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https://www.readbyqxmd.com/read/28092225/comparison-of-dysphagia-outcomes-between-rostral-and-caudal-lateral-medullary-infarct-patients
#1
Min Ho Chun, Daeha Kim, Min Cheol Chang
OBJECTIVE: A detailed knowledge of dysphagia outcomes in lateral medullary infarct (LMI) patients would enable proper establishment of swallowing therapy goals and strategies. However, little is known about the impact of infarct location on dysphagia outcomes in patients with LMI. METHODS: Twenty patients with rostral LMI (rostral group) and 20 patients with caudal LMI (caudal group) participated in the study. All patients underwent swallowing therapy, which included compensatory treatments and strengthening exercises, for >3 months...
January 16, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28090779/preparation-and-in-vitro-in-vivo-evaluation-of-metformin-hydrochloride-rectal-dosage-forms-for-treatment-of-patients-with-type-ii-diabetes
#2
Abdel-Azim Zaghloul, Ahmad Lila, Fathy Abd-Allah, Aly Nada
BACKGROUND: Metformin hydrochloride (MtHCL) is an oral antidiabetic drug and has many other therapeutic benefits. It has poor bioavailability, narrow absorption window and extensive liver metabolism. Moreover, children and elders face difficulty to swallow the commercial oral tablets. OBJECTIVES: Preparation, in vitro/in vivo evaluation of MtHCL suppositories for rectal administration to solve some of these problems. METHODS: Suppository fatty bases (Witepsol®, Suppocire® and Massa®; different grades) and PEG bases 1000, 4000 and 6000 (different ratios), were used to prepare rectal suppository formulations each containing 500 mg drug...
January 16, 2017: Journal of Drug Targeting
https://www.readbyqxmd.com/read/28089208/the-reconstructive-options-for-oropharyngeal-defects-in-the-transoral-robotic-surgery-framework
#3
Giuseppe Meccariello, Filippo Montevecchi, Rossella Sgarzani, Andrea De Vito, Giovanni D'Agostino, Riccardo Gobbi, Chiara Bellini, Claudio Vicini
Transoral robotic surgery (TORS) is a fascinating new technique that has been proved to be a safe and feasible for selected oropharyngeal cancers. Furthermore, TORS offers several advantages in the treatment of locoregionally advanced cancers. Nevertheless, the careful selection of patients is the keypoint for a successful application of this therapeutic modality. However, the reconstruction of large oropharyngeal defects is challenging due to the restoration of velopharyngeal competency and swallowing. Moreover, the absence of mandibular splitting increases the difficulties faced by reconstructive surgeons...
January 11, 2017: Oral Oncology
https://www.readbyqxmd.com/read/28081026/the-effect-of-nebulized-glycopyrrolate-on-posterior-drooling-in-patients-with-brain-injury-two-cases-of-different-brain-lesions
#4
Zee-Ihn Lee, Kwang Jae Yu, Dae Hee Lee, Seong Kyung Hong, Seung Beom Woo, Jong Min Kim, Donghwi Park
Posterior drooling, which can lead to substantial respiratory morbidity, including unexplained lung diseases and recurrent pneumonia, is an important issue in the rehabilitation unit. There are various treatment options for posterior drooling, including pharmacologic therapy, oral motor or behavioral therapy, biofeedback, local glandular injection of botulinum toxin, irradiation, and surgery. Among them, nebulized glycopyrrolate has the following advantages: It is noninvasive and is relatively free of central adverse effects because it does not cross the blood-brain barrier unlike other anticholinergics...
January 9, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28078068/efficacy-of-emg-bioimpedance-triggered-functional-electrical-stimulation-on-swallowing-performance
#5
Corinna Schultheiss, Thomas Schauer, Holger Nahrstaedt, Rainer O Seidl, Jehoschua Bieler
In order to support swallowing, the efficacy of functional electrical stimulation for different stimulation settings of the submental musculature has been investigated. The stimulation was administrated at rest and synchronously to voluntary initiated swallows. The onset of a swallow was detected in real-time by a combined electromyography/ bioimpedance measurement at the neck in order to trigger the stimulation. The amplitude and speed of larynx elevation caused by the FES has been assessed by the observed change in bioimpedance whereas a reduction of bioimpedance corresponds to an increase in larynx elevation...
September 15, 2016: European Journal of Translational Myology
https://www.readbyqxmd.com/read/28070747/enhanced-bulbar-function-in-amyotrophic-lateral-sclerosis-the-nuedexta-treatment-trial
#6
Richard Smith, Erik Pioro, Kathleen Myers, Michael Sirdofsky, Kimberly Goslin, Gregg Meekins, Hong Yu, James Wymer, Merit Cudkowicz, Eric A Macklin, David Schoenfeld, Gary Pattee
The goal of this randomized, blinded, crossover clinical trial was to determine whether Nuedexta (dextromethorphan and quinidine) enhanced speech, swallowing, and salivation in patients with ALS. Sixty patients with amyotrophic lateral sclerosis (ALS) received either Nuedexta or placebo for 28 to 30 days, followed by a 10 to 15-day washout period. Subsequently, patients were switched to the opposite treatment arm for the remaining days of the trial. The primary endpoint was a reduction in the self-report Center for Neurologic Study Bulbar Function Scale (CNS-BFS) score...
January 9, 2017: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/28070602/acupuncture-in-posttonsillectomy-pain-a%C3%A2-prospective-double-blinded-randomized-controlled-trial
#7
J Dingemann, B Plewig, I Baumann, P K Plinkert, S Sertel
BACKGROUND: Postoperative swallowing pain is one of the most unpleasant after-effects of tonsillectomy. During recent years, the demand for alternatives to drug-based pain therapy has continued to grow, although the topic has received little research attention until now. MATERIALS AND METHODS: A total of 46 patients were randomized into verum acupuncture, control acupuncture, and drug-based treatment groups. All patients received nonsteroidal antirheumatic drugs (NSAIDs)...
January 9, 2017: HNO
https://www.readbyqxmd.com/read/28068939/swallowing-interventions-for-the-treatment-of-dysphagia-after-head-and-neck-cancer-a-systematic-review-of-behavioural-strategies-used-to-promote-patient-adherence-to-swallowing-exercises
#8
Roganie Govender, Christina H Smith, Stuart A Taylor, Helen Barratt, Benjamin Gardner
BACKGROUND: Dysphagia is a significant side-effect following treatment for head and neck cancers, yet poor adherence to swallowing exercises is frequently reported in intervention studies. Behaviour change techniques (BCTs) can be used to improve adherence, but no review to date has described the techniques or indicated which may be more associated with improved swallowing outcomes. METHODS: A systematic review was conducted to identify behavioural strategies in swallowing interventions, and to explore any relationships between these strategies and intervention effects...
January 10, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28053809/postoperative-quality-of-life-after-total-gastrectomy-compared-with-partial-gastrectomy-longitudinal-evaluation-by-european-organization-for-research-and-treatment-of-cancer-og25-and-sto22
#9
Jeong-Hwan Lee, Hyuk-Joon Lee, Yun Suk Choi, Tae Han Kim, Yeon-Ju Huh, Yun-Suhk Suh, Seong-Ho Kong, Han-Kwang Yang
PURPOSE: The European Organization for Research and Treatment of Cancer quality-of-life questionnaire-OG25 was developed to evaluate the quality of life in patients with stomach and esophageal cancer. The following are included in the OG25 but not in the STO22: odynophagia, choked when swallowing, weight loss, trouble eating with others, trouble swallowing saliva, trouble talking, and trouble with coughing. In this study, we evaluated the quality of life of gastrectomized patients using both, the OG25 and the STO22...
December 2016: Journal of Gastric Cancer
https://www.readbyqxmd.com/read/28052332/normal-fluoroscopic-appearance-status-post-successful-endoscopic-zenker-diverticulotomy
#10
Naren N Venkatesan, Lisa M Evangelista, Maggie A Kuhn, Peter C Belafsky
OBJECTIVE: Endoscopic Zenker diverticulotomy (EZD) is a primary treatment for Zenker diverticulum (ZD). During EZD, the diverticulum is not excised, and interpretation of postoperative videofluoroscopic swallow study (VFSS) is challenging. The purpose of this investigation was to describe normal VFSS findings status post-successful EZD. METHODS: The charts of all patients with ZD treated at our center between October 01, 2011, and May 30, 2014, were abstracted. Outcome measures included recidivistic diverticulum size, Eating Assessment Tool-10 (EAT-10), penetration aspiration scale, pharyngeal constriction ratio (PCR), and pharyngoesophageal segment (PES) opening...
January 4, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28050248/management-of-achalasia-in-the-uk-do-we-need-new-guidelines
#11
REVIEW
Jihene El Kafsi, Antonio Foliaki, Thomas C B Dehn, Nicholas D Maynard
AIM: It is recommended that management of complex benign upper gastrointestinal pathology is discussed at multi disciplinary team (MDT) meetings. American College of Gastroenterology (ACG) guidelines further recommend that treatment delivery is provided by high volume centres, with objective post-procedural investigations, in order to improve patient outcomes. We aimed to survey the current UK practice in the management of achalasia. METHODS: 443 Upper gastrointestinal (UGI) specialist surgeons throughout the UK were sent a surveymonkey...
December 2016: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28048671/su-f-t-104-determining-the-ntcp-parameters-of-pharyngeal-constrictors-and-proximal-esophagus-for-radiation-induced-swallowing-problems-recorded-six-months-after-radiation-therapy-for-head-and-neck-tumors
#12
P Mavroidis, A Price, M Kostich, R Amdur, W Mendenhall, N Sheets, R Green, S Das, L Marks, B Chera
PURPOSE: To estimate the radiobiological parameters of four NTCP models that describe the dose-response relations of pharyngeal constrictors and proximal esophagus regarding the severity of patient reported swallowing problems 6 months post chemo-radiotherapy. To identify the section/structure that best correlates with the manifestation of the clinical endpoints. Finally, to compare the goodness-of-fit of those models. METHODS: Forty-three patients were treated on a prospective multi-institutional phase II study for oropharyngeal squamous cell carcinoma...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048375/su-d-bra-01-feasibility-study-for-swallowing-prediction-using-pressure-sensors
#13
M Cho, S Kim, T Kim, D Kim, S Kang, K Kim, D Shin, Y Noh, T Suh
PURPOSE: To develop a swallowing prediction system (SPS) using force sensing sensors and evaluate its feasibility. METHODS: The SPS developed consists of force sensing sensor units, a thermoplastic mask, a signal transport device and a control PC installed with an in-house software. The SPS is designed to predict the pharyngeal stage of swallowing because it is known that internal organ movement occurs in pharyngeal stage. To detect prediction signal in the SPS, the force sensing sensor units were attached on both the submental muscle region and thyroid cartilage region of the thermoplastic mask...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048185/su-f-j-31-dual-energy-imaging-in-the-treatment-of-head-and-neck-tumors-a-phantom-study
#14
J Roeske, R Patel, M Surucu
PURPOSE: Organ motion, due to swallowing, can significantly affect the PTV margins used in head and neck patients. Evaluation of swallowing motion 2016 AAPM Annual Meeting Program Medical Physics, Vol. 43, No. 6, June 2016 3412 3412 may be performed using x-ray fluoroscopy. However, regions such as the soft palette and epiglottis may be difficult to visualize due to the presence of bone (mandible, teeth). The goal of this phantom study is to determine if dual energy (DE) subtraction would improve the visualization in these regions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046674/su-f-t-107-correlations-between-dosimetric-indices-of-pharyngeal-constrictors-and-proximal-esophagus-with-associated-patient-reported-outcomes-six-months-after-radiation-therapy-for-head-and-neck-cancer
#15
B Chera, A Price, M Kostich, R Amdur, W Mendenhall, N Sheets, R Green, L Marks, S Das, P Mavroidis
PURPOSE: To compare the correlations between different dosimetric indices derived from the pharyngeal constrictor muscles and proximal esophagus with patient-reported difficulty in swallowing 6 months post radiotherapy using a novel patient reported outcome version of CTCAE (PRO-CTCAE). METHODS: Forty-three patients with oropharyngeal squamous cell carcinoma were treated on a prospective multi-institutional study. All patients received de-intensified 60 Gy intensity modulated radiotherapy...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28044204/25%C3%A2-years-of-dysphagia-rehabilitation-what-have-we-done-what-are-we-doing-and-where-are-we-going
#16
Caryn Easterling
As deglutologists, we strive to use the best evidence available in the treatment of swallowing disorders. Evidence-based medicine is a bottom-up approach that thoughtfully combines the best external evidence with individual clinical expertise and the patients' choice reflective of their clinical state and preferences for their specific care plan. Evidence-based medicine is not restricted to randomized clinical trials and meta-analyses; rather, evidence-based medicine includes our ability to discriminate the best external evidence with which to answer clinical questions and then skillfully and appropriately being able to apply this evidence in the care and treatment of our patients (Sackett et al...
January 2, 2017: Dysphagia
https://www.readbyqxmd.com/read/28041649/development-of-a-nomogram-for-predicting-the-risk-of-anastomotic-leakage-after-a-gastrectomy-for-gastric-cancer
#17
R-H Tu, J-X Lin, C-H Zheng, P Li, J-W Xie, J-B Wang, J Lu, Q-Y Chen, L-L Cao, M Lin, C-M Huang
AIMS: To investigate the incidence of and factors associated with anastomotic leakage (AL) following gastrectomy for gastric cancer. METHODS: We retrospectively analyzed 3632 patients who underwent a laparoscopic gastrectomy or open gastrectomy for gastric cancer. A logistic regression model was used to identify the determinant variables, and a nomogram for AL was developed. RESULTS: A total of 3632 patients were included in the study, 50 of whom (1...
December 20, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28040660/quality-of-life-and-swallowing-with-standard-chemoradiotherapy-versus-accelerated-radiotherapy-and-panitumumab-in-locoregionally-advanced-carcinoma-of-the-head-and-neck-a-phase-iii-randomised-trial-from-the-canadian-cancer-trials-group-hn-6
#18
Jolie Ringash, John N Waldron, Lillian L Siu, Rosemary Martino, Eric Winquist, Jim R Wright, Abdenour Nabid, John H Hay, Alex Hammond, Khalil Sultanem, Sebastien Hotte, Carson Leong, Ali Abdel Halim El-Gayed, Farah Naz, Kevin Ramchandar, Timothy E Owen, Alexander Montenegro, Brian O'Sullivan, Bingshu E Chen, Wendy R Parulekar
AIM: To compare quality of life (QOL) between standard (SFX) chemoradiotherapy (arm A) and altered fractionation radiotherapy (AFX) with panitumumab (PMab; arm B). METHODS: Patients with T any N + M0 or T3-4N0M0 squamous cell head-neck carcinoma were randomised to SFX (70 Gy/35/7 wks) plus cisplatin (100 mg/m(2) IV × 3) versus AFX (70 Gy/35/6 wks) plus PMab (9 mg/kg IV × 3). QOL was collected at baseline, end of radiation therapy (RT) and 2, 4, 6, 12, 24 and 36 months post-RT using the Functional Assessment of Cancer Therapy Head and Neck (FACT-H&N), MD Anderson Dysphagia Index (MDADI) and SWAL-QOL...
December 29, 2016: European Journal of Cancer
https://www.readbyqxmd.com/read/28040606/steinert-syndrome-and-repercussions-in-dental-medicine
#19
REVIEW
Helena Baptista, Inês Lopes Cardoso
Steinert syndrome, also called myotonic dystrophy type 1, is a genetic disorder with autosomal dominant transmission characterized by myotonia and a multisystemic clinical picture that affects several tissues of the human body. The most common systemic phenotypes are: muscular, cardiac, respiratory, CNS, ocular, gynecological, digestive, orthopedical, as well as cognitive and psychological symptoms (cognitive decline). Muscles involved in voluntary movement are highly affected by myotonia especially distal muscles of upper limbs...
December 23, 2016: Archives of Oral Biology
https://www.readbyqxmd.com/read/28039638/effects-of-laparoscopic-myotomy-on-the-esophageal-motility-pattern-of-esophageal-achalasia-as-measured-by-high-resolution-manometry
#20
Renato Salvador, Edoardo Savarino, Elisa Pesenti, Lorenzo Spadotto, Guerrino Voltarel, Giovanni Capovilla, Francesco Cavallin, Loredana Nicoletti, Michele Valmasoni, Alberto Ruol, Stefano Merigliano, Mario Costantini
BACKGROUND: Esophageal achalasia can be classified on the grounds of three distinct manometric patterns that correlate well with final outcome after laparoscopic Heller-Dor myotomy (LHM). No analytical data are available, however, on the postoperative picture and its possible correlation with final outcome. The aims of this study were: (a) to investigate whether manometric patterns change after LHM for achalasia; (b) to ascertain whether postoperative patterns and/or changes can predict final outcome; and (c) to test the hypothesis that the three known patterns represent different stages in the evolution of the disease...
December 30, 2016: Surgical Endoscopy
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