical simulation of interaction between organs and food bolus during swallowing and aspiration.

    PubMed

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

    2017-01-01

    The mechanism of swallowing is still not fully understood, because the process of swallowing is a rapid and complex interaction among several involved organs and the food bolus. In this work, with the aim of studying swallowing and aspiration processes noninvasively and systematically, a computer simulation method for analyzing the involved organs and water (considered as the food bolus) is proposed. The shape and motion of the organs involved in swallowing are modeled in the same way as in our previous study, by using the Hamiltonian moving particle simulation (MPS) method and forced displacements on the basis of motion in a healthy volunteer. The bolus flow is simulated using the explicit MPS method for fluid analysis. The interaction between the organs and the bolus is analyzed using a fluid-structure coupling scheme. To validate the proposed method, the behavior of the simulated bolus flow is compared qualitatively and quantitatively with corresponding medical images. In addition to the healthy motion model, disorder motion models are constructed for reproducing the aspiration phenomenon by computer simulation. The behaviors of the organs and the bolus considered as the food bolus in the healthy and disorder motion models are compared for evaluating the mechanism of aspiration.

  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. New insights into sucking, swallowing and breathing central generators: A complexity analysis of rhythmic motor behaviors.

    PubMed

    Samson, Nathalie; Praud, Jean-Paul; Quenet, Brigitte; Similowski, Thomas; Straus, Christian

    2017-01-18

    Sucking, swallowing and breathing are dynamic motor behaviors. Breathing displays features of chaos-like dynamics, in particular nonlinearity and complexity, which take their source in the automatic command of breathing. In contrast, buccal/gill ventilation in amphibians is one of the rare motor behaviors that do not display nonlinear complexity. This study aimed at assessing whether sucking and swallowing would also follow nonlinear complex dynamics in the newborn lamb. Breathing movements were recorded before, during and after bottle-feeding. Sucking pressure and the integrated EMG of the thyroartenoid muscle, as an index of swallowing, were recorded during bottle-feeding. Nonlinear complexity of the whole signals was assessed through the calculation of the noise limit value (NL). Breathing and swallowing always exhibited chaos-like dynamics. The NL of breathing did not change significantly before, during or after bottle-feeding. On the other hand, sucking inconsistently and significantly less frequently than breathing exhibited a chaos-like dynamics. Therefore, the central pattern generator (CPG) that drives sucking may be functionally different from the breathing CPG. Furthermore, the analogy between buccal/gill ventilation and sucking suggests that the latter may take its phylogenetic origin in the gill ventilation CPG of the common ancestor of extant amphibians and mammals.

  12. 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...

  13. 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.…

  14. The Effects of Age and Preoral Sensorimotor Cues on Anticipatory Mouth Movement During Swallowing

    PubMed Central

    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. Method Using a 2 × 2 repeated-measures design, eating-related lip, jaw, and hand movements were recorded from 24 healthy older (ages 70–85 years) and 24 healthy younger (ages 18–30 years) adults under 4 conditions: typical self-feeding, typical assisted feeding (proprioceptive loss), sensory-loss self-feeding (auditory and visual loss/degradation), and sensory-loss assisted feeding (loss/degradation of all cues). Results All participants demonstrated anticipatory mouth opening. The absence of proprioception delayed lip-lowering onset, and sensory loss more negatively affected offset. Given at least 1 preoral sensorimotor cue, older adults initiated movement earlier than younger adults. Conclusions Preoral sensorimotor information influences anticipatory swallowing/eating-related mouth movements, highlighting the importance of these cues. Earlier movement in older adults may be a compensation, facilitating safe swallowing given other age-related declines. Further research is needed to determine if the negative impact of cue removal may be further exacerbated in a nonhealthy system (e.g., presence of dysphagia or disease), potentially increasing swallowing- and eating-related risks. PMID:26540553

  15. 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.

  16. Protective Effects of Ferulic Acid against Chronic Cerebral Hypoperfusion-Induced Swallowing Dysfunction in Rats

    PubMed Central

    Asano, Takashi; Matsuzaki, Hirokazu; Iwata, Naohiro; Xuan, Meiyan; Kamiuchi, Shinya; Hibino, Yasuhide; Sakamoto, Takeshi; Okazaki, Mari

    2017-01-01

    Ferulic acid (FA), a phenolic phytochemical, has been reported to exert antioxidative and neuroprotective effects. In this study, we investigated the protective effects of FA against the dysfunction of the swallowing reflex induced by ligation of bilateral common carotid arteries (2VO) in rats. In 2VO rats, topical administration of water or citric acid to the pharyngolaryngeal region evoked a diminished number of swallowing events with prolonged latency compared to sham-operated control rats. 2VO rats had an increased level of superoxide anion radical, and decreased dopamine and tyrosine hydroxylase enzyme levels in the striatum, suggesting that 2VO augmented cerebral oxidative stress and impaired the striatal dopaminergic system. Furthermore, substance P (SP) expression in the laryngopharyngeal mucosa, which is believed to be positively regulated by dopaminergic signaling in the basal ganglia, was decreased in 2VO rats. Oral treatment with FA (30 mg/kg) for 3 weeks (from one week before 2VO to two weeks after) improved the swallowing reflex and maintained levels of striatal dopamine and laryngopharyngeal SP expression in 2VO rats. These results suggest that FA maintains the swallowing reflex by protecting the dopamine-SP system against ischemia-induced oxidative damage in 2VO rats. PMID:28273833

  17. Oesophageal transport of solid dosage forms depends on body position, swallowing volume and pharyngeal propulsion velocity.

    PubMed

    Osmanoglou, E; Van Der Voort, I R; Fach, K; Kosch, O; Bach, D; Hartmann, V; Strenzke, A; Weitschies, W; Wiedenmann, B; Trahms, L; Mönnikes, H

    2004-10-01

    Knowledge about transit of solid dosage forms (SDF) in the gastrointestinal tract is incomplete. Detection of magnetically marked capsules (MMC) via superconducting quantum interference device (SQUID) allows monitoring of oesophageal transport of SDF with high tempospatial resolution. The aim of the study was to investigate the influence of body position, volume at swallowing, and oesophageal motility on orogastric transport of SDF. In 360 measurements we determined tempospatial characteristics of orogastric transit of SDFs by a SQUID device in six volunteers. They swallowed MMCs with various amounts of water in upright and supine position with and without simultaneous oesophageal manometry. Orogastric transit time, oesophageal transport velocity and rate of oesophageal retention of SDF depend on swallowing volume and body position at all experimental conditions. At 50 mL water bolus and in upright position, the retention rate depends on the pharyngeal propulsion velocity, and the transport velocity of MMCs in the oesophageal body are faster than the propulsive oesophageal contractions. Body position, swallowing volume and pharyngeal propulsion velocity markedly influence the oesophageal transport of SDF. They should be taken in upright body position with at least 50 mL of water to minimize entrapment in the oesophagus.

  18. 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…

  19. The location and tracking of swallowed dental appliances: the role of radiology.

    PubMed

    Absi, E G; Buckley, J G

    1995-05-01

    Two cases of swallowing mishaps, one involving a spoon-denture and the other an orthodontic partial arch wire, are reported. The former was recovered following interventional radiology, the latter by proctoscopy. The role of radiographic investigation and possible measures to prevent such potential life-threatening emergencies are discussed.

  20. Building a three-dimensional model of the upper gastrointestinal tract for computer simulations of swallowing.

    PubMed

    Gastelum, Alfonso; Mata, Lucely; Brito-de-la-Fuente, Edmundo; Delmas, Patrice; Vicente, William; Salinas-Vázquez, Martín; Ascanio, Gabriel; Marquez, Jorge

    2016-03-01

    We aimed to provide realistic three-dimensional (3D) models to be used in numerical simulations of peristaltic flow in patients exhibiting difficulty in swallowing, also known as dysphagia. To this end, a 3D model of the upper gastrointestinal tract was built from the color cryosection images of the Visible Human Project dataset. Regional color heterogeneities were corrected by centering local histograms of the image difference between slices. A voxel-based model was generated by stacking contours from the color images. A triangle mesh was built, smoothed and simplified. Visualization tools were developed for browsing the model at different stages and for virtual endoscopy navigation. As result, a computer model of the esophagus and the stomach was obtained, mainly for modeling swallowing disorders. A central-axis curve was also obtained for virtual navigation and to replicate conditions relevant to swallowing disorders modeling. We show renderings of the model and discuss its use for simulating swallowing as a function of bolus rheological properties. The information obtained from simulation studies with our model could be useful for physicians in selecting the correct nutritional emulsions for patients with dysphagia.

  1. 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.

  2. Speech and Swallowing Data in Individual Patients Who Underwent Glossectomy after Prosthetic Rehabilitation

    PubMed Central

    Sennes, Luiz Ubirajara

    2016-01-01

    Maintaining oral function in patients undergoing glossectomy boosts interventions such as prosthetic rehabilitation. However, current literature still fails in the presentation of results of prosthetic rehabilitation in relation to speech or swallowing. The objective of this research is to evaluate the effectiveness of prosthetic rehabilitation on voice, speech, and swallowing in patients undergoing glossectomy by performing a systematic literature review and meta-analysis of individual cases. Studies were identified by relevant electronic database and included all dates available. The criteria used were sample with any n; resection due to malignant tumors, restricted to tongue and/or floor of mouth; type of prosthetic rehabilitation; and description of the oral functions outcomes with prosthesis. For the meta-analysis of individual data, associations between the variables of interest and the type of prosthesis were evaluated. Thirty-three of 471 articles met the selection criteria. Results on speech and/or voice and swallowing were reported in 27 and 28 articles, respectively. There were improvement of speech intelligibility and swallowing in 96 patients and in 73 patients, respectively, with prosthesis. Based on the available evidences, this article showed that prosthetic rehabilitation was able to improve oral functions and can be a strategy used with surgical reconstruction in selected cases. PMID:28042295

  3. Role of the retrotrapezoid nucleus/parafacial respiratory group in coughing and swallowing in guinea pigs

    PubMed Central

    Shiba, Keisuke; Mukudai, Shigeyuki; Umezaki, Toshiro; Sakaguchi, Hirofumi; Hisa, Yasuo

    2015-01-01

    The retrotrapezoid/parafacial respiratory group (RTN/pFRG) located ventral to the facial nucleus plays a key role in regulating breathing, especially enhanced expiratory activity during hypercapnic conditions. To clarify the roles of the RTN/pFRG region in evoking coughing, during which reflexive enhanced expiration is produced, and in swallowing, during which the expiratory activity is consistently halted, we recorded extracellular activity from RTN/pFRG neurons during these fictive behaviors in decerebrate, paralyzed, and artificially ventilated guinea pigs. The activity of the majority of recorded respiratory neurons was changed in synchrony with coughing and swallowing. To further evaluate the contribution of RTN/pFRG neurons to these nonrespiratory behaviors, the motor output patterns during breathing, coughing, and swallowing were compared before and after brain stem transection at the caudal margin of RTN/pFRG region. In addition, the effects of transection at its rostral margin were also investigated to evaluate pontine contribution to these behaviors. During respiration, transection at the rostral margin attenuated the postinspiratory activity of the recurrent laryngeal nerve. Meanwhile, the late expiratory activity of the abdominal nerve was abolished after caudal transection. The caudal transection also decreased the amplitude of the coughing-related abdominal nerve discharge but did not abolish the activity. Swallowing could be elicited even after the caudal end transection. These findings raise the prospect that the RTN/pFRG contributes to expiratory regulation during normal respiration, although this region is not an essential element of the neuronal networks involved in coughing and swallowing. PMID:26203106

  4. Change of Swallowing in Patients With Head and Neck Cancer After Concurrent Chemoradiotherapy

    PubMed Central

    2016-01-01

    Objective To evaluate the functional characteristics of swallowing and to analyze the parameters of dysphagia in head and neck cancer patients after concurrent chemoradiotherapy (CCRT). Methods The medical records of 32 patients with head and neck cancer who were referred for a videofluoroscopic swallowing study from January 2012 to May 2015 were retrospectively reviewed. The patients were allocated by duration after starting CCRT into early phase (<1 month after radiation therapy) and late phase (>1 month after radiation therapy) groups. We measured the modified penetration aspiration scale (MPAS) and American Speech-Language-Hearing Association National Outcome Measurement System swallowing scale (ASHA-NOMS). The oral transit time (OTT), pharyngeal delay time (PDT), and pharyngeal transit time (PTT) were recorded to assess the swallowing physiology. Results Among 32 cases, 18 cases (56%) were of the early phase. In both groups, the most common tumor site was the hypopharynx (43.75%) with a histologic type of squamous cell carcinoma (75%). PTT was significantly longer in the late phase (p=0.03). With all types of boluses, except for soup, both phases showed a statistically significant difference in MPAS results. The mean ASHA-NOMS level for the early phase was 5.83±0.78 and that for the late phase was 3.79±1.80, with statistical significance (p=0.01). The PTT and ASHA-NOMS level showed a statistically significant correlation (correlation coefficient=–0.52, p=0.02). However, it showed no relationship with the MPAS results. Conclusion The results of our study suggest that in the late phase that after CCRT, the OTT, PDT, and PTT were longer than in the early phase and the PTT prolongation was statistically significant. Therefore, swallowing therapy targeting the pharyngeal phase is recommended after CCRT. PMID:28119841

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

    USGS Publications Warehouse

    Hothem, Roger L.; Trejo, Bonnie S.; Bauer, Marissa L.; Crayon, John 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.

  6. 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.

  7. Suppression of jaw-opening and trigemino-hypoglossal reflexes during swallowing in the cat.

    PubMed

    Ono, T; Ishiwata, Y; Kuroda, T; Nakamura, Y

    1999-11-01

    Jaw-opening and trigemino-hypoglossal reflexes can be evoked by innocuous as well as noxious afferents from intra-oral structures. It has been reported that the amplitude of the jaw-opening reflex evoked by weak electrical stimulation of the upper lip is subject not only to tonic suppression but also to phase-linked modulation during mastication. In this study, we investigated whether the jaw-opening and trigemino-hypoglossal reflexes are modulated during swallowing. Data were obtained from 8 chloralose-anesthetized cats. Reflexes were monitored by electromyographic activities recorded from the anterior digastric, genioglossus, and styloglossus muscles and, after paralysis, by the efferent discharge in the digastric and hypoglossal nerves. Swallowing was elicited either by water dropped on the tongue or by repetitive stimulation of the superior laryngeal nerve. Jaw-opening and trigemino-hypoglossal reflexes were evoked by stimulation of the lingual nerve, and the evoked afferent volley was recorded from the Gasserian ganglion so that the threshold of the lingual nerve could be determined. The following results were obtained: (1) The jaw-opening and trigemino-hypoglossal reflexes evoked by stimulation of the low-threshold, but not high-threshold, lingual afferents were remarkably suppressed during swallowing; and (2) both the jaw-opening and trigemino-hypoglossal reflexes evoked by low-threshold lingual afferents were suppressed during fictive swallowing after the animals were paralyzed. We conclude that the jaw-opening and trigemino-hypoglossal reflexes evoked by low-threshold lingual afferents are suppressed during swallowing by a central motor program.

  8. Coordination of sucking, swallowing, and breathing and oxygen saturation during early infant breast-feeding and bottle-feeding.

    PubMed

    Goldfield, Eugene C; Richardson, Michael J; Lee, Kimberly G; Margetts, Stacey

    2006-10-01

    This prospective study compared the coordination of sucking, swallowing, and breathing and its relationship to oxygen saturation in infants during breast-feeding and bottle-feeding. After 4 to 6 wk of exclusive breast-feeding, infants began bottle-feedings of expressed human milk using one of two systems: a soft-walled bottle and nipple (system 1, Playtex) or a hard-walled bottle and nipple (system 2, Avent). Infants' sucking, swallowing, breathing, and oxygenation were measured during breast-feeding and bottle-feeding, and coordination of these activities during breast-feeding and bottle-feeding were compared. During breast-feeding, swallowing occurred nonrandomly between breaths and did not interfere with breathing. The same distribution of swallowing occurred in infants fed with system 1, while swallowing occurred randomly in infants fed with system 2. Swallowing significantly increased during bottle-feeding among infants using system 2, but decreased among infants using system 1. Infants using system 2 also had a greater instability in the coordination of sucking, swallowing, and breathing and more perturbation of breathing. Oxygen saturation was significantly higher in infants fed with system 1 compared with system 2. These results suggest that the overall feeding pattern and oxygenation of system 1 are closer to the physiologic norm than system 2.

  9. 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.

  10. 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.

  11. Effects of Strengthening Exercises on Swallowing Musculature and Function in Senior Healthy Subjects: a Prospective Effectiveness and Feasibility Study.

    PubMed

    Kraaijenga, S A C; van der Molen, L; Stuiver, M M; Teertstra, H J; Hilgers, F J M; van den Brekel, M W M

    2015-08-01

    Head and neck cancer (HNC) patients may develop dysphagia due to muscle atrophy and fibrosis following chemoradiotherapy. Strengthening of the swallowing muscles through therapeutic exercise is potentially effective for improving swallowing function. We hypothesize that a customized Swallow Exercise Aid (SEA), developed for isometric and isokinetic strengthening exercises (against resistance), can help to functionally strengthen the suprahyoid musculature, which in turn can improve swallowing function. An effectiveness/feasibility study was carried out with ten senior healthy volunteers, who performed exercises 3 times per day for 6 weeks. Exercises included chin tuck against resistance (CTAR), jaw opening against resistance (JOAR), and effortful swallow exercises with the SEA. Multidimensional assessment consisted of measurements of maximum chin tuck and jaw opening strength, maximum tongue strength/endurance, suprahyoid muscle volume, hyoid bone displacement, swallowing transport times, occurrence of laryngeal penetration/aspiration and/or contrast residue, maximum mouth opening, feasibility/compliance (questionnaires), and subjective swallowing complaints (SWAL-QOL). After 6-weeks exercise, mean chin tuck strength, jaw opening strength, anterior tongue strength, suprahyoid muscle volume, and maximum mouth opening significantly increased (p < .05). Feasibility and compliance (median 86 %, range 48-100 %) of the SEA exercises were good. This prospective effectiveness/feasibility study on the effects of CTAR/JOAR isometric and isokinetic strengthening exercises on swallowing musculature and function shows that senior healthy subjects are able to significantly increase swallowing muscle strength and volume after a 6-week training period. These positive results warrant further investigation of effectiveness and feasibility of these SEA exercises in HNC patients with dysphagia.

  12. The disablement process.

    PubMed

    Verbrugge, L M; Jette, A M

    1994-01-01

    Building on prior conceptual schemes, this article presents a sociomedical model of disability, called The Disablement Process, that is especially useful for epidemiological and clinical research. The Disablement Process: (1) describes how chronic and acute conditions affect functioning in specific body systems, generic physical and mental actions, and activities of daily life, and (2) describes the personal and environmental factors that speed or slow disablement, namely, risk factors, interventions, and exacerbators. A main pathway that links Pathology, Impairments, Functional Limitations, and Disability is explicated. Disability is defined as difficulty doing activities in any domain of life (from hygiene to hobbies, errands to sleep) due to a health or physical problem. Feedback effects are included in the model to cover dysfunction spirals (pernicious loops of dysfunction) and secondary conditions (new pathology launched by a given disablement process). We distinguish intrinsic disability (without personal or equipment assistance) and actual disability (with such assistance), noting the scientific and political importance of measuring both. Disability is not a personal characteristic, but is instead a gap between personal capability and environmental demand. Survey researchers and clinicians tend to focus on personal capability, overlooking the efforts people commonly make to reduce demand by activity accommodations, environmental modifications, psychological coping, and external supports. We compare the disablement experiences of people who acquire chronic conditions early in life (lifelong disability) and those who acquire them in mid or late life (late-life disability). The Disablement Process can help inform research (the epidemiology of disability) and public health (prevention of disability) activities.

  13. Improving swallowing outcomes in patients with head and neck cancer using a theory-based pretreatment swallowing intervention package: protocol for a randomised feasibility study

    PubMed Central

    Smith, Christina H; Barratt, Helen; Taylor, Stuart A

    2017-01-01

    Introduction The incidence of head and neck cancer (HNC) in the UK is rising, with an average of 31 people diagnosed daily. Patients affected by HNC suffer significant short-term and long-term post-treatment morbidity as a result of dysphagia, which affects daily functioning and quality of life (QOL). Pretreatment swallowing exercises may provide additional benefit over standard rehabilitation in managing dysphagia after primary HNC treatments, but uncertainty about their effectiveness persists. This study was preceded by an intervention development phase to produce an optimised swallowing intervention package (SIP). The aim of the current study is to assess the feasibility of this new intervention and research processes within a National Health Service (NHS) setting. Method and analysis A two-arm non-blinded randomised controlled feasibility study will be carried out at one tertiary referral NHS centre providing specialist services in HNC. Patients newly diagnosed with stage III and IV disease undergoing planned surgery and/or chemoradiation treatments will be eligible. The SIP will be delivered pre treatment, and a range of swallowing-related and QOL measures will be collected at baseline, 1, 3 and 6 months post-treatment. Outcomes will test the feasibility of a future randomised controlled trial (RCT), detailing rate of recruitment and patient acceptance to participation and randomisation. Salient information relating to protocol implementation will be collated and study material such as the case report form will be tested. A range of candidate outcome measures will be examined for suitability in a larger RCT. Ethics and dissemination Ethical approval was obtained from an NHS Research Ethics Committee. Findings will be published open access in a peer-reviewed journal, and presented at relevant conferences and research meetings. Trial registration number ISRCTN40215425; Pre-results. PMID:28348190

  14. [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

  15. One-Year Swallowing Outcomes in Patients Treated with Prophylactic Gabapentin During Radiation-Based Treatment for Oropharyngeal Cancer.

    PubMed

    Starmer, Heather M; Yang, WuYang; Gourin, Christine G; Kumar, Rachit; Jones, Bronwyn; McNutt, Todd; Cheng, Sierra; Quon, Harry

    2017-02-15

    Recent investigations by our study team have demonstrated patients using gabapentin for pain management during chemoradiotherapy (CRT) do well maintaining swallowing during treatment with less need for narcotic pain medication, PEG dependence, weight loss, and short-term swallowing morbidity. The purpose of this investigation was to characterize the long-term swallowing function of these patients 1-year following treatment. Sequential patients receiving CRT for oropharyngeal cancer and concurrent gabapentin were evaluated 1-year following treatment for swallowing outcomes. Functional Oral Intake Scores (FOIS) were utilized to assess diet level. The MD Anderson Dysphagia Inventory (MDADI) was chosen to evaluate patient perception of swallowing function. Videofluoroscopic swallowing studies were completed approximately 1 year after treatment to assess physiologic outcomes as well as Penetration Aspiration Scores (PAS). Data from 26 consecutive participants were available for analysis. The majority of patients had advanced stage disease (Stage 3-4). No patients had a PEG tube 1-year following treatment, and the mean FOIS score was 6.83. Pharyngeal deficits were infrequent with reduced pharyngeal constriction and prominence/early closure of cricopharyngeus predominating. Mean PAS score was 1.5, indicating that the majority of patients had either no laryngeal penetration/aspiration, or transient penetration that was fully cleared. Mean MDADI score was 85.52, indicating that, in general, patients perceived their swallowing to be minimally impaired. Patients receiving gabapentin pain management as part of a comprehensive dysphagia prevention protocol during CRT have excellent long-term swallowing outcomes as reflected in diet levels, physiologic functioning, and patient-perceived quality of life.

  16. Esophageal Acid Clearance During Random Swallowing Is Faster in Patients with Barrett’s Esophagus Than in Healthy Controls

    PubMed Central

    Lottrup, Christian; Krarup, Anne L; Gregersen, Hans; Ejstrud, Per; Drewes, Asbjørn M

    2016-01-01

    Background/Aims Impaired esophageal acid clearance may be a contributing factor in the pathogenesis of Barrett’s esophagus. However, few studies have measured acid clearance as such in these patients. In this explorative, cross-sectional study, we aimed to compare esophageal acid clearance and swallowing rate in patients with Barrett’s esophagus to that in healthy controls. Methods A total of 26 patients with histology-confirmed Barrett’s esophagus and 12 healthy controls underwent (1) upper endoscopy, (2) an acid clearance test using a pH-impedance probe under controlled conditions including controlled and random swallowing, and (3) an ambulatory pH-impedance measurement. Results Compared with controls and when swallowing randomly, patients cleared acid 46% faster (P = 0.008). Furthermore, patients swallowed 60% more frequently (mean swallows/minute: 1.90 ± 0.74 vs 1.19 ± 0.58; P = 0.005), and acid clearance time decreased with greater random swallowing rate (P < 0.001). Swallowing rate increased with lower distal esophageal baseline impedance (P = 0.014). Ambulatory acid exposure was greater in patients (P = 0.033), but clearance times assessed from the ambulatory pH-measurement and acid clearance test were not correlated (all P > 0.3). Conclusions More frequent swallowing and thus faster acid clearance in Barrett’s esophagus may constitute a protective reflex due to impaired mucosal integrity and possibly acid hypersensitivity. Despite these reinforced mechanisms, acid clearance ability seems to be overthrown by repeated, retrograde acid reflux, thus resulting in increased esophageal acid exposure and consequently mucosal changes. PMID:27557545

  17. Persistence of Buggy Creek virus (Togaviridae, Alphavirus) for two years in unfed swallow bugs (Hemiptera: Cimicidae: Oeciacus vicarius).

    PubMed

    Brown, Charles R; Moore, Amy T; Young, Ginger R; Komar, Nicholas

    2010-05-01

    Alphaviruses (Togaviridae) have rarely been found to persist for long in the adult insects that serve as their vectors. The ectoparasitic swallow bug (Hemiptera: Cimicidae: Oeciacus vicarius Horvath), the vector for Buggy Creek virus (BCRV; Togaviridae, Alphavirus), lives year-round in the mud nests of its host, the cliff swallow (Petrochelidon pyrrhonota Vieillot). We measured the prevalence of BCRV in swallow bugs at sites with cliff swallows present and at the same sites after cliff swallows had been absent for 2 yr. We collected bugs directly from cliff swallow nests in the field and screened bug pools with BCRV-specific real-time-polymerase chain reaction (RT-PCR) and plaque assay. At two colony sites last occupied by birds 2 yr earlier, we found 12.5 and 55.6% of bug pools positive for BCRV RNA by RT-PCR. Infection rates (per 1,000 bugs) for these sites were 1.32 and 7.39. RNA prevalence in the unfed bugs was not significantly different from that in fed bugs 2 yr earlier at the same sites. The RNA-positive samples from unfed bugs failed to yield cytopathic BCRV by Vero-cell plaque assay. However, viral RNA concentrations did not differ between unfed bugs and bugs at active sites, and over 84% of positive bug pools were cytopathic to Vero cells 4-5 wk later, after cliff swallows moved into one of the colony sites. These data demonstrate the persistence of potentially infectious BCRV in unfed swallow bugs for at least 2 yr in nature.

  18. 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

    2015-10-07

    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.

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

    PubMed Central

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

    2015-01-01

    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

  20. 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.

  1. Videofluoroscopy and oropharyngeal manometry for evaluation of swallowing in elderly patients.

    PubMed

    Reginelli, Alfonso; D'Amora, Marilina; Del Vecchio, Lucia; Monaco, Luigi; Barillari, Maria Rosaria; Di Martino, Natale; Barillari, Umberto; Motta, Gaetano; Cappabianca, Salvatore; Grassi, Roberto

    2016-09-01

    Presbyphagia represents the physiological aging evolution of the swallowing function. It is related to the natural changes of the anatomical structures involved in the swallowing process. These age-related modifications can be asymptomatic in the early stages of life, but in the late stages, they could lead to dysphagia, aspiration pneumonia, dehydration, or malnutrition, reducing the quality of life. Videofluoromanometry (VFM) is the combined study of videofluoroscopy (VFS) and oropharyngeal manometry that allows simultaneous identification of functional and morphological features of the presbyphagia, also in asymptomatic otherwise healthy elderly adults. This study retrospectively evaluated the effectiveness of the VFM and the role of a multidisciplinary team of specialists in the analysis of a large cohort of old patients with presbyphagia, with the objective of achieving early diagnosis of the disease and the best therapy to delay the development of complications such as aspiration pneumonia, malnutrition, and dehydration.

  2. Swallowable Obalon® gastric balloons as an aid for weight loss: a pilot feasibility study.

    PubMed

    Mion, François; Ibrahim, Mostafa; Marjoux, Sophie; Ponchon, Thierry; Dugardeyn, Sonia; Roman, Sabine; Deviere, Jacques

    2013-05-01

    The goal of this study was to evaluate the safety and the impact on weight loss of a new swallowable gastric balloon. In this prospective pilot study, 17 overweight or obese patients were included. Up to three balloons were ingested under fluoroscopic control. All balloons were removed by upper GI endoscopy, 12 weeks after the ingestion of the first balloon. 43 out of 44 attempts (98 %) to swallow a balloon were successful. Nausea and stomach pain were the most frequent side effects. Endoscopic procedures for balloon removal were uneventful. Weight loss was significant at weeks 4, 8, and 12. This pilot study showed no significant side effects induced by up to three balloons, and a significant weight loss.

  3. 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.

  4. Tools and early management of language and swallowing disorders in acute stroke patients.

    PubMed

    Flamand-Roze, Constance; Cauquil-Michon, Cécile; Denier, Christian

    2012-02-01

    The role of the stroke units in improving morbidity, mortality, and recovery from stroke is clearly demonstrated. However, acute management of language disorders in these specialized units remains controversial, and management of swallowing disorders is usually nonstandardized. The recent validation of a scale for rapid screening of language disorders (LAST [Language Screening Test]) in acute stroke patients should allow optimization of their detection and early management. Swallowing disorders should be screened and managed using a standardized protocol. Following early initial evaluation repeated on a daily basis, they justify tailored rehabilitation sessions, adaptation of food textures, team formation, and families' information. The use of these protocols implies the cooperation and coordination of the medical and paramedical teams and the daily presence of speech therapists. These aspects are crucial for patients in the stroke units to achieve full benefits from the management proposed in this paper, leading to diminution of complications and better long-term functional prognosis.

  5. 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.

  6. Americans With Disabilities Act.

    PubMed

    Walk, E E; Ahn, H C; Lampkin, P M; Nabizadeh, S A; Edlich, R F

    1993-01-01

    The Americans with Disabilities Act gives all Americans with disabilities a chance to achieve the same quality of life that individuals without disabilities enjoy. This act prohibits discrimination on the basis of disabilities in employment, public services, privately operated public accommodations, services, and telecommunications. The Americans with Disabilities Act is divided into five titles. Title I of the act pertains to discrimination against the disabled in the workplace. Title II prevents discrimination against persons with a disability in state and local government services. Title III prohibits discrimination against persons with disabilities in places of public accommodations and commercial facilities. Title IV ensures that companies offering telephone services to the general public provide special services for individuals with hearing and speech impairments. Under the enforcement provisions of the Americans with Disabilities Act, stringent penalties will be implemented for failure to comply with its provisions.

  7. 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.

  8. 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.

  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.

  10. Retinoic acid exposure on gestational days 11 to 13 impairs swallowing in rat offspring.

    PubMed

    Holson, R R; Adams, J; Ferguson, S A; Scalzo, F M

    2000-01-01

    We have previously reported that exposure to 10 mg/kg of all-trans-retinoic acid (RA) daily on the 11th, 12th, and 13th days of rat gestation is lethal to all fetuses so exposed, due to an inability to suckle [R.R. Holson et al., Neurotoxicol Teratol 19 (1997) 347-353]. Because this lethal RA effect could be due to any of a variety of causes, from olfactory problems in locating the nipple to a motor problem in sucking or swallowing, we performed the following experiment. Albino dams were exposed to 10-mg/kg RA or vehicle daily over gestational days (GDs) 11 to 13. On the afternoon of GD 21 all pups were delivered by c-section. Tongue cannulae were inserted into the oral cavity of these offspring, and used to infuse a solution of condensed milk directly into the mouth. During and after each of four infusions, the behavioral response to the infusion (typically rolling and curling) was recorded. Controls responded well to this procedure, typically swallowing all milk so infused. In contrast, almost no RA-exposed neonates were able to swallow milk infused into the oral cavity. In such cases the milk simply dribbled out of the mouth, while the stomach was found to be empty at autopsy. However, the RA-treated animals did seem aware that milk was entering their mouths, because they showed a normal behavioral response to milk infusion. We conclude that GD 11-13 retinoid lethality is due to motor not sensory problems in the control of swallowing.

  11. Visualization of swallowing using real-time TrueFISP MR fluoroscopy.

    PubMed

    Barkhausen, Jörg; Goyen, Mathias; von Winterfeld, Friederike; Lauenstein, Thomas; Arweiler-Harbeck, Diana; Debatin, Jörg F

    2002-01-01

    The aim of this study was to evaluate the ability of different real-time true fast imaging with steady precession (TrueFISP) sequences regarding their ability to depict the swallowing process and delineate oropharyngeal pathologies in patients with dysphagia. Real-time TrueFISP visualization of swallowing was performed in 8 volunteers and 6 patients with dysphagia using a 1.5 T scanner (Magnetom Sonata, Siemens, Erlangen Germany) equipped with high-performance gradients (amplitude 40 mT/m). Image quality of four different real-time TrueFISP sequences (TR 2.2-3.0 ms, TE 1.1-1.5 ms, matrix 63 x 128-135 x 256, field of view 250 mm(2), acquisition time per image 139-405 ms) was evaluated. Water, yoghurt, and semolina pudding were assessed as oral contrast agents. Functional exploration of the oropharyngeal apparatus was best possible using the fastest real-time TrueFISP sequence (TR 2.2 ms, TE 1.1 ms, matrix 63 x 128). Increased acquisition time resulted in blurring of anatomical structures. As the image contrast of TrueFISP sequences depends on T2/T1 properties, all tested foodstuff were well suited as oral contrast agents, but image quality was best using semolina pudding. Real-time visualization of swallowing is possible using real-time TrueFISP sequences in conjunction with oral contrast agents. For the functional exploration of swallowing high temporal resolution is more crucial than spatial resolution.

  12. Murray secretion scale and fiberoptic endoscopic evaluation of swallowing in predicting aspiration in dysphagic patients.

    PubMed

    Kuo, Chia-Wei; Allen, Clint Tanner; Huang, Chu-Chun; Lee, Chia-Jung

    2017-03-12

    The objective of this retrospective review is to evaluate the ability of the Murray secretion scale to predict aspiration as determined by fiberoptic endoscopic evaluation of swallowing. Patients with dysphagia undergoing a fiberoptic endoscopic evaluation of swallowing study between January 2013 and November 2015 from a single, tertiary care institution were retrospectively reviewed. The Murray secretion scale and penetration aspiration scale on fiberoptic endoscopic evaluation of swallowing examination were determined. Spearman's correlation analysis, sensitivity, specificity, predictive values, and relative risk evaluating the relationship between the Murray secretion scale and aspiration on fiberoptic endoscopic evaluation of swallowing were calculated. Subgroups of head and neck cancer patients, penetration group, and aspiration group were also analyzed. The mean age of the cases (N = 212) was 62.4 years. Eighty percent were male. There was a strong correlation between Murray secretion scale grade and penetration aspiration scale score (r = 0.785, p < 0.001). The sensitivity and specificity of a Murray secretion scale grade 2 or higher in predicting aspiration were 74 and 90%, respectively. Individuals with a Murray secretion scale grade of 2 or higher were 13.6 times more likely to aspirate than patients with a lower Murray secretion scale grade. All subgroups showed similar trend. Determination of a Murray secretion scale grade, determined by flexible nasopharyngoscopy, may predict patients at high risk for aspiration. In clinical scenarios where more complete assessments of aspiration risk are immediately impossible or impractical, the Murray secretion scale grade may add valuable information to assist in clinical decision-making in patients with dysphagia.

  13. Diverging lesion and connectivity patterns influence early and late swallowing recovery after hemispheric stroke.

    PubMed

    Galovic, Marian; Leisi, Natascha; Pastore-Wapp, Manuela; Zbinden, Martin; Vos, Sjoerd B; Mueller, Marlise; Weber, Johannes; Brugger, Florian; Kägi, Georg; Weder, Bruno J

    2017-04-01

    Knowledge about the recovery of oral intake after hemispheric stroke is important to guide therapeutic decisions, including the administration of enteral tube feeding and the choice of the appropriate feeding route. They aimed to determine the localization and connectivity of lesions in impaired recovery versus recovered swallowing after initially dysphagic stroke. Sixty-two acute ischemic hemispheric stroke patients with impaired oral intake were included in a prospective observational cohort study. Voxel-based lesion-symptom mapping and probabilistic tractography were used to determine the association of lesion location and connectivity with impaired recovery of oral intake ≥7 days (indication for early tube feeding) and ≥4 weeks (indication for percutaneous endoscopic gastrostomy feeding) after stroke. Two distinct patterns influencing recovery of swallowing were recognized. Firstly, impaired recovery of oral intake after ≥7 days was significantly associated with lesions of the superior corona radiata (65% of statistical map, P < 0.05). The affected fibers were connected with the thalamus, primary motor, and supplemental motor areas and the basal ganglia. Secondly, impaired recovery of oral intake after ≥4 weeks significantly correlated with lesions of the anterior insula (54% of statistical map, P < 0.05), which was connected to adjacent operculo-insular areas of deglutition. These findings indicate that early swallowing recovery is influenced by white matter lesions disrupting thalamic and corticobulbar projection fibers. Late recovery is determined by specific cortical lesions affecting association fibers. This knowledge may help clinicians to identify patients at risk of prolonged swallowing problems that would benefit from enteral tube feeding. Hum Brain Mapp 38:2165-2176, 2017. © 2017 Wiley Periodicals, Inc.

  14. 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

  15. Benefit from the Chin-Down Maneuver in the Swallowing Performance and Self-Perception of Parkinson's Disease Patients

    PubMed Central

    Jotz, Geraldo Pereira

    2017-01-01

    Aims. To verify the effectiveness of the maneuver application in swallowing therapy with PD. Materials and Method. We performed an open-label trial, with three groups compounds by PD individuals: the experimental group, control group, and orientation group. The study included PD patients with dysphagia. A cognitive screening, through a questionnaire about depression and quality of life, was conducted. Swallowing assessment was performed through (1) fiberoptic endoscopic evaluation of swallowing (FEES); (2) clinical evaluation and Functional Oral Intake Scale (FOIS); and (3) assessment of the quality life related to swallowing (SWALQOL). A therapeutic program, which consisted of chin-down postural maneuver and orientations on feeding, was applied. Both groups (EG and OG) received on-month therapeutic program. Results. A significant improvement in swallowing, evaluated by clinical assessment, was observed in solid (p < 0.001) and liquid (p = 0.022) consistencies in EG when compared to OG and CG. Patients in EG presented improvement in QoL, with the significant difference in comparison with the other groups, about domain frequency of symptoms (p = 0.029) in SWALQOL questionnaire. Conclusion. The postural maneuver chin-down improved swallowing performance and self-perception, but not the laryngeal signs. This trial is registered with registration number NCT02973698. PMID:28203475

  16. Bilateral Repetitive Transcranial Magnetic Stimulation Combined with Intensive Swallowing Rehabilitation for Chronic Stroke Dysphagia: A Case Series Study

    PubMed Central

    Momosaki, Ryo; Abo, Masahiro; Kakuda, Wataru

    2014-01-01

    The purpose of this study was to clarify the safety and feasibility of a 6-day protocol of bilateral repetitive transcranial magnetic stimulation (rTMS) combined with intensive swallowing rehabilitation for chronic poststroke dysphagia. In-hospital treatment was provided to 4 poststroke patients (age at treatment: 56–80 years; interval between onset of stroke and treatment: 24–37 months) with dysphagia. Over 6 consecutive days, each patient received 10 sessions of rTMS at 3 Hz applied to the pharyngeal motor cortex bilaterally, followed by 20 min of intensive swallowing rehabilitation exercise. The swallowing function was evaluated by the Penetration Aspiration Scale (PAS), Modified Mann Assessment of Swallowing Ability (MMASA), Functional Oral Intake Scale (FOIS), laryngeal elevation delay time (LEDT) and Repetitive Saliva-Swallowing Test (RSST) on admission and at discharge. All patients completed the 6-day treatment protocol and none showed any adverse reactions throughout the treatment. The combination treatment improved laryngeal elevation delay time in all patients. Our proposed protocol of rTMS plus swallowing rehabilitation exercise seems to be safe and feasible for chronic stroke dysphagia, although its efficacy needs to be confirmed in a large number of patients. PMID:24803904

  17. Videofluoroscopy of the oral phase of swallowing in eight to twelve years old children with dental malocclusion.

    PubMed

    Junqueira, Patricia; Costa, Milton Melciades

    2013-11-01

    The objective of this study was to describe the oral phase of swallowing in individuals with dental malocclusion and to generate data that would contribute to the rehabilitation of those patients. The study was based on the evaluation of the swallowing system through videofluoroscopy on thirty-four children of both genders, aged eight to twelve years old who present with Angle Class II and III dental malocclusions. Thirteen children of similar age and gender presenting normal dental occlusion formed the control group. The results indicated that the oral phase of swallowing is different between individuals with normal occlusion and malocclusion. Dental occlusion types Angle Class II and III did not present a swallowing pattern, independently of the amount of liquid ingested. The swallowing appeared effective in the oral phase of individuals with dental malocclusion, even though adaptations were identified. The outcome, in the absence of a single pattern and the efficiency of the adapted swallowing demonstrates, first a need for additional research investigating orofacial myofunctional treatment for patients with malocclusion and second how such analyses should focus on contributing positively to the rehabilitation of these patients.

  18. Conjunctivitis, rhinitis, and sinusitis in cliff swallows (Petrochelidon pyrrhonota) found in association with Mycoplasma sturni infection and cryptosporidiosis.

    PubMed

    Ley, David H; Moresco, Anneke; Frasca, Salvatore

    2012-01-01

    Fledgling cliff swallows were cared for at a rehabilitation facility when clinical signs of ocular disease, characterized by conjunctivitis, epiphora, and hyperaemia of palpebrae and nictitans, were recognized. Treatment consisted of topical and oral antibiotic therapy and one topical steroid administration. However, one cliff swallow died and three were killed due to poor therapeutic response. Conjunctival swabs were obtained ante-mortem from the three cliff swallows and were submitted for mycoplasma culture and molecular diagnostics. Heads of the three birds were fixed in 10% neutral buffered formalin and submitted for histopathologic examination of oculonasal tissues. Mycoplasma cultures and molecular evaluation of isolates identified Mycoplasma sturni, but not Mycoplasma gallisepticum, from each specimen. Histopathologic examination revealed lymphoplasmacytic conjunctivitis, rhinitis and infraorbital sinusitis with follicular lymphoid hyperplasia, epithelial hyperplasia, and protozoal stages compatible with Cryptosporidium spp. arranged in and along the apical surfaces of epithelial cells. Identification of concurrent M. sturni and Cryptosporidium spp. infections in these cliff swallows demonstrates an alternative infectious condition that can produce gross and microscopic lesions comparable with those commonly observed in M. gallisepticum infections of house finches and other passerine species. Conjunctivitis associated with M. sturni and Cryptosporidium spp. in cliff swallows may represent an emerging disease risk to a naïve, high-density and colonial species such as colony-nesting cliff swallows.

  19. 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.

  20. 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

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

    PubMed Central

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

    2011-01-01

    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. Methods Twenty-two healthy adults were enrolled into two groups (ages 20-35 years & 65-82 years, each including 5M, 6F). Maximum tongue strength (Pmax) and endurance (duration 50% of Pmax could be maintained) were measured twice at baseline and once post-meal. Subjects consumed half of a bagel with peanut butter, carrot sticks and milk between measures. Results All subjects demonstrated reduced tongue strength and endurance post-meal. Young adults showed a greater decline in anterior tongue endurance compared with older adults (p=0.05). There was no evidence that changes in tongue strength, perceived effort or meal duration varied by age or gender. The three oldest subjects reported the highest effort and displayed signs of difficulty swallowing while dining. Conclusions Young and old adults demonstrated reduced tongue strength and endurance after dining, but younger subjects showed greater declines in anterior tongue endurance while older adults exhibited signs of swallowing difficulty. PMID:20689047

  3. 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

  4. 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.

  5. 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

  6. 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.

  7. Membrane potential and mechanical responses of the opossum esophagus to vagal stimulation and swallowing.

    PubMed

    Rattan, S; Gidda, J S; Goyal, R K

    1983-10-01

    Studies were performed in anesthetized opossums. The electrical changes, recorded using a suction electrode applied to the outside of the esophagus, and mechanical activity, recorded by an intraluminal catheter, were monitored from 5 cm above the lower esophageal sphincter. Swallowing was associated with membrane hyperpolarization followed by depolarization and spike burst. Electrical stimulation of the decentralized vagus also caused a prompt hyperpolarization followed by an overshoot depolarization. Single pulses of stimulation caused primarily hyperpolarization. The amplitude and duration of hyperpolarization increased with increasing frequencies of vagal stimulation. Spike burst occurred as the membrane potential was recovering from the peak hyperpolarization and moving toward peak depolarization. The latency of onset of spike burst decreased with increasing frequency of vagal stimulation. The muscle contraction occurred after a latency. The latency of contractions, like the latency of spike burst, decreased with increased frequency of vagal stimulation. These studies show that (a) membrane hyperpolarization is present during the latent period of contraction associated with swallowing, suggesting that swallow-induced esophageal response may be mediated by vagal inhibitory pathway to the esophagus and (b) spike bursts can be temporally dissociated from depolarization by changing the vagal stimulation frequency, suggesting that spike burst and depolarization may be mediated by different excitatory mechanisms.

  8. 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.

  9. 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.

  10. 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.

  11. Individual Learning Disabilities.

    ERIC Educational Resources Information Center

    Frostig, Marianne; And Others

    The following workshop presentations consider learning disabilities: "Educational Goals of the Perceptually Handicapped" by Marianne Frostig, "Remediation of Reading Problems" by Gilbert Schiffman, "Early Identification of Learning Disabilities" by Katrina de Hirsch, and "What Are Some Speech and Hearing…

  12. Immune responses of a native and an invasive bird to Buggy Creek Virus (Togaviridae: Alphavirus) and its arthropod vector, the swallow bug (Oeciacus vicarius).

    PubMed

    Fassbinder-Orth, Carol A; Barak, Virginia A; Brown, Charles R

    2013-01-01

    Invasive species often display different patterns of parasite burden and virulence compared to their native counterparts. These differences may be the result of variability in host-parasite co-evolutionary relationships, the occurrence of novel host-parasite encounters, or possibly innate differences in physiological responses to infection between invasive and native hosts. Here we examine the adaptive, humoral immune responses of a resistant, native bird and a susceptible, invasive bird to an arbovirus (Buggy Creek virus; Togaviridae: Alphavirus) and its ectoparasitic arthropod vector (the swallow bug; Oeciacus vicarius). Swallow bugs parasitize the native, colonially nesting cliff swallow (Petrochelidon pyrrhonota) and the introduced house sparrow (Passer domesticus) that occupies nests in cliff swallow colonies. We measured levels of BCRV-specific and swallow bug-specific IgY levels before nesting (prior to swallow bug exposure) and after nesting (after swallow bug exposure) in house sparrows and cliff swallows in western Nebraska. Levels of BCRV-specific IgY increased significantly following nesting in the house sparrow but not in the cliff swallow. Additionally, house sparrows displayed consistently higher levels of swallow bug-specific antibodies both before and after nesting compared to cliff swallows. The higher levels of BCRV and swallow bug specific antibodies detected in house sparrows may be reflective of significant differences in both antiviral and anti-ectoparasite immune responses that exist between these two avian species. To our knowledge, this is the first study to compare the macro- and microparasite-specific immune responses of an invasive and a native avian host exposed to the same parasites.

  13. 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…

  14. Science and Learning Disabilities.

    ERIC Educational Resources Information Center

    Stanovich, Keith E.

    1988-01-01

    Reactions to H. Lee Swanson's paper "Toward a Metatheory of Learning Disabilities" are outlined, and his arguments are applied to reading disabilities, focusing on the importance of the scientific attitude, the misuse of ecological validity, interpretation of Thomas Kuhn's work, modularity and reading disability, and scientific progress…

  15. 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…

  16. 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…

  17. 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.

  18. Development of a numerical simulator of human swallowing using a particle method (Part 2. Evaluation of the accuracy of a swallowing simulation using the 3D MPS method).

    PubMed

    Kamiya, Tetsu; Toyama, Yoshio; Michiwaki, Yukihiro; Kikuchi, Takahiro

    2013-01-01

    The aim of this study was to develop and evaluate the accuracy of a three-dimensional (3D) numerical simulator of the swallowing action using the 3D moving particle simulation (MPS) method, which can simulate splashes and rapid changes in the free surfaces of food materials. The 3D numerical simulator of the swallowing action using the MPS method was developed based on accurate organ models, which contains forced transformation by elapsed time. The validity of the simulation results were evaluated qualitatively based on comparisons with videofluorography (VF) images. To evaluate the validity of the simulation results quantitatively, the normalized brightness around the vallecula was used as the evaluation parameter. The positions and configurations of the food bolus during each time step were compared in the simulated and VF images. The simulation results corresponded to the VF images during each time step in the visual evaluations, which suggested that the simulation was qualitatively correct. The normalized brightness of the simulated and VF images corresponded exactly at all time steps. This showed that the simulation results, which contained information on changes in the organs and the food bolus, were numerically correct. Based on these results, the accuracy of this simulator was high and it could be used to study the mechanism of disorders that cause dysphasia. This simulator also calculated the shear rate at a specific point and the timing with Newtonian and non-Newtonian fluids. We think that the information provided by this simulator could be useful for development of food products, medicines, and in rehabilitation facilities.

  19. Oral motor patterns during feeding in severely physically disabled children.

    PubMed

    Yokochi, K

    1997-12-01

    Oral motor patterns during feeding were investigated in 58 patients with severe physical disability. Five patients showed a pattern resembling sucking. Twenty-nine exhibited an up-and-down movement of the jaw and protrusion of the tongue. Among these, the mouth opened when the food entered and the lips closed before swallowing in 20 patients; the mouth was constantly open in nine. Eight had an up-and-down movement of the jaw without protrusion of the tongue. These patterns were frequently seen in patients with spastic tetraplegia caused by neonatal asphyxia and compensated for oral motor impairment. Sixteen patients showed lateral movement of the jaw at some time during feeding; in these patients the texture of the food was more coarse than in those with other patterns.

  20. Beyond (Models of) Disability?

    PubMed Central

    Beaudry, Jonas-Sébastien

    2016-01-01

    The strategy of developing an ontology or models of disability as a prior step to settling ethical issues regarding disabilities is highly problematic for two reasons. First, key definitional aspects of disability are normative and cannot helpfully be made value-neutral. Second, if we accept that the contested concept of disability is value-laden, it is far from obvious that there are definitive reasons for choosing one interpretation of the concept over another. I conclude that the concept of disability is better left ethically open-ended or broad enough to encompass the examination of various ethical issues (such as oppression, minority rights, or physical discomfort). Alternatively, the concept of disability could be altogether abandoned in order to focus on specific issues without being hindered by debates about the nature of disability. Only political costs, rather than conceptual considerations internal to the models, could be weighed against such a conclusion. PMID:26892249

  1. 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

  2. Effects of Surface Electrical Stimulation Both at Rest and During Swallowing in Chronic Pharyngeal Dysphagia§

    PubMed Central

    Ludlow, Christy L.; Humbert, Ianessa; Saxon, Keith; Poletto, Christopher; Sonies, Barbara; Crujido, Lisa

    2006-01-01

    We tested two hypotheses using surface electrical stimulation in chronic pharyngeal dysphagia: that stimulation 1) lowered the hyoid bone and/or larynx when applied at rest, and 2) increased aspiration, penetration or pharyngeal pooling during swallowing. Bipolar surface electrodes were placed on the skin overlying the submandibular and laryngeal regions. Maximum tolerated levels of stimulation were applied while patients held their mouth closed at rest. Videofluoroscopic recordings were used to measure hyoid movements in the superior-inferior (s-i) and anterior-posterior (a-p) dimensions and the subglottic air column (s-i) position while stimulation was on and off. Patients swallowed 5 ml liquid when stimulation was off, at low sensory stimulation levels, and at maximum tolerated levels (motor). Speech pathologists blinded to condition, tallied the frequency of aspiration, penetration, pooling and esophageal entry from videofluorographic recordings of swallows. Only significant (p=0.0175) hyoid depression occurred during stimulation at rest. Aspiration and pooling were significantly reduced only with low sensory threshold levels of stimulation (p=0.025) and not during maximum levels of surface electrical stimulation. Those patients who had reduced aspiration and penetration during swallowing with stimulation had greater hyoid depression during stimulation at rest (p= 0.006). Stimulation may have acted to resist patients’ hyoid elevation during swallowing. PMID:16718620

  3. Perindopril increases the swallowing reflex by inhibiting substance P degradation and tyrosine hydroxylase activation in a rat model of dysphagia.

    PubMed

    Ikeda, Jun-ichi; Kojima, Natsuki; Saeki, Kohji; Ishihara, Miki; Takayama, Makoto

    2015-01-05

    Patients with hypertension have a high risk of ischemic stroke and subsequent stroke-associated pneumonia. Stroke-associated pneumonia is most likely to develop in patients with dysphagia. The present study was designed to compare the ameliorative effects of different treatments in rat model of dysphagia. Spontaneously hypertensive rats were treated with bilateral common carotid artery occlusion (BCAO) to induce chronic cerebral hypoperfusion causing disorders of the swallowing reflex. Angiotensin-converting enzyme (ACE) inhibitors (perindopril, imidapril and enalapril), an angiotensin II type 1-receptor blocker (losartan), a vasodilator (hydralazine) and an indirect dopamine agonist (amantadine) were dissolved in drinking water and administered to the rats for six weeks. The blood pressure, the swallowing reflex under anesthesia, the substance P content in the striatum and the tyrosine hydroxylase (TH) expression in the substantial nigra were measured. Compared to the vehicle control, the decrease in the swallowing reflex induced by BCAO was attenuated significantly by enalapril, imidapril and perindopril, but only slightly by losartan. Hydralazine had no effect on the swallowing reflex. Amantadine significantly attenuated the decreased swallowing reflex but increased the blood pressure. Cerebral hypoperfusion for six weeks decreased the TH expression and substance P level. Perindopril improved both the TH expressions and substance P level, but imidapril, enalapril and amantadine only improved the substance P level. The present findings indicate that perindopril could be useful for preventing dysphagia in the chronic stage of stroke by attenuating the decrease in TH expression and the decrease in the substance P level.

  4. 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

  5. Productivity of tree swallows (Tachycineta bicolor) exposed to PCBs at the Kalamazoo River superfund site.

    PubMed

    Neigh, Arianne M; Zwiernik, Matthew J; MacCarroll, Monica A; Newsted, John L; Blankenship, Alan L; Jones, Paul D; Kay, Denise P; Giesy, John P

    2006-03-01

    A 123-km stretch of the Kalamazoo River in Michigan, was designated a Superfund site in 1990 due to historical releases of effluent containing polychlorinated biphenyl (PCB)-contaminated paper waste. Risk to bird species in the river ecosystem was evaluated using the tree swallow (Tachycineta bicolor) as a monitor for possible effects due to PCB exposure at two nesting locations, one in the Superfund site and one in an upstream reference location that is less contaminated with PCBs. In 2 of the 3 years of the study, clutch size at the contaminated location was 3.7 +/- 1.4 and 4.8 +/- 0.73 eggs per nest (mean +/- SD), which was significantly less than the clutch size at the reference location (5.0 +/- 1.1 and 5.3 +/- 1.1 eggs per nest). However, there were no statistically significant differences in fledging success, predicted brood size, predicted number of fledglings, or growth of nestlings between the Kalamazoo River Superfund site and an upstream reference location with lesser concentrations of PCBs in the sediments and riparian soils. Productivity and hatching success comparisons between these same sites were also not significantly different; however, the power of these conclusions was less (p < .10). The reduction in clutch size at the co-contaminated location could not be attributed to PCBs due to a number of confounding factors, including Co-cocontaminants, habitat structure, and food availability. Other reproductive parameters were not significantly impaired, and the size of the newly established colony at the Kalamazoo River Superfund site continued to grow over the period of the study. These site-specific observations, combined with multiple lines of evidence approach that considered results reported for the effects of both total PCBs and 2,3,7,8 tetrachlorodibenzo-p-dioxin equivalents (TEQ) on tree swallows at other locations, suggest that there were no significant population-level effects of PCBs on tree swallows at the Kalamazoo River Superfund site.

  6. 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.

  7. 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.

  8. 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

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

    PubMed

    Aoki, Shiro; Hosomi, Naohisa; 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.

  10. Endoscopic removal of an endodontic file accidentally swallowed: clinical and legal approaches.

    PubMed

    Silva, Rhonan F; Martins, Emerson C; Prado, Felippe B; Júnior, Jacy R C; Júnior, Eduardo D

    2011-08-01

    The use of a rubber dam is an essential procedure when treating root canals, and not using it may compromise the success of the treatment, as well as the patient's health. This report presents a case in which a K-file was accidentally swallowed during an endodontic procedure, performed without the use of a rubber dam. Given the absence of immediate clinical complications, the subject underwent a chest radiograph. The file was located at the oesophagogastric junction and was later removed by endoscopy. In addition to the clinical repercussions, this example also illustrates the ethical-legal aspects of this type of accident.

  11. 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

  12. Dynamic paternity allocation as a function of male plumage color in barn swallows.

    PubMed

    Safran, R J; Neuman, C R; McGraw, K J; Lovette, I J

    2005-09-30

    Paternity in male animals can be influenced by their phenotypic signals of quality. Accordingly, the behavior underlying patterns of paternity should be flexible as signals of quality change. To evaluate the dynamics of paternity allocation, we analyzed paternity before and after manipulating plumage coloration, a known signal of quality, in male barn swallows Hirundo rustica. We found that, in successive breeding bouts, only males whose plumage color was experimentally enhanced received greater paternity from their social mates, demonstrating evidence for flexible and dynamic paternity allocation and the importance for males of maintaining signals of quality well after pair bond formation.

  13. Accidental swallowing of a gold cast crown during orthodontic tooth separation.

    PubMed

    Kharbanda, O P; Varshney, P; Dutta, U

    1995-01-01

    Accidental swallowing of a gold cast crown that became loose after separation with brass wire for orthodontic band placement, is reported. The intervention to remove the ingested crown subsequent to its location in the GI tract on immediate radiographic examination of chest and abdomen included endoscopic examination. Since the crown had past distal to the duodenum it was decided to keep a watch on its movement by daily radiographic examination. The crown passed with excreta on the 5th day uneventfully. Literature on ingestion of foreign bodies of dental origin is reviewed. Possible emergencies and their management is discussed.

  14. 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.

  15. Increased Bolus Volume Effect on Delayed Pharyngeal Swallowing Response in Post-stroke Oropharyngeal Dysphagia: A Pilot Study

    PubMed Central

    2016-01-01

    Objective To confirm a relationship between the pharyngeal response and bolus volume, and examine whether increasing the fluid bolus volume can improve penetration and aspiration for stroke dysphagic patients. Methods Ten stroke patients with a delayed pharyngeal response problem confirmed by a videofluoroscopic swallowing study (VFSS) were enrolled. Each subject completed two swallows each of 2 mL, 5 mL, and 10 mL of barium liquid thinned with water. The pharyngeal delay time (PDT) and penetration-aspiration scale (PAS) were measured and the changes among the different volumes were analyzed. Results PDTs were shortened significantly when 5 mL and 10 mL of thin barium were swallowed compared to 2 mL. However, there was no significant difference in PAS as the bolus volume increased. Conclusion The increased fluid bolus volume reduced the pharyngeal delay time, but did not affect the penetration and aspiration status. PMID:28119831

  16. Spontaneous Swallowing during All-Night Sleep in Patients with Parkinson Disease in Comparison with Healthy Control Subjects

    PubMed Central

    Uludag, Irem Fatma; Tiftikcioglu, Bedile Irem; Ertekin, Cumhur

    2016-01-01

    Study Objectives: Spontaneous saliva swallows (SS) appear especially during sleep. The rate of SS was rarely investigated in all-night sleep in patients with Parkinson disease (PD). Dysphagia is a frequent symptom in PD, but the rate of SS was never studied with an all-night sleep electroencephalogram (EEG). Methods: A total of 21 patients with PD and 18 age-matched healthy controls were included in the study. Frequencies of SS and coughing were studied in all-night sleep recordings of patients with PD and controls. During all-night sleep, video-EEG 12-channel recording was used including the electromyography (EMG) of the swallowing muscles, nasal airflow, and recording of vertical laryngeal movement using a pair of EEG electrodes over the thyroid cartilage. Results: The total number of SS was increased while the mean duration of sleep was decreased in PD when compared to controls. Sialorrhea and clinical dysphagia, assessed by proper questionnaires, had no effect in any patient group. The new finding was the so-called salvo type of consecutive SS in one set of swallowing. The amount of coughing was significantly increased just after the salvo SS. Conclusions: In PD, the rate of SS was not sufficient to demonstrate the swallowing disorder, such as oropharyngeal dysphagia, but the salvo type of SS was quite frequent. This is a novel finding and may contribute to the understanding of swallowing problems in patients with dysphagic or nondysphagic PD. Citation: Uludag IF, Tiftikcioglu BI, Ertekin C. Spontaneous swallowing during all-night sleep in patients with Parkinson disease in comparison with healthy control subjects. SLEEP 2016;39(4):847–854. PMID:26943467

  17. 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,…

  18. 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…

  19. 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...

  20. 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…

  1. 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…

  2. Esophagobronchial fistulae: Diagnosis by MDCT with oral contrast swallow examination of a benign and a malignant cause

    PubMed Central

    Hegde, Rahul G; Kalekar, Tushar M; Gajbhiye, Meenakshi I; Bandgar, Amol S; Pawar, Shephali S; Khadse, Gopal J

    2013-01-01

    We report two cases of esophagobronchial fistulae diagnosed by Multi-detector computed tomography (MDCT) oral contrast swallow examination. It is helpful to supplement the CT study with an oral contrast swallow as it aids in confirmation of a suspected fistula and also demonstrates the fistula tract better. We present the clinical details and the imaging findings on MDCT of two cases of esophagobronchial fistulae – one secondary to chronic chest tuberculosis and the other secondary to a squamous cell carcinoma of the upper esophagus – followed by discussion of the etiology, pathogenesis, and imaging of these fistulae. PMID:24082484

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

    PubMed

    Longcore, Jerry R; Dineli, Reza; Haines, Terry A

    2007-03-01

    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.

  4. 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.

  5. 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.

  6. [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.

  7. 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.

  8. Patterns of esophageal inhibition during swallowing, pharyngeal stimulation, and transient LES relaxation. Lower esophageal sphincter.

    PubMed

    Pouderoux, Philippe; Verdier, Eric; Kahrilas, Peter J

    2003-02-01

    Lower esophageal sphincter (LES) relaxation and esophageal body inhibition co-occur during esophageal peristalsis but not necessarily during pharyngeal stimulation or transient LES relaxation (tLESR). This study examined these relationships and the impact on reflux. Nine young volunteers were studied. An artificial high-pressure zone (HPZ) was established, and pH was recorded 8 and 5 cm proximal to the LES. Pharyngeal stimulation was by water injection and gastric distension with liquid or gas. Peristalsis, pharyngeal stimulation, and spontaneous events were recorded. Swallowing relaxed the LES in 100% of trials (the HPZ in 80%) and caused no reflux. Pharyngeal stimulation relaxed the LES in two-thirds of trials, had no effect on the HPZ, and caused no reflux. Gastric distension was associated with 117 tLESRs, 48% with acid reflux, and 32% with gas reflux; there was no effect on the HPZ. We conclude that LES relaxation is a necessary but not sufficient condition for reflux. LES relaxation and esophageal body inhibition are independent events that may be concurrent (swallowing) or dissociated (tLESR).

  9. Relationships among plumage coloration, blood selenium concentrations and immune responses of adult and nestling tree swallows.

    PubMed

    Beck, Michelle L; Hopkins, William A; Hawley, Dana M

    2015-11-01

    In a number of taxa, males and females both display ornaments that may be associated with individual quality and could be reliable signals to potential mates or rivals. We examined the iridescent blue/green back and white breast of adult tree swallows (Tachycineta bicolor) to determine whether plumage reflectance is related to adult or offspring immune responses. We simultaneously addressed the influence of blood selenium levels and the interaction between blood selenium and plumage coloration on adult and nestling immunity. Selenium is a well-known antioxidant necessary for mounting a robust immune response but its importance in wild birds remains poorly understood. In females, the brightness of white breast coloration was positively associated with bactericidal capacity, but there was no association with blood selenium. In contrast, male bactericidal capacity was associated with an interactive effect between dorsal plumage coloration and blood selenium concentration. Males with bluer hues and greater blue chroma showed increased bactericidal capacity as blood selenium concentrations increased, while bactericidal capacity declined in greener males at higher blood selenium concentrations. In nestlings, bactericidal capacity was positively associated with nestling blood selenium concentrations and white brightness of both social parents. These results suggest that white plumage reflectance is indicative of quality in tree swallows and that greater attention should be paid to the reflectance of large white plumage patches. Additionally, the role of micronutrients, such as selenium, in mediating relationships between physiology and signals of quality, should be explored further.

  10. 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

  11. 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

  12. [Migration of eight harmful elements from metal accessories that infants may swallow by mistake].

    PubMed

    Isama, Kazuo; Kawakami, Tsuyoshi; Nishimura, Tetsuji

    2012-01-01

    The International Standard ISO 8124-3:2010 "Safety of toys--Part 3: Migration of certain elements" controls the levels of migrated eight harmful elements (antimony, arsenic, barium, cadmium, chromium, lead, mercury and selenium) from infants toys. Moreover, the Japanese Food Sanitation Law controls the levels of migrated lead from metal accessory toys. However, the levels of migrated harmful elements from metal accessories that are not infants toys are not controlled, since they are not covered by the ISO Standard or the Food Sanitation Law. Therefore, we investigated the level of eight harmful elements migrated from metal accessories that infants may swallow by mistake. The extraction test of ISO 8124-3:2010 was executed in 117 products (total 184 specimens), and the concentration of these eight elements was measured by inductively coupled plasma mass spectroscopy (ICP-MS). As a result, 28 and one products released lead and cadmium beyond the maximum acceptable levels of the ISO standard, respectively. Metal accessories that infants may swallow by mistake should ideally not release harmful elements such as lead and cadmium.

  13. ELECTROMYOGRAPHIC EVALUATION OF MASTICATION AND SWALLOWING IN ELDERLY INDIVIDUALS WITH MANDIBULAR FIXED IMPLANTSUPPORTED PROSTHESES

    PubMed Central

    Berretin-Felix, Giédre; Nary, Hugo; Padovani, Carlos Roberto; Trindade, Alceu Sergio; Machado, Wellington Monteiro

    2008-01-01

    This study evaluated the effect of implant-supported oral rehabilitation in the mandible on the electromyographic activity during mastication and swallowing in edentulous elderly individuals. Fifteen patients aged more than 60 years were evaluated, being 10 females and 5 males. All patients were edentulous, wore removable complete dentures on both dental arches, and had the mandibular dentures replaced by implant-supported prostheses. All patients were submitted to electromyographic evaluation of the masseter, superior orbicularis oris muscles, and the submental muscles, before surgery and 3, 6 and 18 months postoperatively, using foods of different textures. The results obtained at the different periods were analyzed statistically by Kruskal-Wallis non-parametric test. Statistical analysis showed that only the masseter muscle had a significant loss in electromyographic activity (p<0.001), with a tendency of similar response for the submental muscles. Moreover, there was an increase in the activity of the orbicularis oris muscle during rubber chewing after treatment, yet without statistically significant difference. Mandibular fixed implant-supported prostheses in elderly individuals revealed a decrease in electromyographic amplitude for the masseter muscles during swallowing, which may indicate adaptation to new conditions of stability provided by fixation of the complete denture in the mandibular arch. PMID:19089202

  14. 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

  15. 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.

  16. 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

  17. Testosterone, Plumage Colouration and Extra-Pair Paternity in Male North-American Barn Swallows

    PubMed Central

    Eikenaar, Cas; Whitham, Megan; Komdeur, Jan; van der Velde, Marco; Moore, Ignacio T.

    2011-01-01

    In most monogamous bird species, circulating testosterone concentration in males is elevated around the social female's fertile period. Variation in elevated testosterone concentrations among males may have a considerable impact on fitness. For example, testosterone implants enhance behaviours important for social and extra-pair mate choice. However, little is known about the relationship between natural male testosterone concentration and sexual selection. To investigate this relationship we measured testosterone concentration and sexual signals (ventral plumage colour and tail length), and determined within and extra-pair fertilization success in male North American barn swallows (Hirundo rustica erythrogaster). Dark rusty coloured males had higher testosterone concentrations than drab males. Extra-pair paternity was common (42% and 31% of young in 2009 and 2010, respectively), but neither within- nor extra-pair fertilization success was related to male testosterone concentration. Dark rusty males were less often cuckolded, but did not have higher extra-pair or total fertilization success than drab males. Tail length did not affect within- or extra-pair fertilization success. Our findings suggest that, in North American barn swallows, male testosterone concentration does not play a significant direct role in female mate choice and sexual selection. Possibly plumage colour co-varies with a male behavioural trait, such as aggressiveness, that reduces the chance of cuckoldry. This could also explain why dark males have higher testosterone concentrations than drab males. PMID:21853105

  18. 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.

  19. Congenital difficulties with swallowing and breathing associated with maternal polyhydramnios: neurocristopathy or medullary infarction?

    PubMed

    Alvord, E C; Shaw, C M

    1989-10-01

    Two babies with congenital difficulties in swallowing and breathing are presented and contrasted. Both were associated with maternal polyhydramnios, but one was due to medullary infarction and the other to a malformation ("neurocristopathy"). In the former case, isolated tenth and twelfth cranial nerve palsies provided the clue as to the correct etiology, whereas the latter baby had dyscoordination of swallowing and breathing with sleep apnea ("Ondine's curse"). It is somewhat ironic that the case without a difficult delivery had the infarct, probably prenatal in onset, whereas the one with a difficult delivery had the congenital malformation. Neural crest cells are known to migrate widely and to develop greatly different functions, but the fact that their central associations of neural tube origin may also be affected has not previously been emphasized in the etiopathogenesis of the congenital malformation. A variety of syndromes with combinations of many defects may be seen in which too many or too few cells are formed, with more or less serious consequences especially for the respiratory and gastrointestinal systems.

  20. 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.

  1. Premature infant swallowing: patterns of tongue-soft palate coordination based upon videofluoroscopy.

    PubMed

    Goldfield, Eugene C; Buonomo, Carlo; Fletcher, Kara; Perez, Jennifer; Margetts, Stacey; Hansen, Anne; Smith, Vincent; Ringer, Steven; Richardson, Michael J; Wolff, Peter H

    2010-04-01

    Coordination between movements of individual tongue points, and between soft palate elevation and tongue movements, were examined in 12 prematurely born infants referred from hospital NICUs for videofluoroscopic swallow study (VFSS) due to poor oral feeding and suspicion of aspiration. Detailed post-evaluation kinematic analysis was conducted by digitizing images of a lateral view of digitally superimposed points on the tongue and soft palate. The primary measure of coordination was continuous relative phase of the time series created by movements of points on the tongue and soft palate over successive frames. Three points on the tongue (anterior, medial, and posterior) were organized around a stable in-phase pattern, with a phase lag that implied an anterior to posterior direction of motion. Coordination between a tongue point and a point on the soft palate during lowering and elevation was close to anti-phase at initiation of the pharyngeal swallow. These findings suggest that anti-phase coordination between tongue and soft palate may reflect the process by which the tongue is timed to pump liquid by moving it into an enclosed space, compressing it, and allowing it to leave by a specific route through the pharynx.

  2. Propagation Curve and Velocity of Swallowing Pressure in Healthy Young Adults.

    PubMed

    Matsubara, Keigo; Kumai, Yoshihiko; Samejima, Yasuhiro; Yumoto, Eiji

    2015-12-01

    The objective of this study is to construct a propagation curve and determine propagation velocities in young healthy adults examined using a 2.64-mm-diameter high-resolution manometry catheter with 36 circumferential sensors; to explore data reproducibility; and to determine whether the swallowing pressure (SP) propagation velocity correlated with bolus volume. Repeated measures with subjects serving as their own controls. Thirty healthy subjects (average age 25.3 years) swallowed saliva and 2, 5, and 10 mL of cold water to determine the maximum SP from the soft palate to the cervical esophagus. The SP propagation curve was obtained by plotting the duration to reach each SP peak. The SP propagation velocity was calculated for each region. These parameters were examined according to bolus size and gender. The intra-class correlation coefficient for estimating the SP propagation curves was >0.61 (i.e., highly consistent). The propagation velocity was maximal at the meso-hypopharynx and minimal at the UES and cervical esophagus. The SP propagation curve was very reproducible within any subject. Neither the water volume (with the exception of 2 and 5 mL) nor gender exerted any apparent effect on velocity in any region. However, the velocity was quite variable at the cervical esophagus.

  3. The Role of the Modified Barium Swallow Study and Esophagram in Patients with Globus Sensation.

    PubMed

    Dworkin, James P; Dowdall, Jayme R; Kubik, Mark; Thottam, Prasad John; Folbe, Adam

    2015-10-01

    Globus sensation (GS) is a common benign finding that is often associated with frequent throat clearing and is commonly a result of laryngopharyngeal reflux. The primary objective of this investigation was to examine the role of the modified barium swallow study (MBSS) with esophagram in the diagnosis and management patients who present with chief complaints of a GS. We hypothesize that these radiographic swallow studies do not add clinically significant information in the investigation of this common complaint. Retrospective chart review of patients with chief complaints of GS between 2000 and 2009 who underwent both MBSS and esophagram was conducted. Of the 380 patients who underwent MBSS, only 68 patients were eligible for this study. Over 70 % of patients were on reflux medicines, 81 % of the MBSS studies were normal, 62 % of the esophagram results were normal, 18 % of patients had a hiatal hernia, and 10 % exhibited signs of reflux. Esophagoscopy was performed in 45 % of patients, of which 35 % were normal. One patient initially had a normal esophagogastroduodenoscopy and then was subsequently diagnosed with gastric CA. Fifty-nine percent of patients underwent CT Neck with IV contrast, of which 67 % had minor findings. Positive findings are often benign and can be treated with reflux medications. Esophagoscopy was often normal and most sensitive only for hiatal hernia. No hypopharyngeal cancer was noted. Therefore, MBSS and esophagram for patients with GS are most often negative and fail to add significant diagnostic information.

  4. Difficulty Swallowing

    MedlinePlus

    ... yourself? About Stephen J. Schueler, M.D News Advertising How It Works FAQ for Consumers FAQ for Physicians Testimonials Site Map Terms of Use Contact Us FreeMD is provided for information purposes only and should not be used as a ...

  5. Swallowing problems

    MedlinePlus

    ... Brain aneurysm repair Brain surgery Laryngectomy Multiple sclerosis Oral cancer Parkinson disease Stroke Throat or larynx cancer Patient ... Neck Cancer Huntington's Disease Multiple Sclerosis Muscular Dystrophy Oral Cancer Parkinson's Disease Salivary Gland Cancer Scleroderma Spinal Muscular ...

  6. Swallowing Trouble

    MedlinePlus

    ... often be treated by changing eating and living habits in these ways: Eat a bland diet with smaller, more frequent meals. Eliminate tobacco, alcohol and caffeine. Reduce weight and stress. Avoid food within three hours of bedtime. Elevate ...

  7. Swallowing Disorders

    MedlinePlus

    ... Strategy Current Research Research Funded by NINDS Basic Neuroscience Clinical Research Translational Research Research at NINDS Focus ... Information Current Research Research Funded by NINDS Basic Neuroscience Clinical Research Translational Research Research at NINDS Focus ...

  8. Swallowing difficulty

    MedlinePlus

    ... the muscles Changes in the lining of the esophagus A test called upper endoscopy (EGD) is often done. An endoscope is a ... and surgeries that may be used include: Upper endoscopy: The provider ... esophagus using this procedure. For some people, this needs ...

  9. Swallowing Disorders

    MedlinePlus

    ... disorder, but it is more likely in the elderly. It often happens because of other conditions, including Nervous system disorders, such as Parkinson's disease and cerebral palsy Problems with your esophagus, ...

  10. 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.

  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.

  12. Helping Children Understand Disabilities.

    ERIC Educational Resources Information Center

    Zakariya, Sally Banks

    1978-01-01

    The program described uses simulation activities; exposure to aids and appliances; guest speakers; books, movies, slides, and videotapes; and class discussion to help elementary students understand disabilities. (IRT)

  13. The Matter of Disability.

    PubMed

    Mitchell, David T; Snyder, Sharon L

    2016-12-01

    By ruling out questions of impairment from the social critique of disability, Disability Studies (DS) analyses establish a limit point in the field. Of course the setting of "limits" enables possibilities in multiple directions as well as fortifies boundaries of refusal. For instance, impairment (the biological conditions of an organism's inefficient attachment to the world) becomes in DS simultaneously a productive refusal to interpret disabled bodies as inferior to non-disabled bodies (i.e. pathologized) and a bar to thinking through more active engagements with disability as materiality. Disability materiality such as conditions produced by ecological toxicities serve as active switch-points for creative corporeal navigations of the interaction between bodies and environments.In fact in this paper we want to propose a more "lively" definition of disability materiality to existing definitions of impairment as limiting expressions of non-normative bodies. We have no useful ways of explaining disability as adaptation and it's time we begin the process of theorizing more active ideas of materiality that extend existing ideas of disability beyond simplistic conceptions of socially rejected biologies made available by social constructivist thought.

  14. Evaluation of stroke disability.

    PubMed Central

    Jimenez, J.; Keltz, E.; Stein, M. C.; White, M. M.

    1976-01-01

    The disabilities resulting from a stroke are not well understood from the epidemiologic or functional point of view. The stroke may impair mental status, perception, sensation, communication and motor ability; the total resulting disability is related to the extent of impairment in each of these areas. A complete evaluation in all these areas has to be done to determine the degree of disability before any rehabilitation program is planned. A comprehensive approach to evaluating stroke disability is presented that includes correlating the degree of impairment in each of the above-mentioned areas with the overall functional ability of the patient. PMID:1260603

  15. Culture and Disability Behavior

    PubMed Central

    Brodsky, Carroll M.

    1983-01-01

    A substantial amount of literature suggests that illness behavior in the United States is a product of a patient's core culture; equally credible findings do not support this contention. Most students and graduates in the health care professions believe that illness and disability behavior are affected by a patient's culture, but they are hard put to find convincing examples of that relationship. In experience with medical students studying the social and cultural bases of illness behavior, with patients who are disabled and with persons who claim disability in the absence of physical disease or disabling psychopathology, I observed no deviant disability behavior that was typical for the members of any cultural group, and no behavior was displayed by the members of one cultural group that was not seen in members of other cultural groups. No cultural stereotypes were upheld. I did find evidence that disability behavior is influenced by personality factors, social situations and the gains derived from the disability status. Evolving concepts of “entitlement,” which are closely related to socioeconomic status, also have a significant influence. The impact of feedback from others in a person's many social and medical subcultures is a more crucial determinant of illness and disability behavior, except in those for whom illness and disability behavior is determined by the limitations imposed by the disease or by a personality structure resistant to cultural expectations and social feedback. PMID:6666106

  16. Acoustic and Perceptual Profiles of Swallowing Sounds in Children: Normative Data for 4-36 Months from a Cross-Sectional Study Cohort.

    PubMed

    Frakking, Thuy T; Chang, Anne B; O'Grady, Kerry-Ann F; Yang, Julie; David, Michael; Weir, Kelly A

    2017-04-01

    Limited data on cervical auscultation (CA) sounds during the transitional feeding period of 4-36 months in healthy children exist. This study examined the acoustic and perceptual parameters of swallowing sounds in children aged 4-36 months over a range of food and fluid consistencies. Using CA, swallowing sounds were recorded from a microphone as children ate or drank. Acoustic parameters of duration, peak frequency and peak intensity were determined. Perceptual parameters of swallowing/breath sounds heard pre-, during and post-swallow were rated ('present', 'absent', 'cannot be determined') for each texture. 74 children (35 males; mean age = 17.1 months [SD 10.0]) demonstrated mean swallow durations of <1 s. Increasing age correlated to reduced peak frequency on puree (r = -0.48, 95 % CI -0.66, -0.24). Age correlated to peak amplitude when swallowing puree (r = 0.27, 95 % CI 0.02, 0.49), chewable solids (r = 0.31, 95 % CI 0.02, 0.56) and thin fluids (r = 0.48, 95 % CI 0.27, 0.64). The bolus transit sound was present in all swallows. A majority of children had normal breathing sounds and coordinated swallows. A swallow duration of <1 s and the presence of a quick bolus transit sound with normal breathing sounds were found in healthy children. The normative data reported in this study provide a platform for future comparison to abnormal swallowing sounds in children.

  17. Vasectomy and its reversal.

    PubMed

    Belker, A M

    1985-12-01

    Techniques, results, complications, and medicolegal aspects of vasectomy are discussed in this article. Emphasis is placed on techniques that prevent spontaneous recanalization of the ends of the vas deferens after vasectomy. Factors that affect the reversibility of vasectomy are discussed. New microsurgical techniques of vasectomy reversal are described, and results of these new techniques are compared with results of nonmicrosurgical techniques of vasectomy reversal. Indications for bypass vasoepididymostomy during vasectomy reversal procedures, as well as techniques for performing vasoepididymostomy, are discussed.

  18. 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…

  19. 77 FR 8234 - National Institute on Disability and Rehabilitation Research-Disability and Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-14

    ... National Institute on Disability and Rehabilitation Research-- Disability and Rehabilitation Research... Disability and Rehabilitation Research-- Disability and Rehabilitation Research Projects and Centers Program-- Disability and Rehabilitation Research Project--Center on Knowledge Translation for Disability...

  20. The effect of prophylactic percutaneous endoscopic gastrostomy (PEG) tube placement on swallowing and swallow-related outcomes in patients undergoing radiotherapy for head and neck cancer: a systematic review.

    PubMed

    Shaw, Stephanie M; Flowers, Heather; O'Sullivan, Brian; Hope, Andrew; Liu, Louis W C; Martino, Rosemary

    2015-04-01

    Patients undergoing radiotherapy for head and neck cancer (HNC) often experience malnutrition and dehydration during treatment. As a result, some centres place PEG tubes prophylactically (pPEG) to prevent these negative consequences. However, recent research has suggested that pPEG use may negatively affect swallowing physiology, function and/or quality of life, especially in the long term. The purpose of this study was to systematically review the literature on pPEG use in HNC patients undergoing radiotherapy and to determine its impact on swallowing-related outcomes. The following electronic databases were searched for all relevant primary research published through February 24, 2014: AMED, CINAHL, the Cochrane Library, Embase, Healthstar, Medline, and PsycINFO. Main search terms included HNC, radiotherapy, deglutition disorders, feeding tube(s), and prophylactic or elective. References for all accepted papers were hand searched to identify additional relevant research. Methodological quality was assessed using Cochrane's Risk of Bias. At all levels, two blinded raters provided judgments. Discrepancies were resolved by consensus. The search retrieved 181 unique citations. Twenty studies met our inclusion criteria. Quality assessment revealed that all studies were at risk for bias due to non-randomized sampling and unreported or inadequate blinding. Ten studies demonstrated selection bias with significant baseline differences between pPEG patients and controls. Results regarding the frequency and severity of dysphagia and swallowing-related outcomes were varied and inconclusive. The impact of pPEG use on swallowing and swallowing-related outcomes remains unclear. Well-controlled, randomized trials are needed to determine if pPEG places patients at greater risk for developing long-term dysphagia.

  1. The Disabled: Media's Monster.

    ERIC Educational Resources Information Center

    Bogdan, Robert; And Others

    1982-01-01

    From the early nineteenth century to the present, horror, gangster, and adventure films, television, the comics, and newspapers have shown physical and mental disabilities to connote murder, violence, and danger. Such false portrayals have promoted negative public attitudes toward people with disabilities. (Author/MJL)

  2. 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…

  3. 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…

  4. Permanent Disability Evaluation

    PubMed Central

    Chovil, A. C.

    1975-01-01

    This paper is a review of the theory and practice of disability evaluation with emphasis on the distinction between medical impairment and disability. The requirements for making an accurate assessment of medical impairments are discussed. The author suggests three basic standards which can be used for establishing a simplified method of assessing physical impairment. PMID:20469213

  5. Learning Disabled Students.

    ERIC Educational Resources Information Center

    Hoy, Cheri; Gregg, Noel

    1986-01-01

    The emerging population of learning disabled college students is presenting a new challenge to college professionals: admission officers, counselors, financial aid personnel, academic advisors, and professors. Learning disablities interfere with the ability to perceive, process, sort, store, or retrieve information regardless of level of…

  6. 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…

  7. Disciplining Students with Disabilities

    ERIC Educational Resources Information Center

    Burton, Janieth

    2012-01-01

    Discipline in schools can be difficult, especially when dealing with students with disabilities. In fact, Clash (2006) reported that working with students with disabilities under stringent legal demands has become a source of stress for many principals. The typical principal has not received extensive preservice or inservice training in this area.…

  8. Analyzing Disability Accommodation Statements

    ERIC Educational Resources Information Center

    Barnard-Brak, L.; Lan, W. Y.

    2011-01-01

    Studies have indicated that the willingness of faculty members to accommodate students with disabilities differs according to academic discipline and instructor gender. The authors examined the attitudes of faculty members toward students with disabilities as reflected in course syllabi to discern instructor willingness to accommodate these…

  9. 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…

  10. 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…

  11. 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…

  12. Disabled Students of Color.

    ERIC Educational Resources Information Center

    Frank, Zelma Lloyd; Ball-Brown, Brenda

    1993-01-01

    Explores why few disabled students of color use student services. Details why some of these students were unnecessarily placed in special education programs and focuses on the experiences of this group. Addresses general cultural differences that can affect responses between people of color and disability services. Provides guidelines for service…

  13. Learning about Disabilities.

    ERIC Educational Resources Information Center

    Popp, Rita Ann

    1983-01-01

    The author describes lessons provided for regular class elementary students to help them understand disabilities and disabled persons. Objectives, materials needed, and activities are outlined for six lessons focusing on the following topics: individual differences, wheelchairs; devices that help people walk; amputation, artificial limbs, and…

  14. 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…

  15. Transporting Students with Disabilities.

    ERIC Educational Resources Information Center

    Mawdsley, Ralph D.

    1998-01-01

    Under the 1973 Rehabilitation Act (Section 504) and the Individuals with Disabilities Education Act, school districts must transport students with disabilities to a site providing a free, appropriate education in the least restrictive environment. This article discusses federal and state laws governing student transportation, including wheelchair…

  16. 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…

  17. 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:…

  18. 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

  19. Identification of the most significant electrode positions in electromyographic evaluation of swallowing-related movements in humans.

    PubMed

    Zaretsky, E; Pluschinski, P; Sader, R; Birkholz, P; Neuschaefer-Rube, C; Hey, Christiane

    2017-02-01

    Surface electromyography (sEMG) is a well-established procedure for recording swallowing-related muscle activities. Because the use of a large number of sEMG channels is time consuming and technically sophisticated, the aim of this study was to identify the most significant electrode positions associated with oropharyngeal swallowing activities. Healthy subjects (N = 16) were tested with a total of 42 channels placed in M. masseter, M. orbicularis oris, submental and paralaryngeal regions. Each test subject swallowed 10 ml of water five times. After having identified 16 optimal electrode positions, that is, positions with the strongest signals quantified by the highest integral values, differences to 26 other ones were determined by a Mann-Whitney U test. Kruskal-Wallis H test was utilized for the analysis of differences between single subjects, subject subgroups, and single electrode positions. Factors associated with sEMG signals were examined in a linear regression. Sixteen electrode positions were chosen by a simple ranking of integral values. These positions delivered significantly higher signals than the other 26 positions. Differences between single electrode positions and between test subjects were also significant. Sixteen most significant positions were identified which represent swallowing-related muscle potentials in healthy subjects.

  20. 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.

  1. In vivo observations and in vitro experiments on the oral phase of swallowing of Newtonian and shear-thinning liquids.

    PubMed

    Mowlavi, S; Engmann, J; Burbidge, A; Lloyd, R; Hayoun, P; Le Reverend, B; Ramaioli, M

    2016-12-08

    In this study, an in vitro device that mimics the oral phase of swallowing is calibrated using in vivo measurements. The oral flow behavior of different Newtonian and non-Newtonian solutions is then investigated in vitro, revealing that shear-thinning thickeners used in the treatment of dysphagia behave very similar to low-viscosity Newtonian liquids during active swallowing, but provide better control of the bolus before the swallow is initiated. A theoretical model is used to interpret the experimental results and enables the identification of two dynamical regimes for the flow of the bolus: first, an inertial regime of constant acceleration dependent on the applied force and system inertia, possibly followed by a viscous regime in which the viscosity governs the constant velocity of the bolus. This mechanistic understanding provides a plausible explanation for similarities and differences in swallowing performance of shear-thinning and Newtonian liquids. Finally, the physiological implications of the model and experimental results are discussed. In vitro and theoretical results suggest that individuals with poor tongue strength are more sensitive to overly thickened boluses. The model also suggests that while the effects of system inertia are significant, the density of the bolus itself plays a negligible role in its dynamics. This is confirmed by experiments on a high density contrast agent used for videofluoroscopy, revealing that rheologically matched contrast agents and thickener solutions flow very similarly. In vitro experiments and theoretical insights can help designing novel thickener formulations before clinical evaluations.

  2. Test-retest reliability of motor evoked potentials (MEPs) at the submental muscle group during volitional swallowing.

    PubMed

    Doeltgen, Sebastian H; Ridding, Michael C; O'Beirne, Greg A; Dalrymple-Alford, John; Huckabee, Maggie-Lee

    2009-03-30

    Motor evoked potentials (MEPs) recorded from pharyngeal and anterior hyo-mandibular (submental) muscles at rest have been used to evaluate treatment effects on neural pathways underlying swallowing. This study documents a novel methodological approach of recording reliable intra- and inter-session MEPs at the submental muscle group during task-related volitional swallowing. MEPs were elicited by single-pulse transcranial magnetic stimulation (TMS), triggered by a custom-made system when a pre-set level of surface electromyographic activity in the target muscles was breached. Fifteen MEPs were recorded during each of four sessions. Intraclass correlation coefficients (ICCs) were used to assess test-retest reliability within and across sessions for blocks of 3, 5, 10 and 15 trials. Highly reliable intra-session reliability was achieved, maximal for blocks of five trials (0.915). Inter-session reliability varied between 0.474 (three trials per block) and 0.909 (10 trials per block). Surface electromyography-triggered TMS allows reliable measurement of MEP amplitude at the submental muscle group within and across sessions when muscles are pre-activated during volitional swallowing. This methodology will be useful for future investigations on the effects of pathology and modulation of swallowing neural pathways.

  3. Impact of the defoliating moth Hypena opulenta on invasive swallow-worts (Vincetoxicum species) under different light environments

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Black and pale swallow-wort (Vincetoxicum nigrum and V. rossicum, Apocynaceae: Asclepiadoideae) are twining vines from Europe that have become invasive in the northeastern USA and southeastern Canada. Hypena opulenta (Christoph) (Lepidoptera: Erebidae), a defoliating forest moth from the Ukraine, ha...

  4. 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.

  5. Swallowing rehabilitation with nutrition therapy improves clinical outcome in patients with dysphagia at an acute care hospital.

    PubMed

    Iwamoto, Masako; Higashibeppu, Naoki; Arioka, Yasutaka; Nakaya, Yutaka

    2014-01-01

    Dysphagia is associated with nutritional deficits and increased risk of aspiration pneumonia. The aim of the present study was to evaluate the impact of nutrition therapy for the patients with dysphagia at an acute care hospital. We also tried to clarify the factors which improve swallowing function in these patients. Seventy patients with dysphagia were included in the present study. Multidisciplinary nutrition support team evaluated swallowing function and nutrition status. Most patients were fed by parenteral or enteral nutrition at the time of the first round. Of these 70 patients, 36 became able to eat orally. The improvement of swallowing function was associated with higher BMI in both genders and higher AMC in men. Mortality was high in the patients with lower BMI and %AMC, suggesting importance of maintaining muscle mass. Thirteen (38.2%) of 34 patients who did not show any improvement in swallowing function died, but no patients who showed improvement died (p<0.001). In addition, the patients with nutrition intake about<22 kcal/kg/day during follow-up period, showed significantly poorer recovery from dysphagia and poor outcome, compared to those with about>22 kcal/kg/day. These results suggest that it is important to maintain nutritional status to promote rehabilitation in patients with dysphagia even in an acute care hospital.

  6. 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...

  7. 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…

  8. 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.

  9. Identification of dysphagia using the Toronto Bedside Swallowing Screening Test (TOR-BSST©): are 10 teaspoons of water necessary?

    PubMed

    Martino, Rosemary; Maki, Ellen; Diamant, Nicholas

    2014-06-01

    Dysphagia screening often includes administration of water. This study assessed the accuracy in identifying dysphagia with each additional teaspoon of water. The original research of the TOR-BSST(©) permitted this assessment. Trained nurses from acute and rehabilitation facilities prospectively administered the TOR-BSST(©) to 311 eligible stroke inpatients. A sensitivity analysis was conducted for the water item using 10 teaspoons plus a sip as the standard. The proportion of positive screenings was 59.2% in acute and 38.5% in rehabilitation. Of all four items that form the TOR-BSST(©), the water swallow item contributed to the identification of dysphagia in 42.7% in acute and 29.0% in rehabilitation patients. Across all patients, dysphagia accuracy was that five teaspoons resulted in a sensitivity of 79% (95% confidence interval [CI] = 70-86), eight a sensitivity of 92% (95% CI = 85-96) and 10 a sensitivity of 96% (95% CI = 90-99). Although a primary contributor, the water swallow item alone does not identify all patients with dysphagia. For a water swallow to accurately identify dysphagia, it is critical to administer 10 teaspoons. The TOR-BSST(©) water swallow item contributes largely to the total TOR-BSST(©)'s screening score and in making the test highly accurate and reliable.

  10. 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…

  11. Spatial and temporal variation in the diet of tree swallows: implications for trace-element exposure after habitat remediation.

    PubMed

    Beck, Michelle L; Hopkins, William A; Jackson, Brian P

    2013-10-01

    Emerging aquatic insects play a key role in transporting aquatic contaminants into terrestrial ecosystems. Tree swallows are frequently the focus of studies examining this movement because they are thought to forage heavily on emerging aquatic insects when breeding in riparian areas. We examined the tree swallow diet to determine if trace elements from a recently remediated coal fly ash spill were moving into the terrestrial ecosystem. We collected bolus samples from adult tree swallows as they entered the nest box to feed their young. Despite strategically locating boxes in riparian areas, we found that the consumption of insects with an aquatic larval stage ranged from 28 to 75% of insects among colonies. We also found significant differences among colonies in the taxa found in bolus samples. Chironomidae (midges) were the primary emerging aquatic insects consumed by tree swallows, whereas Ephemeroptera were brought to nestlings infrequently. The consumption of insects with an aquatic larval stage, Chironomidae in particular, was positively correlated with exposure to trace elements from the spill. Bolus samples from the spill site contained greater concentrations of many trace elements compared with reference locations, but concentrations of most elements were lower than levels thought to cause reproductive impairment. These results support the hypothesis that emerging aquatic insects transport trace elements to terrestrial consumers and that Chironomidae play an important role in this movement. Our results also indicate that it is important to assess the composition of the diet and to not infer exposure to trace elements based on nesting location.

  12. 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'.

  13. 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...

  14. 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

    ... 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 Act... California red-legged frog on the property subject to the Agreement (Enrolled Property), which is owned...

  15. 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.

  16. Sexual selection for white tail spots in the barn swallow in relation to habitat choice by feather lice.

    PubMed

    Kose; Mänd; Møller

    1999-12-01

    Many bird species have white spots in their tails or wing feathers, and such characters have been hypothesized to be either reliable signals (handicaps) or amplifiers that facilitate the message of a signal. In barn swallows, Hirundo rustica, the size of the white spots in the tail feathers is sexually dimorphic and positively correlated with feather length. We tested whether such spots act as handicaps or amplifiers. These white spots affect sexual selection in barn swallows, as shown by an experiment in which we randomly subjected males to (1) a considerable reduction of the size of all the spots by the use of a black permanent marker pen, (2) a small reduction of the size of the spots, or (3) no reduction. There was a positive association between spot size and the number of offspring produced per season. The white tail spots were preferred by feather-eating Mallophaga as a feeding site: holes made by Mallophaga were more abundant in the white spots than expected by chance. A habitat choice experiment with Mallophaga on barn swallow tail feathers revealed that they preferred white spots over black parts of the tail feathers. We therefore expected long-tailed male barn swallows to have more Mallophaga than short-tailed males. However, the opposite relationship was observed, indicating that long-tailed males may reliably signal their quality by the presence of large white tail spots without parasite damage. Thus white tail spots in barn swallows appear to be a reliable signal of phenotypic quality. Copyright 1999 The Association for the Study of Animal Behaviour.

  17. 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.

  18. Human esophageal response during chest pain induced by swallowing cold liquids.

    PubMed

    Meyer, G W; Castell, D O

    1981-11-06

    Normal persons often note chest or back pain during rapid ingestion of cold liquids, commonly believed to result from cold-induced "spasm" of esophageal muscle. We studied the effects of swallowing cold liquids on esophageal function in five normal subjects, aged 20 to 44 years, by comparing their response to cold ice cream (-5 degrees C) and room temperature ice cream mix (20 degrees C). Decreased peristaltic amplitude was seen during cold ice cream ingestion, primarily in the midesophagus. When seven subjects rapidly ingested ice cream until chest pain was produced and maintained for at least 60 s, complete absence of motor activity in the distal esophagus occurred, with slow return to normal during the ensuing five minutes. Our studies indicate that ingestion of cold liquids significantly depresses peristaltic amplitudes and frequency of peristalsis in normal persons, and pain is associated with complete absence of motor activity in the body of the esophagus, rather than esophageal "spasm" as commonly believed.

  19. Differential effects of egg albumen content on barn swallow nestlings in relation to hatch order.

    PubMed

    Ferrari, R P; Martinelli, R; Saino, N

    2006-05-01

    In diverse animal taxa, egg mass variation mediates maternal effects with long-term consequences for offspring ontogeny and fitness. Patterns of egg mass variation with laying order differ considerably among birds, but no study has experimentally investigated the function of variation in albumen or yolk egg content in the wild. In barn swallows (Hirundo rustica), absolute and relative albumen mass increased with egg laying order. Experimental albumen removal delayed hatching, had larger negative effects on growth of late-hatched nestlings, and reduced nestling survival. Laying order positively predicted hatch order. Because nestling competitive ability depends on size, and albumen egg content influences hatchling size, present results suggest that by increasing albumen content of late eggs mothers reduce hatching asynchrony and enhance growth particularly of late-hatched nestlings. Thus, variation in albumen mass with laying order may function to mitigate the negative phenotypic consequences of hatching late in species that adopt a 'brood-survival' strategy.

  20. FETAL RAT INTESTINAL ABSORPTION OF HORSERADISH PEROXIDASE FROM SWALLOWED AMNIOTIC FLUID

    PubMed Central

    Orlic, Donald; Lev, Robert

    1973-01-01

    Horseradish peroxidase (HRP) injected into amniotic fluid is swallowed by rat fetuses and within 3–6 h reaches the gut lumen. This macromolecular protein is then absorbed by the columnar lining cells via a system of apical cytoplasmic tubules formed by invaginations of the plasma membrane. From cytoplasm subjacent to the brush border HRP is transported, within vacuoles, to the supranuclear region, where some is retained for at least 18 h, and to interepithelial spaces. Extracellular enzyme is then found throughout the epithelial basement membrane and between connective tissue cells of the mucosal and submucosal layers Finally, HRP can be detected within lumina of blood and lymphatic capillaries, strongly suggesting that it is transported from the intestine to the circulation. PMID:4118449

  1. Ontogeny of innate and adaptive immune defense components in free-living tree swallows, Tachycineta bicolor.

    PubMed

    Palacios, Maria G; Cunnick, Joan E; Vleck, David; Vleck, Carol M

    2009-04-01

    Little is known about the development of immune function in wild animals. We investigated the ontogeny of immune defense in a free-living bird, the tree swallow. We assessed total and differential leukocyte counts, natural antibodies, complement activity, in vivo skin swelling response, and in vitro lymphocyte proliferation and compared the levels of development between nestlings and young adults. We also assessed whether body condition explained variation in these immune components. We found some support for the prediction that innate defenses, which do not need to generate a broad repertoire of specific receptors, would reach adult levels earlier than adaptive defenses. In contrast, we found limited support for the prediction that adaptive defenses, which are thought to be more costly to develop, would be more related to body condition than innate defenses. We discuss our findings in the context of other studies on the ontogeny of immune function.

  2. Exploring Postsecondary Education Disability Service's Standards: Alignment with Disability Studies

    ERIC Educational Resources Information Center

    Guzman, Alberto

    2009-01-01

    A study analyzing the perspectives held by higher education's disability service providers in regards to disability and/or students with disabilities in the implementation of program standards was carried out using a sequential mixed-methods design. Using the knowledge gather by Disability Studies scholars, the study used the constructs of…

  3. Tree swallow (Tachycineta bicolor) exposure to polychlorinated biphenyls at the Kalamazoo River superfund site, Michigan, USA.

    PubMed

    Neigh, Arianne M; Zwiernik, Matthew J; Bradley, Patrick W; Kay, Denise P; Park, Cyrus S; Jones, Paul D; Newsted, John L; Blankenship, Alan L; Giesy, John P

    2006-02-01

    In 1990, a portion of the Kalamazoo River in Michigan, USA, was designated a Superfund site because of the presence of polychlorinated biphenyls (PCBs) in the sediment and floodplain soils. During a four-year period from 2000 to 2003, several avian species were monitored for reproductive effects and concentrations of PCBs in tissues attributed to food chain transfer from contaminated sediments. The tree swallow (Tachycineta bicolor) was chosen as a model receptor for contamination of passerine species. A top-down methodology was used to evaluate the bioaccumulation of PCBs, including non-ortho and mono-ortho congeners, in tree swallow eggs, nestlings, and adults at the Kalamazoo River area of concern (KRAOC) and at an upstream reference site. Generally, a sixfold difference in tissue concentrations of total PCBs was observed between the two sites with concentrations in eggs and nestlings at the KRAOC ranging from 0.95 to 15 microg PCB/g wet weight. Concentrations of 2,3,7,8-tetrachlorodibenzo-p-dioxin equivalents (TEQsWHO Avian) for PCBs, based on bird-specific World Health Organization toxic equivalence factors, were 10- to 30-fold greater in the KRAOC than at the reference location. Egg and nestling TEQsWHO-Avian ranged from 0.21 to 2.4 ng TEQ/g wet weight at the KRAOC. Hazard quotients calculated from literature-derived toxicity reference values were below 1.0 at both the target and the reference site based on the no-observed-adverse-effect level and the lowest-observed-adverse-effect level.

  4. 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.

  5. 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.

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

    USGS Publications Warehouse

    Sykes, P.W.; 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.

  7. 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.

  8. Recommendation of Nasogastric Tube Removal in Acute Stroke Patients Based on Videofluoroscopic Swallow Study

    PubMed Central

    2017-01-01

    Objective To evaluate the safety of nasogastric tube (NGT) removal and change to oral feeding with a food thickener for acute stroke patients in whom a videofluoroscopic swallow study (VFSS) confirmed thin liquid aspiration. Methods We retrospectively examined data of 199 patients with first stroke who were diagnosed with dysphagia from 2011 to 2015. Swallowing function was evaluated using VFSS. Patients included in this study were monitored for 4 weeks to identify the occurrence of aspiration pneumonia. The penetration-aspiration scale (PAS) was used to assess VFSS findings. The patients were divided into thin-liquid aspiration group (group 1, n=104) and no thin-liquid aspiration group (group 2, n=95). Results The feeding method was changed from NGT feeding to oral feeding with food thickener (group 1) and without food thickener (group 2). The PAS scores of thin and thick liquids were 6.46±0.65 and 1.92±0.73, respectively, in group 1 and 2.65±0.74 and 1.53±0.58, respectively, in group 2. Aspiration pneumonia developed in 1.9% of group 1 and 3.2% of group 2 (p=0.578), with no significant difference between the groups. Conclusion We concluded that removing the NGT and changing to oral feeding with a food thickener is a safe food modification for acute stroke patients with thin liquid aspiration. Therefore, we recommend that VFSS should be conducted promptly in acute stroke patients to avoid unnecessary prolonged NGT feeding. PMID:28289630

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. 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

  14. Intellectual Disabilities. NICHCY Disability Fact Sheet #8

    ERIC Educational Resources Information Center

    National Dissemination Center for Children with Disabilities, 2011

    2011-01-01

    "Intellectual disability" is a term used when a person has certain limitations in mental functioning and in skills such as communicating, taking care of him or herself, and social skills. These limitations will cause a child to learn and develop more slowly than a typical child. Following a brief story about a child with an intellectual…

  15. The eyeglass reversal.

    PubMed

    Oh, Songjoo

    2011-07-01

    Some figures, such as the Necker cube, are spontaneously reversible between alternative percepts. Before learning those skilled reversals, how do people achieve reversals for the very first time? It has been known that, in the case of a first reversal, people can be expected to see the reversal when given specific information about how the figures are ambiguous. This point was confirmed by using drawing versions of reversible figures. To demonstrate how intention plays a role in the initial reversal of a real object, a pair of regular eyeglasses, reversible in perspective, were presented to naïve observers in monocular vision. When the eyeglasses were viewed inwardly and the observers were given information that the eyeglasses could be ambiguous, they were able to easily see the reversal. When the eyeglasses were viewed outwardly, observers saw it only after they had been informed of exactly what the two alternative percepts were.Interestingly, many observers often mistakenly saw the inwardly viewed eyeglasses as placed outwardly from the beginning of the observation, while they saw the outwardly viewed eyeglasses correctly. Taking these results together, for the first reversal of a real object, the specificity of intention varies with the ambiguity of the object.

  16. 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.

  17. 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…

  18. 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…

  19. 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…

  20. 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.