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https://www.readbyqxmd.com/read/28793390/interventions-for-maintaining-nasogastric-feeding-after-stroke-an-integrative-review-of-effectiveness-and-acceptability
#1
REVIEW
Catherine Mahoney, Linda Veitch
AIMS AND OBJECTIVES: To investigate the effectiveness and acceptability of interventions for maintaining nasogastric tubes (NGT) in adult stroke patients. BACKGROUND: Internationally, incidence of Cerebral Vascular Disease (CVD) continues to increase and stroke is the largest cause of complex disability in adults. Dysphagia is common following a stroke which necessitates feeding via a NGT. NGT are not well tolerated by stroke patients and may be frequently dislodged...
August 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28770403/route-of-feeding-as-a-proxy-for-dysphagia-after-stroke-and-the-effect-of-transdermal-glyceryl-trinitrate-data-from-the-efficacy-of-nitric-oxide-in-stroke-randomised-controlled-trial
#2
Lisa J Woodhouse, Polly Scutt, Shaheen Hamdy, David G Smithard, David L Cohen, Christine Roffe, Daniel Bereczki, Eivind Berge, Christopher F Bladin, Valeria Caso, Hanne K Christensen, Rónán Collins, Anna Czlonkowska, Asita de Silva, Anwar Etribi, Ann-Charlotte Laska, George Ntaios, Serefnur Ozturk, Stephen J Phillips, Kameshwar Prasad, Szabolcs Szatmari, Nikola Sprigg, Philip M Bath
Post-stroke dysphagia is common, associated with poor outcome and often requires non-oral feeding/fluids. The relationship between route of feeding and outcome, as well as treatment with glyceryl trinitrate (GTN), was studied prospectively. The Efficacy of Nitric Oxide in Stroke (ENOS) trial assessed transdermal GTN (5 mg versus none for 7 days) in 4011 patients with acute stroke and high blood pressure. Feeding route (oral = normal or soft diet; non-oral = nasogastric tube, percutaneous endoscopic gastrostomy tube, parenteral fluids, no fluids) was assessed at baseline and day 7...
August 2, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28762896/ambulance-delivered-transdermal-glyceryl-trinitrate-versus-sham-for-ultra-acute-stroke-rationale-design-and-protocol-for-the-rapid-intervention-with-glyceryl-trinitrate-in-hypertensive-stroke-trial-2-right-2-trial-isrctn26986053
#3
Jason P Appleton, Polly Scutt, Mark Dixon, Harriet Howard, Lee Haywood, Diane Havard, Trish Hepburn, Tim England, Nikola Sprigg, Lisa J Woodhouse, Joanna M Wardlaw, Alan A Montgomery, Stuart Pocock, Philip M Bath
Rationale Vascular nitric oxide levels are low in acute stroke and donors such as glyceryl trinitrate have shown promise when administered very early after stroke. Potential mechanisms of action include augmentation of cerebral reperfusion, thrombolysis and thrombectomy, lowering blood pressure, and cytoprotection. Aim To test the safety and efficacy of four days of transdermal glyceryl trinitrate (5 mg/day) versus sham in patients with ultra-acute presumed stroke who are recruited by paramedics prior to hospital presentation...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28758080/effects-of-capping-of-the-tracheostomy-tube-in-stroke-patients-with-dysphagia
#4
Yong Kyun Kim, Sang-Heon Lee, Jang-Won Lee
OBJECTIVE: To investigate the impact of tracheostomy tube capping on swallowing physiology in stroke patients with dysphagia via videofluoroscopic swallowing study (VFSS). METHODS: This study was conducted as a prospective study that involved 30 stroke patients. Then, 4 mL semisolid swallowing was conducted with capping of the tracheostomy tube or without capping of the tracheostomy tube. The following five parameters were measured: laryngeal elevation, pharyngeal transit time, post-swallow pharyngeal remnant, upper esophageal sphincter width (UES), and penetration-aspiration scale (PAS) score...
June 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28756476/development-of-pyriform-sinus-suctioning-programs-for-aspiration-pneumonia-prevention-during-the-acute-stroke
#5
Yuki Inui, Yayoi Kamakura, Junko Fukada, Masahiko Yoneda, Emiko Kataoka, Yasuko Usami, Miki Sugiura, Tetsuya Nagatani, Yukio Seki, Norikazu Hatano, Keizo Yasui
Aspiration due to dysphagia is a factor associated with pneumonia during acute stroke. In such cases, it is likely that secretions in the pyriform sinuses enter the laryngeal inlet. The present study was based on the idea that it is possible to reduce aspiration pneumonia by periodically suctioning and removing such secretions (pyriform sinus suctioning), a study was conducted in a single facility. The incidence of pneumonia as a dependent variable was compared between before (control) and after (intervention group) intervention with pyriform sinus suctioning as an independent variable...
July 29, 2017: Dysphagia
https://www.readbyqxmd.com/read/28748320/the-relationship-between-lesion-localization-and-dysphagia-in-acute-stroke
#6
Stephanie K Daniels, Shweta Pathak, Shalini V Mukhi, Carol B Stach, Robert O Morgan, Jane A Anderson
Factors that can facilitate early identification of individuals at risk of dysphagia such as stroke location are potentially of great benefit. The aim of this study was to examine the role of hemisphere and lesion location in assessing dysphagia pattern and airway invasion as identified through the use of validated, standardized interpretation measures for the videofluoroscopic swallowing study. Consecutive patients (N = 80) presenting with stroke symptoms who had a first-time acute ischemic stroke confirmed on diffusion-weighted magnetic resonance imaging (DW-MRI) scan participated...
July 26, 2017: Dysphagia
https://www.readbyqxmd.com/read/28741720/alteplase-for-acute-ischemic-stroke-after-heparin-reversal-with-protamine-a-case-report-and-review
#7
Gabriel V Fontaine, Shawn M Smith
BACKGROUND: Few patients presenting with acute ischemic stroke (AIS) are eligible for alteplase, especially those receiving ongoing anticoagulation. We describe the first reported case of a patient receiving full-dose intravenous (IV) alteplase for AIS after heparin reversal with protamine. CASE: A 73-year-old male presented with AIS. He was treated with IV heparin, tirofiban, loading-dose prasugrel, and aspirin prior to percutaneous coronary intervention (PCI) for placement of a right coronary artery stent...
July 25, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28716980/early-dysphagia-screening-by-trained-nurses-reduces-pneumonia-rate-in-stroke-patients-a-clinical-intervention-study
#8
Christoph Palli, Simon Fandler, Kathrin Doppelhofer, Kurt Niederkorn, Christian Enzinger, Christian Vetta, Esther Trampusch, Reinhold Schmidt, Franz Fazekas, Thomas Gattringer
BACKGROUND AND PURPOSE: Dysphagia is a common stroke symptom and leads to serious complications such as aspiration and pneumonia. Early dysphagia screening can reduce these complications. In many hospitals, dysphagia screening is performed by speech-language therapists who are often not available on weekends/holidays, which results in delayed dysphagia assessment. METHODS: We trained the nurses of our neurological department to perform formal dysphagia screening in every acute stroke patient by using the Gugging Swallowing Screen...
July 17, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28702192/freezing-of-gait-is-an-early-clinical-feature-of-progressive-supranuclear-palsy
#9
Yasushi Osaki, Yukari Morita, Yuka Miyamoto, Kounosuke Furuta, Hirokazu Furuya
BACKGROUND AND AIM: Early clinical diagnosis of progressive supranuclear palsy (PSP) remains challenging. AIM: We attempted to identify any sign or symptom to diagnose PSP earlier. METHODS: A total of 401 patients, 40 with PSP and 361 with other neurodegenerative disorders, were included. We followed these patients for at least 1 year since 2009. We reviewed the signs and symptoms of patients with PSP in a standardized manner, and observed four manifestations: "vertical supranuclear gaze abnormality," "movement disorders," "pseudobulbar palsy" and "dementia of frontal type...
May 2017: Neurology and Clinical Neuroscience
https://www.readbyqxmd.com/read/28681743/the-effect-of-sensory-level-electrical-stimulation-of-the-masseter-muscle-in-early-stroke-patients-with-dysphagia
#10
Man Mohan Mehndiratta, Poonam Gupta, Mandeep Kaur
No abstract text is available yet for this article.
July 2017: Neurology India
https://www.readbyqxmd.com/read/28681742/the-effect-of-sensory-level-electrical-stimulation-of-the-masseter-muscle-in-early-stroke-patients-with-dysphagia-a-randomized-controlled-study
#11
Ebru K Umay, Atilay Yaylaci, Guleser Saylam, Ibrahim Gundogdu, Eda Gurcay, Dehen Akcapinar, Zeynep Kirac
BACKGROUND: Dysphagia is a serious cause of morbidity and mortality in stroke patients. AIMS: As the first study in literature, we aimed to evaluate the effects of sensory-level electrical stimulation (SES) to bilateral masseter muscles in early stroke patients with dysphagia. SETTINGS AND DESIGN: This study was conducted at the Physical Medicine and Rehabilitation Clinic of our hospital between 2013 and 2015. MATERIALS AND METHODS: Ninety-eight patients with dysphagia within the first month after ischemic stroke were included in this study...
July 2017: Neurology India
https://www.readbyqxmd.com/read/28681366/proposal-for-a-modified-jaw-opening-exercise-for-dysphagia-a-randomized-controlled-trial
#12
Yuji Koyama, Ayaka Sugimoto, Takahide Hamano, Takashi Kasahara, Minoru Toyokura, Yoshihisa Masakado
OBJECTIVE: To verify the feasibility and effectiveness of a newly developed modified jaw opening exercise (MJOE) in post-stroke patients with pharyngeal residue who completed a sixweek exercise regimen. DESIGN: Double-blind, randomized, controlled trial. PARTICIPANTS: 16 patients with stroke-related dysphagia. INTERVENTIONS: Participants were allocated to an intervention group (MJOE: one set of five repetitions at 80% maximum voluntary contraction (MVC) for 6 seconds) or a control group (isometric jaw closing exercise: one set of five repetitions at 20% MVC for 6 seconds)...
July 20, 2017: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/28665908/small-rural-hospitals-have-a-harder-time-achieving-success-in-continuous-quality-improvement-an-example-from-a-stroke-care-network
#13
Kelley Elkins, Lisa Bellamy, Jing Guo, Michael R Dobbs
BACKGROUND: University of Kentucky HealthCare established a Stroke Care Network (SCN) in 2008 to address the challenges of rural stroke care and improve care quality. METHODS: The SCN collects quality data from each affiliate that include volumes, mortality, length of stay, turnaround times, rt-PA door-to-needle time, 8 stroke core measures, and dysphagia screen measure. Characteristics of affiliate hospital studies include number of beds, Stroke Disease-Specific Care (DSC) certification by The Joint Commission, Appalachian designated county or not, time dedicated to stroke coordinator, submission of quality data for the calendar year, success of data, and utilization of American Heart Association's Get With the Guidelines...
July 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28644539/effortful-swallow-with-resistive-electrical-stimulation-training-improves-pharyngeal-constriction-in-patients-post-stroke-with-dysphagia
#14
H Kim, J-W Park, K Nam
This study aimed to evaluate the effect of effortful swallow combined with surface electrical stimulation as a form of resistance training on pharyngeal constriction function in post-stroke patients with dysphagia. Nineteen patients post-stroke with dysphagia received 20 min effortful swallow training with resistive electrical stimulation for 5 days per week for 4 weeks. Electrical stimulation was applied on the infrahyoid area as resistance against hyoid elevation. Stimulation intensity was adjusted daily up to the maximum tolerable level of the participant...
June 23, 2017: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/28640722/stroke-ineffective-tube-securement-reduces-nutrition-and-drug-treatment
#15
Sophie Brazier, Stephen J Taylor, Kaylee Allan, Rowan Clemente, Deirdre Toher
Stroke patients with dysphagia often depend on nutrition, hydration and medication via nasogastric (NG) feeding tubes. Securing tubes using tape is associated with repeated tube loss. In this study, the authors determined cause and effect by auditing tube placement methods, delays incurred, duration and costs. Of 202 NG tube placements in 75 patients, 67 placements occurred in 17 patients over a full course of enteral nutrition (EN) and 40 of these placements were tracked. Tubes were secured by tape in 100%, mittens 31% and special observation 5...
June 22, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28639039/a-novel-endoscopic-surgery-for-dysphagia-after-stroke
#16
Jian Wang, Wuyi Li, Yongjin Li, Xiaofeng Jin, Yanyan Niu, Xu Tian, Hong Huo
BACKGROUND: Dysphagia is a common complication in stroke patients, which severely affects quality of life. This study aimed to evaluate the effectiveness and safety of temperature-controlled plasma radiofrequency (coblation)-assisted endoscopic cricopharyngeal myotomy (CAECPM) for the treatment sustained (>6 months) dysphagia in stroke patients. METHODS: This retrospective case-control study included a total of 24 stroke patients with sustained dysphagia, who were either treated with transcervical cricopharyngeal myotomy (CPM) (n = 16) or CAECPM (n = 12)...
June 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28635876/-salivation-after-stroke
#17
Z A Zalyalova
Salivation after stroke (sialorrhea, hypersalivation, ptyalism) can be caused by the overproduction or a lack of utilization of saliva. Patients after stroke often have sialorrhea as a result of dysphagia. Neurogenic dysphagia in acute period after stroke occurs in 25-65% of patients. The mortality rate among people with post-stroke dysphagia and tube feeding ranges from 20 to 24%. Patients who suffering from profuse salivation have difficulties with articulation and swallowing, bad breath, irritation and maceration of perioral area, contamination of clothing and bed linen...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28626054/prediction-of-recurrent-stroke-or-transient-ischemic-attack-after-noncardiogenic-posterior-circulation-ischemic-stroke
#18
Changqing Zhang, Yilong Wang, Xingquan Zhao, Liping Liu, ChunXue Wang, Yuehua Pu, Xinying Zou, Yuesong Pan, Ka Sing Wong, Yongjun Wang
BACKGROUND AND PURPOSE: Posterior circulation ischemic stroke (IS) is generally considered an illness with a poor prognosis. However, there are no effective rating scales to predict recurrent stroke following it. Therefore, our aim was to identify clinical or radiological measures that could assist in predicting recurrent cerebral ischemic episodes. METHODS: We prospectively enrolled 723 noncardiogenic posterior circulation IS patients with onset of symptoms <7 days...
June 16, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28621030/plugging-the-patient-evidence-gap-what-patients-with-swallowing-disorders-post-stroke-say-about-thickened-liquids
#19
Arlene McCurtin, Chiara Healy, Linda Kelly, Fiona Murphy, Jean Ryan, Joanne Walsh
BACKGROUND: Oropharyngeal dysphagia post-stroke is well known, with its presence increasing the risk of poor outcomes in particular aspiration and aspiration pneumonia. Management to minimize the risk of aspiration and improve swallow safety post-stroke includes the treatment of thickened liquids (TL), an established bolus modification intervention. Despite widespread use, there is a lack of robust empirical evidence and minimal patient evidence as to the experience and acceptability of using thickeners by people who experience dysphagia after a stroke...
June 16, 2017: International Journal of Language & Communication Disorders
https://www.readbyqxmd.com/read/28620998/a-survey-of-speech-language-therapy-provision-for-people-with-post-stroke-dysarthria-in-the-uk
#20
Nick Miller, Steven Bloch
BACKGROUND: A large number of people who experience a stroke are affected by dysarthria. This may be in isolation or in association with aphasia and/or dysphagia. Despite evidence highlighting the psychological and social impact of having post-stroke dysarthria and a number of clinical guidelines that make recommendations for appropriate management, little is known currently about UK service delivery issues relating to speech and language therapy (SLT) assessment and treatment for this group...
June 16, 2017: International Journal of Language & Communication Disorders
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