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Silent aspiration

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https://www.readbyqxmd.com/read/28900040/reduced-diaphragm-excursion-during-reflexive-citric-acid-cough-test-in-subjects-with-subacute-stroke
#1
Yong-Min Choi, Geun-Young Park, Yeonji Yoo, Donggyun Sohn, YongJun Jang, Sun Im
BACKGROUND: Diaphragm excursion is limited during respiratory maneuvers after a stroke. How the diaphragm is limited during reflexive coughs and affects the effectiveness of cough in stroke patients is unclear. This study aimed to measure reflexive cough strength by cough peak flow (CPF) induced by citric acid nebulization (2.8 mol/L), record diaphragm excursions during reflexive coughs in stroke subjects at risk of silent aspiration, and compare these values with those of stroke subjects without risk of aspiration or dysphagia...
September 12, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28890708/reduced-maximum-pitch-elevation-predicts-silent-aspiration-of-small-liquid-volumes-in-stroke-patients
#2
Akila Theyyar Rajappa, Kristie R Soriano, Courtney Ziemer, Michelle S Troche, Jaime Bauer Malandraki, Georgia A Malandraki
BACKGROUND AND PURPOSE: Preliminary evidence has shown that reduced ability to maximally raise vocal pitch correlates with the occurrence of aspiration (i.e., airway invasion by food or liquid). However, it is unclear if this simple task can be used as a reliable predictor of aspiration in stroke patients. Our aim was to examine whether maximum vocal pitch elevation predicted airway invasion and dysphagia in stroke. METHODS: Forty-five consecutive stroke patients (<1 month poststroke) at a rehabilitation setting participated in a videofluoroscopic swallow study and two maximum vocal pitch elevation tasks...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28879323/pneumonitis-and-pneumonia-after-aspiration
#3
REVIEW
Young Gon Son, Jungho Shin, Ho Geol Ryu
Aspiration pneumonitis and aspiration pneumonia are clinical syndromes caused by aspiration. These conditions are clinically significant due to their high morbidity and mortality. However, aspiration as a preceding event are often unwitnessed, particularly in cases of asymptomatic or silent aspiration. Furthermore, despite the difference in treatment approaches for managing aspiration pneumonitis and aspiration pneumonia, these two disease entities are often difficult to discriminate from one another, resulting in inappropriate treatment...
March 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28831578/predictive-value-of-the-new-zealand-secretion-scale-nzss-for-pneumonia
#4
Anna Miles, Alex Hunting, Mary McFarlane, Daniel Caddy, Samantha Scott
Accumulated pharyngo-laryngeal secretions have been associated with aspiration and pneumonia. While traditional secretion scales evaluate location and amount, the eight-point New Zealand Secretion Scale (NZSS) uniquely encompasses a responsiveness subcomponent. This prospective observational study investigated the predictive value of NZSS for aspiration and pneumonia. Consecutive inpatients (N:180) referred for flexible endoscopic evaluation of swallowing (FEES) were recruited (neurological 49%, critical care 31%, structural 15%, other 5% etiologies)...
August 23, 2017: Dysphagia
https://www.readbyqxmd.com/read/28673831/risk-factors-for-laryngeal-penetration-aspiration-in-patients-with-acute-traumatic-cervical-spinal-cord-injury
#5
Tiina Ihalainen, Irina Rinta-Kiikka, Teemu M Luoto, Tuomo Thesleff, Mika Helminen, Anna-Maija Korpijaakko-Huuhka, Antti Ronkainen
BACKGROUND CONTEXT: Laryngeal penetration-aspiration, the entry of material into the airways, is considered the most severe subtype of dysphagia and is common among patients with acute cervical spinal cord injury (SCI). PURPOSE: The aim of this study was to investigate risk factors for penetration-aspiration in patients with acute traumatic cervical spinal cord injury (TCSCI). STUDY DESIGN: This is a prospective cohort study. PATIENT SAMPLE: Thirty-seven patients with TCSCI were included in the study...
June 30, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28631744/traumatic-cervical-spinal-cord-injury-a-prospective-clinical-study-of-laryngeal-penetration-and-aspiration
#6
T Ihalainen, I Rinta-Kiikka, T M Luoto, E A Koskinen, A-M Korpijaakko-Huuhka, A Ronkainen
STUDY DESIGN: Prospective cohort study. OBJECTIVES: Dysphagia is a relatively common secondary complication in patients with traumatic cervical spinal cord injuries (TCSCI). The purpose of this study was to determine the incidence of aspiration and penetration in patients with acute TCSCI. SETTING: Tampere University Hospital, Tampere, Finland. METHODS: A total of 46 patients with TCSCI were evaluated with a videofluoroscopic swallowing study (VFSS)...
June 20, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28578512/infected-colloid-cyst
#7
Atilla Yilmaz, Mustafa Aras, Yurdal Serarslan, Mustafa Emrah Kaya
INTRODUCTION: Colloid cysts are the most common pathologic lesions of the third ventricle. Although they are histologically benign, they may grow and can cause the hydrocephalus. A 5-year-old male patient underwent to surgery with the diagnosis of colloid cyst. In operation, after the anterior transcallosal approach, the cyst was punctured by syringe and obviously pus aspirated. CONCLUSION: Colloid cysts mostly remain silent and detected incidentally. Although it is rarely defined, rhinorrhea, hypopituitarism, diabetes insipidus, spasmodic torticollis, drop attack, aseptic meningitis, and coexistence with neurocysticercosis have been reported, but this is the first reported case of an infected colloid cyst...
June 3, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28483151/postoperative-swallowing-assessment-after-lung-transplantation
#8
Brooke Baumann, Sara Byers, Tamara Wasserman-Wincko, Libby Smith, Bridget Hathaway, Jay Bhama, Norihisa Shigemura, J W Awori Hayanga, Jonathan D'Cunha, Jonas T Johnson
BACKGROUND: Dysphagia, aspiration, and potential pneumonia represent a major source of morbidity in patients undergoing lung transplantation. Conditions that potentiate dysphagia and aspiration include frailty and prolonged intubation. Our group of speech-language pathologists has been actively involved in performance of a bedside evaluation of swallowing, and instrumental evaluation of swallowing with modified barium swallow, and postoperative management in patients undergoing lung transplantation...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28480825/imported-leishmaniasis-in-a-dog-in-a-sandfly-populated-area-in-northeastern-romania
#9
Geta Pavel, Dorina Timofte, Diana Mocanu, Razvan Malancus, Carmen Solcan
We report the importation of a clinical case of canine leishmaniasis (CanL) in Romania, a country where several types of sandflies are present with the potential to develop a new focus of CanL. The Staffordshire Bull Terrier dog was imported into Romania from Spain 1.5 y before he developed clinical symptomatology that included proliferative dermatitis, lymphadenomegaly, and bilateral uveitis. Hematologic analyses showed regenerative anemia and subacute inflammation. Cytologic examination of lymph node fine-needle aspirates revealed Leishmania spp...
May 1, 2017: Journal of Veterinary Diagnostic Investigation
https://www.readbyqxmd.com/read/28474131/dysphagia-in-friedreich-ataxia
#10
Megan J Keage, Martin B Delatycki, Isabelle Gupta, Louise A Corben, Adam P Vogel
The objective of the study was to comprehensively characterise dysphagia in Friedreich ataxia (FRDA) and identify predictors of penetration/aspiration during swallowing. We also investigated the psychosocial impact of dysphagia on individuals with FRDA. Sixty participants with FRDA were screened for dysphagia using a swallowing quality of life questionnaire (Swal-QOL) and case history. Individuals reporting dysphagia underwent a standardised oromotor assessment (Frenchay Dysarthria Assessment, 2, FDA-2) and videofluoroscopic study of swallowing (VFSS)...
May 4, 2017: Dysphagia
https://www.readbyqxmd.com/read/28456464/laryngeal-closure-during-swallowing-in-stroke-survivors-with-cortical-or-subcortical-lesion
#11
Taeok Park, Youngsun Kim, Byung-Mo Oh
BACKGROUND: One of the major, and most harmful, symptoms of dysphagia in stroke survivors is aspiration. Survivors of unilateral cortical strokes with dysphagia and resulting aspiration have been reported to have greater initiation delays in laryngeal closure than those who did not aspirate. Few studies have reported such data in survivors of subcortical stroke. METHODS: This study measured initiation of laryngeal closure (ILC) and laryngeal closure duration (LCD) in 2 groups of subjects: 15 stroke survivors with cortical lesions and 15 stroke survivors with subcortical lesions...
April 26, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28286961/people-with-intellectual-disabilities-and-dysphagia
#12
Janet Robertson, Darren Chadwick, Susannah Baines, Eric Emerson, Chris Hatton
PURPOSE: Dysphagia (difficulties in eating, drinking or swallowing) is associated with serious health complications and psychosocial sequelae. This review aims to summarise the state of the evidence regarding dysphagia in people with intellectual disabilities (excluding prevalence), identify gaps in the evidence base and highlight future research priorities. METHOD: Studies published from 1 January 1990 to 19 July 2016 were identified using Medline, Cinahl, PsycINFO, Web of Science, email requests and cross citations...
March 12, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28257317/pulmonary-infections-in-critical-intensive-care-rapid-diagnosis-and-optimizing-antimicrobial-usage
#13
Ivor S Douglas
PURPOSE OF REVIEW: Diagnosis of pulmonary infection, including hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) in the critically ill patient remains a common and therapeutically challenging diagnosis with significant attributable morbidity, mortality, and cost. Current clinical approaches to surveillance, early detection and, conventional culture-based microbiology are inadequate for optimal targeted antibiotic treatment and stewardship. Efforts to enhance diagnosis of HAP and VAP and the impact of these novel approaches on rational antimicrobial selection and stewardship are the focus of recent studies reviewed here...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28100202/a-novel-reflex-cough-testing-device
#14
Kazunori Fujiwara, Katsuyuki Kawamoto, Yoko Shimizu, Takahiro Fukuhara, Satoshi Koyama, Hideyuki Kataoka, Hiroya Kitano, Hiromi Takeuchi
BACKGROUND: The reflex cough test is useful for detecting silent aspiration, a risk factor for aspiration pneumonia. However, assessing the risk of aspiration pneumonia requires measuring not only the cough reflex but also cough strength. Currently, no reflex cough testing device is available that can directly measure reflex cough strength. We therefore developed a new testing device that can easily and simultaneously measure cough strength and the time until the cough reflex, and verified whether screening with this new instrument is feasible for evaluating the risk of aspiration pneumonia...
January 18, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28081029/a-rarely-seen-complication-that-causes-increase-in-morbidity-in-tetraplegic-patients-zenker-diverticula
#15
Zeynep Kiraç Ünal, Ebru Umay, İbrahim Gündoğdu, Yasemin Tombak, Aytül Çakci
Although spinal cord injury (SCI) damages the spinal cord, physiological changes due to SCI can affect many organs and systems of the human body. While respiratory problems are common following cervical SCI, dysphagia is a relatively uncommon secondary complication that occurs after cervical SCI. We report a case of recurrent aspiration pneumonia due to Zenker diverticulum in 26-year-old tetraplegic patient with a chronic history of silent aspirations and dysphagia contributing to functional disability.
September 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28074215/-management-of-dysphagia-in-acute-stroke-a%C3%A2-prospective-study-for-validation-of-current-recommendations
#16
B Lindner-Pfleghar, H Neugebauer, S Stösser, J Kassubek, A Ludolph, R Dziewas, M Prosiegel, A Riecker
BACKGROUND: The German expert recommendations on the management of dysphagia in patients after acute stroke suggest an algorithm for clinical and technical investigations to identify patients at risk for aspiration and thus reduce the rate of aspiration pneumonia. The effectiveness of this algorithm has, however, not yet been prospectively validated . METHODS: In this study 144 consecutive stroke patients were assessed by a full bedside swallowing assessment including the screening procedures of standardized swallowing assessment (SSA) and 2 out of 6...
February 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28002821/cutaneous-metastasis-a-study-of-138-cases-diagnosed-by-fine-needle-aspiration-cytology
#17
Uma Handa, Reetu Kundu, Kislay Dimri
BACKGROUND: Cutaneous metastases can occur in a wide variety of internal malignancies and may be the first sign of a clinically silent visceral cancer. STUDY DESIGN: A retrospective analysis was made of 138 cases diagnosed with cutaneous and subcutaneous metastasis on fine-needle aspiration cytology (FNAC). Primary tumors of the skin/subcutis were excluded. RESULTS: Of 138 cases, the primary was known in 101 cases and unknown in 37 cases. The age of the patients ranged from 5 to 86 years, and 76 (55...
2017: Acta Cytologica
https://www.readbyqxmd.com/read/27880897/direct-probing-of-germinal-center-responses-reveals-immunological-features-and-bottlenecks-for-neutralizing-antibody-responses-to-hiv-env-trimer
#18
Colin Havenar-Daughton, Diane G Carnathan, Alba Torrents de la Peña, Matthias Pauthner, Bryan Briney, Samantha M Reiss, Jennifer S Wood, Kirti Kaushik, Marit J van Gils, Sandy L Rosales, Patricia van der Woude, Michela Locci, Khoa M Le, Steven W de Taeye, Devin Sok, Ata Ur Rasheed Mohammed, Jessica Huang, Sanjeev Gumber, AnaPatricia Garcia, Sudhir P Kasturi, Bali Pulendran, John P Moore, Rafi Ahmed, Grégory Seumois, Dennis R Burton, Rogier W Sanders, Guido Silvestri, Shane Crotty
Generating tier 2 HIV-neutralizing antibody (nAb) responses by immunization remains a challenging problem, and the immunological barriers to induction of such responses with Env immunogens remain unclear. Here, some rhesus monkeys developed autologous tier 2 nAbs upon HIV Env trimer immunization (SOSIP.v5.2) whereas others did not. This was not because HIV Env trimers were immunologically silent because all monkeys made similar ELISA-binding antibody responses; the key difference was nAb versus non-nAb responses...
November 22, 2016: Cell Reports
https://www.readbyqxmd.com/read/27879283/infant-videofluoroscopic-swallow-study-testing-swallowing-interventions-and-future-acute-respiratory-illness
#19
Eric R Coon, Rajendu Srivastava, Gregory J Stoddard, Sheena Reilly, Christopher G Maloney, Susan L Bratton
OBJECTIVES: Tube feedings are commonly prescribed to infants with swallowing abnormalities detected by videofluoroscopic swallow study (VFSS), but there are no studies demonstrating efficacy of these interventions to reduce risk of acute respiratory illness (ARI). We sought to measure the association between swallowing interventions and future ARI, among VFSS-tested infants. METHODS: Retrospective cohort of all infants (<12 months) tested with VFSS at a children's hospital between January 1, 2010, and January 1, 2012...
December 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27872397/pulmonary-mycobacterium-marinum-infection-fish-tank-granuloma-of-the-lung
#20
Prasad Palani Velu, Susan E Fernandes, Ian F Laurenson, Donald D Noble
A 65-year-old man presented with a six-month history of lethargy, weight loss and dry cough. He had a background of mild chronic obstructive pulmonary disease. Chest radiograph showed new right upper lobe cavitary opacification. Sputum cultures were acid-fast bacilli smear positive and yielded Mycobacterium marinum - a non-tuberculous mycobacterium (NTM) often found in aquatic environments and rarely associated with respiratory disease. The suspected source was silent aspiration of contaminated water, likely due to his initiating the siphon of his fish-tank by mouth...
November 2016: Scottish Medical Journal
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