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Silent aspiration

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https://www.readbyqxmd.com/read/29129487/-evaluation-of-dysphagia-results-after-one-year-of-incorporating-videofluoroscopy-into-its-study-introduction
#1
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
#2
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...
October 18, 2017: 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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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)...
November 2017: Spinal Cord
https://www.readbyqxmd.com/read/28578512/infected-colloid-cyst
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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