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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. Swallowing Foreign Bodies as an Example of Impulse Control Disorder in a Patient With Intellectual Disabilities

    PubMed Central

    Tettenborn, Christian; Schneider, Udo; Ohlmeier, Martin D.; Zedler, Markus; Zakhalev, Roman; Krueger, Martin

    2010-01-01

    Objective. Foreign body ingestion can be a challenge to multiprofessional approaches involving medical, surgical, neurological, and psychiatric teams. Case presentation. A 41-year-old male patient with intellectual disabilities presented after having swallowed approximately 20 sharp objects. While admitted to a psychiatric ward, surgeons removed a glove from his stomach endoscopically and pharmacologically facilitated the objects' complication-free bowel passage. The patient explained the swallowing as a means to release himself from tension induced by stress. His aberrant behavior also seemed to serve as a means to exert pressure on psychosocial workers. Other deviations included the pushing of sharp objects under the skin and multiple paraphiliae. As a child, the patient suffered from early psychological and physical traumatization. Both parents were allegedly physically abusive alcoholics. Conclusion. Apart from possible alcohol embryopathy and traumatic brain damage, meningitis, which the patient had at the age of three, is discussed as the most likely reason for his oligophrenia, associated with left-sided, temporo-parietal atrophy and epilepsy. PMID:20941350

  3. Swallowing difficulty

    MedlinePlus

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

  4. Swallowing Disorders

    MedlinePlus

    ... Others may have trouble swallowing liquids, foods, or saliva. This makes it hard to eat. Often, it can be difficult to take in enough calories and fluids to nourish your body. Anyone can have a ...

  5. Endoscopic Evaluation of Swallowing (Endoscopy)

    MedlinePlus

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

  6. Swallowing chalk

    MedlinePlus

    Chalk is a form of limestone. Chalk poisoning occurs when someone accidentally or intentionally swallows chalk. This article is for information only. Do NOT use it to treat or manage an actual poison exposure. If you or someone you are with has ...

  7. Videofluoroscopic Swallowing Study (VFSS)

    MedlinePlus

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

  8. Senators seek to reverse Supreme Court on disability rights.

    PubMed

    1998-09-18

    U.S. Senators Thurmond and Helms are seeking to undo the U.S. Supreme Court's ruling that requires State and local prisons to offer inmates the services that are mandated by Federal disability-rights laws. Their proposed legislation, called S.2266, would exempt State and local prisons from the public accommodations requirements contained in the Americans with Disabilities Act and the Rehabilitation Act. The Senators believe that if the Court's ruling is not amended, prisoners will file endless lawsuits to seek special privileges, which would drag Federal judges into the particulars of running State and local prisons.

  9. "What's the difference?" women's wheelchair basketball, reverse integration, and the question(ing) of disability.

    PubMed

    Spencer-Cavaliere, Nancy; Peers, Danielle

    2011-10-01

    The inclusion of able-bodied athletes within disability sport, a phenomenon known as reverse integration, has sparked significant debate within adapted physical activity. Although researchers and practitioners have taken up positions for or against reverse integration, there is a lack of supporting research on the experiences of athletes who already play in such settings. In this study, we explore how competitive female athletes who have a disability experience reverse integration in Canadian wheelchair basketball. Athletic identity was used as the initial conceptual framework to guide semistructured interviews with nine participants. The results suggest that participation in this context contributed to positive athletic identities. Interviews also pointed to the unexpected theme of "what's the difference?" that this sporting context provided a space for the questioning and creative negotiation of the categories of disability and able-bodiedness. Methodologically, this paper also explores the possibilities and challenges of inter- worldview and insider-outsider research collaboration.

  10. 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…

  11. Tailored Barium Swallow Study

    MedlinePlus

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

  12. [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.

  13. 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.

  14. [The neural mechanisms underlying swallowing].

    PubMed

    Inoue, Makoto

    2015-02-01

    Swallowing is regarded as the first step in nutrition; it transports food boluses and liquid from the mouth to the stomach and is a defensive response to prevent aspiration. Swallowing movements are produced by a central pattern generator (CPG) located in the lower brainstem. The swallowing CPG includes two main groups of neurons: one is located within the nucleus tractus solitarii and contains the generator neurons involved in triggering, shaping, and timing the sequential or rhythmic swallowing pattern and the other is located in the ventrolateral medulla and contains switching neurons that distribute the swallowing drive to various pools of related motoneurons. Swallowing movements can be triggered by either central inputs or peripheral inputs from pharyngeal and laryngeal regions, but the precise neural mechanisms of the swallowing CPG remain to be fully elucidated. This review discusses the fundamental knowledge of ingestion behaviors, with a focus on swallowing.

  15. [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.

  16. The Swallow Park Sundials

    NASA Astrophysics Data System (ADS)

    De Villiers, P.

    2014-02-01

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

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

    ERIC Educational Resources Information Center

    Pritchard, Andrew; Roy, Ashok

    2006-01-01

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

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

    PubMed

    Kley, C; Biniek, R

    2005-12-01

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

  19. 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…

  20. Difficulty Swallowing After Stroke (Dysphagia)

    MedlinePlus

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

  1. What Happens to Swallowed Gum?

    MedlinePlus

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

  2. Reversal of axonal loss and disability in a mouse model of progressive multiple sclerosis

    PubMed Central

    Basso, Alexandre S.; Frenkel, Dan; Quintana, Francisco J.; Costa-Pinto, Frederico A.; Petrovic-Stojkovic, Sanja; Puckett, Lindsay; Monsonego, Alon; Bar-Shir, Amnon; Engel, Yoni; Gozin, Michael; Weiner, Howard L.

    2008-01-01

    Axonal degeneration is an important determinant of progressive neurological disability in multiple sclerosis (MS). Thus, therapeutic approaches promoting neuroprotection could aid the treatment of progressive MS. Here, we used what we believe is a novel water-soluble fullerene derivative (ABS-75) attached to an NMDA receptor antagonist, which combines antioxidant and anti-excitotoxic properties, to block axonal damage and reduce disease progression in a chronic progressive EAE model. Fullerene ABS-75 treatment initiated after disease onset reduced the clinical progression of chronic EAE in NOD mice immunized with myelin-oligodendrocyte glycoprotein (MOG). Reduced disease progression in ABS-75–treated mice was associated with reduced axonal loss and demyelination in the spinal cord. Fullerene ABS-75 halted oxidative injury, CD11b+ infiltration, and CCL2 expression in the spinal cord of mice without interfering with antigen-specific T cell responses. In vitro, fullerene ABS-75 protected neurons from oxidative and glutamate-induced injury and restored glutamine synthetase and glutamate transporter expression in astrocytes under inflammatory insult. Glutamine synthetase expression was also increased in the white matter of fullerene ABS-75–treated animals. Our data demonstrate the neuroprotective effect of treatment with a fullerene compound combined with a NMDA receptor antagonist, which may be useful in the treatment of progressive MS and other neurodegenerative diseases. PMID:18340379

  3. 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.

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

    PubMed

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

    2014-05-23

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

    PubMed Central

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

    2014-01-01

    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 laryngeal 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 different 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 confirmed 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. PMID:25332758

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

    PubMed Central

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

    2013-01-01

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

  7. [Case report: swallowed hearing aid].

    PubMed

    Walther, E K

    1995-11-01

    An 86-year-old man presented ambulatory with acute dysphagia. Radiologic examination and endoscopy revealed a swallowed postauricular hearing aid. The earmold of the hearing aid became visible in the hypopharynx after mucus and saliva were removed. It could be extracted without effort once the connecting tube was disconnected from the coupling device lodged in the upper esophageal sphincter. The hearing aid itself was impacted in the proximal esophagus and was extracted without any problems. The postoperative phase was uneventful with normal swallowing and discharge. Technical inspection revealed that the hearing aid no longer worked. Diffusion of toxic substances (zinc, mercury) from the impacted batteries is not to be expected.

  8. Effects of chemoradiotherapy on voice and swallowing

    PubMed Central

    Lazarus, Cathy L.

    2009-01-01

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

  9. 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…

  10. 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…

  11. How to swallow an elephant

    SciTech Connect

    Powell, K.B.

    1995-03-01

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

  12. Coordination of Mastication, Swallowing and Breathing

    PubMed Central

    Matsuo, Koichiro; Palmer, Jeffrey B.

    2009-01-01

    Summary The pathways for air and food cross in the pharynx. In breathing, air may flow through either the nose or the mouth, it always flows through the pharynx. During swallowing, the pharynx changes from an airway to a food channel. The pharynx is isolated from the nasal cavity and lower airway by velopharyngeal and laryngeal closure during the pharyngeal swallow. During mastication, the food bolus accumulates in the pharynx prior to swallow initiation. The structures in the oral cavity, pharynx and larynx serve multiple functions in breathing, speaking, mastication and swallowing. Thus, the fine temporal coordination of feeding among breathing, mastication and swallowing is essential to provide proper food nutrition and to prevent pulmonary aspiration. This review paper will review the temporo-spatial coordination of the movements of oral, pharyngeal, and laryngeal structures during mastication and swallowing, and temporal coordination between breathing, mastication, and swallowing. PMID:20161022

  13. 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…

  14. 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…

  15. 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…

  16. Classification of penetration--aspiration versus healthy swallows using dual-axis swallowing accelerometry signals in dysphagic subjects.

    PubMed

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

    2013-07-01

    Swallowing accelerometry is a promising noninvasive approach for the detection of swallowing difficulties. In this paper, we propose an approach for classification of swallowing accelerometry recordings containing either healthy swallows or penetration-aspiration (entry of material into the airway) in dysphagic patients. The proposed algorithm is based on the wavelet packet decomposition of swallowing accelerometry signals in combination with linear discriminant analysis as a feature reduction method and Bayes classification. The proposed algorithm was tested using swallowing accelerometry signals collected from 40 patients during the regularly scheduled videoflouroscopy exam. The participants were instructed to swallow several 5-mL sips of thin liquid barium in a head neutral position. The results of our numerical analysis showed that the proposed algorithm can differentiate healthy swallows from aspiration swallows with an accuracy greater than 90%. These results position swallowing accelerometry as a valid approach for the detection of swallowing difficulties, particularly penetration-aspiration in patients suspected of dysphagia. PMID:23372074

  17. Swallow-breath interaction and phase of respiration with swallow during nonnutritive suck among low-risk preterm infants.

    PubMed

    Reynolds, Eric W; Grider, Debbie; Caldwell, Rhonda; Capilouto, Gilson; Vijaygopal, Pooja; Patwardhan, Abhijit; Charnigo, Richard

    2010-11-01

    This study describes swallow-breath interaction and phase of respiration with swallow during nonnutritive suck (NNS) in low-risk preterm infants. Suckle and swallow, thoracic motion, and airflow were measured in 16 infants during NNS. Logistic regression models were used to describe swallow-breath interaction and phase of respiration with swallow. One hundred seventy-six swallows occurred in 35 NNS periods. Swallow-breath interaction occurred as: central apnea (CA), obstructive apnea (OA), or attenuated respiration (AR). AR was associated with increased weeks post-first nipple feeding. OA occurred less often in males and with increased weeks post-first nipple feeding. In looking at the phase of respiration, more swallows occurred at beginning expiration with increased gestational age, increased weeks post-first nipple feed, and increased weeks before first nipple feed. More swallows occurred at midexpiration with more swallows per study, increased birth weight (BWT), and weeks before first nipple feed. Fewer swallows occurred at end expiration with increased weeks before first nipple feed. Fewer swallows occurred at midinspiration with increased swallows per study. Fewer swallows occurred at apnea with increasing BWT, more occurred with increased swallows per study. In low-risk preterm infants, swallow-breath interaction progresses from CA and OA to AR. The phase of respiration with swallow shows a maturation progression.

  18. 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…

  19. Movements of temporomandibular condyles during swallowing.

    PubMed

    Čimić, Samir; Šimunković, Sonja Kraljević; Gospić, Renata Kevilj; Badel, Tomislav; Dulčić, Nikša; Ćatić, Amir

    2015-03-01

    There have been studies that investigated mandibular movements and positioning during swallowing, but the results were inconsistent, and still the exact position of the condyles during swallowing is unknown. The purpose of this investigation was to study the kinematics of the mandible and the condyles, and to determine the actual movement paths and position of mandible and condyles during the process of swallowing. The study was performed on a sample of 44 dental students. Measurements were done with an electronic axiograph. After non-occlusing attachment was fixed in the mouth, every subject swallowed for five times from the rest position. The final swallowing position of the left and the right condyles was measured in the sagittal plane. The final swallowing position of the sagittal incisal point was measured in sagittal, frontal and horizontal plane, and data was statistically analyzed. The condyles showed average movement toward posterior (left 0.17 mm, SD 0.28, right 0.16 mm, SD 0.25) and superior (left 0.14 mm, SD 0.20, right 0.14 mm, SD 0.23). Anterior and/or inferior position had 20% of participants. The average sagittal incisal point movement during swallowing was toward anterior (0.30 mm, SD 0.53) and superior (0.81 mm, SD 0.84). The mean mandibular lateral movement was 0.1 mm (SD 0.1). The results of the study suggest that retrusion during swallowing is not the rule, although on average there is a slight tendency of condylar movement toward posterior. Swallowing can be used as auxiliary method for determining vertical dimension of occlusion.

  20. Movements of temporomandibular condyles during swallowing.

    PubMed

    Čimić, Samir; Šimunković, Sonja Kraljević; Gospić, Renata Kevilj; Badel, Tomislav; Dulčić, Nikša; Ćatić, Amir

    2015-03-01

    There have been studies that investigated mandibular movements and positioning during swallowing, but the results were inconsistent, and still the exact position of the condyles during swallowing is unknown. The purpose of this investigation was to study the kinematics of the mandible and the condyles, and to determine the actual movement paths and position of mandible and condyles during the process of swallowing. The study was performed on a sample of 44 dental students. Measurements were done with an electronic axiograph. After non-occlusing attachment was fixed in the mouth, every subject swallowed for five times from the rest position. The final swallowing position of the left and the right condyles was measured in the sagittal plane. The final swallowing position of the sagittal incisal point was measured in sagittal, frontal and horizontal plane, and data was statistically analyzed. The condyles showed average movement toward posterior (left 0.17 mm, SD 0.28, right 0.16 mm, SD 0.25) and superior (left 0.14 mm, SD 0.20, right 0.14 mm, SD 0.23). Anterior and/or inferior position had 20% of participants. The average sagittal incisal point movement during swallowing was toward anterior (0.30 mm, SD 0.53) and superior (0.81 mm, SD 0.84). The mean mandibular lateral movement was 0.1 mm (SD 0.1). The results of the study suggest that retrusion during swallowing is not the rule, although on average there is a slight tendency of condylar movement toward posterior. Swallowing can be used as auxiliary method for determining vertical dimension of occlusion. PMID:26040084

  1. 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

  2. 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.

  3. Drooling, saliva production, and swallowing in cerebral palsy.

    PubMed

    Senner, Jill E; Logemann, Jerilyn; Zecker, Steven; Gaebler-Spira, Deborah

    2004-12-01

    Fourteen participants (six females, eight males) ranging in age from 7 years 11 months to 18 years 2 months (mean 11y 7mo) with a confirmed diagnosis of spastic cerebral palsy (CP) were included in the study. Participants included those who drooled (CP+, n=14); age- and sex-matched children with spastic CP who were dry to mild and never to infrequent droolers (CP-, n=14) as well as typically developing peers (CTRL, n=14) served as controls. Frequency of swallowing was measured by using simultaneous cervical ausculation and videotaping of the head and neck. Saliva production was measured with the Saxon test, a simple gauze-chewing procedure. In addition, Pediatric Evaluation of Disability Inventory (PEDI), Test of Nonverbal Intelligence-3 (TONI-3), dysarthria severity scale, and Gross Motor Function Classification System (GMFCS) scores were obtained for each participant. Both groups of participants with CP tended to swallow less frequently than typically developing participants and tended to produce less saliva than typically developing controls; however, these differences were not statistically significant. No correlation was found between amount of saliva produced and amount drooled (r=0.245). An analysis of variance (ANOVA) conducted on the PEDI functional skills mean scores indicated significant differences between the three groups (F(2,39)=23.522,p<0.0001). Likewise, an ANOVA conducted on the TONI-3 scores revealed statistically significant differences between the three groups (F(2,39)=31.761, p<0.0001). A Spearman's rho correlation indicated that GMFCS scores were not significantly correlated with drooling severity (Spearman's rho correlation=0.3951,p=0.037). Drooling severity was found to be positively correlated with dysarthria severity (Spearman's rho correlation=0.82,p<0.0001). These findings suggest that drooling in patients with CP is related to swallowing difficulties rather than hypersalivation. PMID:15581152

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

    PubMed

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

    2016-08-01

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

  5. Computer-assisted detection of swallowing difficulty.

    PubMed

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

    2016-10-01

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

  6. 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

  7. 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.

  8. Variations in tongue-palate swallowing pressures when swallowing xanthan gum-thickened liquids.

    PubMed

    Steele, Catriona M; Molfenter, Sonja M; Péladeau-Pigeon, Melanie; Polacco, Rebecca C; Yee, Clemence

    2014-12-01

    Thickened liquids are frequently recommended to reduce the risk of aspiration in patients with oropharyngeal dysphagia. Although it has previously been reported that tongue-palate pressures increase when swallowing spoon-thick and semi-solid consistencies compared to thin liquids, relatively little is known about how swallowing behaviors differ when swallowing liquids of nectar- or honey-thick consistency. Furthermore, previous studies have primarily used starch-based thickeners, and little is known about swallowing behaviors with xanthan gum-thickened liquids, which have recently been introduced for dysphagia management. In this study, we measured variations in tongue-palate pressures during the swallowing of liquids thickened to apparent viscosities of 190, 250, and 380 mPa s at 50/s using increasing concentrations of xanthan gum (0.5, 0.63 and 0.87 w/w%). The viscosity differences between these nectar- and honey-thick stimuli were confirmed to exceed sensory perceptual discrimination thresholds. Data were collected from 78 healthy adults in two sex-balanced age-groups (young; mature) and compared to reference values obtained during water swallowing. The results confirm that increased amplitudes of tongue-palate pressure were used when swallowing the thickened liquid stimuli, compared to swallows of water, and for the honey-thick liquid compared to the two nectar-thick liquids. Age-related reductions were seen in tongue strength but not in swallowing pressures, which fell below 40 % of maximum isometric pressure values. Thus, the use of xanthan gum-thickened liquids is unlikely to tax the swallowing system in terms of tongue pressure generation requirements, even in seniors with reduced maximum isometric tongue pressure measures.

  9. Peripheral and central control of swallowing initiation in healthy humans.

    PubMed

    Aida, Seiya; Takeishi, Ryosuke; Magara, Jin; Watanabe, Masahiro; Ito, Kayoko; Nakamura, Yuki; Tsujimura, Takanori; Hayashi, Hirokazu; Inoue, Makoto

    2015-11-01

    We investigated (1) how peripheral inputs might assist central inputs in the control of voluntary evoked swallowing, (2) inter-individual variation in involuntary and voluntary swallowing initiation, and (3) whether natural chewing behavior affects the initiation of involuntary swallowing in healthy humans. Eleven participants completed a repetitive saliva swallowing test (RSST), chewing test (CHEW), and rest period (REST). In RSST, participants repetitively swallowed as quickly as possible. In CHEW, subjects chewed gum freely. We delivered pharyngeal electrical stimulation (PEStim) to the laryngopharynx and compared the number of swallows that occurred with and without PEStim. PEStim significantly increased the number of voluntary evoked swallows in RSST, as well as the number of swallows in CHEW and REST trials, although this facilitatory effect was larger in REST trials. We found a positive correlation between the number of swallows at RSST without PEStim and that at REST with PEStim within individuals. Additionally, we found a significant positive correlation between the number of swallows at RSST with PEStim and the sum of that at RSST without PEStim and at REST with PES. Based on the current results, we suggest that (1) peripheral inputs within a certain range appear to facilitate the central inputs that control voluntary swallowing, (2) inter-individual variations in swallowing initiation may arise from differences in the excitability of the common neural network in the lower brainstem, and (3) during chewing, food reduction in the oral cavity is prioritized, such that the neural network associated with chewing may regulate swallowing initiation.

  10. The videofluoroscopic swallowing study shows a sustained improvement of dysphagia in children with Niemann-Pick disease type C after therapy with miglustat.

    PubMed

    Fecarotta, Simona; Amitrano, Michele; Romano, Alfonso; Della Casa, Roberto; Bruschini, Diana; Astarita, Luca; Parenti, Giancarlo; Andria, Generoso

    2011-03-01

    Niemann-Pick disease type C (NPC) is a rare autosomal recessive lysosomal storage disorder characterized by defective intracellular lipid trafficking, with secondary accumulation of free cholesterol, sphingosine, and glycosphingolipids. NPC is clinically characterized by a wide spectrum of manifestations with progressive visceral and neurological involvement, including dysphagia. Neurological manifestations represent the most debilitating findings. Swallowing impairment is a frequent cause of morbidity and disability in NPC patients and progressive dysphagia may be considered a marker of neurological progression. Recently substrate reduction therapy with miglustat has been proposed for the treatment of neurological manifestations in NPC patients. This observational study reports on the long-term use of miglustat in four pediatric patients with NPC and shows the efficacy of the treatment to improve or prevent dysphagia, and persistence after 3 years of treatment or more. We used a videofluoroscopic analysis of liquid barium swallowing to provide additional information on patterns of impairment of the swallowing mechanism and to detect aspiration. In three patients showing dysphagia and aspiration we observed the improvement of the swallowing function and the sustained absence of barium aspiration in the airways after miglustat treatment, while the patient with normal swallowing function at baseline did not show any deterioration. We suggest that the videofluoroscopic study of swallowing should be routinely used to monitor the effects of treatment on swallowing ability in NPC patients. PMID:21344635

  11. 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.

  12. 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…

  13. 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.

  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. 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,…

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

    PubMed

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

    2016-08-01

    The objective of this study was to determine the clinical characteristics of swallowing disorders in severe brain injury in the arousal phase after coma. Between December 1, 2013 and June 30, 2014, eleven patients with severe acquired brain injury who were admitted to rehabilitation center (Male 81.8 %; 40.7 ± 14.6 years) were included in the study. Evaluation of swallowing included a functional examination, clinical functional swallowing test, and naso-endoscopic swallowing test. All patients had swallowing disorders at admission. The first functional swallowing test showed oral (77.8 %) and pharyngeal (66.7 %) food bolus transport disorders; and alterations in airway protection mechanisms (80 %). Swallowing test under endoscopic control showed a disorder in swallowing coordination in 55.6 % of patients tested. Seven (63.6 %) patients resumed oral feeding within an average of 6 weeks after admission to rehabilitation center and 14 weeks after acquired brain injury. Six (85.7 %) of these seven patients continued to require modified solid and liquid textures. Swallowing disorders are a major concern in severe brain injury in the arousal phase. Early bedside assessment of swallowing is essential for detection of swallowing disorders to propose appropriate medical rehabilitation care to these patients in a state of altered consciousness.

  17. 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…

  18. Transnasal endoscopic evaluation of swallowing: A bedside technique to evaluate ability to swallow pureed diets in elderly patients with dysphagia

    PubMed Central

    Sakamoto, Torao; Horiuchi, Akira; Nakayama, Yoshiko

    2013-01-01

    BACKGROUND: Endoscopic evaluation of swallowing (EES) is not commonly used by gastroenterologists to evaluate swallowing in patients with dysphagia. OBJECTIVE: To use transnasal endoscopy to identify factors predicting successful or failed swallowing of pureed foods in elderly patients with dysphagia. METHODS: EES of pureed foods was performed by a gastroenterologist using a small-calibre transnasal endoscope. Factors related to successful versus unsuccessful swallowing of pureed foods were analyzed with regard to age, comorbid diseases, swallowing activity, saliva pooling, vallecular residues, pharyngeal residues and airway penetration/aspiration. Unsuccessful swallowing was defined in patients who could not eat pureed foods at bedside during hospitalization. Logistic regression analysis was used to identify independent predictors of swallowing of pureed foods. RESULTS: During a six-year period, 458 consecutive patients (mean age 80 years [range 39 to 97 years]) were considered for the study, including 285 (62%) men. Saliva pooling, vallecular residues, pharyngeal residues and penetration/aspiration were found in 240 (52%), 73 (16%), 226 (49%) and 232 patients (51%), respectively. Overall, 247 patients (54%) failed to swallow pureed foods. Multivariate logistic regression analysis demonstrated that the presence of pharyngeal residues (OR 6.0) and saliva pooling (OR 4.6) occurred significantly more frequently in patients who failed to swallow pureed foods. CONCLUSIONS: Pharyngeal residues and saliva pooling predicted impaired swallowing of pureed foods. Transnasal EES performed by a gastroenterologist provided a unique bedside method of assessing the ability to swallow pureed foods in elderly patients with dysphagia. PMID:23936875

  19. Effects of Effortful Swallow on Cardiac Autonomic Regulation.

    PubMed

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

    2016-04-01

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

  20. Swallowing Disorders - Multiple Languages: MedlinePlus

    MedlinePlus

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

  1. 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.

  2. Changes in swallowing physiology and patient perception of swallowing function following chemoradiation for head and neck cancer.

    PubMed

    Rogus-Pulia, Nicole M; Pierce, Margaret C; Mittal, Bharat B; Zecker, Steven G; Logemann, Jeri A

    2014-04-01

    Patients treated with chemoradiation for head and neck cancer often report difficulty with swallowing and are frequently diagnosed with dysphagia. The extent to which patient awareness of dysphagia corresponds to observed physiologic changes in swallowing is unclear. The purpose of this study was to determine how both patient awareness of swallowing function and swallowing physiology individually change following chemoradiation and then to clarify the relationship between them. Twenty-one patients with head and neck cancer treated with chemoradiation were assessed before and after treatment and matched with twenty-one control subjects. The modified barium swallow test was utilized to examine swallowing physiology. Each subject was also given a series of items regarding awareness of specific dysphagia symptoms. Results showed decreased swallow efficiencies, higher percentages of residue, and more occurrences of penetration and aspiration following chemoradiation. Patients also had significantly higher ratings for 4 of the 12 items ("dry mouth," "food sticking in my mouth," "need water to help food go down," and "change in sense of taste"). Only one strong and significant correlation was found between ratings for "I have difficulty swallowing" and swallow efficiency values. Based on these findings, it appears that patients sense a general difficulty with swallowing but have less awareness of specific symptoms of dysphagia.

  3. Coordinate Mapping of Hyolaryngeal Mechanics in Swallowing

    PubMed Central

    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.

    2014-01-01

    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

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

    PubMed Central

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

    2014-01-01

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

  5. Using sensory properties of food to trigger swallowing: a review.

    PubMed

    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.

  6. 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

  7. Relationship between Quantified Instrumental Swallowing Examination and Comprehensive Clinical Swallowing Examination.

    PubMed

    Oh, Jong-Chi; Park, Ji-Hyuk; Jung, Min-Ye; Yoo, Eun-Young; Chang, Ki-Yeon; Lee, Teak-Young

    2016-03-01

    The aim of this study was to identify the correlation between the Mann Assessment of Swallowing Ability (MASA) and the Videofluoroscopic Dysphagia Scale (VDS) to investigate the applicability of the MASA as a follow-up test of swallowing function. Criterion validity was assessed for MASA results versus VDS scores of tests administered to 54 patients who had a stroke and dysphagia. A significant correlation was found between the MASA and the VDS (correlation coefficient = -0.509). In analyses of test-re-test reliability and inter-rater reliability of the scoring scale, intraclass correlation coefficients (2, 1) were high (0.98, 0.99). In conclusion, the results of the present study indicate that the MASA holds adequate clinical test-re-test and inter-rater reliabilities and criterion validity for measuring the swallowing abilities of Korean patients who had a stroke and dysphagia. The MASA could contribute to more systematic management of swallowing problems and efficient therapeutic service.

  8. 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

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  10. 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. 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…

  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. 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…

  14. 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…

  15. Temporal and durational patterns associating respiration and swallowing.

    PubMed

    Klahn, M S; Perlman, A L

    1999-01-01

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

  16. Swallowing therapy in patients with neurological disorders causing cricopharyngeal dysfunction.

    PubMed

    Bartolome, G; Neumann, S

    1993-01-01

    The results of swallowing therapy in 28 patients with neurological disorders causing cricopharyngeal (CP) dysfunction are reported. Variables described include the type of swallowing disorder, type and degree of aspiration, and therapeutic strategies. Patients were monitored by cineradiography before, during, and after therapy. Success of therapy was defined by progress in type, ease and safety of feeding, and range of diet. As an example, a case of an unusually severe disorder of a CP opening subsequent to brainstem meningoencephalitis is described. The bedside clinical evaluation, otolaryngologic findings, and radiographic studies helped determine an individualized program of swallowing therapy. Therapy goals, direct and indirect therapeutic strategies, and the treatment outcome are presented. Ninety percent of patients with CP dysfunction improved with swallowing therapy, 65% by objective and 25% by subjective criteria. We conclude that in neurological patients with CP, dysfunction can effectively be treated with swallowing therapy and that surgical approaches to CP dysfunction should be deferred pending the outcome of conservative management.

  17. Aspiration and swallowing in Parkinson disease and rehabilitation with EMST

    PubMed Central

    Troche, M.S.; Okun, M.S.; Rosenbek, J.C.; Musson, N.; Fernandez, H.H.; Rodriguez, R.; Romrell, J.; Pitts, T.; Wheeler-Hegland, K.M.; Sapienza, C.M.

    2010-01-01

    Objective: Dysphagia is the main cause of aspiration pneumonia and death in Parkinson disease (PD) with no established restorative behavioral treatment to date. Reduced swallow safety may be related to decreased elevation and excursion of the hyolaryngeal complex. Increased submental muscle force generation has been associated with expiratory muscle strength training (EMST) and subsequent increases in hyolaryngeal complex movement provide a strong rationale for its use as a dysphagia treatment. The current study's objective was to test the treatment outcome of a 4-week device-driven EMST program on swallow safety and define the physiologic mechanisms through measures of swallow timing and hyoid displacement. Methods: This was a randomized, blinded, sham-controlled EMST trial performed at an academic center. Sixty participants with PD completed EMST, 4 weeks, 5 days per week, for 20 minutes per day, using a calibrated or sham, handheld device. Measures of swallow function including judgments of swallow safety (penetration–aspiration [PA] scale scores), swallow timing, and hyoid movement were made from videofluoroscopic images. Results: No pretreatment group differences existed. The active treatment (EMST) group demonstrated improved swallow safety compared to the sham group as evidenced by improved PA scores. The EMST group demonstrated improvement of hyolaryngeal function during swallowing, findings not evident for the sham group. Conclusions: EMST may be a restorative treatment for dysphagia in those with PD. The mechanism may be explained by improved hyolaryngeal complex movement. Classification of evidence: This intervention study provides Class I evidence that swallow safety as defined by PA score improved post EMST. GLOSSARY CI = confidence interval; EMST = expiratory muscle strength training; MEP = maximum expiratory pressure; PA = penetration–aspiration; PD = Parkinson disease; SWAL-QOL = Swallowing Quality of Life Questionnaire; UES = upper esophageal

  18. 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…

  19. 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

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

    PubMed

    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.

  1. 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

  2. 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.

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  4. 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…

  5. Interactive image processing in swallowing research

    NASA Astrophysics Data System (ADS)

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

    1991-06-01

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

  6. Clock gene variation in Tachycineta swallows.

    PubMed

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

    2012-01-01

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

  7. Swallow syncope associated with complete atrioventricular block in an adolescent.

    PubMed

    Tuzcu, V; Halakatti, R

    2007-01-01

    We describe a 16-year-old female with a history of swallowing-induced syncope. The physical examination, ECG, echocardiography, barium swallow test, and thyroid function tests were within normal limits. The ambulatory ECG revealed intermittent complete atrioventricular block only associated with swallowing. There was also intermittent first-degree atrioventricular block not related to eating. An electrophysiologic study was performed during the implantation of a single-chamber transvenous ventricular pacemaker. There was mild atrioventricular nodal conduction disturbance with a His-ventricular interval of 70 msec and Wenckebach cycle length of 420 msec. During 1 year follow-up, the patient remained asymptomatic.

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

    PubMed

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

    2016-01-01

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

  9. Changes in the frequency of swallowing during electrical stimulation of superior laryngeal nerve in rats.

    PubMed

    Tsuji, Kojun; Tsujimura, Takanori; Magara, Jin; Sakai, Shogo; Nakamura, Yuki; Inoue, Makoto

    2015-02-01

    The aim of the present study was to investigate the adaptation of the swallowing reflex in terms of reduced swallowing reflex initiation following continuous superior laryngeal nerve stimulation. Forty-four male Sprague Dawley rats were anesthetized with urethane. To identify swallowing, electromyographic activity of the left mylohyoid and thyrohyoid muscles was recorded. To evoke the swallowing response, the superior laryngeal nerve (SLN), recurrent laryngeal nerve, or cortical swallowing area was electrically stimulated. Repetitive swallowing evoked by continuous SLN stimulation was gradually reduced, and this reduction was dependent on the resting time duration between stimulations. Prior SLN stimulation also suppressed subsequent swallowing initiation. The reduction in evoked swallows induced by recurrent laryngeal nerve or cortical swallowing area stimulation was less than that following superior laryngeal nerve stimulation. Decerebration had no effect on the reduction in evoked swallows. Prior subthreshold stimulation reduced subsequent initiation of swallowing, suggesting that there was no relationship between swallowing movement evoked by prior stimulation and the subsequent reduction in swallowing initiation. Overall, these data suggest that reduced sensory afferent nerve firing and/or trans-synaptic responses, as well as part of the brainstem central pattern generator, are involved in adaptation of the swallowing reflex following continuous stimulation of swallow-inducing peripheral nerves and cortical areas.

  10. 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.

  11. 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...

  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. PMID:27374286

  13. 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.

  14. 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.

  15. Facilitation of the swallowing reflex with bilateral afferent input from the superior laryngeal nerve.

    PubMed

    Takahashi, Kojiro; Shingai, Tomio; Saito, Isao; Yamamura, Kensuke; Yamada, Yoshiaki; Kitagawa, Junichi

    2014-03-01

    To determine the cooperative effect of laryngeal afferent signals on the swallowing reflex, we examined whether afferent signals originating from the left and right superior laryngeal nerve (SLN) modulates elicitation of the swallowing reflex in urethane-anesthetized rats. Mylohyoid electromyographic activity was recorded to quantify the swallowing reflex. The onset latency of the swallowing reflex and the time intervals between successive swallows were used to quantify and compare the effects of unilateral and bilateral electrical stimulations of the SLN. The mean latency of the first swallow and the mean time interval between swallows evoked with low frequency stimulation were both significantly different between unilateral and bilateral stimulations of the SLN. These findings suggest that facilitatory effect of afferent signals originating from the SLN bilaterally increase the motoneuronal activity in the medullary swallowing center and enhance the swallowing reflex.

  16. Disability Identity--Disability Pride

    ERIC Educational Resources Information Center

    Martin, Nicola

    2012-01-01

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

  17. Learning Disabilities

    MedlinePlus

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

  18. Amniotic fluid volume and fetal swallowing rate in sheep

    SciTech Connect

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

    1985-07-01

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

  19. Application of Kinesio Taping method for newborn swallowing difficultly

    PubMed Central

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

    2016-01-01

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

  20. Central Nervous System Control of Voice and Swallowing

    PubMed Central

    Ludlow, Christy L.

    2015-01-01

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

  1. 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.

  2. Physical and related sensory properties of a swallowable bolus.

    PubMed

    Loret, C; Walter, M; Pineau, N; Peyron, M A; Hartmann, C; Martin, N

    2011-10-24

    Rheology and water content properties of cereal boluses collected just before swallowing were investigated. No specific physical markers for swallowing were found between subjects. Each subject had his own mastication strategy leading to food boluses with different rheological and water content properties. However, for most of the subjects, similar physical properties were found for food boluses obtained from consumption of different cereals. Results showed that the food boluses from different cereals exhibited gel-like properties being in a range from 14.1 kPa to 21.2 kPa (G'(1 Hz, 0.4%)), when swallowed. The food boluses had a static yield stress varying from 1.3 kPa to 4.3 kPa. Another interesting finding was that the water content of food boluses might be an important marker for swallowing since it was similar for different cereal food boluses (around 50%). This physical property might drive the fluid sensory perception, which could also be a sensory swallowing threshold. PMID:21620879

  3. Automatic food intake detection based on swallowing sounds

    PubMed Central

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

    2012-01-01

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

  4. 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.

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

    PubMed

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

    2015-07-01

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

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

    PubMed Central

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

    1995-01-01

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

  7. 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.

  8. 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.

  9. Fiber-optic endoscopic evaluation of swallowing to assess swallowing outcomes as a function of head position in a normal population

    PubMed Central

    2014-01-01

    Background Head position practice has been shown to influence pill-swallowing ability, but the impact of head position on measures of swallowing outcomes has not yet been studied with fiber-optic endoscopic evaluation of swallowing (FEES). The primary purpose of this study was to determine whether head position impacts penetration-aspiration scale scores and/or post-swallow pharyngeal residue as assessed by FEES. Documenting the incidence of pharyngeal residue and laryngeal penetration and aspiration in a normal population was a secondary goal. Methods Adults without swallowing difficulties (N = 84) were taught a pill swallowing technique based on learning five head positions and were asked to practice with small, hard candies (e.g., TicTacs) for two weeks. Then they demonstrated swallowing in each of the head positions for two conditions, liquid and purée, while undergoing FEES. Results Out of 840 examined swallows, one event of aspiration and 5 events of penetration occurred. During practice >50% participants found positions they preferred over the center position for swallowing but head position was not associated with penetration-aspiration scores assessed by FEES. Significant associations and non-significant trends were found between pharyngeal residue and three variables: age, most preferred head position, and least preferred head position. Conclusion Head position during swallowing (head up) and age greater than 40 years may result in increased pharyngeal residue but not laryngeal penetration or aspiration. PMID:24755159

  10. Comparison of endoscopy and barium swallow with marshmallow in dysphagia.

    PubMed

    Somers, S; Stevenson, G W; Thompson, G

    1986-06-01

    Forty-four patients with dysphagia were examined both by endoscopy and by barium swallow with a marshmallow bolus. In these patients 36 stenoses were found: 34 by radiology and 30 by endoscopy. The radiologic criteria for stenosis included arrest of the marshmallow in a manner to support a column of barium and reproduction of the patient's symptoms at the time this occurred. Radiologic false negative findings were partly due to an inability by patients to swallow an adequate marshmallow bolus; endoscopic failures were associated with small endoscopes and mild stenoses.

  11. 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:…

  12. Contribution of eye retraction to swallowing performance in the northern leopard frog, Rana pipiens.

    PubMed

    Levine, Robert P; Monroy, Jenna A; Brainerd, Elizabeth L

    2004-03-01

    Most anurans retract and close their eyes repeatedly during swallowing. Eye retraction may aid swallowing by helping to push food back toward the esophagus, but this hypothesis has never been tested. We used behavioral observations, cineradiography, electromyography and nerve transection experiments to evaluate the contribution of eye retraction to swallowing in the northern leopard frog, Rana pipiens. Behavioral observations of frogs feeding on 1.5 cm long crickets reveal a high degree of variability in eye retraction and swallowing. Eye retraction can occur bilaterally or unilaterally, and both swallowing movements and eye retraction can occur separately as well as together. During swallowing, cineradiography shows that the eyes and associated musculature retract well into the oropharynx and appear to make contact with the prey item. This contact appears to help push the prey toward the esophagus, and it may also serve to anchor the prey for tongue-based transport. Electromyographic recordings confirm strong activity in the retractor bulbi muscles during eye retraction. After bilateral denervation of the retractor bulbi, frogs maintain the ability to swallow but show a 74% increase in the number of swallows required per cricket (from a mean of 2.3 swallows to a mean of 4.0 swallows per cricket). Our results indicate that, in Rana pipiens feeding on medium-sized crickets, eye retraction is an accessory swallowing mechanism that assists the primary tongue-based swallowing mechanism.

  13. A Pilot Study of the Head Extension Swallowing Exercise: New Method for Strengthening Swallowing-Related Muscle Activity.

    PubMed

    Oh, Jong-Chi

    2016-10-01

    This pilot study examined the effect of a new head extension swallowing exercise (HESE) on submental muscle activity and tongue strength in healthy volunteers. Fifteen young adults (10 females and 5 males) were instructed to extend their head backwards as much as possible, and while watching the ceiling, swallowed their saliva every 10 s for a duration of 20 min. Twenty-four treatments were performed over 8 weeks. The outcome variables evaluated at baseline, 4 and 8 weeks of training, and 12-week follow-up included mean and peak submental muscle activation amplitudes during normal and effortful swallowing measured via surface electromyography, and anterior and posterior isometric tongue pressures were measured with the Iowa Oral Performance Instrument. Results indicated that the muscle activation amplitudes during effortful swallowing increased significantly at 4 and 8 weeks compared to baseline (p < 0.025). However, the increases in amplitudes during normal swallowing were minor (nonsignificant) after 8 weeks compared to baseline. The isometric pressures of the tongue tip and the posterior part of the oral tongue were significantly higher at 8 weeks compared to baseline (p < 0.025). Thus, the 8-week HESE protocol significantly improved suprahyoid muscle activity during effortful swallowing as well as the isometric tongue pressures. The HESE appears effective in exercising and strengthening the suprahyoid muscles and tongue muscles in healthy participants. Although encouraging, these results need to be replicated in clinical trials for testing the therapeutic effects of the HESE in older adults and patients with dysphagia who present with decreased hyolaryngeal elevation.

  14. Statistical Learning, Letter Reversals, and Reading

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  15. 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…

  16. 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…

  17. 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…

  18. 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…

  19. [Age-related changes in swallowing. Physiology and pathophysiology].

    PubMed

    Muhle, P; Wirth, R; Glahn, J; Dziewas, R

    2015-04-01

    The term presbyphagia refers to all changes of swallowing physiology that are manifested with increasing age. Alterations in the pattern of deglutition that are part of healthy aging are called primary presbyphagia. Primary presbyphagia is not an illness in itself but contributes to a more pervasive naturally diminished functional reserve, making older adults more susceptible to dysphagia. If disorders in swallowing occur in the elderly as a comorbidity of a specific disease, for example stroke or neurodegenerative disorders, this is called secondary presbyphagia. Increasing age has an impact on each stage of deglutition. In the oral preparatory phase a diminished input for smell and taste as well as a usually multifactorial cause of dry mouth are the most important influencing factors. Sarcopenia, the degenerative loss of skeletal muscle mass, strength and quality associated with aging, interferes in particular with the oropharyngeal phase. A decreased sensory feedback from the oropharyngeal mucosa leads to a delayed triggering of the swallowing reflex. Finally, a reduction in connective tissue elasticity and changes of the axial skeleton lead to various modifications of the swallowing pattern with advanced age.

  20. 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.

  1. 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.

  2. Evaluation of Swallowing in Infants with Congenital Heart Defect

    PubMed Central

    Pereira, Karine da Rosa; Firpo, Cora; Gasparin, Marisa; Teixeira, Adriane Ribeiro; Dornelles, Silvia; Bacaltchuk, Tzvi; Levy, Deborah Salle

    2014-01-01

    Introduction Surgical repair of congenital heart disease in the first years of life compromises the coordination of the suction, breathing, and swallowing functions. Objective To describe the alterations in swallowing found in infants with congenital heart defect during their hospitalization. Methods Prospective, cross-sectional study in a reference hospital for heart disease. The sample consisted of 19 postsurgical patients who underwent an evaluation of swallowing. The infants included were younger than 7 months and had a diagnosis of congenital heart defect and suspected swallowing difficulties. Results Of the 19 infants with congenital heart defect, the median age was 3.2 months. A significant association was found between suction rhythm and dysphagia (p = 0.036) and between oral-motor oral feeding readiness and dysphagia (p = 0.014). Conclusions The data suggest that dysphagia often occurs after surgery in infants with congenital heart defect. Infants with congenital heart defect had very similar behavior to preterm infants in terms of oral feeding readiness. PMID:25992152

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

    PubMed

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

    2015-01-01

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

  4. Electrical stimulation and swallowing: how much do we know?

    PubMed

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

    2012-08-01

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

  5. Evaluation of swallowing in infants with congenital heart defect.

    PubMed

    Pereira, Karine da Rosa; Firpo, Cora; Gasparin, Marisa; Teixeira, Adriane Ribeiro; Dornelles, Silvia; Bacaltchuk, Tzvi; Levy, Deborah Salle

    2015-01-01

    Introduction Surgical repair of congenital heart disease in the first years of life compromises the coordination of the suction, breathing, and swallowing functions. Objective To describe the alterations in swallowing found in infants with congenital heart defect during their hospitalization. Methods Prospective, cross-sectional study in a reference hospital for heart disease. The sample consisted of 19 postsurgical patients who underwent an evaluation of swallowing. The infants included were younger than 7 months and had a diagnosis of congenital heart defect and suspected swallowing difficulties. Results Of the 19 infants with congenital heart defect, the median age was 3.2 months. A significant association was found between suction rhythm and dysphagia (p = 0.036) and between oral-motor oral feeding readiness and dysphagia (p = 0.014). Conclusions The data suggest that dysphagia often occurs after surgery in infants with congenital heart defect. Infants with congenital heart defect had very similar behavior to preterm infants in terms of oral feeding readiness.

  6. Evaluation of Children with Feeding and Swallowing Problems.

    ERIC Educational Resources Information Center

    Arvedson, Joan C.

    2000-01-01

    This article discusses how speech-language pathologists are in a strategic position to identify the problems, carry out an evaluation of feeding and swallowing skills, and determine the needs for medical team referral. It focuses on guidelines for obtaining a history, physical examinations, and observing a typical meal. (Contains references.)…

  7. 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…

  8. Ablation of swallowing-induced atrial tachycardia affects heart rate variability: a case report.

    PubMed

    Hojo, Rintaro; Fukamizu, Seiji; Ishikawa, Tae; Hayashi, Takekuni; Komiyama, Kota; Tanabe, Yasuhiro; Tejima, Tamotsu; Kobayashi, Yoichi; Sakurada, Harumizu

    2014-05-01

    A 47-year-old man underwent slow pathway ablation for slow-fast atrioventricular nodal reentrant tachycardia. Following the procedure, he felt palpitations while swallowing, and swallowing-induced atrial tachycardia was diagnosed. Swallowing-induced atrial tachycardia arose from the right atrium-superior vena cava junction and was cured by catheter ablation. After the procedure, the patient's heart rate variability changed significantly, indicating suppression of parasympathetic nerve activity. In this case, swallowing-induced atrial tachycardia was related to the vagal nerve reflex. Analysis of heart rate variability may be helpful in elucidating the mechanism of swallowing-induced atrial tachycardia.

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

    PubMed

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

    2016-08-01

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

  10. 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.

  11. Differential involvement of two cortical masticatory areas in modulation of the swallowing reflex in rats.

    PubMed

    Tsujimura, Takanori; Tsuji, Kojun; Ariyasinghe, Sajjiv; Fukuhara, Takako; Yamada, Aki; Hayashi, Hirokazu; Nakamura, Yuki; Iwata, Koichi; Inoue, Makoto

    2012-10-24

    To clarify the functional role of cortical descending inputs involved in the swallowing reflex, the effect of electrical stimulation of two cortical masticatory areas (CMAs: A- and P-area) on rhythmic jaw movements (RJMs) and superior laryngeal nerve (SLN)-evoked swallows were studied. RJMs and swallowing reflex were elicited by repetitive electrical stimulation of CMAs and the SLN, respectively. The electromyographic activities of jaw-closer (masseter), jaw-opener (digastric), and laryngeal-elevator (thyrohyoid) muscles were recorded to identify the RJMs and swallowing reflex. The number of evoked swallows was significantly lower, and swallowing interval was significantly longer during A-area stimulation compared with those without stimulation. Conversely, these parameters were not significantly altered during P-area stimulation. The inhibition of swallows by A-area stimulation was not affected by an increase in sensory input by wooden stick application between upper and lower teeth, or A-area stimulation preceding SLN stimulation. The present findings suggest that the swallowing reflex is inhibited by activation of the A-area, but not the P-area. Since no changes in swallows were seen after the increase in intraoral sensory input and prior activation of masticatory central pattern generator (CPG), swallowing inhibition may be mediated by direct inputs from the A-area or inputs via the masticatory CPG into the swallowing CPG.

  12. 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…

  13. 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.

  14. Use of respiratory inductance plethysmography for the detection of swallowing in the elderly.

    PubMed

    Moreau-Gaudry, Alexandre; Sabil, Abdelkebir; Benchetrit, Gila; Franco, Alain

    2005-01-01

    It is essential to have a user-friendly, noninvasive bedside procedure at our disposal in order to study swallowing and swallowing disorders in the elderly in view of the frailty of this age group. In the present work, respiratory inductance plethysmography (RIP) is proposed as an appropriate clinical tool for such studies. An automated process for the detection of swallowing is used involving the derivative of the respiratory volume signal. The accuracy of the automated detection is given by the area under the Receiver Operating Characteristic (ROC) curve and is found to be greater than 0.9. At the optimal threshold, RIP constitutes a reliable and objective bedside clinical tool for studying swallowing in the elderly, as well as being user-friendly and noninvasive. In addition, RIP can be used to monitor swallowing in order to analyze swallowing disorders and put in place medical supervision of swallowing for individuals who might aspirate.

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

    PubMed

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

    2016-08-01

    Some stroke patients with a unilateral lesion demonstrate acute dysphagia characterized by a markedly prolonged swallowing time, making us think they are reluctant to swallow. In order to clarify the clinical characteristics and causative lesions of delayed swallowing, we conducted a retrospective analysis of 20 right-handed patients without a history of swallowing dysfunction who underwent videofluorography on suspicion of dysphagia after a first ischemic stroke. The oral processing time plus the postfaucial aggregation time required to swallow jelly for patients classified as having delayed swallowing was over 10 s. The time required for swallowing jelly was significantly longer than that without the hesitation (median value, 24.1 vs. 8.9 s, P < 0.001). The oral processing time plus the postfaucial aggregation time required for patients with delayed swallowing to swallow thickened water was largely over 5 s and significantly longer than that of patients without swallowing hesitation (median value, 10.2 vs. 3.3 s, P < 0.001). Swallowing hesitation caused by acute unilateral infarction could be separated into two different patterns. Because four of the five patients with a rippling tongue movement in the swallowing hesitation pattern had a lesion in the left primary motor cortex, which induces some kinds of apraxia, swallowing hesitation with a rippling tongue movement seems to be a representative characteristic of apraxia. The patients with swallowing hesitation with a temporary stasis of the tongue in this study tended to have broad lesions in the frontal lobe, especially in the middle frontal gyrus, which is thought to be involved in higher cognition.

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

    PubMed

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

    2016-08-01

    Some stroke patients with a unilateral lesion demonstrate acute dysphagia characterized by a markedly prolonged swallowing time, making us think they are reluctant to swallow. In order to clarify the clinical characteristics and causative lesions of delayed swallowing, we conducted a retrospective analysis of 20 right-handed patients without a history of swallowing dysfunction who underwent videofluorography on suspicion of dysphagia after a first ischemic stroke. The oral processing time plus the postfaucial aggregation time required to swallow jelly for patients classified as having delayed swallowing was over 10 s. The time required for swallowing jelly was significantly longer than that without the hesitation (median value, 24.1 vs. 8.9 s, P < 0.001). The oral processing time plus the postfaucial aggregation time required for patients with delayed swallowing to swallow thickened water was largely over 5 s and significantly longer than that of patients without swallowing hesitation (median value, 10.2 vs. 3.3 s, P < 0.001). Swallowing hesitation caused by acute unilateral infarction could be separated into two different patterns. Because four of the five patients with a rippling tongue movement in the swallowing hesitation pattern had a lesion in the left primary motor cortex, which induces some kinds of apraxia, swallowing hesitation with a rippling tongue movement seems to be a representative characteristic of apraxia. The patients with swallowing hesitation with a temporary stasis of the tongue in this study tended to have broad lesions in the frontal lobe, especially in the middle frontal gyrus, which is thought to be involved in higher cognition. PMID:27277890

  18. Magnetoencephalographic evidence for the modulation of cortical swallowing processing by transcranial direct current stimulation.

    PubMed

    Suntrup, Sonja; Teismann, Inga; Wollbrink, Andreas; Winkels, Martin; Warnecke, Tobias; Flöel, Agnes; Pantev, Christo; Dziewas, Rainer

    2013-12-01

    Swallowing is a complex neuromuscular task that is processed within multiple regions of the human brain. Rehabilitative treatment options for dysphagia due to neurological diseases are limited. Because the potential for adaptive cortical changes in compensation of disturbed swallowing is recognized, neuromodulation techniques like transcranial direct current stimulation (tDCS) are currently considered as a treatment option. Here we evaluate the effect of tDCS on cortical swallowing network activity and behavior. In a double-blind crossover study, anodal tDCS (20 min, 1 mA) or sham stimulation was administered over the left or right swallowing motor cortex in 21 healthy subjects in separate sessions. Cortical activation was measured using magnetoencephalography (MEG) before and after tDCS during cued "simple", "fast" and "challenged" swallow tasks with increasing levels of difficulty. Swallowing response times and accuracy were measured. Significant bilateral enhancement of cortical swallowing network activation was found in the theta frequency range after left tDCS in the fast swallow task (p=0.006) and following right tDCS in the challenged swallow task (p=0.007), but not after sham stimulation. No relevant behavioral effects were observed on swallow response time, but swallow precision improved after left tDCS (p<0.05). Anodal tDCS applied over the swallowing motor cortex of either hemisphere was able to increase bilateral swallow-related cortical network activation in a frequency specific manner. These neuroplastic effects were associated with subtle behavioral gains during complex swallow tasks in healthy individuals suggesting that tDCS deserves further evaluation as a treatment tool for dysphagia.

  19. 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.

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

    NASA Astrophysics Data System (ADS)

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

    2012-11-01

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

  1. [Management of swallowing disorders after brain injuries in adults].

    PubMed

    Fichaux, Bourin P; Labrune, M

    2008-01-01

    The management of swallowing disorders after brain injury must be soon as well. The physiopathological analysis and the organization of the therapeutic project of these patients require the intervention of an interdisciplinary team. Dysphagia falls under a complex clinical context associating impairments of cognition, communication and behavioural control. The management associates speech therapist, caregivers, otolaryngolologist, phoniatrician, physiotherapist and nutritional therapist without forgetting the family circle. The fluctuations of consciousness and concentration of our patients brings us to constantly readjusting and rehabilitating the strategies of feeding. Obstacles with their evolution towards a normal feeding are akinesia, limits of motor functions, impairements of cognition and behavioural control. In the located lesions swallow recovers can be fast, instead of in severe brain-injury the challenge is to ensure safe and adequate nutrition, using a variety of strategies depending on the presenting symptoms. The purpose of this article is to relate our experience beside patients with an acute or recent cerbrovascular event.

  2. 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.

  3. Costs and benefits of late nesting in cliff swallows.

    PubMed

    Brown, Charles R; Roche, Erin A; O'Brien, Valerie A

    2015-02-01

    Many organisms of temperate latitudes exhibit declines in reproductive success as the breeding season advances. Experiments can delay the onset of reproduction for early breeders to investigate the consequences of late nesting, but it is rarely possible to observe a distinct second round of nesting in species that normally nest only once. The colonial cliff swallow (Petrochelidon pyrrhonota) is a migratory songbird that has a relatively short breeding season in the western Great Plains, USA, with birds rarely nesting late in the summer. Previous work suggested that ectoparasitism is a primary reason why reproductive success in this species declines over the summer. At colony sites where nests were fumigated to remove ectoparasitic swallow bugs (Oeciacus vicarius), cliff swallows frequently undertook a distinct round of late nesting after previously fledging young that year. Mark-recapture revealed that late-nesting pairs at these colonies produced fewer offspring that survived to the next breeding season, and that survival of late-nesting adults was lower during the next year, relative to pairs nesting earlier in the season. These reproductive costs applied in the absence of ectoparasites and likely reflect other environmental costs of late nesting such as seasonal declines in food availability or a delayed start of fall migration. Despite the costs, the estimated fitness for perennial early-and-late nesters in the absence of ectoparasites was equivalent to that of birds that nested only early in the season. The collective disadvantages of late nesting likely constrain most cliff swallows to raising a single brood in the middle latitudes of North America.

  4. An evaluation of texture manipulations to increase swallowing.

    PubMed

    Kadey, Heather; Piazza, Cathleen C; Rivas, Kristi M; Zeleny, Jason

    2013-01-01

    The purpose of the current investigation was to identify an appropriate texture for initial treatment of 1 child's feeding problem. Variability in mouth clean (a product measure of swallowing) during a texture assessment suggested that individual pureed foods differentially affected feeding behavior. A single-food assessment identified individual problematic foods. We used the results of these assessments to inform treatment, resulting in high levels of mouth clean across foods. PMID:24114170

  5. Methods to preclude aspiration or swallowing of dental appliances.

    PubMed

    Zakaria, A A

    1975-05-01

    A technique which precludes the swallowing of dental restorations during fitting and cementation has been described. An alternative technique is to spot-weld a small loop or wire to the finished crown. Dental floss may be attached to the loop. Another method is to attach a piece of unwaxed floss to the completed crown with Eastman adhesive 910. The floss is removed after the restoration is cemented.

  6. The swallowed toothbrush: a radiographic clue of bulimia.

    PubMed

    Riddlesberger, M M; Cohen, H L; Glick, P L

    1991-01-01

    Swallowed toothbrushes were noted in the esophagus of one teenager and the stomach of two others with bulimia. The presence of a toothbrush in the lumen of the gastrointestinal tract should make the radiologist suspicious of bulimia/anorexia nervosa. A toothbrush shows a characteristic radiographic image with parallel rows of short metallic radiodensities due to the metallic plates that hold the bristles in place.

  7. Visualizing Hyolaryngeal Mechanics in Swallowing Using Dynamic MRI

    PubMed Central

    Pearson, William G.; Zumwalt, Ann C.

    2013-01-01

    Introduction Coordinates of anatomical landmarks are captured using dynamic MRI to explore whether a proposed two-sling mechanism underlies hyolaryngeal elevation in pharyngeal swallowing. A principal components analysis (PCA) is applied to coordinates to determine the covariant function of the proposed mechanism. Methods Dynamic MRI (dMRI) data were acquired from eleven healthy subjects during a repeated swallows task. Coordinates mapping the proposed mechanism are collected from each dynamic (frame) of a dynamic MRI swallowing series of a randomly selected subject in order to demonstrate shape changes in a single subject. Coordinates representing minimum and maximum hyolaryngeal elevation of all 11 subjects were also mapped to demonstrate shape changes of the system among all subjects. MophoJ software was used to perform PCA and determine vectors of shape change (eigenvectors) for elements of the two-sling mechanism of hyolaryngeal elevation. Results For both single subject and group PCAs, hyolaryngeal elevation accounted for the first principal component of variation. For the single subject PCA, the first principal component accounted for 81.5% of the variance. For the between subjects PCA, the first principal component accounted for 58.5% of the variance. Eigenvectors and shape changes associated with this first principal component are reported. Discussion Eigenvectors indicate that two-muscle slings and associated skeletal elements function as components of a covariant mechanism to elevate the hyolaryngeal complex. Morphological analysis is useful to model shape changes in the two-sling mechanism of hyolaryngeal elevation. PMID:25090608

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

    PubMed

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

    2016-08-01

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

  9. Thirty years of blackouts: a case report of swallow syncope

    PubMed Central

    Lambiris, Irene; Mendoza, Ivan; Helguera, Marcelo; Escudero, Jose Baez; Bonilla, Cesar

    2013-01-01

    Deglutition syncope has been demonstrated in isolated case reports, the first being described over 50 years ago. It is thought to be caused by a hypersensitive vagotonic reflex in response to esophageal dilation after swallowing. It can cause syncope due to complete atrioventricular (AV) block and acute reduction of cardiac output. Although rare, its lethality is worthy of discussion, as early recognition can offer complete treatment with placement of a pacemaker. A 54-year-old man presented with 30 years of lightheadedness and syncope, followed by disorientation and tremors, after eating sandwiches or drinking carbonated beverages. He initially was evaluated by a neurologist. Work-up included cardiac 2D transthoracic echocardiogram, electroencephalogram, swallow stud, pulmonary function tests, electrocardiogram, and cardiac stress testing. All tests were within normal limits, and it was determined that he was suffering from convulsive syncope and deglutition syncope. Referral to the cardiac electrophysiology department with tilt-table testing accompanied by swallow evaluation was then recommended. The tests demonstrated marked vagal response resulting in sinus bradycardia with second-degree AV block and pauses up to 3.5 seconds. Patient experienced near syncope. A rate-responsive, dual-chamber Boston Scientific pacemaker with DDDR programming was implanted. Patient has remained asymptomatic at follow-up. PMID:23882389

  10. 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.

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

    PubMed

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

    2016-08-01

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

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

    PubMed Central

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

    2016-01-01

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

  13. 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.

  14. 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

  15. Anthropometric and demographic correlates of dual-axis swallowing accelerometry signal characteristics: a canonical correlation analysis.

    PubMed

    Hanna, Fady; Molfenter, Sonja M; Cliffe, Rebecca E; Chau, Tom; Steele, Catriona M

    2010-06-01

    Swallowing accelerometry has been proposed as a potential minimally invasive tool for collecting assessment information about swallowing. The first step toward using sounds and signals for dysphagia detection involves characterizing the healthy swallow. The purpose of this article is to explore systematic variations in swallowing accelerometry signals that can be attributed to demographic factors (such as participant gender and age) and anthropometric factors (such as weight and height). Data from 50 healthy participants (25 women and 25 men), ranging in age from 18 to 80 years and with approximately equal distribution across four age groups (18-35, 36-50, 51-65, 66 and older) were analyzed. Anthropometric and demographic variables of interest included participant age, gender, weight, height, body fat percent, neck circumference, and mandibular length. Dual-axis (superior-inferior and anterior-posterior) swallowing accelerometry signals were obtained for five saliva and five water swallows per participant. Several swallowing signal characteristics were derived for each swallowing task, including variance, amplitude distribution skewness, amplitude distribution kurtosis, signal memory, total signal energy, peak energy scale, and peak amplitude. Canonical correlation analysis was performed between the anthropometric/demographic variables and swallowing signal characteristics. No significant linear relationships were identified for saliva swallows or for superior-inferior axis accelerometry signals on water swallows. In the anterior-posterior axis, signal amplitude distribution kurtosis and signal memory were significantly correlated with age (r = 0.52, P = 0.047). These findings suggest that swallowing accelerometry signals may have task-specific associations with demographic (but not anthropometric) factors. Given the limited sample size, our results should be interpreted with caution and replication studies with larger sample sizes are warranted.

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

    PubMed

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

    2016-08-01

    Quantitative, reliable measures of swallowing physiology can be made from an modified barium swallowing study. These quantitative measures have not been previously employed to study large dysphagic patient populations. The present retrospective study of 139 consecutive patients with dysphagia seen in a university tertiary voice and swallowing clinic sought to use objective measures of swallowing physiology to (1) quantify the most prevalent deficits seen in the patient population, (2) identify commonly associated diagnoses and describe the most prevalent swallowing deficits, and (3) determine any correlation between objective deficits and Eating Assessment Tool (EAT-10) scores and body mass index. Poor pharyngeal constriction (34.5 %) and airway protection deficits (65.5 %) were the most common swallowing abnormalities. Reflux-related dysphagia (36 %), nonspecific pharyngeal dysphagia (24 %), Parkinson disease (16 %), esophageal abnormality (13 %), and brain insult (10 %) were the most common diagnoses. Poor pharyngeal constriction was significantly associated with an esophageal motility abnormality (p < 0.001) and central neurologic insult. In general, dysphagia symptoms as determined by the EAT-10 did not correlate with swallowing function abnormalities. This preliminary study indicates that reflux disease is common in patients with dysphagia and that associated esophageal abnormalities are common in dysphagic populations and may be associated with specific pharyngeal swallowing abnormalities. However, symptom scores from the EAT-10 did not correspond to swallowing pathophysiology.

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

    PubMed

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

    2016-08-01

    Quantitative, reliable measures of swallowing physiology can be made from an modified barium swallowing study. These quantitative measures have not been previously employed to study large dysphagic patient populations. The present retrospective study of 139 consecutive patients with dysphagia seen in a university tertiary voice and swallowing clinic sought to use objective measures of swallowing physiology to (1) quantify the most prevalent deficits seen in the patient population, (2) identify commonly associated diagnoses and describe the most prevalent swallowing deficits, and (3) determine any correlation between objective deficits and Eating Assessment Tool (EAT-10) scores and body mass index. Poor pharyngeal constriction (34.5 %) and airway protection deficits (65.5 %) were the most common swallowing abnormalities. Reflux-related dysphagia (36 %), nonspecific pharyngeal dysphagia (24 %), Parkinson disease (16 %), esophageal abnormality (13 %), and brain insult (10 %) were the most common diagnoses. Poor pharyngeal constriction was significantly associated with an esophageal motility abnormality (p < 0.001) and central neurologic insult. In general, dysphagia symptoms as determined by the EAT-10 did not correlate with swallowing function abnormalities. This preliminary study indicates that reflux disease is common in patients with dysphagia and that associated esophageal abnormalities are common in dysphagic populations and may be associated with specific pharyngeal swallowing abnormalities. However, symptom scores from the EAT-10 did not correspond to swallowing pathophysiology. PMID:27106909

  18. The influence of volition on breathing-swallowing coordination in healthy adults.

    PubMed

    Kelly, Bronwen N; Huckabee, Maggie-Lee; Jones, Richard D; Carroll, Grant J

    2007-12-01

    This research was designed to clarify the role of cortical modulation in the coordination of respiration and swallowing. Time-locked recordings of submental surface electromyography, nasal airflow, and thyroid acoustics were used to evaluate nonnutritive breathing-swallowing coordination (BSC) and swallowing apnea duration (SAD) of 20 healthy adults during 3 conditions. These conditions represented a continuum of volitional through nonvolitional swallowing control on the basis of a decreasing level of cortical activation: voluntarily initiated swallows during wakefulness, nonvolitional awake swallows, and reflexively initiated swallows during sleep. Differing proportions of swallows at the cusps between inspiration and expiration were found between the volitional and nonvolitional conditions, irrespective of the level of arousal. SAD was unaltered by condition. In conclusion, BSC is influenced by degree of volition but not by level of arousal. This implies that cortical influence on BSC is limited to conditions in which swallowing is voluntarily initiated and indirectly implicates the recruitment of the supplementary motor or insular cortices. SAD remained stable across conditions and may therefore be considered relatively impervious to suprabulbar influence.

  19. The Sequence of Swallowing Events During the Chin-Down Posture

    PubMed Central

    Young, Jennifer L.; Macrae, Phoebe; Anderson, Cheryl; Taylor-Kamara, Isha

    2015-01-01

    Purpose This study investigated the effect of the chin-down posture on the sequence of swallowing events in healthy adults. Method Sixteen healthy participants performed 45 5-ml thin liquid swallows during videofluoroscopy: 5 neutral head position, 30 chin-down posture, and then 10 neutral head position. Eight swallowing events were measured: the time of hyoid burst, bolus head in the pharynx, bolus tail in the pharynx, laryngeal vestibule closure (LVC), upper esophageal sphincter (UES) opening, bolus head in the UES, bolus tail exiting the pharynx, and laryngeal vestibule opening (LVO). Results Our key finding is that LVC was one of the first 3 swallowing events in 69% of neutral swallows and in 78% of chin-down swallows (p = .006). Also, LVO occurred last in 14% of chin-down swallows but never occurred last in the preceding neutral swallows (p ≤ .001). Thus, in chin-down swallows, LVC occurred earlier and LVO occurred later. Conclusions The chin-down posture may be beneficial for individuals with delayed onset of LVC and reduced duration of the LVC. Future studies are needed to examine this effect in individuals with dysphagia. PMID:26225454

  20. 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.

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

    PubMed

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

    2016-02-15

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

  2. A novel automated detection system for swallowing sounds during eating and speech under everyday conditions.

    PubMed

    Fukuike, C; Kodama, N; Manda, Y; Hashimoto, Y; Sugimoto, K; Hirata, A; Pan, Q; Maeda, N; Minagi, S

    2015-05-01

    The wave analysis of swallowing sounds has been receiving attention because the recording process is easy and non-invasive. However, up until now, an expert has been needed to visually examine the entire recorded wave to distinguish swallowing from other sounds. The purpose of this study was to establish a methodology to automatically distinguish the sound of swallowing from sound data recorded during a meal in the presence of everyday ambient sound. Seven healthy participants (mean age: 26·7 ± 1·3 years) participated in this study. A laryngeal microphone and a condenser microphone attached to the nostril were used for simultaneous recording. Recoding took place while participants were taking a meal and talking with a conversational partner. Participants were instructed to step on a foot pedal trigger switch when they swallowed, representing self-enumeration of swallowing, and also to achieve six additional noise-making tasks during the meal in a randomised manner. The automated analysis system correctly detected 342 out of the 352 self-enumerated swallowing events (sensitivity: 97·2%) and 479 out of the 503 semblable wave periods of swallowing (specificity: 95·2%). In this study, the automated detection system for swallowing sounds using a nostril microphone was able to detect the swallowing event with high sensitivity and specificity even under the conditions of daily life, thus showing potential utility in the diagnosis or screening of dysphagic patients in future studies.

  3. Enhancing the Self-Concept and Self-Esteem of Upper Elementary Grade Students with Learning Disabilities through Counseling, Modeling, Reverse-Role Tutoring, and Parent and Teacher Education.

    ERIC Educational Resources Information Center

    Guindon, Jerry

    This practicum addressed the self-concept and self-esteem problems of 10 upper elementary grade students with learning disabilities through development, implementation, and evaluation of a group counseling program. The program involved educating students about their learning disabilities as well as using counseling strategies which stressed…

  4. Reducing Obesity Among People With Disabilities

    PubMed Central

    Fox, Michael H.; Witten, Mary Helen; Lullo, Carolyn

    2015-01-01

    Achieving healthy weight for people with disabilities in the United States is a challenge. Obesity rates for adults and children with disabilities are significantly higher than for those without disabilities, with differences remaining even when controlling for other factors. Reasons for this disparity include lack of healthy food options for many people with disabilities living in restrictive environments, difficulty with chewing or swallowing food, medication use contributing to changes in appetite, physical limitations that can reduce a person’s ability to exercise, constant pain, energy imbalance, lack of accessible environments in which to exercise or fully participate in other activities, and resource scarcity among many segments of the disability population. In order for there to be a coordinated national effort to address this issue, a framework needs to be developed from which research, policy, and practice can emerge. This paper reviews existing literature and presents a conceptual model that can be used to inform such a framework, provides examples of promising practices, and discusses challenges and opportunities moving forward. PMID:26113785

  5. 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

  6. 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…

  7. Learning Disabilities.

    ERIC Educational Resources Information Center

    McCarthy, James J.; McCarthy, Joan F.

    An attempt to collate basic knowledge concerning learning disabilities, the text discusses the background and definition of learning disabilities, and its identification, etiology, and epidemiology. Guidelines for diagnostic evaluation are presented as are approaches from perceptual motor, developmental, visual, neurophysiological, linguistic, and…

  8. Unilateral Superior Laryngeal Nerve Lesion in an Animal Model of Dysphagia and Its Effect on Sucking and Swallowing

    PubMed Central

    Campbell-Malone, Regina; Holman, Shaina D.; Lukasik, Stacey L.; Fukuhara, Takako; Gierbolini-Norat, Estela M.; Thexton, Allan J.; German, Rebecca Z.

    2013-01-01

    We tested two hypotheses relating to the sensory deficit that follows a unilateral superior laryngeal nerve (SLN) lesion in an infant animal model. We hypothesized that it would result in (1) a higher incidence of aspiration and (2) temporal changes in sucking and swallowing. We ligated the right-side SLN in six 2–3-week-old female pigs. Using videofluoroscopy, we recorded swallows in the same pre- and post-lesion infant pigs. We analyzed the incidence of aspiration and the duration and latency of suck and swallow cycles. After unilateral SLN lesioning, the incidence of silent aspiration during swallowing increased from 0.7 to 41.5 %. The durations of the suck containing the swallow, the suck immediately following the swallow, and the swallow itself were significantly longer in the post-lesion swallows, although the suck prior to the swallow was not different. The interval between the start of the suck containing a swallow and the subsequent epiglottal movement was longer in the post-lesion swallows. The number of sucks between swallows was significantly greater in post-lesion swallows compared to pre-lesion swallows. Unilateral SLN lesion increased the incidence of aspiration and changed the temporal relationships between sucking and swallowing. The longer transit time and the temporal coordinative dysfunction between suck and swallow cycles may contribute to aspiration. These results suggest that swallow dysfunction and silent aspiration are common and potentially overlooked sequelae of unilateral SLN injury. This validated animal model of aspiration has the potential for further dysphagia studies. PMID:23417250

  9. Effect of supraglottic and super-supraglottic swallows on tongue pressure production against hard palate.

    PubMed

    Fujiwara, Shigehiro; Ono, Takahiro; Minagi, Yoshitomo; Fujiu-Kurachi, Masako; Hori, Kazuhiro; Maeda, Yoshinobu; Boroumand, Sara; Nitschke, Ina; Ursula, Vith; Bohlender, Jörg

    2014-12-01

    The objectives of this study were to evaluate the state of tongue pressure production during supraglottic swallow (SS) and super-supraglottic swallow (SSS) performed by healthy adults, and to investigate the effects of these swallowing maneuvers on the oral stage of swallowing. The participants were 19 healthy individuals. Tongue pressure against the hard palate during swallowing was measured using a tongue pressure sensor sheet system with five pressure-sensitive points. The tasks comprised swallowing 5 mL of water by normal wet swallow, SS, and SSS, and the parameters for analysis were the duration, the maximal magnitude, and the integrated value of tongue pressure during swallowing. The duration of tongue pressure was significantly longer at the anterior-median part of the hard palate during both SS and SSS than with normal wet swallow. The maximal magnitude increased significantly only at the posterior part of the hard palate during SS, but at all points during SSS. The integrated value increased significantly only at the posterior-median part of the hard palate during SS, but at all points except the mid-median part of the hard palate during SSS. The maximal magnitude and integrated value were also significantly higher at the anterior-median and posterior circumferential parts during SSS than during SS. These results show that these two swallowing maneuvers, which are known primarily as techniques to protect the airway, also function to strengthen the tongue pressure produced by the contact between the tongue and the hard palate during swallowing and this effect is more pronounced during SSS.

  10. Displacement of oropharyngeal structures during suction-swallowing cycles.

    PubMed

    Engelke, W; Glombek, J; Psychogios, M; Schneider, S; Ellenberger, D; Santander, P

    2014-07-01

    Suction ability plays an important role in supporting oral nutrition and needs special care following neurological disorders and tumor-associated defects. However, the details of suction are still poorly understood. The present study evaluates displacement of orofacial structures during suction and deglutition based on manometric controlled MRI. Nine healthy subjects were scanned wearing an intraoral mouthpiece for water intake by suction and subsequent swallowing. Suction-swallowing cycles were identified by intraoral negative pressure. Midsagittal MRI slices (3 T; temporal resolution 0.53 s) were analyzed at rest, suction and pharyngeal swallowing. The mandibular displacement was measured as the distance between the anterior nasal spine and the inferior point of the mandible. Following areas were defined: subpalatal compartment (SCA), retrolingual (RLA), epipharyngeal (EPA) and mouth floor area (MFA). During rest, an average distance of 7 cm was observed between the mandibular measurement points. The measured SCA was 3.67 cm(2), the RLA 6.98 cm(2), the EPA 9.00 cm(2) and the MFA 15.21 cm(2) (average values). At the end of suction, the mandibular distance reduces (to 6.88 cm), the SCA increases significantly (to 5.96 cm(2); p = 0.0002), the RLA decreases (to 6.45 cm(2)), the EPA increases (to 10.59 cm(2)) and the MFA decreases (to 15.02 cm(2)). During deglutition, the mandible lifted significantly (to 6.81 cm; p = 0.0276), the SCA reduced to zero, the RLA was not measurable, the EPA reduces significantly (to 3.01 cm(2); p < 0.0001) and the MFA increases (to 16.36 cm(2)). According to these observations, a combined displacement of the tongue in an anteroposterior direction with active tongue dorsum-velum contact appears to be the predominant activity during suction and responsible for the expansion of the subpalatal area.

  11. Swallowing accelerometry signal feature variations with sensor displacement.

    PubMed

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

    2015-07-01

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

  12. Swallowing accelerometry signal feature variations with sensor displacement.

    PubMed

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

    2015-07-01

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

  13. 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.

  14. 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.

  15. 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...

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

    PubMed

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

    2015-09-01

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

  17. 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…

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  19. 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…

  20. 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.

  1. 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…

  2. 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.

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  4. 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,…

  5. 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…

  6. 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…

  7. 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…

  8. 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.…

  9. 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

  10. 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...

  11. 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...

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

    EPA Science Inventory

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

  13. 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…

  14. 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.

  15. 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.

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

    PubMed

    Taniwaki, Mitsuru; Kohyama, Kaoru

    2012-10-01

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

  17. Developmental Disabilities

    MedlinePlus

    ... many causes of developmental disabilities, including Genetic or chromosome abnormalities. These cause conditions such as Down syndrome and Rett syndrome. Prenatal exposure to substances. Drinking alcohol when ... also help. NIH: National Institute of Child Health and Human Development

  18. Intellectual disability

    MedlinePlus

    ... Infectious diseases. Certain infections can lead to intellectual disability. Preventing these diseases reduces the risk. For example, rubella syndrome can be prevented through vaccination. Avoiding exposure to cat feces that can cause ...

  19. Emergency admissions due to swallowed foreign bodies in adults

    PubMed Central

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

    2013-01-01

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

  20. 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

  1. 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.

  2. Increased oxidative stress in barn swallows from the Chernobyl region.

    PubMed

    Bonisoli-Alquati, Andrea; Mousseau, Timothy A; Møller, Anders Pape; Caprioli, Manuela; Saino, Nicola

    2010-02-01

    The Chernobyl nuclear accident produced the largest unintended release of radionuclides in history, with dramatic consequences for humans and other organisms. Exposure to ionizing radiation is known to reduce circulating and stored levels of specific antioxidants in birds and humans, thus potentially increasing oxidative stress. However, overall effects of radioactive exposure on oxidative status have never been investigated in any free ranging vertebrate. We measured plasma antioxidant capacity and concentration of reactive oxygen metabolites in adult barn swallows (Hirundo rustica) from colonies with variable background radiation levels in the Chernobyl region in Ukraine and Belarus. We predicted that antioxidants would decrease while reactive oxygen metabolites would increase with exposure to increasing levels of radiation at the breeding sites. Consistent with this expectation, radiation level positively predicted plasma concentration of reactive oxygen metabolites, whereas no significant covariation was found with non-enzymatic plasma antioxidant capacity. An index of oxidative stress was also larger in barn swallows exposed to high contamination levels. Thus, radioactive contamination appeared to be responsible for the increased generation of reactive oxygen metabolites and the imbalance between reactive oxygen metabolites and non-enzymatic plasma antioxidant capacity.

  3. 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…

  4. Visual and auditory stimuli associated with swallowing activate mirror neurons: a magnetoencephalography study.

    PubMed

    Ushioda, Takashi; Watanabe, Yutaka; Sanjo, Yusuke; Yamane, Gen-Yuki; Abe, Shinichi; Tsuji, Yusuke; Ishiyama, Atushi

    2012-12-01

    In the present study, we evaluated activated areas of the cerebral cortex with regard to the mirror neuron system during swallowing. To identify the activated areas, we used magnetoencephalography. Subjects were ten consenting volunteers. Swallowing-related stimuli comprised an animated image of the left profile of a person swallowing water with laryngeal elevation as a visual swallowing trigger stimulus and a swallowing sound as an auditory swallowing trigger stimulus. As control stimuli, a still frame image of the left profile without an additional trigger was shown, and an artificial sound as a false auditory trigger was provided. Triggers were presented at 3,000 ms after the start of image presentation. The stimuli were combined and presented and the areas activated were identified for each stimulus. With animation and still-frame stimuli, the visual association area (Brodmann area (BA) 18) was activated at the start of image presentation, while with the swallowing sound and artificial sound stimuli, the auditory areas BA 41 and BA 42 were activated at the time of trigger presentation. However, with animation stimuli (animation stimulus, animation + swallowing sound stimuli, and animation + artificial sound stimuli), activation in BA 6 and BA 40, corresponding to mirror neurons, was observed between 620 and 720 ms before the trigger. Besides, there were also significant differences in latency time and peak intensity between animation stimulus and animation + swallowing sound stimuli. Our results suggest that mirror neurons are activated by swallowing-related visual and auditory stimuli.

  5. 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

  6. 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. PMID:27378508

  7. 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.

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

    PubMed Central

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

    2013-01-01

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

  9. Laryngeal and tracheal afferent nerve stimulation evokes swallowing in anaesthetized guinea pigs.

    PubMed

    Tsujimura, Takanori; Udemgba, Chioma; Inoue, Makoto; Canning, Brendan J

    2013-09-15

      We describe swallowing reflexes evoked by laryngeal and tracheal vagal afferent nerve stimulation in anaesthetized guinea pigs. The swallowing reflexes evoked by laryngeal citric acid challenges were abolished by recurrent laryngeal nerve (RLN) transection and mimicked by electrical stimulation of the central cut ends of an RLN. By contrast, the number of swallows evoked by upper airway/pharyngeal distensions was not significantly reduced by RLN transection but they were virtually abolished by superior laryngeal nerve transection. Laryngeal citric acid-evoked swallowing was mimicked by laryngeal capsaicin challenges, implicating transient receptor potential vanilloid 1 (TRPV1)-expressing laryngeal afferent nerves arising from the jugular ganglia. The swallowing evoked by citric acid and capsaicin and evoked by electrical stimulation of either the tracheal or the laryngeal mucosa occurred at stimulation intensities that were typically subthreshold for evoking cough in these animals. Swallowing evoked by airway afferent nerve stimulation also desensitized at a much slower rate than cough. We speculate that swallowing is an essential component of airway protection from aspiration associated with laryngeal and tracheal afferent nerve activation. PMID:23858010

  10. Mechanism of sequential swallowing during straw drinking in healthy young and older adults.

    PubMed

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

    2004-02-01

    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 samples of two 10-s straw drinking trials were obtained for 20 healthy young men (age 29 +/- 3 years) and 18 healthy older men (age 69 +/- 7 years). Hyolaryngeal complex (HLC) movement patterns, leading edge of the bolus location at swallow onset, and occurrences of airway invasion were determined. Two HLC patterns were identified: (a). HLC lowering with the epiglottis returned to upright between swallows and (b). partially maintained HLC elevation with the epiglottis inverted between swallows. The bolus was frequently in the hypopharynx at swallow onset. Strong associations were identified between age and HLC pattern, age and leading edge of the bolus location, and HLC pattern and leading edge location. Laryngeal penetration was uncommon overall; however, it occurred more frequently in the older adults than in the young adults. A significant relation was identified between age and the average Penetration-Aspiration Scale score. Laryngeal penetration was associated with both HLC movement patterns and hypopharyngeal bolus location, particularly in older adults. Results indicate that subtle age-related differences are evident in healthy young and older adults with sequential straw drinking. These data suggest that specific inherent swallowing patterns may increase the risk of laryngeal penetration with normal aging.

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

    PubMed

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

    2013-09-01

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

  12. 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.

  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. Reversible dementias

    PubMed Central

    Tripathi, Manjari; Vibha, Deepti

    2009-01-01

    In recent years, more attention has been given to the early diagnostic evaluation of patients with dementia which is essential to identify patients with cognitive symptoms who may have treatable conditions. Guidelines suggest that all patients presenting with dementia or cognitive symptoms should be evaluated with a range of laboratory tests, and with structural brain imaging with computed tomography (CT) or magnetic resonance imaging (MRI). While many of the disorders reported as ‘reversible dementias’ are conditions that may well be associated with cognitive or behavioral symptoms, these symptoms are not always sufficiently severe to fulfill the clinical criteria for dementia. Thus, while the etiology of a condition may be treatable it should not be assumed that the associated dementia is fully reversible. Potentially reversible dementias should be identified and treatment considered, even if the symptoms are not sufficiently severe to meet the clinical criteria for dementia, and even if partial or full reversal of the cognitive symptoms cannot be guaranteed. In the literature, the most frequently observed potentially reversible conditions identified in patients with cognitive impairment or dementia are depression, adverse effects of drugs, drug or alcohol abuse, space-occupying lesions, normal pressure hydrocephalus, and metabolic conditions land endocrinal conditions like hypothyroidism and nutritional conditions like vitamin B-12 deficiency. Depression is by far the most common of the potentially reversible conditions. The review, hence addresses the common causes of reversible dementia and the studies published so far. PMID:21416018

  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. 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…

  19. Intellectual Disability

    MedlinePlus

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

  20. Intellectual Disability

    MedlinePlus

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

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

    PubMed

    Gray, L P

    1983-07-01

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

  2. 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.

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

    USGS Publications Warehouse

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

    1982-01-01

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

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

    PubMed

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

    2015-04-01

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

  5. 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.

  6. Variability of Oral and Pharyngeal Transit Between Two Consecutive Swallows in Chagas’ Disease

    PubMed Central

    Dantas, Roberto Oliveira; dos Santos, Carla Manfredi; de Aguiar Cassiani, Rachel; do Nascimento, Weslania Viviane

    2013-01-01

    Background Chagas’ disease causes dysphagia, regurgitation and retention of food in the esophageal body. Patients have longer pharyngeal clearance, which might be consequent of the involvement of the central nervous system or an adaptation to the esophageal transit impairment. If there is central nervous system involvement by the disease, we expect a larger difference in the oral and pharyngeal phases of swallowing between two consecutive swallows than that seen in controls. Our objective was to evaluate the difference of oral and pharyngeal transit duration between two consecutive swallows in patients with Chagas’ disease compared with controls. Methods By videofluoroscopy, the duration of oral and pharyngeal transit, pharyngeal clearance, upper esophageal sphincter transit, hyoid movement and oropharyngeal transit was measured in 17 patients with Chagas’ disease and 15 asymptomatic volunteers. Each subject swallowed in duplicate and in sequence 5 mL and 10 mL of barium liquid and 5 mL and 10 mL of barium paste boluses. The differences were calculated between the two swallows of each volume and consistency in patients and controls. Results There were no differences between controls and patients in the values of the differences between the two consecutive swallows, except for the hyoid movement duration of the 5 mL liquid bolus, causing a higher difference in controls than in patients. Conclusion Oral and pharyngeal transit variation between two consecutive swallows is similar between patients with Chagas’ disease and controls, which suggests that the longer pharyngeal clearance duration previously described is not a consequence of impairment of the central nervous system control of swallowing.

  7. New airway and swallow manifestations of Simpson-Golabi-Behmel syndrome.

    PubMed

    Glamuzina, Emma; Aftimos, Salim; Keesing, Melissa; Mahadevan, Murali

    2009-10-01

    Simpson-Golabi-Behmel syndrome (SGBS) is an X-linked disorder of overgrowth associated with multiple congenital malformations. We report on a child with typical facial and visceral manifestations of SGBS. In addition there were complex airway anomalies, swallow difficulties and associated bronchiectasis that have not previously been described. The case highlights the importance of comprehensive airway and swallow assessment in children with this overgrowth syndrome. PMID:19631996

  8. 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.

  9. New airway and swallow manifestations of Simpson-Golabi-Behmel syndrome.

    PubMed

    Glamuzina, Emma; Aftimos, Salim; Keesing, Melissa; Mahadevan, Murali

    2009-10-01

    Simpson-Golabi-Behmel syndrome (SGBS) is an X-linked disorder of overgrowth associated with multiple congenital malformations. We report on a child with typical facial and visceral manifestations of SGBS. In addition there were complex airway anomalies, swallow difficulties and associated bronchiectasis that have not previously been described. The case highlights the importance of comprehensive airway and swallow assessment in children with this overgrowth syndrome.

  10. 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.

  11. Speech and swallowing following tongue cancer surgery and free flap reconstruction--a systematic review.

    PubMed

    Lam, Lisetta; Samman, Nabil

    2013-06-01

    This was a systematic review of the current research on speech and swallowing outcomes and the factors affecting these outcomes after primary resection of tongue cancer and free flap reconstruction. A structured search in various electronic databases and relevant journals was performed. Retrieved articles were critically appraised in three rounds according to the level of evidence, the methodological quality, and the specific domain of speech and swallowing. A total of 21 articles were in the final review and the findings were categorized according to the area of tongue resection. For patients with resection and free flap reconstruction limited to either the oral tongue or the base of tongue (BOT), significant decline in speech and swallowing function was evident in the early postoperative phase, but the majority recovered close to preoperative level after 1 year. Poorer speech and swallowing outcomes were found following resections involving both oral and base of tongue (OBOT) regardless of the type of free flap reconstruction. Results overall were influenced by multiple factors including tumor size, area of resection, method of reconstruction and the use of adjuvant therapy. The use of free flaps in the immediate reconstruction of the tongue after tumor resection should aim at the maintenance of the mobility of the residual tongue and restoration of tongue bulk in order to optimize the recovery of speech and swallowing function. Future research in this field should employ standardized and reliable evaluation of speech and swallowing outcomes using multiple modalities in well-designed cohort studies with longer follow-up.

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

    PubMed Central

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

    2015-01-01

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

  13. Targeted exercise therapy for voice and swallow in persons with Parkinson’s disease

    PubMed Central

    Russell, John A.; Ciucci, Michelle R.; Connor, Nadine P.; Schallert, Timothy

    2010-01-01

    Sensorimotor deficits affecting voice and swallowing ability can have a devastating impact on the quality of life of people with Parkinson disease (PD). Recent scientific findings in animal models of PD pinpoint targeted exercise therapy as a potential treatment to reduce neurochemical loss and decrease parkinsonian symptoms. Although there may be beneficial effects, targeted exercise therapy is not a standard component of therapy for the cranial sensiromotor deficits seen in PD. In this paper we review the scientific evidence for targeted training for voice and swallowing deficits. The literature search revealed 19 publications that included targeted training for voice and only one publication that included targeted training for swallowing. We summarize 3 main findings: 1) targeted training may be associated with lasting changes in voice behavior, 2) targeted training of sensorimotor actions with anatomical or functional overlap with voice and swallowing may improve voice and swallowing to some degree, but it is unknown whether these effects endure over time, and 3) evidence regarding cranial sensorimotor interventions for Parkinson disease is sparse. We concluded that targeted training for voice and swallow is a promising but under-studied intervention for cranial sensorimotor deficits associated with PD and posit that animal models can be useful in designing empirically based studies that further the science on targeted training. PMID:20233583

  14. 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.

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  18. The effects of intraoral pressure sensors on normal young and old swallowing patterns.

    PubMed

    Hind, Jacqueline A; Nicosia, Mark A; Gangnon, Ronald; Robbins, Joanne

    2005-01-01

    Lingual pressure generation plays a crucial role in oropharyngeal swallowing. To more discretely study the dynamic oropharyngeal system, a 3-bulb array of pressure sensors was designed with the Kay Elemetrics Corporation (Lincoln Park, NJ). The influence of the device upon normal swallowing mechanics and boluses representative of flow relative to age and bolus condition was the focus of this study. Twelve healthy adults in two age groups (31 +/- 5 years, 2 males and 4 females, and 78 +/- 7 years, 2 males and 4 females) participated. Each subject was instructed to swallow four boluses representative of conditions with and without three pressure sensors affixed to the hard palate. Post-swallow residue at four locations, Penetration/Aspiration Scale scores, and three bolus flow timing measures were assessed videofluoroscopically with respect to age and bolus condition. The only statistically significant influences attributable to the presence of the pressure sensors were slight increases in residue in the oral cavity and upper esophageal sphincter with some bolus consistencies, 8% more frequent trace penetration of the laryngeal vestibule predominantly with effortful swallowing, and variances in oral clearance duration. We conclude that the presence of the pressure sensors does not significantly alter normal swallowing patterns of healthy individuals.

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

    PubMed

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

    2008-01-01

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

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

    PubMed Central

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

    2010-01-01

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

  1. 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

  2. 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.

  3. Disability Experience and Measurement.

    PubMed

    Verbrugge, Lois M

    2016-10-01

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

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

    PubMed

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

    2014-08-01

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

  5. 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.

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

    PubMed

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

    2015-12-01

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

  7. Swallowing disorders in Pierre Robin sequence: its correction by distraction.

    PubMed

    Monasterio, Fernando Ortíz; Molina, Fernando; Berlanga, Fidel; López, María Elena; Ahumada, Héctor; Takenaga, Raúl H; Ysunza, Antonio

    2004-11-01

    Pierre Robin sequence is characterized by micro-gnathia, glossoptosis, feeding difficulties, and upper respiratory obstruction, which are frequently complicated by bronchial aspiration and pulmonary infection. Gastroesophageal reflux is also common in these patients. To assess the results of mandibular distraction, a study was performed in 18 patients to detect swallowing disorders associated with apnea episodes and gastroesophageal reflux. Polysomnography, barium pharyngoscopy, determination of blood gases, and esophageal pH measurements were undertaken before and 4 months after distraction osteogenesis. Bilateral corticotomies, followed by distraction with external devices, were performed, achieving 7 to 19 mm of elongation (mean = 12 mm). Gastroesophageal reflux was found in 83% of cases associated with apnea episodes, but it disappeared after distraction osteogenesis. Mean preoperative oxygen saturation was 72%, and it was 93% afterward. The preoperative apnea index was 18.3, and the preoperative 8.5 hypopnea index was 8.5; both disappeared. Pharyngeal transit time became less than 1 second after treatment. Abnormal tongue movements and barium stasis in the pharyngeal recess and in the trachea were eliminated in all the patients.

  8. Effect of gabapentin on swallowing during and after chemoradiation for oropharyngeal squamous cell cancer.

    PubMed

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

    2014-06-01

    The aim of this study was to examine the impact of gabapentin (neurontin) on swallowing and feeding tube use during chemoradiation (CRT) for oropharyngeal squamous cell carcinoma (OPSCC), and physiologic swallowing outcomes following completion of treatment. A total of 23 patients treated for OPSCC with concurrent CRT and prophylactically treated for pain using gabapentin were assessed. Historical controls were matched for T stage and primary site of disease. Timing of PEG use and removal were recorded. Video fluoroscopic swallowing studies were completed post-treatment to assess physiologic outcomes as well as penetration-aspiration scores (PAS). Functional oral intake scale (FOIS) scores were determined at the time of swallowing evaluation to assess diet level. Patients treated with gabapentin began using their PEG tubes later (3.7 vs. 2.29 weeks; P = 0.013) and had their PEG tubes removed earlier (7.29 vs. 32.56 weeks; P = 0.039) than the historical controls. A number of physiologic parameters were found to be less impacted in the gabapentin group, including oral bolus control (P = 0.01), epiglottic tilt (P = 0.0007), laryngeal elevation (P = 0.0017), and pharyngeal constriction (P = 0.002). PAS scores were significantly lower in the group treated with gabapentin (1.89 vs. 4; P = 0.0052). Patients receiving gabapentin had more advanced diet levels at the time of the initial swallowing study as evidenced by their FOIS scores (5.4 vs. 3.21; P = 0.0003). We conclude that patients using gabapentin for pain management during CRT appears to do well maintaining swallow function during treatment and have favorable post-treatment physiologic swallowing outcomes. Prospective evaluation is warranted.

  9. Differences in videofluoroscopic swallowing study (VFSS) findings according to the vascular territory involved in stroke.

    PubMed

    Kim, Seo Yeon; Kim, Tae Uk; Hyun, Jung Keun; Lee, Seong Jae

    2014-08-01

    Dysphagia affects up to half of stroke patients and increases the risk of pneumonia and fatal outcomes. In order to assess swallowing difficulty, videofluoroscopic swallowing study (VFSS) has traditionally been the gold standard. The purpose of this study was to compare the patterns of post-stroke swallowing difficulties according to the vascular territories involved in the stroke. One hundred and three patients who were diagnosed with first ischemic stroke by brain magnetic resonance imaging and had swallowing difficulty were included in this study. Location of the stroke was classified into three groups: territorial anterior infarcts (TAI) (n = 62), territorial posterior infarcts (TPI) (n = 19) and white matter disease (WMD) (n = 22). Oral cavity residue existed significantly in the TAI group more than in any other groups (P = 0.017). The WMD group showed more residue in the valleculae (P = 0.002) and the TPI group showed more residue in the pyriform sinuses (P = 0.001). The oral transit time, pharyngeal delay time and pharyngeal transit time did not show significant differences among the groups with swallowing of both thick and thin liquids. Penetration and aspiration were more frequent in the TPI group (P < 0.05) with swallowing of both thick and thin liquids. The results suggest that TAI is more related to oral phase dysfunction and TPI is more related to pharyngeal dysfunction. In ischemic stroke, patterns of swallowing difficulty may differ according to the vascular territory involved and this should be considered in the management of post-stroke dysphagia.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  12. 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

  13. Rural People with Disabilities

    MedlinePlus

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

  14. Facts about Developmental Disabilities

    MedlinePlus

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

  15. What Are Learning Disabilities?

    MedlinePlus

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

  16. Sexuality and Intellectual Disability

    MedlinePlus

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

  17. Vasectomy reversal.

    PubMed

    Belker, A M

    1987-02-01

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

  18. 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.

  19. Use of computer and respiratory inductance plethysmography for the automated detection of swallowing in the elderly.

    PubMed

    Moreau-Gaudry, Alexandre; Sabil, Abdelkebir; Baconnier, Pierre; Benchetrit, Gila; Franco, Alain

    2005-01-01

    Deglutition disorders can occur at any age but are especially prevalent in the elderly. The resulting morbidity and mortality are being recognized as major geriatric health issues, Because of difficulties in studying swallowing in the frail elderly, a new, non-invasive, user-friendly, bedside technique has been developed. Ideally suited to such patients, this tool, an intermediary between purely instrumental and clinical methods, combines respiratory inductance plethysmography (RIP) and the computer to detect swallowing automatically, Based on an automated analysis of the airflow estimated by the RIP-derived signal, this new tool was evaluated according to its capacity to detect clinical swallowing from among the 1643 automatically detected respiratory events, This evaluation used contingency tables and Receiver Operator Characteristic (ROC) curves, Results were all significant (chi2(1,n=1643)>100, p<0.01). Considering its high accuracy in detecting swallowing (area under the ROC curve greater than 0.9), this system would be proposed to study deglutition and then deglutition disorders in the frail elderly, to set up medical supervision and to evaluate the efficiency of a swallowing disorder remedial therapeutic.

  20. A model experiment to understand the oral phase of swallowing of Newtonian liquids.

    PubMed

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

    2015-11-01

    A model experiment to understand the oral phase of swallowing is presented and used to explain some of the mechanisms controlling the swallowing of Newtonian liquids. The extent to which the flow is slowed down by increasing the viscosity of the liquid or the volume is quantitatively studied. The effect of the force used to swallow and of the gap between the palate and the roller used to represent the contracted tongue are also quantified. The residual mass of liquid left after the model swallow rises strongly when increasing the gap and is independent of bolus volume and applied force. An excessively high viscosity results in higher residues, besides succeeding in slowing down the bolus flow. A realistic theory is developed and used to interpret the experimental observations, highlighting the existence of an initial transient regime, at constant acceleration, that can be followed by a steady viscous regime, at constant velocity. The effect of the liquid viscosity on the total oral transit time is lower when the constant acceleration regime dominates bolus flow. Our theory suggests also that tongue inertia is the cause of the higher pressure observed at the back of the tongue in previous studies. The approach presented in this study paves the way toward a mechanical model of human swallowing that would facilitate the design of novel, physically sound, dysphagia treatments and their preliminary screening before in vivo evaluations and clinical trials.

  1. Swallowing outcome after TORS for sleep apnea: short- and long-term evaluation.

    PubMed

    Eesa, Mohamed; Montevecchi, Filippo; Hendawy, Ehsan; D'Agostino, Giovanni; Meccariello, Giuseppe; Vicini, Claudio

    2015-06-01

    The aim of this study was to evaluate outcomes related to swallowing function in patients who underwent transoral robotic surgery (TORS) for sleep apnea on both short- and long-term scales. 78 patients who underwent TORS for sleep apnea between 2011 and 2014 were followed up for an average period of 20 ± 7.12 months (range 7-32 months), then swallowing outcomes determined by MD Anderson Dysphagia Inventory (MDADI) questionnaire, gastrografin fluoroscopy imaging results, nasogastric tube dependence and subjectively by recording the patients' complaints were analyzed and reported. Minimal insignificant short-term impact on swallowing function (4.58 ± 7.03 preoperative MDADI score versus 5.18 ± 8.32 post-operative) (p = 0.56) was registered. Mean time for start of oral feeding was 1.05 ± 0.25 days (average, 1-3). In no case nasogastric tube feeding was required. Only five patients (6 %) showed significant aspiration on gastrografin fluoroscopy examination after 1 week; there was no significant correlation between the volume of tissue removed from both tongue base and epiglottis to the incidence of aspiration as shown by gastrografin fluoroscopy examination (p = 0.72). No long-term swallowing complaint was registered. Patients who underwent TORS tongue base reduction and supraglottoplasty for sleep apnea proved to have a reasonable short-term swallowing outcomes with no long-term sequelae.

  2. A model experiment to understand the oral phase of swallowing of Newtonian liquids.

    PubMed

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

    2015-11-01

    A model experiment to understand the oral phase of swallowing is presented and used to explain some of the mechanisms controlling the swallowing of Newtonian liquids. The extent to which the flow is slowed down by increasing the viscosity of the liquid or the volume is quantitatively studied. The effect of the force used to swallow and of the gap between the palate and the roller used to represent the contracted tongue are also quantified. The residual mass of liquid left after the model swallow rises strongly when increasing the gap and is independent of bolus volume and applied force. An excessively high viscosity results in higher residues, besides succeeding in slowing down the bolus flow. A realistic theory is developed and used to interpret the experimental observations, highlighting the existence of an initial transient regime, at constant acceleration, that can be followed by a steady viscous regime, at constant velocity. The effect of the liquid viscosity on the total oral transit time is lower when the constant acceleration regime dominates bolus flow. Our theory suggests also that tongue inertia is the cause of the higher pressure observed at the back of the tongue in previous studies. The approach presented in this study paves the way toward a mechanical model of human swallowing that would facilitate the design of novel, physically sound, dysphagia treatments and their preliminary screening before in vivo evaluations and clinical trials. PMID:26602372

  3. 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

  4. 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

  5. Esophageal Transit, Contraction and Perception of Transit After Swallows of Two Viscous Boluses

    PubMed Central

    Dalmazo, Jucileia; Aprile, Lilian Rose Otoboni; Dantas, Roberto Oliveira

    2015-01-01

    Background There have been results showing the influence of bolus viscosities and consistency on esophageal motility and transit. However, there is no description about the influence of two different viscous boluses on esophageal contractions, bolus transit and perception of transit. Our objective in this investigation was to evaluate the esophageal transit and contraction after swallows of two viscous boluses. Methods By impedance and manometric methods, we measured the esophageal transit and contraction after swallows of two viscous boluses of 5 mL volume, 100% barium sulfate and yogurt, swallowed in duplicate in the supine and upright positions. The bolus transit, esophageal contractions and the perception of bolus transit through the esophagus were evaluated in both positions. Impedance and contraction were measured at 5, 10, 15 and 20 cm from the lower esophageal sphincter. After each swallow, the volunteers were asked about the sensation of bolus transit through the esophagus. Results In supine position, the yogurt had a less frequent complete bolus transit than barium. Also in the supine position, the esophageal transit was longer with yogurt than with barium. Esophageal contractions after swallows were similar between barium and yogurt boluses. There was no difference in perception of transit between the two boluses. Conclusion Although both 100% barium sulfate and yogurt are viscous boluses and have similar viscosities, the transit through the esophagus is slower with yogurt bolus than with barium bolus, which suggests that viscosity may be not the sole factor to determine transit.

  6. 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.

  7. 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.

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

    PubMed Central

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

    2015-01-01

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

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

    USGS Publications Warehouse

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

    2009-01-01

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

  10. On the physiology of normal swallowing as revealed by magnetic resonance imaging in real time.

    PubMed

    Olthoff, Arno; Zhang, Shuo; Schweizer, Renate; Frahm, Jens

    2014-01-01

    The aim of this study was to assess the physiology of normal swallowing using recent advances in real-time magnetic resonance imaging (MRI). Therefore ten young healthy subjects underwent real-time MRI and flexible endoscopic evaluations of swallowing (FEES) with thickened pineapple juice as oral contrast bolus. MRI movies were recorded in sagittal, coronal, and axial orientations during successive swallows at about 25 frames per second. Intermeasurement variation was analyzed and comparisons between real-time MRI and FEES were performed. Twelve distinct swallowing events could be quantified by real-time MRI (start time, end time, and duration). These included five valve functions: oro-velar opening, velo-pharyngeal closure, glottal closure, epiglottic retroflexion, and esophageal opening; three bolus transports: oro-velar transit, pharyngeal delay, pharyngeal transit; and four additional events: laryngeal ascent, laryngeal descent, vallecular, and piriform sinus filling and pharyngeal constriction. Repetitive measurements confirmed the general reliability of the MRI method with only two significant differences for the start times of the velo-pharyngeal closure (t(8) = -2.4, P ≤ 0.046) and laryngeal ascent (t(8) = -2.6, P ≤ 0.031). The duration of the velo-pharyngeal closure was significantly longer in real-time MRI compared to FEES (t(8) = -3.3, P ≤ 0.011). Real-time MRI emerges as a simple, robust, and reliable tool for obtaining comprehensive functional and anatomical information about the swallowing process. PMID:24693283

  11. 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

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

    NASA Technical Reports Server (NTRS)

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

    1974-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1980-01-01

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

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

    PubMed Central

    2014-01-01

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

  15. Early identification and treatment of communication and swallowing deficits in Parkinson disease.

    PubMed

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

    2013-08-01

    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

  16. 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

  17. 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.

  18. Usefulness of videofluoroscopic swallow study in treacher collins syndrome with cleft palate: a case report.

    PubMed

    Hwang, Do-Won; Jung, Kang-Jae; Kim, Seung-Yeon; Kim, Jae-Hyung

    2014-10-01

    A 3-year-old girl had multiple anomalies compatible with Treacher Collins Syndrome (TCS). From the neonatal period, sucking was poor, making tube feeding necessary. Excessive saliva was retained in the oral cavity. Nasal leakage caused by the cleft palate was observed when she spoke. The initial videofluoroscopic swallow study (VFSS) showed a poor posterior bolus transit and nasopharyngeal regurgitation. A delayed swallow reflex and bolus stasis at the vallecular and pyriform sinuses were recognized. Based on the VFSS findings, the patient underwent palatoplasty at 20 months of age. At approximately 23 months of age, a follow-up VFSS was performed; poor posterior bolus transit, nasopharyngeal regurgitation, and delayed swallow reflex were not observed. Finally, the patient was able to eat ground or chopped foods and solid foods orally. We deem VFSS to be helpful in deciding the appropriate management of dysphagia in TCS.

  19. Relationship between swallowing function and gas exchange during day and night in patients with obstructive sleep apnea syndrome.

    PubMed

    Teramoto, S; Ishii, T; Matsuse, T

    2001-01-01

    Patients with obstructive sleep apnea syndrome (OSAS) are likely to exhibit an impaired swallowing reflex. However, mechanisms of disturbed swallowing reflex have not been determined. Because the upper-airway function is inhibited by hypoxia and hypercapnia, we examined the relationship between the swallowing function and gas exchange during day and night in patients with OSAS. Twenty-four patients with OSAS and 24 age-matched controls were studied. OSAS was diagnosed from overnight polysomnography. The swallowing reflex was judged by the latent time (LT) for swallowing following bolus injection of distilled water at the suprapharynx, the inspiratory suppression time (IST) from swallowing termination to the next onset of inspiration, and the threshold for evoking the swallowing response in terms of a volume of water (TV). Whereas the LT values are positively correlated with PaCO2 but not with PaO2 during the day, the values of IST and TV were not associated with daytime PaCO2 or PaO2. Nocturnal nadir SaO2 was correlated with LT, IST, and TV. These results indicate that oxyhemoglobin desaturation and hypercapnia may be associated with one of the mechanisms of the impaired swallowing function in patients with OSAS. PMID:11720400

  20. 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...

  1. 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…

  2. 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

  3. Adapting human videofluoroscopic swallow study methods to detect and characterize dysphagia in murine disease models.

    PubMed

    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.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2008-01-01

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

  6. 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.

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

    SciTech Connect

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

    2011-02-15

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

  8. Invasive swallow-worts: an allelopathic role for -(-) antofine remains unclear.

    PubMed

    Gibson, Donna M; Vaughan, Richard H; Milbrath, Lindsey R

    2015-02-01

    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 root tissues that causes pronounced inhibition in laboratory bioassays of native plant species co-located in habitats where swallow-wort is found. To further evaluate the allelopathic potential of -(-) antofine, we: determined its concentration in young plant tissues; used in situ approaches to assess antofine stability, potential activity of degradation products, activity in sterile and nonsterile soil; and determined accumulation and concentration in hydroponic cultivation and field collected soil samples. Extracts of seeds and young seedlings were found to have approximately 2-3 times the level of -(-) antofine in comparison to root extracts of adult plants. Breakdown products of antofine accumulated rapidly with exposure to light, but more slowly in the dark, at ambient temperatures, and these products did not retain biological activity. Extraction efficiencies of control soil spiked with -(-) antofine were low but easily detectable by HPLC. Soil samples collected over two growing seasons at four different sites where either pale swallow-wort or black swallow-wort populations are present were negative for the presence of -(-) antofine. Dose response curves using sterile and nonsterile soil spiked with -(-) antofine demonstrated a requirement for at least 20-55 × greater -(-) antofine concentrations in soil to produce similar phytotoxic effects to those previously seen in agar bioassays with lettuce seedlings. Sterile soil had a calculated EC50 of 686 μM (250 μg/g) as compared to nonsterile soil treatments with a calculated EC50 of 1.88 mM (640 μg/g). When pale swallow-wort and black swallow-wort adult plants were grown in hydroponic cultivation, -(-) antofine

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

    Shiozu, Hiroyasu; Higashijima, Misako; Koga, Tomoshige

    2015-01-01

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

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

    PubMed

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

    2015-11-01

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

  12. 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

  13. Pale swallow-wort establishment and survival across four disturbance regimes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pale swallow-wort (Cynanchum rossicum (Kleopow) Borhidi) is an increasingly problematic invasive perennial vine in the northeastern U.S. and southeastern Canada. Currently, sufficient biological data on this herbaceous species is lacking. Such data are necessary for further development of a biolog...

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  15. 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…

  16. Effects of olfactory and gustatory stimuli on neural excitability for swallowing.

    PubMed

    Abdul Wahab, Norsila; Jones, Richard D; Huckabee, Maggie-Lee

    2010-12-01

    This project evaluated the effects of olfactory and gustatory stimuli on the amplitude and latency of motor-evoked potentials (MEPs) from the submental muscles when evoked by transcranial magnetic stimulation (TMS). Sixteen healthy volunteers (8 males; age range 19-43) participated in the study. Lemon concentrate at 100% and diluted in water to 25% were presented separately as odor and tastant stimuli. Tap water was used as control. 15 trials of TMS-evoked MEPs triggered by volitional contraction of the submental muscles and volitional swallowing were measured at baseline, during control condition, during stimulus presentation, and immediately, 30-, 60-, and 90-min poststimulation for each of the four stimulus presentations. Experiments were repeated using the combined odor and tastant concentrations that most influenced the MEP independently. Differences in MEP amplitude measured during swallowing were seen at 30-, 60-, and 90-min poststimulation for simultaneous olfactory and gustatory stimulation as opposed to no differences seen at any point for stimuli presented separately. This study has shown that combined odor and tastant stimulation (i.e., flavor) can increase MEP amplitude during swallowing and that this enhancement of MEP can persist for at least 90min following stimulation. As increased MEP amplitude has been associated with improved swallowing performance, a follow-up study is underway to determine the biomechanical changes produced by altered MEPs to facilitate translation of these data to clinical dysphagia management. PMID:20849867

  17. Regional differences in length change and electromyographic heterogeneity in sternohyoid muscle during infant mammalian swallowing.

    PubMed

    Konow, Nicolai; Thexton, Allan; Crompton, A W; German, Rebecca Z

    2010-08-01

    A complex sling of muscles moves and stabilizes the hyoid bone during many mammalian behaviors. One muscle in this sling, the sternohyoid, is recruited during food acquisition, processing, and swallowing, and also during nonfeeding behaviors. We used synchronous sonomicrometry and electromyography to investigate regional (intramuscular) changes in length and electromyographic (EMG) activity of the sternohyoid during swallowing in the infant pig. The simple straplike architecture of the sternohyoid led us to hypothesize that limited regional variation in length and muscle activity would be present. We found statistically significant regional differences in EMG activity, and, with respect to length dynamics, the sternohyoid did not behave homogeneously during swallowing. The midbelly region typically shortened while the anterior and posterior regions lengthened, although in a minority of swallows (12.5%) the midbelly lengthened simultaneously with the end-regions. Despite its nonpennate architecture and evolutionarily conservative innervation, the mammalian sternohyoid appears to contain previously unrecognized populations of regionally specialized motor units. It also displays differential contraction patterns, very similar to the sternohyoid of nonmammalian vertebrates. PMID:20538841

  18. Effects of enhanced bolus flavors on oropharyngeal swallow in patients treated for head and neck cancer

    PubMed Central

    Pauloski, Barbara Roa; Logemann, Jerilyn A.; Rademaker, Alfred W.; Lundy, Donna; Sullivan, Paula A.; Newman, Lisa A.; Lazarus, Cathy; Bacon, Mary

    2014-01-01

    Background Treatment for head and neck cancer can reduce peripheral sensory input and impair oropharyngeal swallow. This study examined the effect of enhanced bolus flavor on liquid swallows in these patients. Methods Fifty-one patients treated for head and neck cancer with chemoradiation or surgery and 64 healthy adult control subjects served as subjects. All were randomized to receive sour, sweet, or salty bolus flavor. Patients were evaluated at 7–10 days, 1 month, and 3 months after completion of tumor treatment. Control subjects received 1 assessment. Results All bolus flavors affected oropharyngeal swallow; sour flavor significantly shortened pharyngeal transit time across all evaluations. Conclusions Sour flavor influenced the swallow of patients treated for head and neck cancer, as well as that of control subjects in a manner similar to those with neurologic impairment observed in an earlier study. Sour flavor may improve the speed of pharyngeal transit regardless of whether a patient has suffered peripheral or central sensory damage. PMID:22907789

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

    NASA Astrophysics Data System (ADS)

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

    2001-05-01

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

  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. 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).

  2. 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).

  3. 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…

  4. 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…

  5. 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…

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

    PubMed

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

    2015-01-01

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

  7. 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…

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

    MedlinePlus

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

  9. Impact of Children’s Feeding/Swallowing Problems: Validation of a New Caregiver Instrument

    PubMed Central

    Okelo, Sande O.; Wright, Jennifer M.; Collaco, Joseph M.; McGrath-Morrow, Sharon A.; Eakin, Michelle N.

    2015-01-01

    The impact of caring for children with deglutition disorders is poorly understood and tools to measure the unique concerns of these caregivers are lacking. The aims of this investigation were to develop and validate The Feeding/Swallowing Impact Survey (FS-IS) as an instrument designed to measure and improve understanding of caregiver issues. Demographic, economic, and dysphagic data were provided by the primary caregivers of 164 children (median age: 14 months, male: 78, female: 86) presenting for initial outpatient feeding/swallowing evaluations. Caregivers completed the PEDS-QL™ Family Impact Module (PEDS-QL™ FIM) and the FS-IS. A principal component analysis was conducted on the FS-IS to identify appropriate subscales. Concurrent validity was assessed by examining correlations between the FS-IS and PEDS-QL™ FIM. Caring for children with feeding/swallowing problems adversely impacted the Health-Related Quality of Life (HRQoL) of their caregivers. The FS-IS had a strong 3-factor solution to indicate 3 subscales: Daily Activities, Worry, and Feeding Difficulties. All three sub-scales and total score of the FS-IS correlated with PEDS-QL™ FIM. The FS-IS was validated as an instrument that may help clinicians detect specific factors that influence caregiver HRQoL, identify caregivers who might benefit from additional support, and ultimately improve the care of their children with feeding/swallowing disorders. PMID:25159316

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

    PubMed Central

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

    2015-01-01

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

  11. 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.

  12. 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.

  13. 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.…

  14. Tongue pressure during swallowing is decreased in patients with Duchenne muscular dystrophy.

    PubMed

    Hamanaka-Kondoh, Sato; Kondoh, Jugo; Tamine, Ken-Ichi; Hori, Kazuhiro; Fujiwara, Shigehiro; Maeda, Yoshinobu; Matsumura, Tsuyoshi; Yasui, Kumiko; Fujimura, Harutoshi; Sakoda, Saburo; Ono, Takahiro

    2014-06-01

    Although dysphagia is a life-threatening problem in patients with Duchenne muscular dystrophy (DMD), the pathophysiology of oral stage dysphagia is yet to be understood. The present study investigated the tongue motor deficit during swallowing in patients with DMD and its relationship with disease-specific palatal morphology. Tongue pressure during swallowing water was recorded in 11 male patients with DMD and 11 age- and sex-matched healthy subjects using an intra-oral sensor with five measuring points, and the state of tongue pressure production was compared between the groups. Palatal morphology was assessed by a non-contact three-dimensional scanner on maxillary plaster models. In patients with DMD, the normal sequential order of tongue-palate contact was lost and the maximal magnitude and integrated value of tongue pressure on the mid-anterior part of palate were smaller than those in healthy subjects. The width of the palate in patients was greater than that in healthy subjects and the depth of the palate in patients had a negative correlation with tongue pressure magnitude on the median palate. Our results suggested that the deteriorated tongue motor kinetics prevented tongue movement during swallowing that was appropriate for the depth of the palate and affects the state of tongue pressure production during swallowing.

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

    PubMed

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

    2014-06-01

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

  16. 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.…

  17. 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

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

    PubMed

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

    2014-06-01

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

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

    PubMed Central

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

    2014-01-01

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

  20. 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…

  1. 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)

  2. 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…

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  4. 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…

  5. Sequential evolution of cortical activity and effective connectivity of swallowing using fMRI.

    PubMed

    Mihai, Paul Glad; Otto, Mareile; Platz, Thomas; Eickhoff, Simon B; Lotze, Martin

    2014-12-01

    Swallowing consists of a hierarchical sequence of primary motor and somatosensory processes. The temporal interplay of different phases is complex and clinical disturbances frequent. Of interest was the temporal interaction of the swallowing network. Time resolution optimized functional magnetic resonance imaging was used to describe the temporal sequence of representation sites of swallowing and their functional connectivity. Sixteen young healthy volunteers were investigated who swallowed 2 ml of water 20 times per run with a repetition time for functional imaging of 514 ms. After applying the general linear model approach to identify activation magnitude in preselected regions of interest repeated measures analysis of variance (rmANOVA) was used to detect relevant effects on lateralization, time, and onset. Furthermore, dynamic causal modeling (DCM) was applied to uncover where the input enters the model and the way in which the cortical regions are connected. The temporal analysis revealed a successive activation starting at the premotor cortex, supplementary motor area (SMA), and bilateral thalamus, followed by the primary sensorimotor cortex, the posterior insula, and cerebellum and culminating with activation in the pons shortly before subsiding. The rmANOVA revealed that activation was lateralized initially to the left hemisphere and gradually moved to the right hemisphere over time. The group random effects DCM analysis resulted in a most likely model that consisted of inputs to SMA and M1S1, bidirectionally connected, and a one-way connection from M1S1 to the posterior insula.

  6. 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...

  7. 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.

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

    PubMed

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

    2012-12-01

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

  9. 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.

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

    PubMed

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

    2015-09-01

    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.

  11. 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.

  12. Radionuclide uptake and growth of barn swallows nesting by radioactive leaching ponds

    SciTech Connect

    Millard, J.B.; Whicker, F.W.; Markham, O.D. )

    1990-04-01

    Populations of barn swallows (Hirundo rustica) nested seasonally near the Test Reactor Area (TRA) radioactive leaching ponds on the Idaho National Engineering Laboratory. These birds utilized leaching pond arthropods as a food source and contaminated mud for nest construction. Over 20 fission and activation products were detected in immature and adult TRA birds. The radionuclide exhibiting the highest mean concentration in adult birds was 51Cr, with 16.1 Bq g-1. Mean concentrations of detectable radionuclides were used to calculate internal dose rates. Approximately 72% of the total dose rate of 219 microGy d-1 (22 mrad d-1) for adult birds was due to 24Na. Swallow thyroids contained a mean 131I concentration of 3330 Bq g-1. An average dose rate to the thyroid was calculated to be 4300 microGy d-1 or 450 mGy (45 rad) for the entire breeding season. Data from LiF-700 thermoluminescent dosimeters in swallow nests indicated that average dose rates were 840 microGy d-1 for eggs and 2200 Gy d-1 for nestlings, for a total of 54 mGy (5.4 rad) during the nesting period. The breeding biology and growth rate were investigated for TRA swallows and comparison group located 15 km and 100 km away. Total mortality rates for the comparison group vs. 1976 and 1977 TRA populations were not found to be significantly (p greater than 0.9) different. Nonlinear regression was used to fit individual growth curves and estimate parameters using a logistic model. First clutch TRA swallows were found to have a significantly lower mean growth rate compared to either the first clutch comparison group or the second clutch of TRA birds. Mean asymptotic weights achieved by immature TRA birds were also found to be significantly lower than those achieved by comparison group birds. Both growth rate and asymptotic weights for TRA birds were within the normal range reported in the literature.

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

    PubMed Central

    Kim, Soojeong

    2015-01-01

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

  14. 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. PMID:18166988

  15. Alendronate sodium hydrate (oral jelly) for the treatment of osteoporosis: review of a novel, easy to swallow formulation.

    PubMed

    Imai, Kazuhiro

    2013-01-01

    Osteoporosis is a skeletal disorder characterized by loss of bone mass, decreased bone strength, and an increased risk of bone fracture. The disease progresses with age, especially in postmenopausal women. Japan is one of the most rapidly aging societies worldwide. Japanese individuals over 65 years of age constituted 23.0% of the population in 2010 and 25.1% to 25.2% as of 2013. The estimated number of people with osteoporosis in Japan is currently 13 million. Bisphosphonates increase bone mineral density by inhibiting osteoclast-mediated bone resorption, thereby reducing the risk of fractures. Alendronate sodium hydrate (alendronate) is a bisphosphonate that potently inhibits bone resorption and is used to treat osteoporosis. Sufficient water is required to take an alendronate oral tablet; insufficient water could result in digestive system diseases, such as esophageal ulceration. Elderly patients with swallowing difficulty may choke on the tablet. Taking a tablet with oral jelly is a method to prevent digestive system disease and reduce the choking hazard. Once-weekly alendronate oral jelly was approved in 2012 by the Ministry of Health, Labour, and Welfare of Japan as the world's first drug for osteoporosis in a jelly formulation. It consists of a jelly portion and an air portion. The jelly formulation is smoothly discharged by pushing the air portion. Therefore, elderly patients with physical disabilities are able to easily take all of the jelly formulation from the package. In this review, this new formulation of alendronate sodium hydrate (oral jelly) is introduced and discussed in terms of osteoporosis treatment. This new formulation provides an alternative so that patients may select a method of dosing tailored to their preferences. Management of osteoporosis involves assessing fracture risk and preventing fractures. Higher adherence to the treatment of patients with osteoporosis and prevention of osteoporotic fractures are issues to be resolved. PMID

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

    USGS Publications Warehouse

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

    2006-01-01

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

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

    PubMed

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

    2014-05-10

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

  18. What is an Intellectual Disability?

    MedlinePlus

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

  19. Swallowing therapy with neurologic patients: results of direct and indirect therapy methods in 66 patients suffering from neurological disorders.

    PubMed

    Neumann, S

    1993-01-01

    The results of direct and indirect therapy methods applied to 66 patients suffering from neurological disorders are presented. Variables considered were age, time since lesion, localization of central nervous system lesion, type of swallowing disorder (defined according to swallowing phase, type of aspiration and degree of aspiration), cognitive deficits (memory, planning/problem-solving, and attention deficits), and duration of therapy. Success of therapy was defined by progress in type, ease, and safety of feeding and by range of diet. Therapeutic outcome was correlated with the above-listed variables. The findings suggest that swallowing therapy is effective for patients with neurological disorders.

  20. Intellectual and Developmental Disabilities

    MedlinePlus

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

  1. Rural Economies and Disability.

    ERIC Educational Resources Information Center

    O'Donnell, Dennis

    Both the rural economy and the disability community in rural areas can benefit from a recognition that they are mutually dependent. With the decline of rural America, the economic base underpinning all aspects of disability support systems is weakening. In addition, rural disability services often are compartmentalized along functional lines with…

  2. Substance Abuse and Disability.

    ERIC Educational Resources Information Center

    Sales, Amos

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

  3. 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…

  4. 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…

  5. 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…

  6. Congenital hypomyelinating neuropathy: a reversible case.

    PubMed

    Ghamdi, M; Armstrong, D L; Miller, G

    1997-01-01

    A boy was born at 39 weeks gestation with severe weakness and hypotonia, fractured femurs, poor suck and swallow, and absent deep tendon reflexes. Electrodiagnostic studies revealed marked slowing of motor nerve conduction velocities and normal muscle electrical activity with no evidence of acute denervation. Muscle biopsy showed mild type 2 fiber predominance, and sural nerve biopsy revealed large axons without myelin, and axons with insufficient amount of myelin for their diameter. There was no evidence of inflammation or demyelination. Gradual clinical improvement in tone and strength occurred in a cephalocaudal direction. By 4 months, motor nerve conduction velocities and clinical examination were normal apart from absent deep tendon reflexes. On review at 19 months, motor development and neurological examination were completely normal. Pathogenesis of this reversible pathologically documented case of congenital hypomyelinating neuropathy is unclear. No evidence was found for an inflammatory, toxic, metabolic, or demyelinating cause. Abnormal expression of a developmental gene, as in reversible cytochrome oxidase deficiency, may be a cause of this neuropathy.

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

    PubMed

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

    2016-06-01

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

  8. Neural representation of swallowing is retained with age. A functional neuroimaging study validated by classical and Bayesian inference.

    PubMed

    Windel, Anne-Sophie; Mihai, Paul Glad; Lotze, Martin

    2015-06-01

    We investigated the neural representation of swallowing in two age groups for a total of 51 healthy participants (seniors: average age 64 years; young adults: average age 24 years) using high spatial resolution functional magnetic resonance imaging (fMRI). Two statistical comparisons (classical and Bayesian inference) revealed no significant differences between subject groups, apart from higher cortical activation for the seniors in the frontal pole 1 of Brodmann's Area 10 using Bayesian inference. Seniors vs. young participants showed longer reaction times and higher skin conductance response (SCR) during swallowing. We found a positive association of SCR and fMRI-activation only among seniors in areas processing sensorimotor performance, arousal and emotional perception. The results indicate that the highly automated swallowing network retains its functionality with age. However, seniors with higher SCR during swallowing appear to also engage areas involved in attention control and emotional regulation, possibly suggesting increased attention and emotional demands during task performance.

  9. [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

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

    PubMed

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

    2016-08-01

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

  11. Speech-Language and swallowing manifestations and rehabilitation in an 11-year-old girl with MELAS syndrome.

    PubMed

    Vandana, V P; Bindu, Parayil Sankaran; Sonam, Kothari; Taly, Arun B; Gayathri, N; Madhu, N; Sinha, S

    2015-01-01

    Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is a rare mitochondrial disease. The available studies on MELAS syndrome are limited to evaluation of radiological, audiological, genetic, and neurological findings. Among the various neurological manifestations, speech-language and swallowing manifestations are less discussed in the literature. This report describes the speech-language and swallowing function in an 11-year-old girl with MELAS syndrome. The intervention over a period of 6 months is discussed.

  12. 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

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

    PubMed

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

    2016-08-01

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

  14. Assessment of communication and swallowing post-laryngectomy: a telerehabilitation trial.

    PubMed

    Ward, Elizabeth; Crombie, Jane; Trickey, Megan; Hill, Anne; Theodoros, Deborah; Russell, Trevor

    2009-01-01

    Ten laryngectomy patients were assessed using a purpose-designed, multimedia videoconferencing system incorporating a freestanding, self-focusing camera. Swallowing, stoma and communication status were assessed simultaneously by a remote clinician and face-to-face, by a second clinician at the patient's site. The remote trial took place over a distance of approximately 1700 km using a commercial 3G phone network. A satisfaction questionnaire was also completed. There was excellent agreement between the two assessing clinicians. Image quality obtained via the freestanding camera was rated as lower than direct observation, but it was sufficient to assess the stoma and status of the voice prosthesis. During the trial, occasional difficulties with audio delays and image distortion were experienced, although these were manageable. Both patient and clinician satisfaction with remote assessment was high. The results provide further evidence to support the use of telerehabilitation for evaluating the speech and swallowing status of laryngectomy patients following discharge from acute care. PMID:19590028

  15. 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

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

    PubMed

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

    2015-10-01

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

  17. 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.

  18. Underwater-seal nasogastric tube drainage to relieve gastric distension caused by air swallowing.

    PubMed

    Solomon, A W; Bramall, J C; Ball, J

    2011-02-01

    Air swallowing can occur as a psychogenic phenomenon, because of abnormal anatomy, or during non-invasive positive pressure ventilation. Gross distension of the stomach with air can have severe consequences for the respiratory and gastrointestinal systems. We report the case of a 62-year-old man with severe dynamic hyperinflation due to chronic obstructive pulmonary disease, who developed respiratory failure requiring intubation a few hours after radical prostatectomy. Following a percutaneous tracheostomy and weaning of sedation on day six, his abdomen began to enlarge progressively. X-rays revealed massive gastric distension due to air swallowing, which continued despite all efforts to optimise therapy. The use of an underwater seal drainage system on a nasogastric tube improved ventilation and ultimately aided weaning from mechanical support.

  19. The effect of swallowing treatments on corticobulbar excitability: a review of transcranial magnetic stimulation induced motor evoked potentials.

    PubMed

    Macrae, Phoebe R; Jones, Richard D; Huckabee, Maggie-Lee

    2014-08-15

    Transcranial magnetic stimulation (TMS) has been used extensively as a method of investigating the corticomotor physiology of many motor tasks, including healthy and disordered swallowing. Changes in excitability of cortical projections to various swallowing muscles have been documented in response to treatments with TMS induced motor evoked potentials (MEPs). These studies have provided valuable insight into CNS response to swallowing impairment, and more importantly, the adaptations associated with functional recovery. However, unique obstacles are presented when investigating corticobulbar neurophysiology associated with the complex task of swallowing. Stringent methodological control and supplementary outcome measures are required to ensure robust and clinically applicable findings. This article offers a tutorial for the researcher who may be considering the use of TMS for investigating changes in cortical excitability associated with various swallowing paradigms. Included is a review of the mechanisms of TMS and what can be measured with this technique, a summary of existing research using MEPs to investigate swallowing, a review of methodological factors that may influence outcomes, and proposed directions for new areas of research.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  6. 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

  7. Stable nitrogen isotopes of nestling tree swallows indicate exposure to different types of oil sands reclamation.

    PubMed

    Farwell, A J; Harms, N J; Smits, J E G; Dixon, D G

    2014-01-01

    Tree swallows (Tachycineta bicolor) inhabiting reclaimed wetlands on the oil sands in northern Alberta are potentially exposed to elevated levels of oil sands constituents such as polycyclic aromatic compounds (PAC) through diet. While increased detoxification enzyme activity as measured using 7-ethoxyresorufin O-deethylase in nestlings is a generally accepted indicator of exposure to oil sands constituents, there is no apparent method to detect dietary exposure specific to oil sands processed material (OSPM). In this study, stable C and N isotopes were analyzed from muscle and feathers of nestling tree swallows (15 d old) to distinguish dietary exposure of birds near reference and OSPM wetlands. High δ¹⁵N and low δ¹³C values in the nestling tissues differentiated those from the OSPM wetlands and reference sites. Lower δ¹⁵N values of nestlings compared to the δ¹⁵N values of larval chironomids from an earlier study suggested that the majority of the diet of the nestlings was derived from non-OSPM sources, despite residence near and on the OSPM wetlands. Our finding of limited utilization of OSPM resources by tree swallows indicates either low abundance or diversity of dietary items emerging from OSPM wetlands, or sensory avoidance of prey from those wetlands. Minimal consumption of OSPM-derived dietary sources may be attributed to published findings of limited adverse effects on tree swallow reproduction, or growth and development for these same nestlings. This study demonstrated that stable isotope analysis, particularly for N isotopes, may serve as a useful tool to trace dietary exposure to OSPM constituents as part of avian ecotoxicology assessments of reclaimed wetlands on the oil sands. PMID:24627996

  8. Stable nitrogen isotopes of nestling tree swallows indicate exposure to different types of oil sands reclamation.

    PubMed

    Farwell, A J; Harms, N J; Smits, J E G; Dixon, D G

    2014-01-01

    Tree swallows (Tachycineta bicolor) inhabiting reclaimed wetlands on the oil sands in northern Alberta are potentially exposed to elevated levels of oil sands constituents such as polycyclic aromatic compounds (PAC) through diet. While increased detoxification enzyme activity as measured using 7-ethoxyresorufin O-deethylase in nestlings is a generally accepted indicator of exposure to oil sands constituents, there is no apparent method to detect dietary exposure specific to oil sands processed material (OSPM). In this study, stable C and N isotopes were analyzed from muscle and feathers of nestling tree swallows (15 d old) to distinguish dietary exposure of birds near reference and OSPM wetlands. High δ¹⁵N and low δ¹³C values in the nestling tissues differentiated those from the OSPM wetlands and reference sites. Lower δ¹⁵N values of nestlings compared to the δ¹⁵N values of larval chironomids from an earlier study suggested that the majority of the diet of the nestlings was derived from non-OSPM sources, despite residence near and on the OSPM wetlands. Our finding of limited utilization of OSPM resources by tree swallows indicates either low abundance or diversity of dietary items emerging from OSPM wetlands, or sensory avoidance of prey from those wetlands. Minimal consumption of OSPM-derived dietary sources may be attributed to published findings of limited adverse effects on tree swallow reproduction, or growth and development for these same nestlings. This study demonstrated that stable isotope analysis, particularly for N isotopes, may serve as a useful tool to trace dietary exposure to OSPM constituents as part of avian ecotoxicology assessments of reclaimed wetlands on the oil sands.

  9. 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

  10. 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.

  11. Coordination of tongue activity during swallowing in mouth-breathing children.

    PubMed

    Knösel, Michael; Klein, Sabine; Bleckmann, Annalen; Engelke, Wilfried

    2012-09-01

    Habitual mouth breathing is often accompanied by habitual anterior tongue thrust, instead of a lip closure, in order to create the anterior seal necessary for the initiation of physiological deglutition. We tested the null hypothesis of no significant influence of oral maneuver and the use of oral screens on tongue coordination and position during deglutition in 29 subjects (age = 6-16; mean = 9.69 years; 13/16 female/male) with habitual open-mouth posture using intraoral polysensography. The target parameters for swallowing were swallowing-associated nasal airflow interruption (NAI) and coordination of tongue-palate contact during NAI. Conventional myofunctional maneuvers could be facilitated and made more efficient, in terms of increasing the numbers of favorable early tongue-palate contacts typical of somatic swallowing, if accompanied by the application of an oral screen. Habitual open-mouth breathing does not necessarily coincide with distinctively pronounced proportions of late tongue-palate contact.

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

    PubMed Central

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

    2014-01-01

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

  13. 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.

  14. 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.

  15. 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.

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

    PubMed Central

    Zheng, H; Biller, J A

    2009-01-01

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

  17. Microorganisms associated with feathers of barn swallows in radioactively contaminated areas around chernobyl.

    PubMed

    Czirják, Gábor Arpád; Møller, Anders Pape; Mousseau, Timothy A; Heeb, Philipp

    2010-08-01

    The Chernobyl catastrophe provides a rare opportunity to study the ecological and evolutionary consequences of low-level, environmental radiation on living organisms. Despite some recent studies about negative effects of environmental radiation on macroorganisms, there is little knowledge about the effect of radioactive contamination on diversity and abundance of microorganisms. We examined abundance patterns of total cultivable bacteria and fungi and the abundance of feather-degrading bacterial subset present on feathers of barn swallows (Hirundo rustica), a colonial migratory passerine, around Chernobyl in relation to levels of ground level environmental radiation. After controlling for confounding variables, total cultivable bacterial loads were negatively correlated with environmental radioactivity, whereas abundance of fungi and feather-degrading bacteria was not significantly related to contamination levels. Abundance of both total and feather-degrading bacteria increased with barn swallow colony size, showing a potential cost of sociality. Males had lower abundance of feather-degrading bacteria than females. Our results show the detrimental effects of low-level environmental radiation on total cultivable bacterial assemblage on feathers, while the abundance of other microorganism groups living on barn swallow feathers, such as feather-degrading bacteria, are shaped by other factors like host sociality or host sex. These data lead us to conclude that the ecological effects of Chernobyl may be more general than previously assumed and may have long-term implications for host-microbe interactions and overall ecosystem functioning.

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

    SciTech Connect

    Kraus, M.L. )

    1989-09-01

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

  19. 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

  20. Fiberoptic endoscopic evaluation of swallowing in patients with acute traumatic brain injury.

    PubMed

    Leder, S B

    1999-10-01

    Dysphagia and aspiration in intensive care unit patients with acute traumatic brain injury (TBI) is a frequent and potentially life-threatening problem. Any diagnostic technique used with this population, therefore, must be able to be performed in a timely and efficient manner while providing objective information on the nature of the swallowing problem. The purpose of the present study was to investigate the utility of using the fiberoptic endoscopic evaluation of swallowing (FEES) technique to diagnosis pharyngeal stage dysphagia and determine aspiration status in patients who presented with acute TBI. A total of 47 subjects were assessed with FEES. Thirty of 47 (64%) subjects swallowed successfully and were able to take an oral diet: 2 of 30 (7%) thickened liquids and purée consistencies, 8 of 30 (27%) a soft diet, and 20 of 30 (67%) a regular diet. Seventeen of 47 (36%) subjects exhibited pharyngeal stage dysphagia with aspiration and were not permitted an oral diet based on objective results provided by FEES. Of the 17 subjects who aspirated, 9 of 17 (53%) exhibited silent aspiration. Younger subjects (mean age 34 years, 3 months) aspirated significantly less often than older subjects (mean age 51 years, 8 months). No significant age difference was observed for gender or between overt and silent aspirators. It was concluded that FEES is an objective and sensitive tool that can be used successfully to diagnose pharyngeal stage dysphagia, determine aspiration status, and make recommendations for oral or nonoral feeding in patients with acute TBI.

  1. 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.

  2. 3 CFR 8726 - Proclamation 8726 of October 3, 2011. National Disability Employment Awareness Month, 2011

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... disabilities remains too high—nearly double the rate of people without disabilities—and reversing this trend is... agencies’ electronic and information technology more accessible to individuals with disabilities. This will... better use technology at work. To win the future, we must harness the power of our Nation’s...

  3. 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…

  4. 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 Central

    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. PMID:23460922

  5. Disability and global development.

    PubMed

    Durocher, Joan; Lord, Janet; Defranco, Allison

    2012-07-01

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

  6. 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.

  7. Effects of aural stimulation with capsaicin ointment on swallowing function in elderly patients with non-obstructive dysphagia

    PubMed Central

    Kondo, Eiji; Jinnouchi, Osamu; Ohnishi, Hiroki; Kawata, Ikuji; Nakano, Seiichi; Goda, Masakazu; Kitamura, Yoshiaki; Abe, Koji; Hoshikawa, Hiroshi; Okamoto, Hidehiko; Takeda, Noriaki

    2014-01-01

    Objective In the present study, an attempt was made to examine the effects of aural stimulation with ointment containing capsaicin on swallowing function in order to develop a novel and safe treatment for non-obstructive dysphagia in elderly patients. Design A prospective pilot, non-blinded, non-controlled study with case series evaluating a new treatment. Setting Secondary hospitals. Patients and methods The present study included 26 elderly patients with non-obstructive dysphagia. Ointment containing 0.025% capsaicin (0.5 g) was applied to the external auditory canal with a cotton swab under otoscope only once or once a day for 7 days before swallowing of a bolus of colored water (3 mL), which was recorded by transnasal videoendoscopy and evaluated according to the endoscopic swallowing score. Results After a single application of 0.025% capsaicin ointment to the right external auditory canal, the endoscopic swallowing score was significantly decreased, and this effect lasted for 60 minutes. After repeated applications of the ointment to each external auditory canal alternatively once a day for 7 days, the endoscopic swallowing score decreased significantly in patients with more severe non-obstructive dysphagia. Of the eight tube-fed patients of this group, three began direct swallowing exercises using jelly, which subsequently restored their oral food intake. Conclusion These findings suggest that stimulation of the external auditory canal with ointment containing capsaicin improves swallowing function in elderly patients with non-obstructive dysphagia. By the same mechanism used by angiotensin-converting enzyme inhibitors to induce cough reflex, which has been shown to prevent aspiration pneumonia, aural stimulation with capsaicin may reduce the incidence of aspiration pneumonia in dysphagia patients via Arnold’s ear-cough reflex stimulation. PMID:25328387

  8. 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.

  9. Isolation and characterization of microsatellite markers from three species of swallows in the genus Tachycineta: T. albilinea, T. bicolor and T. leucorrhoa.

    PubMed

    Makarewich, C A; Stenzler, L M; Ferretti, V; Winkler, D W; Lovette, I J

    2009-03-01

    We describe 30 microsatellite loci developed from three species of swallows in the genus Tachycineta: T. bicolor (tree swallow), T. albilinea (mangrove swallow), and T. leucorrhoa (white-rumped swallow). These commonly studied birds nest in secondary cavities and are distributed from Alaska to Argentina. Primer pairs were designed for each species individually and tested for cross-amplification in 40-48 individuals of all three species. Polymorphism ranged from 5 to 65 alleles per locus (mean = 19.1). These markers will allow comparative studies of extra-pair paternity rates among members of the genus as well as the assessment of population structure. PMID:21564713

  10. Minority Perceptions of the Disabled.

    ERIC Educational Resources Information Center

    Grand, Sheldon A.; Strohmer, Douglas C.

    1983-01-01

    Investigated the attitudes of Black versus White male students (N=60) toward three different disability types. Results showed significant differences between race, disability type, and social distance with Blacks evaluating disabled persons more highly. (LLL)

  11. 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.

  12. Powerful MS Drug Used Early May Reverse Some Disability

    MedlinePlus

    ... lead researcher Dr. Gavin Giovannoni. He is a neurology professor at Queen Mary University of London in ... was published online Oct. 12 in the journal Neurology . SOURCES: Gavin Giovannoni, M.D., Ph.D., professor, ...

  13. 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)

  14. Learning Disabilities: Lifelong Issues.

    ERIC Educational Resources Information Center

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

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

  15. Biologic Patterns of Disability.

    ERIC Educational Resources Information Center

    Granger, Carl V.; Linn, Richard T.

    2000-01-01

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

  16. Disability Employment 101

    ERIC Educational Resources Information Center

    US Department of Education, 2005

    2005-01-01

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

  17. Disability Employment 101

    ERIC Educational Resources Information Center

    US Department of Education, 2006

    2006-01-01

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

  18. 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…

  19. 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…

  20. Some Ideologies of Disability

    ERIC Educational Resources Information Center

    Low, Colin

    2006-01-01

    The paper analyses the "separate systems of honour" which constitute the ideologies surrounding disability. After critiquing traditional (false conscious and liberal) and radical (separate development and pseudo-radical) responses to the disadvantaged and humiliating situation of disability, it concludes by advancing a genuinely radical response…

  1. Disabling the SAT.

    ERIC Educational Resources Information Center

    Freedman, Miriam Kurtzig

    2003-01-01

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

  2. 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…

  3. Educating Disabled Kids.

    ERIC Educational Resources Information Center

    Johnson, Mary

    1986-01-01

    Despite many accomplishments since the passing of the Education for All Handicapped Children Act, not all disabled children are benefiting from the law. Examples are cited from Douglas Biklen's study of schools that have achieved the integration of disabled and nondisabled students. (MLF)

  4. 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…

  5. 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…

  6. Disability: Our Challenge.

    ERIC Educational Resources Information Center

    Hourihan, John P., Ed.

    Ten papers from a 1978 lecture series on employment, civil rights, education, social aspects, and recreation and leisure for disabled persons are presented. It is explained that as disabled persons, the lecturers presented role models to the students at the Regional Education Program for Handicapped College Students at Teachers College, Columbia.…

  7. 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…

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

    PubMed Central

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

    2012-01-01

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

  9. 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

    2015-01-01

    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.

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

    PubMed Central

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

    2016-01-01

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

  11. DNA damage in barn swallows (Hirundo rustica) from the Chernobyl region detected by use of the comet assay.

    PubMed

    Bonisoli-Alquati, Andrea; Voris, Andrew; Mousseau, Timothy A; Møller, Anders Pape; Saino, Nicola; Wyatt, Michael D

    2010-04-01

    We investigated levels of DNA damage in blood cells of barn swallows (Hirundo rustica) inhabiting the Chernobyl region to evaluate whether chronic exposure to low-level radioactive contamination continues to induce genetic damage in free-living populations of animals. Blood samples were obtained from barn swallows collected at sites with different background levels of radiation, including a relatively uncontaminated area. The extent of DNA damage was evaluated using the alkaline (pH=12.1) comet assay, a robust and sensitive electrophoresis-based technique widely employed in research ranging from biomonitoring to clinical studies. We found that levels of DNA damage, as indexed by the extent of DNA migration, were increased in barn swallows living in areas surrounding Chernobyl when compared to swallows sampled at low-level sites. The results we obtained are consistent with previous findings on this same species, which showed that swallows breeding in areas heavily contaminated with radionuclides have increased mutation rates, higher oxidative stress and incidence of morphological aberrations and tumors. Overall, these results indicate that chronic exposure to radioactive contaminants, even 20years after the accident at the Chernobyl nuclear power plant, continues to induce DNA damage in cells of free-living animals.

  12. Disentangling the disablement process.

    PubMed

    Lawrence, R H; Jette, A M

    1996-07-01

    A model was proposed to assess the premise that functional limitations are an intermediary stage between risk factors (e.g., sex and frequency of walking a mile), pathology/impairments (e.g., musculoskeletal problems), and the onset and course of Instrumental Activities of Daily Living (IADL) disability. Analyses were based on two random subsamples (each with n = 524) of Longitudinal Study of Aging respondents who were nondisabled at baseline (1984) and reinterviewed in 1988 and 1990. The model's central premise was supported in two ways. The main influence of age, frequency of walking, and musculoskeletal problems was on the onset of functional limitations, rather than the onset of IADL disability. And, onset of lower body functional limitations influenced future disability (1990) through its relationship with disability in 1988 and functional limitations in 1990. The results underscore the value of clinical trials which focus on minimizing functional limitations as a strategy for preventing disability.

  13. Workers with disabilities.

    PubMed

    Blanck, P D; Pransky, G

    1999-01-01

    Individuals with disabilities constitute a sizable portion of the workforce and represent the majority of working-age persons who are unable to work. Historically, barriers to employment have included attitudinal discrimination by employers, lack of workplace accommodations, and inadequate job training. The disability rights movement has achieved considerable success in promoting legislation to remove these barriers and uphold equal employment. Research suggests that many employers actively attempt to incorporate persons with disabilities into the workforce and gain substantial economic benefit from their participation, without incurring burdensome expenses. Occupational health providers are asked by employers and others to provide input on feasibility and safety, a difficult task given the lack of scientific study on the occupational abilities and risks associated with specific disabilities. Providers have an important role in promoting the equal employment of disabled persons, by providing objective opinions on their ability and risks on the job and suggesting workplace accommodations and treatments that enhance the ability to work.

  14. 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

  15. 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

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

    NASA Astrophysics Data System (ADS)

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

    2014-11-01

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

  17. 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.

  18. Microstomia caused by swallowing of caustic soda: report of a case.

    PubMed

    Martins, Wilson Denis; Westphalen, Fernando Henrique; Westphalen, Vania Portela Ditzel

    2003-11-15

    A case of microstomia caused by swallowing caustic soda is presented. A 54-year old man developed a progressive stricture of the circumoral region following accidental ingestion of caustic soda when he was 9 years old. He was treated by a general surgeon who performed bilateral commissurotomies when he was 19 years old and lived normally until he needed major dental prosthetic treatment. His dentist was unable to perform the treatment due to the mouth stricture. The surgical option was to perform bilateral buccal mucosal flaps. A review of the literature and the surgical technique are presented.

  19. 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

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

    PubMed

    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.

  1. Technological applications in the assessment of acquired neurogenic communication and swallowing disorders in adults.

    PubMed

    Hallowell, B; Katz, R C

    1999-01-01

    The role of technology is expanding rapidly in many aspects of the diagnostic process with patients who have neurogenic communication and swallowing disorders. In this article we discuss a broad selection of technological tools that enhance a wide range of diagnostic tasks, such as taking case histories, administering and scoring tests, performing acoustic, physiologic, cognitive, and linguistic analyses, making normative comparisons, profiling diagnostic results, and making diagnostic decisions. Clinicians are encouraged to scrutinize the relative value of all diagnostic tools to maintaining the quality of service. An appendix includes information for contacting vendors and manufacturers of the products discussed.

  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. 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.

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

    PubMed

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

    2013-05-17

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

  5. 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

  6. 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.

  7. 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…

  8. 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...

  9. 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…

  10. BIOENERGETICS-BASED MODELING OF INDIVIDUAL PCB CONGENERS IN NESTLING TREE SWALLOWS FROM TWO CONTAMINATED SITES ON THE UPPER HUDSON RIVER, NEW YORK

    EPA Science Inventory

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

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

    PubMed

    Kimura, Yurika; Ohno, Keiko; Honjyo, Motomu

    2015-12-01

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

  12. High frequency of leaf swallowing and its relationship to intestinal parasite expulsion in "village" chimpanzees at Bulindi, Uganda.

    PubMed

    McLennan, Matthew R; Huffman, Michael A

    2012-07-01

    Self-medication by great apes to control intestinal parasite infections has been documented at sites across Africa. Chimpanzees (Pan troglodytes) swallow the leaves of certain plant species whole, without chewing. Previous studies demonstrated a relationship between chimpanzee leaf swallowing and expulsion of nematode worms (Oesophagostomum sp.) and tapeworms (Bertiella sp.) in dung. We investigated the relationship between leaf swallowing and parasite expulsion in chimpanzees inhabiting a fragmented forest-farm mosaic at Bulindi, Uganda. During 13 months whole undigested leaves occurred in chimpanzee dung at a considerably higher frequency (10.4% of dungs) than at other sites (0.4-4.0%). Leaf swallowing occurred year-round and showed no pronounced seasonality. Chimpanzees egested adults of multiple species of Oesophagostomum (including O. stephanostomum) and proglottids of two tapeworms-Bertiella sp. and probably Raillietina sp. The latter may not be a true infection, but the byproduct of predation on domestic fowl. Compared to previous studies, the co-occurrence of whole leaves and parasites in chimpanzee dung was low. Whereas the presence of leaves in dung increased the probability of adult nematode expulsion, no association between leaf swallowing and the shedding of tapeworm proglottids was apparent. Anthropogenic habitat changes have been linked to alterations in host-parasite interactions. At Bulindi, deforestation for agriculture has increased contact between apes and people. Elevated levels of leaf swallowing could indicate these chimpanzees are especially vulnerable to parasite infections, possibly due to environmental changes and/or increased stress levels arising from a high frequency of contact with humans. Frequent self-medication by chimpanzees in a high-risk environment could be a generalized adaptation to multiple parasite infections that respond differently to the behavior. Future parasitological surveys of apes and humans at Bulindi are needed

  13. 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

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

    PubMed

    Kimura, Yurika; Ohno, Keiko; Honjyo, Motomu

    2015-12-01

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

  15. Dickens and disability.

    PubMed

    Wainapel, S F

    1996-12-01

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

  16. 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…

  17. 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…

  18. Student Disability and Experiential Education

    ERIC Educational Resources Information Center

    Klein, Gerald D.

    2009-01-01

    As a significant percentage of students in higher education today have one or more disabilities, it is important for instructors to be aware of what disabilities, and how disabilities, impact student performance. Students with a wide range of disabilities can encounter significant obstacles when experiential instructional methods are implemented…

  19. Reflections on Growing Up Disabled.

    ERIC Educational Resources Information Center

    Jones, Reginald L., Ed.

    The book offers firsthand accounts of the experiences and perceptions of disabled persons, as well as the views of parents of disabled children. Entries include the following titles: "Reflections of Disabled Children" (J. Umbreit and D. Baker); "The Handicap That Had No Name" (D. Brown); "Orthopedically Disabled: Determination on Wheels" (D.…

  20. Information Package on Disability Studies.

    ERIC Educational Resources Information Center

    Harris, Perri; Lewin, Lori

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

  1. Premature Infant Swallowing: Patterns of Tongue-Soft Palate Coordination Based Upon Videofluoroscopy

    PubMed Central

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

    2009-01-01

    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. PMID:20181397

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

    PubMed

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

    2016-09-01

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

  3. Testosterone, plumage colouration and extra-pair paternity in male North-American barn swallows.

    PubMed

    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.

  4. 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

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

    PubMed

    O'Leary, Mark T; Hanson, Ben

    2010-01-01

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

  6. 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.

  7. Validation of the Persian Translation of the Swallowing Disturbance Questionnaire in Parkinson's Disease Patients

    PubMed Central

    Rajaei, Ali; Azargoon, S. Abolfazl; Nilforoush, Mohammad Hussein; Barzegar Bafrooei, Ebrahim; Ashtari, Fereshteh; Chitsaz, Ahmad

    2014-01-01

    Dysphagia, as a common finding in Parkinson's disease (PD) patients, was estimated to be present in 80–95% of this population during different stages of the disease. The Swallowing Disturbance Questionnaire (SDQ) was created as a self-rated dysphagia screening tool in PD. According to the guidelines for cross-cultural adaptation, Persian version of this questionnaire (SDQ-P) was developed. 59 Persian patients (39 men and 20 women) participated in the study. They responded to the SDQ-P and underwent videofluoroscopic swallowing study (VFSS). Aspiration during VFSS was compared with questionnaire results for each individual. Cronbach's alpha coefficient for the questionnaire was 0.86 and based on SDQ-P 15 patients (25.4%) were dysphagic, while 10 patients (16.9%) showed aspiration during VFSS. SDQ-P sensitivity and specificity in predicting aspiration were 96.7 and 91.2%; therefore, the SDQ-P could be a prognostic tool for aspiration. The positive predictive value (PPV), the negative predictive value (NPV), and the pre- and posttest probabilities of aspiration were 0.67, 1, 16.9%, and 66.7%, respectively. In summary, this study demonstrated the reliability and also the feasibility of SDQ-P for screening of aspiration in Iranian patients with PD. Further evaluation of SDQ-P in larger subject population would be suggested. PMID:25405058

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

    PubMed

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

    2012-01-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2016-05-01

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

  11. 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.

  12. 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

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

    PubMed

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

    2014-08-15

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

  14. Phylogeny of the genus Hirundo and the Barn Swallow subspecies complex.

    PubMed

    Dor, Roi; Safran, Rebecca J; Sheldon, Frederick H; Winkler, David W; Lovette, Irby J

    2010-07-01

    The cosmopolitan Barn Swallow complex (Hirundo rustica and related Hirundo species) provides a model system for studies of mate choice, sexual selection, and related topics in behavioral ecology, but the phylogenetic and phylogeographic relationships within this group are not yet completely resolved. We reconstructed the phylogeny of all 14 species of Hirundo as well as all six Barn Swallow (H. rustica) subspecies using maximum likelihood and Bayesian methods based on sequences of mitochondrial DNA from six protein-coding genes (5217 bp) and one nuclear intron (1039 bp) for most taxa. We found four well-supported clades within the genus, but low support values for one node decreased our ability to determine the relationships among them. H. rustica is recently derived and has a wide geographic distribution, and its six subspecies form a monophyletic group with respect to other Hirundo species. These subspecies divide into two well-supported clades, geographically corresponding to Asia-America and Europe-Middle East. The former comprises two groups, an East Asian subspecies that is sister to Southeast Asian, American, and Northwest Asian subspecies. In the other clade, European and East-Mediterranean subspecies are intermixed and both show some divergence from the Egyptian subspecies.

  15. 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.

  16. 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.

  17. 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.

  18. 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

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

    USGS Publications Warehouse

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

    2011-01-01

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

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

    PubMed

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

    2007-10-01

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

  1. Carotenoids, sexual signals and immune function in barn swallows from Chernobyl.

    PubMed

    Camplani, A; Saino, N; Møller, A P

    1999-06-01

    Carotenoids have been hypothesized to facilitate immune function and act as free-radical scavengers, thereby minimizing the frequency of mutations. Populations of animals exposed to higher levels of free radicals are thus expected to demonstrate reduced sexual coloration if use of carotenoids for free-radical scavenging is traded against use for sexual signals. The intensity of carotenoid-based sexual coloration was compared among three populations of barn swallows Hirundo rustica differing in exposure to radioactive contamination. Lymphocyte and immunoglobulin concentrations were depressed, whereas the heterophil:lymphocyte ratio, an index of stress, was enhanced in Chernobyl swallows compared to controls. Spleen size was reduced in Chernobyl compared to that of two control populations. Sexual coloration varied significantly among populations, with the size of a secondary sexual character (the length of the outermost tail feathers) being positively related to coloration in the two control populations, but not in the Chernobyl population. Thus the positive covariation between coloration and sexual signalling disappeared in the population subject to intense radioactive contamination. These findings suggest that the reliable signalling function of secondary sexual characters breaks down under extreme environmental conditions, no longer providing reliable information about the health status of males.

  2. 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

  3. 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.

  4. [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.

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

    USGS Publications Warehouse

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

    2007-01-01

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

  6. 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).

  7. Does the addition of specific acupuncture to standard swallowing training improve outcomes in patients with dysphagia after stroke? a randomized controlled trial

    PubMed Central

    Xia, Wenguang; Zheng, Chanjuan; Zhu, Suiqiang; Tang, Zhouping

    2015-01-01

    Objective: To assess the effect of adding acupuncture to standard swallowing training for patients with dysphagia after stroke. Design: Single-blind randomized controlled trial. Setting: Inpatient and outpatient clinics. Subjects: A total of 124 patients with dysphagia after stroke were randomly divided into two groups: acupuncture and control. Interventions: The acupuncture group received standard swallowing training and acupuncture treatment. In comparison, the control group only received standard swallowing training. Participants in both groups received six days of therapy per week for a four-week period. Main measures: The primary outcome measures included the Standardized Swallowing Assessment and the Dysphagia Outcome Severity Scale. The secondary outcome measures included the Modified Barthel Index and Swallowing-Related Quality of Life, which were assessed before and after the four-week therapy period. Results: A total of 120 dysphagic subjects completed the study (60 in acupuncture group and 60 in control group). Significant differences existed in the Standardized Swallowing Assessment, Dysphagia Outcome Severity Scale, Modified Barthel Index, and Swallowing-Related Quality of Life scores of each group after the treatment (P < 0.01). After the four-week treatment, the Standardized Swallowing Assessment (mean difference − 2.9; 95% confidence interval (CI) – 5.0 to − 0.81; P < 0.01), Dysphagia Outcome Severity Scale (mean difference 2.3; 95% CI 0.7 to 1.2; P < 0.01), Modified Barthel Index (mean difference 17.2; 95% CI 2.6 to 9.3; P < 0.05) and Swallowing-Related Quality of Life scores (mean difference 31.4; 95% CI 3.2 to 11.4; P < 0.01) showed more significant improvement in the acupuncture group than the control group. Conclusions: Acupuncture combined with the standard swallowing training may be beneficial for dysphagic patients after stroke. PMID:25819076

  8. [Home care workers' oral health awareness and practice for disabled elderly].

    PubMed

    Atsushi, Ohyama; Yoshinori, Toriyama; Yoshiyuki, Sasaki; Izumi, Koyama; Chie, Shimizu; Norimasa, Kurosaki; Shiro, Mataki

    2003-03-01

    The purpose of this study was to investigate the level of oral health awareness, and to explore the needs for home care workers to provide oral health care for disabled elderly. We conducted a questionnaire survey at two home-help service centers and a social welfare council. Subjects for this investigation were 63 home care workers. The results were as follows: 1. Ninety-six percent of home care workers thought it was necessary to provide oral health care for disabled elderly, but only 11 percent of them put oral care into practice on a daily basis. 2. From the results of a cause and effect diagram, necessities of oral care were summarized as six major causes: 1) Disabled elderly are often unable to brush their teeth, 2) The oral hygiene level may affect physical condition, 3) Disabled elderly should be protected from oral diseases, 4) Disabled elderly should have their mouths kept clean, 5) Eating and swallowing may become increasingly difficult, 6) Disabled elderly should take in adequate nutrition. 3. Sixty-eight percent of home care workers took part in a training course of nursing care including oral care. 4. Home care workers, dentists, dental hygienists, and nurses taught oral health care to home care workers. 5. From the results of a cause and effect diagram, there were three major items that home care workers want to know: 1) denture management, 2) the routine of oral care, 3) infection control. 6. Home care workers recognized that oral care should be provided by family members of disabled elderly or home care workers. PMID:12708030

  9. Approach to learning disability.

    PubMed

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

    2001-06-01

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

  10. Cognition and Learning Disabilities.

    ERIC Educational Resources Information Center

    Jacobs, Linda

    1984-01-01

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

  11. Disability and Obesity

    MedlinePlus

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

  12. Ethics in neurodevelopmental disability.

    PubMed

    Racine, Eric; Bell, Emily; Shevell, Michael

    2013-01-01

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

  13. Drugs, discrimination and disability.

    PubMed

    Gibson, Frances

    2009-12-01

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

  14. Autism and learning disability.

    PubMed

    O'Brien, Gregory; Pearson, Joanne

    2004-06-01

    In this article a short overview is given of the relationship between autism and learning disability. Autism exists with any level of intelligence, but many individuals with autism suffer also from learning disability. Although both disorders show overlap in some behaviours they are different in many aspects. Are they distinct syndromes which influence each other, or do they belong to a broad spectrum of a condition?

  15. Swallowing sunscreen

    MedlinePlus

    Older sunscreens used para-aminobenzoic acid (PABA) to protect skin from the sun's rays. However, many of today's sunscreens are PABA-free. Sunscreens may contain any of these ingredients: Cinnamates Padimate- ...

  16. Swallowing Problems

    MedlinePlus

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

  17. Swallowing Trouble

    MedlinePlus

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

  18. Shampoo - swallowing

    MedlinePlus

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

  19. Sports and disability.

    PubMed

    Wilson, Pamela E; Clayton, Gerald H

    2010-03-01

    Participation in recreational and competitive sports at an early age has long been touted as a positive influence on growth and development, and for fostering lifelong healthy lifestyles. The benefits of an active lifestyle include not only fitness, but the promotion of a sense of inclusion and improved self-esteem. These benefits are well documented in all populations, and their importance has been summarized in the recent Healthy People 2010 guidelines. The American Academy of Pediatrics has recently produced a summary statement on the benefits of activity for disabled children. They note that children with disabilities tend to have an overall lower level of fitness and an increased level of obesity. For this population, developing a lifelong desire to be active can be a simple means for limiting illness and much of the morbidity associated with sedentary lifestyles often associated with disability. For disabled youth, participation in disabled sports programs available nationally and internationally can be an effective means to promote such precepts. The goal of this focused review is to improve the learner's knowledge of the positive impact that active lifestyles can have on overall health in the disabled youth population and, as a result, modify their practice by incorporating recreational and competitive sport activities as part of improving overall patient care.

  20. Vasectomy reversal in humans.

    PubMed

    Bernie, Aaron M; Osterberg, E Charles; Stahl, Peter J; Ramasamy, Ranjith; Goldstein, Marc

    2012-10-01

    Vasectomy is the most common urological procedure in the United States with 18% of men having a vasectomy before age 45. A significant proportion of vasectomized men ultimately request vasectomy reversal, usually due to divorce and/or remarriage. Vasectomy reversal is a commonly practiced but technically demanding microsurgical procedure that restores patency of the male excurrent ductal system in 80-99.5% of cases and enables unassisted pregnancy in 40-80% of couples. The discrepancy between the anastomotic patency rates and clinical pregnancy rates following vasectomy reversal suggests that some of the biological consequences of vasectomy may not be entirely reversible in all men. Herein we review what is known about the biological sequelae of vasectomy and vasectomy reversal in humans, and provide a succinct overview of the evaluation and surgical management of men desiring vasectomy reversal.

  1. 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...

  2. 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.

  3. 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…

  4. The Synthesis of a Novel Swallow-tailed Glycol and Linear Alkoxy-substitued Dibenzocoronene Tetracarboxdiimide Derivatives

    NASA Astrophysics Data System (ADS)

    Shao, Zheng-Wei; Wang, Ying; Wang, Wen-Guang; Pu, Jia-Ling

    2016-05-01

    In this paper, a novel dibenzocoronene tetracarboxdiimide derivative decorated with swallow-tailed glycol chain and alkoxy chain was synthesized by means of benzannulation reaction of substituted perylene diimide with 2,3-Dichloro-5,6-dicyano-1,4-benzoquinone (DDQ) as an effective oxidant with high yield, and its structure were confirmed by HNMR, 13CNMR and HRMS.

  5. 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'.

  6. 76 FR 45602 - Proposed Safe Harbor Agreement for California Red-Legged Frog, at Swallow Creek Ranch, San Luis...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-29

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

  7. 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.

  8. 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…

  9. 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.

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

    PubMed

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

    2016-09-26

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

  11. Legal, Ethical, and Financial Aspects of Providing Services to Children with Swallowing Disorders in the Public Schools.

    ERIC Educational Resources Information Center

    O'Toole, Thomas J.

    2000-01-01

    This article considers the role of the speech-language pathologist in providing services to children with swallowing disorders in the public school setting. Topics addressed include requirements (or aspects) under various federal laws and regulations, as well as ethical, liability, and funding issues. (Contains references.) (Author/CR)

  12. 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.

  13. Passive hinge forces in the feeding apparatus of Aplysia aid retraction during biting but not during swallowing.

    PubMed

    Sutton, G P; Macknin, J B; Gartman, S S; Sunny, G P; Beer, R D; Crago, P E; Neustadter, D M; Chiel, H J

    2004-06-01

    Swallowing and biting responses in the marine mollusk Aplysia are both mediated by a cyclical alternation of protraction and retraction movements of the grasping structure, the radula and underlying odontophore, within the feeding apparatus of the animal, the buccal mass. In vivo observations demonstrate that Aplysia biting is associated with strong protractions and rapid initial retractions, whereas Aplysia swallowing is associated with weaker protractions and slower initial retractions. During biting, the musculature joining the radula/odontophore to the buccal mass (termed the "hinge") is stretched more than in swallowing. To test the hypothesis that stretch of the hinge might contribute to rapid retractions observed in biting, we analyzed the hinge's passive properties. During biting, the hinge is stretched sufficiently to assist retraction. In contrast, during swallowing, the hinge is not stretched sufficiently for its passive forces to assist retraction, because the odontophore's anterior movement is smaller than during biting. A quantitative model demonstrated that steady-state passive forces were sufficient to generate the retraction movements observed during biting. Experimental measures of the relative magnitude of the hinge's active and passive forces at the protraction displacements of biting suggest that passive forces are at least a third of the total force.

  14. 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

  15. 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.

  16. Justice and Reverse Discrimination.

    ERIC Educational Resources Information Center

    Goldman, Alan H.

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

  17. Quantum reverse hypercontractivity

    SciTech Connect

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

    2015-10-15

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

  18. Reverse Discrimination: Recent Cases.

    ERIC Educational Resources Information Center

    Steinhilber, August W.

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

  19. 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.

  20. Liver abscess caused by an unnoticed swallowed toothpick perforating the colonic wall.

    PubMed

    Serwe, S; Weber, J; Strock, P; Lens, V

    2007-10-01

    We present an unusual case of a liver abscess caused by a swallowed toothpick in a 43-year-old man. The abscess was first punctured under percutaneous ultrasound control and intraveneous administration of antibiotics whereas the diagnosis of the foreign body stuck in the sigmoid bowel wall was only made by a follow-up computed tomography since the patient had no complains indicating a colonic pathology. Even more, the patient did not remember ever having ingested a foreign body. The wooden toothpick was then successfully removed by endoscopy. The case report stresses the need for a search of the cause of unexplained liver abscesses and highlights the importance of computed tomography as the first imaging technique as the foreign body was missed on the ultrasound examination. Finally, the non-surgical treatment as first line management of liver abscesses will be discussed.