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Silent aspiration

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https://www.readbyqxmd.com/read/28286961/people-with-intellectual-disabilities-and-dysphagia
#1
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
#2
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
#3
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
#4
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.
January 9, 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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/27821134/asphyxia-due-to-laryngeal-spasm-as-a-severe-complication-of-awake-deep-brain-stimulation-for-parkinson-s-disease-a-case-report
#10
Kajetan L von Eckardstein, Friederike Sixel-Döring, Stephan Kazmaier, Claudia Trenkwalder, Jason M Hoover, Veit Rohde
BACKGROUND: In accordance with German neurosurgical and neurological consensus recommendations, lead placements for deep brain stimulation (DBS) in patients with Parkinson's disease (PD) are usually performed with the patient awake and in "medication off" state. This allows for optimal lead position adjustment according to the clinical response to intraoperative test stimulation. However, exacerbation of Parkinsonian symptoms after withdrawal of dopaminergic medication may endanger the patient by inducing severe "off" state motor phenomena...
November 8, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27798948/optimizing-outcomes-following-total-and-subtotal-tongue-reconstruction-a-systematic-review-of-the-contemporary-literature
#11
Oscar J Manrique, Hyuma A Leland, Claude-Jean Langevin, Alex Wong, Joseph N Carey, Pedro Ciudad, Hung-Chi Chen, Ketan M Patel
Background More than 45,000 Americans are diagnosed with oropharyngeal cancer annually and multimodal treatment often requires wide excision, lymphadenectomy, chemotherapy, and radiation. Total and subtotal lingual resection severely impairs speech, swallow, and quality of life (QoL). This study investigates functional outcomes and QoL following subtotal and total tongue resection with free tissue transfer reconstruction. Materials and Methods A systematic review of the English language literature was performed using PubMed, Ovid, Embase, and Cochrane databases based on predetermined inclusion/exclusion criteria...
February 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27790452/cutaneous-metastasis-from-cholangiocarcinoma-presenting-as-thigh-mass
#12
Kachnar Varma, Anshu Singh, Vatsala Misra
Skin is an uncommon site for metastasis with only 0.7-9% of all patients with cancer being affected when compared to other organs. Generally, the time lag between the diagnosis of primary malignancy and the recognition of the skin metastases is long, but sometimes these metastases may be the first indication of otherwise clinically silent visceral malignancies as seen in our case. In cholangiocarcinomas, the occurrence of cutaneous metastases is extremely rare. Their most common sites of metastasis are visceral organs i...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27619029/morphology-of-nerve-endings-in-vocal-fold-of-human-newborn
#13
Janaina Gonçalves da Silva Leite, Maria Luzete Costa Cavalcante, Francisco Vagnaldo Fechine-Jamacaru, Margarida Maria de Lima Pompeu, José Alberto Dias Leite, Dulce Maria Nascimento Coelho, Marcos Rabelo de Freitas
Sensory receptors are distributed throughout the oral cavity, pharynx, and larynx. Laryngeal sensitivity is crucial for maintaining safe swallowing, thus avoiding silent aspiration. Morphologic description of different receptor types present in larynx vary because of the study of many different species, from mouse to humans. The most commonly sensory structures described in laryngeal mucosa are free nerve endings, taste buds, muscle spindles, glomerular and corpuscular receptors. This study aimed at describing the morphology and the distribution of nerve endings in premature newborn glottic region...
October 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27608338/does-objective-measurement-of-tracheal-tube-cuff-pressures-minimise-adverse-effects-and-maintain-accurate-cuff-pressures-a-systematic-review-and-meta-analysis
#14
C A Hockey, A A J van Zundert, J D Paratz
Correct inflation pressures of the tracheal cuff are recommended to ensure adequate ventilation and prevent aspiration and adverse events. However there are conflicting views on which measurement to employ. The aim of this review was to examine whether adjustment of cuff pressure guided by objective measurement, compared with subjective measurement or observation of the pressure value alone, was able to prevent patient-related adverse effects and maintain accurate cuff pressures. A search of PubMed, Web of Science, Embase, CINAHL and ScienceDirect was conducted using keywords 'cuff pressure' and 'measure*' and related synonyms...
September 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27602145/branchiogenic-carcinoma-with-high-risk-type-human-papillomavirus-infection-a-case-report
#15
Hiroyuki Maeda, Zeyi Deng, Taro Ikegami, Sen Matayoshi, Shinya Agena, Asanori Kiyuna, Yukashi Yamashita, Takayuki Uehara, Akira Ganaha, Mikio Suzuki
Branchiogenic carcinoma (BC) usually appears as a mass lesion with a predominant cystic component. Since lymph node metastasis from oropharyngeal carcinoma (OPC) has a cystic appearance, it is occasionally difficult to distinguish between BC and nodal metastases from clinically silent OPC. Factors associated with the malignant transformation process in BC remain obscure. The present study reports the case of a 56-year-old man with a right cystic cervical mass that was diagnosed as squamous cell carcinoma based on examination by fine-needle aspiration biopsy...
September 2016: Oncology Letters
https://www.readbyqxmd.com/read/27555974/tuberculous-empyema-necessitatis-in-a-40-year-old-immunocompetent-male
#16
Farhang Babamahmoodi, Lotfollah Davoodi, Roya Sheikholeslami, Fatemeh Ahangarkani
Empyema necessitans (EN) is a kind of empyema that diffuses to extrapleural space and can involve chest pain. Tuberculosis (TB) is the most common cause of EN. This disease can be found in both immunocompromised and immunocompetent individuals but is usually seen in the immunocompromised individuals. Because of long duration and ambiguous symptoms of the disease, diagnosis can be hard. The disease can be treated both medically and surgically. Missing the disease can lead to undesirable effects on patient's condition and health care setting...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/27516725/clinical-utility-of-bronchoalveolar-lavage-pepsin-in-diagnosis-of-gastroesophageal-reflux-among-wheezy-infants
#17
Ahmed Fathi Abdallah, Tarek El-Desoky, Khalid Fathi, Wagdy Fawzi Elkashef, Ahmed Zaki
Background. There is no gold standard test for diagnosis of gastroesophageal reflux disease (GERD) associated infantile wheezing. Objectives. To evaluate the value of bronchoalveolar lavage (BAL) pepsin assay in diagnosis of GERD in wheezy infants. Methods. Fifty-two wheezy infants were evaluated for GERD using esophageal combined impedance-pH (MII-pH) monitoring, esophagogastroduodenoscopy with esophageal biopsies, and BAL pepsin. Tracheobronchial aspirates from 10 healthy infants planned for surgery without history of respiratory problems were examined for pepsin...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/27512573/the-provision-of-enteral-nutritional-support-during-definitive-chemoradiotherapy-in-head-and-neck-cancer-patients
#18
REVIEW
Sarah Bishop, Warren Michael Reed
Combination chemoradiation is the gold standard of management for locally advanced squamous cell carcinomas of the head and neck. One of the most significant advantages of this approach to treatment is organ preservation which may not be possible with radical surgery. Unfortunately, few treatments are without side-effects and the toxicity associated with combined modality treatment causes meaningful morbidity. Patients with head and neck cancer (HNC) may have difficulties meeting their nutritional requirements as a consequence of tumour location or size or because of the acute toxicity associated with treatment...
December 2015: Journal of Medical Radiation Sciences
https://www.readbyqxmd.com/read/27405422/clinical-characteristics-of-dysphagia-in-children-with-down-syndrome
#19
Arwen Jackson, Jennifer Maybee, Maura K Moran, Kristine Wolter-Warmerdam, Francis Hickey
Aspiration is an often unrecognized comorbidity in children with Down syndrome with serious medical consequences. This retrospective chart review of swallow study reports characterizes oral and pharyngeal phase dysphagia and diet modifications on videofluoroscopic swallow studies (VFSS) in a large cohort of children with Down syndrome. A total of 158 pediatric patients (male = 95; female = 63; mean age 2.10 years, SD 3.17 years) received an initial VFSS at a pediatric teaching hospital as part of their medical care...
October 2016: Dysphagia
https://www.readbyqxmd.com/read/27228428/accuracy-of-clinical-swallowing-evaluation-for-diagnosis-of-dysphagia-in-children-with-laryngomalacia-or-glossoptosis
#20
Marisa Gasparin, Cláudia Schweiger, Denise Manica, Antônio Carlos Maciel, Gabriel Kuhl, Deborah Salle Levy, Paulo José Cauduro Marostica
OBJECTIVE: To investigate the accuracy of clinical evaluation of swallowing in a sample of children with laryngomalacia or glossoptosis and describe the prevalence of dysphagia in each of these diseases, as well as characterize the swallow response to speech and language therapy interventions. STUDY DESIGN: Children aged 1 month to 11 years receiving care at the Department of Otolaryngology, Hospital de Clínicas de Porto Alegre, Brazil, were evaluated in a cross-sectional design...
January 2017: Pediatric Pulmonology
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