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Guideline management dysphagia

Maureen A Lefton-Greif, Joan C Arvedson
Speech-language pathologists (SLPs) have played primary roles in the evaluation and management of children with feeding/swallowing disorders for more than five decades. Medical, surgical, and technological advances have improved the survival of young fragile infants and children, many of whom will present with feeding/swallowing problems. Regardless of their underlying etiologies, many of these children are at risk for aspiration-induced lung disease, undernutrition or malnutrition, developmental deficits, and stressful interactions with their caregivers...
November 2016: Seminars in Speech and Language
Manon C W Spaander, Todd H Baron, Peter D Siersema, Lorenzo Fuccio, Brigitte Schumacher, Àngels Escorsell, Juan-Carlos Garcia-Pagán, Jean-Marc Dumonceau, Massimo Conio, Antonella de Ceglie, Janusz Skowronek, Marianne Nordsmark, Thomas Seufferlein, André Van Gossum, Cesare Hassan, Alessandro Repici, Marco J Bruno
This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE), endorsed by the European Society for Radiotherapy and Oncology (ESTRO), the European Society of Digestive Endoscopy (ESDO), and the European Society for Clinical Nutrition and Metabolism (ESPEN). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations for malignant disease 1 ESGE recommends placement of partially or fully covered self-expandable metal stents (SEMSs) for palliative treatment of malignant dysphagia over laser therapy, photodynamic therapy, and esophageal bypass (strong recommendation, high quality evidence)...
October 2016: Endoscopy
Usha Krishnan, Hayat Mousa, Luigi Dall'Oglio, Nusrat Homaira, Rachel Rosen, Christophe Faure, Frédéric Gottrand
BACKGROUND: Esophageal atresia (EA) is one of the most common congenital digestive anomalies. With improvements in surgical techniques and intensive care treatments, the focus of care of these patients has shifted from mortality to morbidity and quality of life issues. These children face gastrointestinal (GI) problems not only in early childhood but also through adolescence and adulthood. However, there is currently a lack of a systematic approach to the care of these patients. The gastrointestinal working group of International Network on Esophageal Atresia (INoEA) comprised of members from ESPGHAN/NASPGHAN was charged with the task of developing uniform evidence-based guidelines for the management of GI complications in children with EA...
August 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
Sarah J Sternlieb, Celine Satija, David T Pointer, Byron E Crawford, Lacey Sullivan, Emad Kandil
Struma ovarii is a rare type of ovarian teratoma comprised of at least 50% thyroid tissue. While most are benign, 70% of malignant cases are diagnosed as papillary carcinoma. Management of patients with thyroid nodules following gynecologic surgery remains controversial and variable. Historically, the treatment of choice has been surgical removal to rule out ovarian carcinoma. Thyroid follow-up and further treatment options are guided by tumor characteristics. The patient in this case presented to the endocrine surgeon with multiple thyroid nodules, dysphagia and a history of struma ovarii that was surgically treated at an outside hospital...
August 2016: Gland Surgery
Shilpi Ajwani, Sumedh Jayanti, Nadia Burkolter, Craig Anderson, Sameer Bhole, Rhonda Itaoui, Ajesh George
AIMS AND OBJECTIVES: This paper aims to identify current evidence on the role of nurses and allied health professionals in the oral health management of stroke patients, detailing their current knowledge, attitudes and practices and the potential benefits of an integrated oral care program. BACKGROUND: Stroke has disabling oral health effects, such as dysphagia and hindered brushing due to upper limb hemiparesis. Together, these can increase bacterial load, increasing risk of pneumonia...
August 18, 2016: Journal of Clinical Nursing
Madhu Subramanian, Tjasa Hranjec, Laindy Liu, Erica I Hodgman, Christian T Minshall, Joseph P Minei
BACKGROUND: No guidelines exist for the evaluation of patients after near hanging. Most patients receive a comprehensive workup, regardless of exam. We hypothesize that patients with a normal neurologic exam, without major signs or symptoms suggestive of injury, require no additional workup. METHODS: We reviewed medical charts of adult trauma patients who presented to a Level I Trauma Center between 1995 and 2013 after an isolated near hanging episode. Demographics, Glasgow Coma Score (GCS), imaging, and management were collected...
August 18, 2016: Journal of Trauma and Acute Care Surgery
Edoardo Savarino, Nicola de Bortoli, Massimo Bellini, Francesca Galeazzi, Mentore Ribolsi, Renato Salvador, Vincenzo Savarino, Roberto Penagini
Patients with esophageal symptoms potentially associated to esophageal motor disorders such as dysphagia, chest pain, heartburn and regurgitation, represent one of the most frequent reasons for referral to gastroenterological evaluation. The utility of esophageal manometry in clinical practice is: (1) to accurately define esophageal motor function, (2) to identify abnormal motor function, and (3) to establish a treatment plan based on motor abnormalities. With this in mind, in the last decade, investigations and technical advances, with the introduction of high-resolution esophageal manometry, have enhanced our understanding and management of esophageal motility disorders...
October 2016: Digestive and Liver Disease
Hardip Malhi
Dysphagia is a condition in which patients have difficulty with some or all parts of the swallowing process. It can lead to penetration of food or drink into the larynx, which can cause aspiration. The prevalence varies but it is thought that 10% of acutely hospitalised elderly patients suffer from dysphagia. There are both obvious and less obvious indicators. Dysphagia is caused by a variety of conditions and can be short term or long term. It affects the patient physically, psychologically and socially. Because nurses spend the most time with patients, they are often the first ones to identify a problem...
May 26, 2016: British Journal of Nursing: BJN
Sonia Hines, Kate Kynoch, Judy Munday
BACKGROUND: Dysphagia, or difficulty in swallowing, is a serious and life-threatening medical condition that affects a significant number of individuals with acute neurological impairment, largely from stroke. Dysphagia is not generally considered a major cause of mortality; however, the complications that result from this medical condition, namely, aspiration pneumonia and malnutrition, are among the most common causes of death in the older adults. METHODS: This is an update of an existing systematic review...
July 2016: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Nadine Lawson, Gintas P Krisciunas, Susan E Langmore, Kerlly Castellano, William Sokoloff, Reza Hayatbakhsh
PURPOSE: The Australian healthcare system has invested heavily in multidisciplinary cancer care teams. Despite such investments, guidelines that clearly delineate standard of care dysphagia treatment are lacking and services provided to Head and Neck Cancer (HNC) patients are not always consistent. There is little consensus regarding the frequency and intensity of dysphagia therapy. This is largely due to a lack of well-designed clinical trials that establish the efficacy of any dysphagia therapy in this patient population...
April 19, 2016: International Journal of Speech-language Pathology
Debbie Hebert, M Patrice Lindsay, Amanda McIntyre, Adam Kirton, Peter G Rumney, Stephen Bagg, Mark Bayley, Dar Dowlatshahi, Sean Dukelow, Maridee Garnhum, Ev Glasser, Mary-Lou Halabi, Ester Kang, Marilyn MacKay-Lyons, Rosemary Martino, Annie Rochette, Sarah Rowe, Nancy Salbach, Brenda Semenko, Bridget Stack, Luchie Swinton, Valentine Weber, Matthew Mayer, Sue Verrilli, Gabrielle DeVeber, John Andersen, Karen Barlow, Caitlin Cassidy, Marie-Emmanuelle Dilenge, Darcy Fehlings, Ryan Hung, Jerome Iruthayarajah, Laura Lenz, Annette Majnemer, Jacqueline Purtzki, Mubeen Rafay, Lyn K Sonnenberg, Ashleigh Townley, Shannon Janzen, Norine Foley, Robert Teasell
Stroke rehabilitation is a progressive, dynamic, goal-orientated process aimed at enabling a person with impairment to reach their optimal physical, cognitive, emotional, communicative, social and/or functional activity level. After a stroke, patients often continue to require rehabilitation for persistent deficits related to spasticity, upper and lower extremity dysfunction, shoulder and central pain, mobility/gait, dysphagia, vision, and communication. Each year in Canada 62,000 people experience a stroke...
June 2016: International Journal of Stroke: Official Journal of the International Stroke Society
Timothy Benstead, Caitlin Jackson-Tarlton, Desmond Leddin
BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a rapidly progressing degenerative motor neuron disease that results in significant muscle weakness. Defects in energy metabolism and difficulties in swallowing eventually lead to a reduction in body mass. Weight loss exacerbates symptoms and serves as an independent negative prognostic factor. Percutaneous endoscopic gastrostomy (PEG) is often inserted in patients with ALS to either supplement or replace oral feeding. However, the criteria for PEG placement and timing of insertion are important clinical decisions that have not been fully studied...
April 4, 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Roger Newman, Natàlia Vilardell, Pere Clavé, Renée Speyer
BACKGROUND: Fluid thickening is a well-established management strategy for oropharyngeal dysphagia (OD). However, the effects of thickening agents on the physiology of impaired swallow responses are not fully understood, and there is no agreement on the degree of bolus thickening. AIM: To review the literature and to produce a white paper of the European Society for Swallowing Disorders (ESSD) describing the evidence in the literature on the effect that bolus modification has upon the physiology, efficacy and safety of swallowing in adults with OD...
April 2016: Dysphagia
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
Vitaliana De Sanctis, Paolo Bossi, Giuseppe Sanguineti, Fabio Trippa, Daris Ferrari, Almalina Bacigalupo, Carla Ida Ripamonti, Michela Buglione, Stefano Pergolizzi, Johannes A Langendjik, Barbara Murphy, Judith Raber-Durlacher, Elvio G Russi, Rajesh V Lalla
BACKGROUND: Oral mucositis (OM) due to radiotherapy and systemic therapies in head and neck cancer treatment represents a major problem causing a wide spectrum of clinical signs and symptoms. This adverse event may reduce quality of life, resulting from debilitating oral pain, bleeding, dysphagia, infections, impairment of food intake, high rate of hospitalization and may interfere with the delivery of programmed treatment plans, ultimately jeopardizing patient outcome. Globally, there is a lack of evidence on effective measures for the prevention and treatment of OM, and only scant uniform conclusions and recommendations can be derived from the existing literature and guidelines...
April 2016: Critical Reviews in Oncology/hematology
Ben Hanson
PURPOSE OF REVIEW: Texture modification is a widespread practice as a strategy for the management of dysphagia and can be very effective in individual cases. However, it is often performed in a qualitative, subjective manner and practices vary internationally according to multiple sets of national guidelines. This article aims to identify best practice by reviewing the theory and practice of texture modification, focussing on recent advances. RECENT FINDINGS: Instrumental assessment of texture modification in vivo is challenging, and studies including rheology and perception have indicated that fluid viscosity is only one of many factors affecting texture modification in practice...
June 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Asmaa Abdelhamid, Diane Bunn, Maddie Copley, Vicky Cowap, Angela Dickinson, Lucy Gray, Amanda Howe, Anne Killett, Jin Lee, Francesca Li, Fiona Poland, John Potter, Kate Richardson, David Smithard, Chris Fox, Lee Hooper
BACKGROUND: Eating and drinking difficulties are recognised sources of ill health in people with dementia. In the EDWINA (Eating and Drinking Well IN dementiA) systematic review we aimed to assess effectiveness of interventions to directly improve, maintain or facilitate oral food and drink intake, nutrition and hydration status, in people with cognitive impairment or dementia (across all settings, levels of care and support, types and degrees of dementia). Interventions included oral nutrition supplementation, food modification, dysphagia management, eating assistance and supporting the social element of eating and drinking...
2016: BMC Geriatrics
Prabhat Khakural, Ranjan Sapkota, Uttam K Shrestha, Prakash Sayami
Inflammatory myofibroblastic tumour (IMT) is an uncommon mesenchymal tumour, which can occur anywhere in the body, rarely in esophagus. Mostly, the diagnosis is postoperative, after the hispathological evaluation of the specimen. There are no definite guidelines regarding the diagnosis and management. Here, we report a 60 year old lady presenting with dysphagia, diagnosed to have a submucosal esophageal tumor with Barium esophagogram and contrast enhanced computed tomography. She was managed successfully with surgical enucleation with the final histopathological diagnosis of IMT...
2015: Journal of Cardiothoracic Surgery
Antonio Schindler, Nerina Denaro, Elvio G Russi, Nicole Pizzorni, Paolo Bossi, Anna Merlotti, Massimo Spadola Bissetti, Gianmauro Numico, Alessandro Gava, Ester Orlandi, Orietta Caspiani, Michela Buglione, Daniela Alterio, Almalina Bacigalupo, Vitaliana De Sanctis, Giovanni Pavanato, Carla Ripamonti, Marco C Merlano, Lisa Licitra, Giuseppe Sanguineti, Johannes A Langendijk, Barbara Murphy
BACKGROUND: Head and neck cancer (HNC) and its therapy are associated with acute and late swallowing dysfunction. Consensus guidelines regarding evaluation and management are lacking. To address this gap, a multidisciplinary team of experts (oncologists, practitioners, deglutologists, etc.) met in Milan 17-18 February 2013 with the aim of reaching a consensus on the management of swallowing difficulties in HNC patients treated with radiotherapy with or without systemic therapies (such as chemotherapy and targeted agents)...
November 2015: Critical Reviews in Oncology/hematology
Rebecca L Nund, Nerina A Scarinci, Bena Cartmill, Elizabeth C Ward, Pim Kuipers, Sandro V Porceddu
PURPOSE: Third-party disability pertains to the consequences of a person's impairment which impacts on the functioning and ability of their family members or significant others. With the emergence of research demonstrating the pervasive effects of dysphagia following head and neck cancer (HNC) on the carer, the aim of this study was to identify the International Classification of Functioning, Disability and Health (ICF) domains and categories that describe the third-party disability of carers of people with dysphagia following HNC...
2016: Disability and Rehabilitation
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