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Silent aspiration

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https://www.readbyqxmd.com/read/29785679/drooling-in-parkinson-s-disease-evidence-of-a-role-for-divided-attention
#1
Hannah Reynolds, Nick Miller, Richard Walker
Drooling is a frequently reported symptom in Parkinson's Disease (PD) with significant psychosocial impact and negative health consequences including silent aspiration of saliva with the associated risk of respiratory infections. It is suggested that in PD drooling is associated with inefficient oropharyngeal swallowing which reduces the effective clearance of saliva rather than hyper-salivation. This is compounded by unintended mouth opening and flexed posture increasing anterior loss of saliva. It is reported to occur most frequently during cognitively distracting concurrent tasks suggesting an impact from divided attention in a dual-task situation...
May 21, 2018: Dysphagia
https://www.readbyqxmd.com/read/29766275/implementing-cough-reflex-testing-in-a-clinical-pathway-for-acute-stroke-a-pragmatic-randomised-controlled-trial
#2
Makaela Field, Rachel Wenke, Arman Sabet, Melissa Lawrie, Elizabeth Cardell
Silent aspiration is common after stroke and can lead to subsequent pneumonia. While standard bedside dysphagia assessments are ineffective at predicting silent aspiration, cough reflex testing (CRT) has shown promise for identifying patients at risk of silent aspiration. We investigated the impact of CRT on patient and service outcomes when embedded into a clinical pathway. 488 acute stoke patients were randomly allocated to receive either CRT or standard care (i.e. bedside assessment). Primary outcomes included confirmed pneumonia within 3 months post stroke and length of acute inpatient stay...
May 15, 2018: Dysphagia
https://www.readbyqxmd.com/read/29703016/a-case-report-of-life-threatening-acute-dysphagia-in-dermatomyositis-challenges-in-diagnosis-and-treatment
#3
Kyoung Min Kwon, Jung Soo Lee, Yeo Hyung Kim
RATIONALE: Although dysphagia is a known complication of dermatomyositis, sudden onset of dysphagia without the notable aggravation of other symptoms can make the diagnosis and treatment challenging. PATIENT CONCERNS: A 53-year-old male diagnosed as dermatomyositis 1 month ago came to our emergency department complaining of a sudden inability to swallow solid foods and liquids. The patient showed generalized edema, but the muscle power was not different compared with 1 month ago...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29628853/crohn-s-disease-associated-silent-aspiration-in-the-outpatient-setting-anesthesiologists-beware
#4
Christopher Snell, Scott Coleman, Michele Van Hal, Farshad Rashidian, Gary Okum, Michael Stuart Green
Every anesthesia provider fears aspiration of gastric contents during an anesthetic, and it may occur even in the absence of overt signs such as coughing or choking. Whether the aspiration is frank or silent, catastrophic and deleterious consequences may ensue. Therefore, familiarity with risk factors for silent aspiration is essential. Crohn's disease reportedly delays gastric emptying making these patients more susceptible to silent aspiration during surgery. Anesthesia providers must be cognizant of this risk and vigilant in the recognition to formulate a specific treatment plan preoperatively...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29559406/working-party-approved-by-the-french-society-of-anaesthesia-and-intensive-care-medicine-sfar-and-the-french-society-for-the-study-of-diabetes-sfd
#5
Gaëlle Cheisson, Sophie Jacqueminet, Emmanuel Cosson, Carole Ichai, Anne-Marie Leguerrier, Bogdan Nicolescu-Catargi, Alexandre Ouattara, Igor Tauveron, Paul Valensi, Dan Benhamou
In diabetic patients undergoing surgery, we recommend assessing glycaemic control preoperatively by assessing glycated haemoglobin (HbA1c) levels and recent capillary blood sugar (glucose) levels, and to adjust any treatments accordingly before surgery, paying particular attention to specific complications of diabetes. Gastroparesis creates a risk of stasis and aspiration of gastric content at induction of anaesthesia requiring the use of a rapid sequence induction technique. Cardiac involvement can be divided into several types...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29454226/dysphagia-and-laryngeal-pathology-in-post-surgical-cardiothoracic-patients
#6
Anna Miles, Naomi McLellan, Rochelle Machan, David Vokes, Alexandra Hunting, Mary McFarlane, Jennifer Holmes, Kelly Lynn
PURPOSE: Cardiothoracic surgery is known to result in dysphagia and laryngeal injury. While prevalence has been explored, extent, trajectory and longevity of symptoms are poorly understood. This retrospective, observational study explored dysphagia and laryngeal injury in patients following cardiothoracic surgery referred for instrumental swallowing assessment. METHODS: Clinical notes and endoscopic recordings of 106 patients (age range 18-87yrs; mean 63yrs; SD 15yrs) (including 190 endoscopes) at one large tertiary centre were reviewed by two speech-language pathologists and a laryngologist...
February 9, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29390364/silent-aspiration-in-infants-with-prader-willi-syndrome-identified-by-videofluoroscopic-swallow-study
#7
Parisa Salehi, Holly J Stafford, Robin P Glass, Anne Leavitt, Anita E Beck, Amber McAfee, Lusine Ambartsumyan, Maida Chen
Feeding intolerance in Prader-Willi syndrome (PWS) infants is well-recognized, but their swallow physiology is not well understood. Swallow dysfunction increases risks of respiratory compromise and choking, which have a high incidence in PWS. To investigate swallow pathology in PWS infants we undertook a retrospective review of videofluoroscopic swallow studies (VFSS) in infants with PWS seen at our institution. We hypothesize that VFSS will characterize swallow pathology suspected by clinical observation during a feeding evaluation and may help determine feeding safety in these infants...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29389984/systematic-dysphagia-screening-and-dietary-modifications-to-reduce-stroke-associated-pneumonia-rates-in-a-stroke-unit
#8
Yvonne Teuschl, Michaela Trapl, Paulina Ratajczak, Karl Matz, Alexandra Dachenhausen, Michael Brainin
BACKGROUND AND PURPOSE: While formal screening for dysphagia following acute stroke is strongly recommended, there is little evidence on how multi-consistency screening and dietary modifications affect the rate of stroke-associated pneumonia (SAP). This observational study reports which factors affect formal screening on a stroke-unit and how dietary recommendations relate to SAP. METHOD: Analyses from a database including 1394 patients admitted with acute stroke at our stroke-unit in Austria between 2012 and 2014...
2018: PloS One
https://www.readbyqxmd.com/read/29388314/silent-aspiration-predicts-mortality-in-older-adults-with-aspiration-pneumonia-admitted-to-acute-hospitals
#9
Takeshi Nakashima, Keisuke Maeda, Kanae Tahira, Kousuke Taniguchi, Kumiko Mori, Hiroyasu Kiyomiya, Junji Akagi
AIM: Aspiration pneumonia is a common disease resulting in poor outcomes for older adults. It is known that silent aspiration might lead to aspiration pneumonia, but its role in this is unclear. The aim of the present study was to investigate whether silent aspiration is associated with mortality in aspiration pneumonia patients. METHODS: A multicenter (acute hospital) study including 170 aspiration pneumonia patients was carried out. Cough latency time after inhalation of 1% citric acid mist was used to assess silent aspiration...
January 31, 2018: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29356410/neonatal-swallowing-assessment-using-fiberoptic-endoscopic-evaluation-of-swallowing-fees
#10
Susanne Vetter-Laracy, Borja Osona, Antonia Roca, Jose A Peña-Zarza, Jose A Gil, Joan Figuerola
OBJECTIVES: Swallowing disorders which lead to aspiration are common in premature infants with a postmenstrual age (PMA) of >36 weeks. Aspiration is often silent and the unique symptom is desaturation during feeding. The aim of this study was 1) to determine the number of prematures with desaturations during feeding due to aspiration, using Fiberoptic Endoscopic Evaluation of Swallowing (FEES); 2) to relate clinical factors and FEES findings to aspiration; and 3) to describe type and efficacy of suggested treatments...
April 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29280496/silent-aspiration-who-is-at-risk
#11
Priatharisiny Velayutham, Alexandria L Irace, Kosuke Kawai, Pamela Dodrill, Jennifer Perez, Monica Londahl, Lauren Mundy, Natasha D Dombrowski, Reza Rahbar
OBJECTIVE: To determine the prevalence of silent aspiration in pediatric patients and identify which diagnoses may be associated with this finding. METHODS: An institutional review board-approved retrospective review was conducted for all patients under the age of 18 who underwent modified barium swallow (MBS) studies at a tertiary children's hospital in 2015. Speech-language pathologists reviewed MBS studies to identify aspiration/silent aspiration on each fluid consistency tested...
December 27, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29229113/measuring-voluntary-and-reflexive-cough-strength-in-healthy-individuals
#12
Claire Mills, Richard Jones, Maggie-Lee Huckabee
BACKGROUND: Cough reflex testing is a validated tool for identifying patients at risk of silent aspiration. However, inter- and intra-rater reliabilities of perceptual judgements of cough strength are sub-optimal. Although there are clinically established methods for measuring volitional cough strength, no similar methods are identified for reflexive cough strength. This study evaluated three measurement methods of voluntary and suppressed reflexive cough strength. METHODS: Fifty-three healthy subjects (≥50 years) participated in this study...
November 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29219248/-my-mother-told-me-that-i-should-not-a-qualitative-study-exploring-the-restrictions-placed-on-adolescent-girls-living-with-hiv-in-zambia
#13
Constance Rs Mackworth-Young, Virginia Bond, Alison Wringe, Katongo Konayuma, Sue Clay, Chipo Chiiya, Mutale Chonta, Kirsty Sievwright, Anne L Stangl
INTRODUCTION: Adolescent girls in sub-Saharan Africa are disproportionately affected by HIV due to a range of social and structural factors. As they transition to adulthood, they are recipients of increasing blame for HIV infection and 'improper' sex, as well as increasing scrutiny, restrictions and surveillance. This study used a qualitative and participatory approach to explore the messaging and restrictions imposed on adolescent girls living with HIV in Zambia. METHODS: Thirty-four in-depth interviews and four participatory workshops were carried out with 24 adolescent girls aged 15 to 19 years old living with HIV in Lusaka, Zambia...
December 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/29129487/-evaluation-of-dysphagia-results-after-one-year-of-incorporating-videofluoroscopy-into-its-study-introduction
#14
Ruth García Romero, Ignacio Ros Arnal, María José Romea Montañés, José Antonio López Calahorra, Cristina Gutiérrez Alonso, Beatriz Izquierdo Hernández, Carlos Martín de Vicente
INTRODUCTION: Dysphagia is very common in children with neurological disabilities. These patients usually suffer from respiratory and nutritional problems. The videofluoroscopic swallowing study (VFSS) is the most recommended test to evaluate dysphagia, as it shows the real situation during swallowing. OBJECTIVES: To analyse the results obtained in our centre after one year of the implementation of VFSS, the clinical improvement after confirmation, and the prescription of an individualised treatment for the patients affected...
November 9, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29080497/a-new-evaluation-of-masticatory-ability-in-patients-with-dysphagia-the-saku-saku-test
#15
I Tagashira, H Tohara, Y Wakasugi, K Hara, A Nakane, Y Yamazaki, M Matsubara, S Minakuchi
OBJECTIVE: In the elderly and patients with dysphagia, masticatory problems often cause aspiration or choking. Although simple methods to predict aspiration and silent aspiration exist, methods for evaluating the masticatory function of patients with dysphagia are lacking. Accordingly, we developed a simple test to assess the chewing and swallowing ability of patients with dysphagia. METHODS: One hundred and five patients with dysphagia were included. We used the Saku-Saku Test (SST), in which patients were asked to eat a rice cracker, and evaluated the quality of mandibular rotation during mastication...
January 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29074517/how-do-workplaces-working-practices-and-colleagues-affect-uk-doctors-career-decisions-a-qualitative-study-of-junior-doctors-career-decision-making-in-the-uk
#16
Sharon Spooner, Emma Pearson, Jonathan Gibson, Kath Checkland
OBJECTIVES: This study draws on an in-depth investigation of factors that influenced the career decisions of junior doctors. SETTING: Junior doctors in the UK can choose to enter specialty training (ST) programmes within 2 years of becoming doctors. Their specialty choices contribute to shaping the balance of the future medical workforce, with views on general practice (GP) careers of particular interest because of current recruitment difficulties. This paper examines how experiences of medical work and perceptions about specialty training shape junior doctors' career decisions...
October 25, 2017: BMJ Open
https://www.readbyqxmd.com/read/28969246/effect-of-ondansetron-on-prevention-of-ventilator-associated-pneumonia-in-intensive-care-unit-patients-in-kashani-hospital-in-2013
#17
Hossein Madineh, Omolbanin Rahimi, Mohamadreza Abedin Zadeh, Majid Kabiri
INTRODUCTION: Ventilator Associated Pneumonia (VAP) is the second most common infection with high mortality (24-50%). Ondansetron is a reliable and safe drug and it is currently used in the prevention of nausea and vomiting and has no side effects. AIM: The aim of the present study was to examine the effect of ondansetron on prevention of VAP in Intensive Care Unit (ICU) patients. MATERIALS AND METHODS: The present study was a randomized clinical trial study (IRCT201406156480N6), carried out at Kashani Hospital, Iran, in 2013 on 80 patients aged from 15-65 years...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28900040/reduced-diaphragm-excursion-during-reflexive-citric-acid-cough-test-in-subjects-with-subacute-stroke
#18
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...
December 2017: Respiratory Care
https://www.readbyqxmd.com/read/28890708/reduced-maximum-pitch-elevation-predicts-silent-aspiration-of-small-liquid-volumes-in-stroke-patients
#19
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
#20
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: Journal of Dental Anesthesia and Pain Medicine
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