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parkinson and aspiration pneumonia

Michelle S Troche, Alexandra E Brandimore, Karen W Hegland, Pamela R Zeilman, Kelly D Foote, Michael S Okun
There is no consensus regarding the effects of deep brain stimulation (DBS) surgery on swallowing outcomes in Parkinson's disease (PD). No prospective studies have compared airway protective outcomes following DBS to the subthalamic nucleus (STN) versus globus pallidus interna (GPi). A recent retrospective study described swallowing outcomes pre- and post-STN vs. GPi DBS in a cohort of 34 patients with PD. The results revealed that the patients who received GPi DBS maintained their swallowing function post-DBS, while those in the STN group significantly worsened in swallowing safety...
September 2016: Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
Bróna Kelly, Catherine Blake, Olive Lennon
BACKGROUND: The rate of people with Parkinson's disease (PD) is predicted to double by 2030 resulting in an even greater burden to an already struggling Irish health care system. There is a paucity of information regarding hospital utilisation among the PD population in an Irish context. OBJECTIVE: To examine trends of acute hospital in-patient admissions of patients admitted with a secondary diagnosis of PD between 2009 and 2012 in Ireland. METHOD: Data concerning patients, aged over and under 65 years with a previously existing diagnosis of Parkinson's Disease were requested from the HIPE database for the years 2009-2012...
October 19, 2016: Journal of Parkinson's Disease
Yu-Hsuan Wu, Wei-Ju Lee, Yi-Huei Chen, Ming-Hong Chang, Ching-Heng Lin
BACKGROUND: To evaluate the association between the premotor symptoms and the prognosis of PD. METHODS: A total of 1213 patients who were diagnosed of PD from January 2001 to December 2008 were selected from the Taiwan's National Health Insurance Research Database. Patients were traced back to determine the presence of premotor symptoms, including rapid eye movement sleep behavior disorder (RBD), depression, and constipation. Cox's regression analysis was used to detect the risks between the occurrence of premotor symptoms and the outcome (including death, psychosis, accidental injury, dementia and aspiration pneumonia)...
2016: PloS One
Erica Tilley, James McLoughlin, Simon A Koblar, Sebastian H Doeltgen, Cindy Stern, Sarahlouise White, Micah D J Peters
BACKGROUND: Progressive supranuclear palsy (PSP) is an adult onset neurodegenerative condition associated with mobility, balance, speech, swallowing, vision and cognitive changes. The condition is diagnosed using the National Institute for Neurological Disorders and Stroke (NINDS) and the Society of Progressive Supranuclear Palsy (SPSP) criteria. Therapeutic interventions for PSP are important, and a healthcare team should include a physiotherapist, occupational therapist and speech therapist...
June 2016: JBI Database of Systematic Reviews and Implementation Reports
Tatiana M Anderson, Alfredo J Garcia, Nathan A Baertsch, Julia Pollak, Jacob C Bloom, Aguan D Wei, Karan G Rai, Jan-Marino Ramirez
Breathing must be tightly coordinated with other behaviours such as vocalization, swallowing, and coughing. These behaviours occur after inspiration, during a respiratory phase termed postinspiration. Failure to coordinate postinspiration with inspiration can result in aspiration pneumonia, the leading cause of death in Alzheimer's disease, Parkinson's disease, dementia, and other neurodegenerative diseases. Here we describe an excitatory network that generates the neuronal correlate of postinspiratory activity in mice...
August 4, 2016: Nature
Michelle S Troche, Beate Schumann, Alexandra E Brandimore, Michael S Okun, Karen W Hegland
Patients with Parkinson's disease (PD) have progressive and pervasive disorders of airway protection. Recent work has highlighted the relationship between reflex and voluntary cough and swallowing safety. The goal of this study was to test the sensitivity and specificity of several airway protective and disease-specific factors for predicting swallowing safety outcomes in PD. Sixty-four participants (44 males) completed measures of voluntary and reflex cough, and swallowing safety. Clinical predictors included disease severity and duration, and cough airflow and sensitivity measures...
July 26, 2016: Dysphagia
Jong Hwa Lee, Kyeong Woo Lee, Sang Beom Kim, Sook Joung Lee, Sang Myung Chun, Sung Moon Jung
OBJECTIVE: To describe the correlation between the functional dysphagia scale and aspiration pneumonia and which characteristics influence the occurrence of aspiration pneumonia in patients with idiopathic Parkinson disease. METHODS: Fifty-three patients with idiopathic Parkinson disease were prospectively evaluated in this study. Disease severity and functional status were measured by modified Hoehn and Yahr (H&Y) staging, Schwab and England activities of daily living (S-E ADL) scale and Korean version of Mini-Mental State Examination (K-MMSE)...
June 2016: Annals of Rehabilitation Medicine
I Suttrup, T Warnecke
Oropharyngeal and esophageal dysphagia are a frequent, but seldom diagnosed symptom of Parkinson's disease (PD). More than 80 % of patients with PD develop dysphagia during the course of their disease leading to a reduced quality of life, complicated medication intake, malnutrition and aspiration pneumonia, which is a major cause of death in PD. The underlying pathophysiology is poorly understood. Impaired dopaminergic and non-dopaminergic mechanisms of the cortical swallowing network as well as peripheral neuromuscular involvement have been suggested to contribute to its multifactorial genesis...
July 2016: Fortschritte der Neurologie-Psychiatrie
Abhimanyu Mahajan, Poojitha Balakrishnan, Achint Patel, Ioannis Konstantinidis, Dominic Nistal, Narender Annapureddy, Priti Poojary, Girish N Nadkarni, Christos Sidiropoulos
The total number of people living with Parkinson's disease (PD) worldwide is expected to double by 2030. The risk factors for emergency department visits in PD patients have been described before, however, there is limited data on inpatient hospitalizations of PD patients. We derived our study cohort from the Nationwide Inpatient Sample (NIS) database from 2002-2011. The NIS is a stratified 20% sample of discharges from all U.S. hospitals. We extracted causes of hospitalization using International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes and calculated inpatient mortality, length of stay and cost...
September 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
María Elena Baeza-Monedero, Beatriz Montero-Errasquín, Juan Sánchez-Corral, Alfonso J Cruz-Jentoft
OBJECTIVE: To describe the indications of insertion of a percutaneous gastrostomy (PG) in older patients in a university hospital, as well as patient characteristics, short and long term complications, and mortality. METHODS: Retrospective descriptive study of all patients over 75 years who had a PG inserted during a three year period by the Interventional Radiology Department. The indication of the procedure was reviewed, and the incidence of complications and mortality during a 36 months follow-up period were assessed through electronic medical records...
May 5, 2016: Revista Española de Geriatría y Gerontología
Claire Takizawa, Elizabeth Gemmell, James Kenworthy, Renée Speyer
Oropharyngeal dysphagia is a common condition after stroke, Parkinson's disease (PD), and Alzheimer's disease (AD), and can cause serious complications including malnutrition, aspiration pneumonia, and premature mortality. Despite its high prevalence among the elderly and associated serious complications, dysphagia is often overlooked and under-diagnosed in vulnerable patient populations. This systematic review aimed to improve understanding and awareness of the prevalence of dysphagia in susceptible patient populations...
June 2016: Dysphagia
Yasuyo Okumachi, Daisuke Yamashita, Tomoko Higo, Toshihiro Takata
AIM: To examine the causes of death in elderly patients with advanced dementia, we retrospectively investigated the medical records for death discharge cases hospitalized in the Department of Geriatric Medicine at Saiseikai-Nakatsu Hospital and examined death certificates issued throughout the hospital. METHODS: (1) From 2010 to 2013, 31 patients with advanced dementia died in the hospital or were discharged to receive terminal care at home. We evaluated their medical records to examine the pathological background and disease with which they were diagnosed when admitted to and discharged from the hospital...
2015: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Julia K Ellerston, Amanda C Heller, Daniel R Houtz, Katherine A Kendall
OBJECTIVE: Dysphagia and associated aspiration pneumonia are commonly reported sequelae of Parkinson's disease (PD). Previous studies of swallowing in patients with PD have described prolonged pharyngeal transit time, delayed onset of pharyngeal transit, cricopharyngeal (CP) achalasia, reduced pharyngeal constriction, and slowed hyolaryngeal elevation. These studies were completed using inconsistent evaluation methodology, reliance on qualitative analysis, and a lack of a large control group, resulting in concerns regarding diagnostic precision...
May 2016: Annals of Otology, Rhinology, and Laryngology
Inga Suttrup, Tobias Warnecke
More than 80 % of patients with Parkinson's disease (PD) develop dysphagia during the course of their disease. Swallowing impairment reduces quality of life, complicates medication intake and leads to malnutrition and aspiration pneumonia, which is a major cause of death in PD. Although the underlying pathophysiology is poorly understood, it has been shown that dopaminergic and non-dopaminergic mechanisms are involved in the development of dysphagia in PD. Clinical assessment of dysphagia in PD patients is challenging and often delivers unreliable results...
February 2016: Dysphagia
Karen W Hegland, Michelle S Troche, Alexandra Brandimore, Michael S Okun, Paul W Davenport
Aspiration pneumonia is a common cause of death in people with Parkinson's disease (PD). Dysfunctional swallowing occurs in the majority of people with PD, and research has shown that cough function is also impaired. Previous studies suggest that testing reflex cough by having participants inhale a cough-inducing stimulus through a nebulizer may be a reliable indicator of swallowing dysfunction, or dysphagia. The primary goal of this study was to determine the cough response to two different cough-inducing stimuli in people with and without PD...
February 2016: Dysphagia
Ali Rajaei, Fereshteh Ashtari, Seyed Abolfazl Azargoon, Ahmad Chitsaz, Mohammad Hussein Nilforoush, Masoud Taheri, Saba Sadeghi
BACKGROUND: Dysphagia is a common disorder among patients with Parkinson's disease (PD). It occurs in up to 80% of all (PD) patients during the early stages of the disease and up to 95% in the advanced stages; but professionals may not hear from the patients about dysphagia symptoms until these symptoms reach an advanced stage and lead to medical complications. MATERIALS AND METHODS: Thirty-three PD patients (mean age 66.09 ± 9.4 years; 24 men, nine women) participated in this study at our Neurology Institute, between April 20, 2013, and October 26, 2013...
2015: Advanced Biomedical Research
Umer Akbar, Bhavpreet Dham, Ying He, Nawaz Hack, Samuel Wu, Michelle Troche, Patrick Tighe, Eugene Nelson, Joseph H Friedman, Michael S Okun
INTRODUCTION: Careful examination of long-term analyses and trends is essential in understanding the medico-economic burden of this common complication. We sought to describe the long-term (32-year) trends of incidence and mortality in PD patients hospitalized with aspiration pneumonia (AsPNA). METHODS: Incidence and mortality of AsPNA in hospitalized PD versus non-PD patients was assessed by logistic regression analysis applied to a national database between the years 1979 and 2010...
September 2015: Parkinsonism & related Disorders
Daniel Martinez-Ramirez, Leonardo Almeida, Juan C Giugni, Bilal Ahmed, Masa-Aki Higuchi, Christopher S Little, John P Chapman, Caroline Mignacca, Aparna Wagle Shukla, Christopher W Hess, Karen Wheeler Hegland, Michael S Okun
BACKGROUND: Aspiration pneumonia is an important cause of morbidity and mortality in Parkinson's disease (PD). Clinical characteristics of PD patients in addition to specific alterations in swallowing mechanisms contribute to higher swallowing times and impairment in the effective clearance of the airway. These issues may render patients more prone to dysphagia and aspiration events. We aimed to determine the frequency of aspiration events in a hospitalized PD cohort, and to report the number of in-hospital swallow evaluations...
2015: BMC Neurology
Makito Hirano, Chiharu Isono, Hikaru Sakamoto, Shuichi Ueno, Susumu Kusunoki, Yusaku Nakamura
Abnormal swallowing, dysphagia, is a potentially fatal symptom in Parkinson's disease (PD) and is characterized by frequent silent aspiration, an unrecognized risk of suffocation and aspiration pneumonia. Several studies have reported that the injection of apomorphine, a dopamine agonist, alleviated dysphagia in some patients with PD. The effects of other antiparkinson medications against dysphagia remain controversial. Rotigotine is another dopamine agonist with non-oral administration, i.e., a transdermal patch...
August 2015: Dysphagia
Ichiro Nozaki, Yuko Kato-Motozaki, Tokuhei Ikeda, Kazuya Takahashi, Atsuro Tagami, Chiho Ishida, Kiyonobu Komai
INTRODUCTION: Qing fei tang, which is used for various respiratory diseases, is useful for reducing relapse of aspiration pneumonia and bronchopneumonia in stroke, but the effect remains unknown in Parkinson's syndrome. We report two cases of Japanese patients with progressive supranuclear palsy and relapsing aspiration pneumonia and bronchopneumonia, which was successfully prevented by qing fei tang. CASE PRESENTATION: Two Japanese men with progressive supranuclear palsy and receiving total enteral feeding (patient one (66-years-old) and patient two (76-years-old)) had experienced recurrent aspiration pneumonia and bronchopneumonia, which was unresponsive to conventional therapy...
2015: Journal of Medical Case Reports
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