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https://www.readbyqxmd.com/read/28324903/instrumental-assessment-of-pediatric-dysphagia
#1
Joan C Arvedson, Maureen A Lefton-Greif
Speech-language pathologists (SLPs) have fulfilled primary roles in the evaluation and management of children with feeding/swallowing disorders for more than five decades. The increased incidence and prevalence of newborns, infants, and children with feeding and swallowing disorders has resulted in increased use of instrumental swallowing evaluations. The videofluoroscopic swallow study and fiberoptic endoscopic evaluation of swallowing are the two most commonly used swallowing assessments by SLPs, with ultrasound used less frequently...
April 2017: Seminars in Speech and Language
https://www.readbyqxmd.com/read/28324139/-diagnosis-and-treatment-of-dysphagia
#2
S Cantemir, A Laubert
Most swallowing problems can be treated, although the treatment depends on the type of dysphagia. A multidisciplinary team of surgeons, phoniatrists, and speech-language therapists is necessary to develop the appropriate treatment strategy. A thorough medical history, clinical investigation of the swallowing muscles, and fiberoptic endoscopic evaluation of swallowing with foods of different consistencies help to decide whether swallowing exercises alone are sufficient, or whether an additional pharmacologic or surgical treatment is needed to prevent aspiration, malnutrition, and dehydration...
March 21, 2017: HNO
https://www.readbyqxmd.com/read/28322006/aspiration-and-dysphagia-screening-in-acute-stroke-the-gugging-swallowing-screen-revisited
#3
T Warnecke, S Im, C Kaiser, C Hamacher, S Oelenberg, R Dziewas
BACKGROUND AND PURPOSE: The Gugging Swallowing Screen (GUSS) is a tool to screen aspiration risk in acute stroke. We aimed to replicate its validity in a larger second cohort of patients with acute stroke, including the more severe with a National Institutes of Health Stroke Scale (NIHSS) ≥ 15. METHODS: In a prospective, double-blind design, the GUSS was validated with the Fiberoptic Endoscopic Evaluation of Swallowing scale. Patients were categorized into different stroke severities as assessed by the NIHSS, and the diagnostic properties were calculated separately for each subgroup...
April 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28321993/metatropic-dysplasia-a-skeletal-dysplasia-with-challenging-airway-and-other-anesthetic-concerns
#4
Mary C Theroux, Martha Lopez, Patricia J Olszewsky, Sabina DiCindio, Lynda Arai, Colleen Ditro, Michael B Bober, Olubukola Opeyemi Olla, Tetsu Uejima, David W West, William G Mackenzie
BACKGROUND: Metatropic dysplasia is a rare form of skeletal dysplasia requiring multiple anesthetics for surgical and imaging procedures, most of which are orthopedic procedures. We provide centralized care to patients with skeletal dysplasia at our tertiary care pediatric hospital, and we were able to collect the largest number of metatropic dysplasia patients reported to date. AIM: The aim of this retrospective study was to describe and characterize the anesthetic difficulties in this high-risk population...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28316781/dyspnea-and-dysphagia-associated-to-hypopharyngeal-fibrolipoma-a-case-report
#5
Marco A Mendez Saenz, Vicente J Villagomez Ortiz, Mario Jesús Jr Villegas González, Baltazar Gonzalez Andrade, Miguel Angel Liñan Arce, German A Soto-Galindo, José Luis Treviño González
Fibrolipomas are benign lesions conformed by fat and connective tissue, classified as histologic variants of lipomas. They are rarely located in the head and neck and represent less than 0.6% of the benign tumors of the larynx and hypopharynx. Their clinical presentation depends on its location and size. We present the case of a 51-year-old male patient who reported progressive dyspnea, dysphagia and obstructive sleep symptoms with a duration of 3 months, without apparent cause. A pharyngolaryngeal fiberoptic endoscopy showed a smooth, rounded mass in the posterior wall of the hypopharynx, partially obstructing the laryngeal vestibule, creating a valve effect...
April 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28288578/case-report-of-pierre-robin-sequence-with-severe-upper-airway-obstruction-who-was-rescued-by-fiberoptic-nasotracheal-intubation
#6
Satoru Takeshita, Hiroko Ueda, Tatenobu Goto, Daisuke Muto, Hiroki Kakita, Kazuo Oshima, Takahisa Tainaka, Takayuki Ono, Yoshiaki Kazaoka, Yasumasa Yamada
BACKGROUND: Pierre Robin sequence (PRS) refers to the association of micrognathia, glossoptosis, and airway obstruction. Cases with severe dyspnea due to upper airway obstruction immediately after birth are very rare. We here report two cases with PRS who developed severe dyspnea due to morphological abnormality immediately after birth and were rescued by fiberoptic nasotracheal intubation. CASE PRESENTATION: The patient in case 1 had micrognathia and cleft palate, and his tongue protruded into the nasal cavity via a cleft palate...
March 14, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28286927/murray-secretion-scale-and-fiberoptic-endoscopic-evaluation-of-swallowing-in-predicting-aspiration-in-dysphagic-patients
#7
Chia-Wei Kuo, Clint Tanner Allen, Chu-Chun Huang, Chia-Jung Lee
The objective of this retrospective review is to evaluate the ability of the Murray secretion scale to predict aspiration as determined by fiberoptic endoscopic evaluation of swallowing. Patients with dysphagia undergoing a fiberoptic endoscopic evaluation of swallowing study between January 2013 and November 2015 from a single, tertiary care institution were retrospectively reviewed. The Murray secretion scale and penetration aspiration scale on fiberoptic endoscopic evaluation of swallowing examination were determined...
March 12, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28275908/narrow-band-imaging-enhances-the-detection-rate-of-penetration-and-aspiration-in-fees
#8
Julie C Nienstedt, Frank Müller, Almut Nießen, Susanne Fleischer, Jana-Christiane Koseki, Till Flügel, Christina Pflug
Narrow band imaging (NBI) is widely used in gastrointestinal, laryngeal, and urological endoscopy. Its original purpose was to visualize vessels and epithelial irregularities. Based on our observation that adding NBI to common white light (WL) improves the contrast of the test bolus in fiberoptic endoscopic evaluation of swallowing (FEES), we now investigated the potential value of NBI in swallowing disorders. 148 FEES images were analyzed from 74 consecutive patients with swallowing disorders, including 74 with and 74 without NBI...
March 9, 2017: Dysphagia
https://www.readbyqxmd.com/read/28275351/botulinum-toxin-is-effective-in-the-management-of-neurogenic-dysphagia-clinical-electrophysiological-findings-and-tips-on-safety-in-different-neurological-disorders
#9
Enrico Alfonsi, Domenico A Restivo, Giuseppe Cosentino, Roberto De Icco, Giulia Bertino, Antonio Schindler, Massimiliano Todisco, Mauro Fresia, Andrea Cortese, Paolo Prunetti, Matteo C Ramusino, Arrigo Moglia, Giorgio Sandrini, Cristina Tassorelli
Background and Aims: Neurogenic dysphagia linked to failed relaxation of the upper esophageal sphincter (UES) can be treated by injecting botulinum toxin (BTX) into the cricopharyngeal (CP) muscle. We compared the effects of this treatment in different neurological disorders with dysphagia, to evaluate its efficacy over time including the response to a second injection. Materials and Methods: Sixty-seven patients with neurogenic dysphagia associated with incomplete or absent opening of the UES (24 with brainstem or hemispheric stroke, 21 with parkinsonian syndromes, 12 with multiple sclerosis, and 10 with spastic-dystonic syndromes secondary to post-traumatic encephalopathy) were treated with the injection of IncobotulinumtoxinA (dose 15-20 U) into the CP muscle under electromyographic guidance...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28274023/evaluation-of-fastrach-laryngeal-mask-airway-as-an-alternative-to-fiberoptic-bronchoscope-to-manage-difficult-airway-a-comparative-study
#10
Radhey Shyam, Ajay Kumar Chaudhary, Pushplata Sachan, Prithvi Kumar Singh, Gyan Prakash Singh, Vinod Kumar Bhatia, Girish Chandra, Dinesh Singh
INTRODUCTION: Awake intubation via Fiberoptic Bronchoscope (FB) is the gold standard for management of difficult airway but patients had to face problems like oxygen desaturation, tachycardia, hypertension and anxiety due to awake state. This study was conducted to assess feasibility of Fastrach Laryngeal Mask Airway (FLMA) to manage difficult airway as a conduit for intubation as well as for ventilation. MATERIALS AND METHODS: After ethical approval and informed consent, 60 patients with difficult airway were randomly enrolled in FB group and FLMA group...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28267558/rapid-detection-of-donor-cell-free-dna-in-lung-transplant-recipients-with-rejections-using-donor-recipient-hla-mismatch
#11
Jun Zou, Brian Duffy, Michael Slade, Andrew Lee Young, Nancy Steward, Ramsey Hachem, T Mohanakumar
Fiberoptic bronchoscopy and transbronchial lung biopsy are currently the gold standard for detection of acute rejection following human lung transplantation (LTx). However, these surveillance procedures are expensive and invasive. Up to now, there are few new methods that have demonstrated clinical utility for detecting early stages of rejection following human lung transplantation. We optimized and technically validated a novel method to quantify donor-derived circulating cell free DNA (DcfDNA) that can be used as an early biomarker for lung allograft rejection...
March 4, 2017: Human Immunology
https://www.readbyqxmd.com/read/28262247/use-of-the-totaltrack-vlm-for-emergent-endotracheal-intubation-in-predicted-difficult-airway-with-obstruction-by-expanding-space-occupying-lesions-and-reduced-interincisor-opening
#12
B Izquierdo-González, M Á Gómez-Ríos, E Freire-Vila
Acute cervical pathology may lead to serious airway compromise resulting from anatomical distortion secondary to obstruction or deviation of the upper airway, scenarios where any airway device can be fallible. Passage of a fiberoptic bronchoscopy to expose the glottis may be very difficult and tracheostomy may be impractical or risky in advanced cases. We present the use of the TotalTrack VLM to secure the airway for emergent surgery in 2 uncooperative patients with difficult airway due to Ludwig's angina and neck hematoma, respectively, both accompanied by trismus...
March 2, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28259883/measurement-of-oxygen-desaturation-is-not-useful-for-the-detection-of-aspiration-in-dysphagic-stroke-patients
#13
Thomas Marian, Jens Schröder, Paul Muhle, Inga Claus, Stephan Oelenberg, Christina Hamacher, Tobias Warnecke, Sonja Suntrup-Krüger, Rainer Dziewas
BACKGROUND: Dysphagia is one of the most dangerous symptoms of acute stroke. Various screening tools have been suggested for the early detection of this condition. In spite of conflicting results, measurement of oxygen saturation (SpO2) during clinical swallowing assessment is still recommended by different national guidelines as a screening tool with a decline in SpO2 ≥2% usually being regarded as a marker of aspiration. This paper assesses the sensitivity of SpO2 measurements for the evaluation of aspiration risk in acute stroke patients...
March 4, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28245603/testing-of-piezo-actuated-glass-micro-membranes-by-optical-low-coherence-reflectometry
#14
Sabina Merlo, Paolo Poma, Eleonora Crisà, Dino Faralli, Marco Soldo
In this work, we have applied optical low-coherence reflectometry (OLCR), implemented with infra-red light propagating in fiberoptic paths, to perform static and dynamic analyses on piezo-actuated glass micro-membranes. The actuator was fabricated by means of thin-film piezoelectric MEMS technology and was employed for modifying the micro-membrane curvature, in view of its application in micro-optic devices, such as variable focus micro-lenses. We are here showing that OLCR incorporating a near-infrared superluminescent light emitting diode as the read-out source is suitable for measuring various parameters such as the micro-membrane optical path-length, the membrane displacement as a function of the applied voltage (yielding the piezo-actuator hysteresis) as well as the resonance curve of the fundamental vibration mode...
February 25, 2017: Sensors
https://www.readbyqxmd.com/read/28244680/dysphagia-in-infants-with-single-ventricle-anatomy-following-stage-1-palliation-physiologic-correlates-and-response-to-treatment
#15
Katlyn Elizabeth McGrattan, Heather McGhee, Allan DeToma, Elizabeth G Hill, Sinai C Zyblewski, Maureen Lefton-Greif, Lucinda Halstead, Scott M Bradley, Bonnie Martin-Harris
BACKGROUND: Deficits in swallowing physiology are a leading morbidity for infants with functional single ventricles and systemic outflow tract obstruction following stage 1 palliation. Despite the high prevalence of this condition, the underlying deficits that cause this post-operative impairment remain poorly understood. OBJECTIVE: Identify the physiologic correlates of dysphagia in infants with functional single ventricles and systemic outflow tract obstruction following stage 1 palliative surgery...
February 28, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28239594/subluxation-of-the-cricoarytenoid-joint-after-external-laryngeal-trauma-a-rare-case-and-review-of-the-literature
#16
Eviatar Friedlander, Paula Martínez Pascual, Julia Da Costa Belisario, Daniel Poletti Serafini
Cricoarytenoid joint subluxation is rare condition. There are <200 cases reported in the English literature. The most frequent cause of this condition is a traumatic tracheal intubation which account for approximately 80 % of all cases. The most common symptoms are dysphonia and pain of the anterior region of the neck which appear after upper airway manipulation or cervical trauma. In this report we present a well-documented case of a 31 year old male that was referred to the outpatient clinic because of acute dysphonia and pain that appeared immediately after receiving a blow of a soccer ball...
March 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28236864/a-comparison-of-various-supraglottic-airway-devices-for-fiberoptical-guided-tracheal-intubation
#17
Thomas Metterlein, Anna Dintenfelder, Christoph Plank, Bernhard Graf, Gabriel Roth
BACKGROUND: Fiberoptical assisted intubation via placed supraglottic airway devices has been described as safe and easy procedure to manage difficult airways. However visualization of the glottis aperture is essential for fiberoptical assisted intubation. Various different supraglottic airway devices are commercially available and might offer different conditions for fiberoptical assisted intubation. The aim of this study was to compare the best obtainable view of the glottic aperture using different supraglottic airway devices...
March 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28235524/awake-tracheal-intubation-in-anticipated-difficult-airways-lma-fastrach-vs-flexible-bronchoscope-a-pilot-study
#18
Sherine F Hanna, Marianne Mikat-Stevens, James Loo, Raj Uppal, W Scott Jellish, Matthew Adams
STUDY OBJECTIVE: To compare the use of LMA Fastrach intubating laryngeal mask airway (ILMA) to flexible bronchoscopy (FB) for awake intubation in patients with difficult airways. DESIGN: Randomized prospective study. SETTING: Large academic medical center. PATIENTS: Forty adult patients, American Society of Anesthesiologists I-IV, meeting the criteria for awake intubation based on history and physical examination. INTERVENTIONS: After sedation and airway topicalization, patients were randomized to either FB group, n=19, or ILMA group, n=21...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28221153/ultra-mini-pnl-ump-material-indications-technique-advantages-and-results
#19
Janak D Desai
Stone disease has afflicted mankind since centuries; records from ancient civilisations of India and Egypt have shown stones in human bodies. The scientific mind of humans has always made smart endeavours to remove the kidney stones. From large instruments made like the beaks of different animals and birds in 600 BC (Indian civilisation) to extremely sophisticated and miniaturised endoscopic intruments of today the human race has travelled a long way. The theme has always been to remove the stones with minimal morbidity and mortality and with minimum pain to the patient...
January 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28218980/microbiologic-yield-of-bronchoalveolar-lavage-specimens-from-stem-cell-transplant-recipients
#20
Kenneth K Sakata, Christine L Klassen, Kathryn B Bollin, Thomas E Grys, James L Slack, Lewis J Wesselius, Holenarasipur R Vikram
PURPOSE: Stem cell transplant (SCT) recipients commonly undergo bronchoalveolar lavage (BAL) collection as an infectious pulmonary work-up. Previous studies report the utility and overall diagnostic yield of fiberoptic bronchoscopy with BAL in this vulnerable population, though none focused purely on microbiologic yield or made comparisons with less invasive means of pathogen detection. We sought to determine and elaborate on the microbiologic yield of BAL in SCT recipients, assess a correlation between BAL studies and less invasive means of pathogen detection, and assess the utility of repeating a BAL within 30 days...
February 20, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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