Differential Response Pattern of Oropharyngeal Pressure by Bolus and Dry Swallows.

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Hasegawa, Mana; Kurose, Masayuki; Okamoto, Keiichiro; Yamada, Yoshiaki; Tsujimura, Takanori; Inoue, Makoto; Sato, Taisuke; Narumi, Takatsune; Fujii, Noritaka; Yamamura, Kensuke

2018-02-01

The aim of this study was to determine if bolus and dry swallow showed similar pressure changes in the oropharynx using our newly developed device. A unique character of it includes that baropressure can be measured with the sensor being placed in the balloon and can assess the swallowing mechanics in terms of pressure changes in the oropharynx with less influences of direct contacts of boluses and oropharyngeal structures during swallow indirectly. Fifteen healthy subjects swallowed saliva (dry), 15 ml of water, 45 ml of water, and 15 ml of two different types of food in terms of viscosity (potage soup-type and mayonnaise-type foods). Suprahyoid muscle activity was recorded simultaneously. Three parameters, area under the curve (AUC), peak amplitude, and duration of pressure, were analyzed from each swallow. Almost all of the bolus swallowing events had biphasic baropressure responses consisting of an early phase and late phase (99%), whereas 90% of the saliva swallowing events had a single phase. AUC, peak, and duration displayed greater effects during the late phase than during the early phase. Baropressure of the early phase, but not of the late phase, significantly increased with increasing volume; however, small but significant viscosity effects on pressure were seen during both phases. Peak pressure of the late phase was preceded by maximum muscle activity, whereas that of the early phase was seen when muscle activity displayed a peak response. These findings indicated that our device with the ability to measure baropressure has the potential to provide additional parameter to assess the swallow physiology, and biphasic baropressure responses in the early and late phases could reflect functional aspects of the swallowing reflexes.

The association between saliva control, silent saliva penetration, aspiration, and videofluoroscopic findings in Parkinson's disease patients

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Rajaei, Ali; Ashtari, Fereshteh; Azargoon, Seyed Abolfazl; Chitsaz, Ahmad; Nilforoush, Mohammad Hussein; Taheri, Masoud; Sadeghi, Saba

2015-01-01

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. They were asked two questions; one about saliva control and the other about silent saliva penetration and aspiration. Next, they underwent the videofluoroscopic swallowing study (VFSS). Results: The Pearson Correlation coefficient between the Penetration–Aspiration Scale (PAS) scores and question 1 scores was 0.48 (P < 0.05, =0.25), and there was a significant correlation between the PAS scores and question 2 scores, and also question 1 scores + question 2 scores (r = 0.589, P < 0.05, =0 and r = 0589, P < 0.05, =0). Conclusions: This study showed a significant correlation between the questions about saliva control, silent saliva penetration, and aspiration, and laryngeal penetration and aspiration during VFSS. Therefore, by using these two questions, the potential silent laryngeal penetration and aspiration during meals could be detected before it led to aspiration pneumonia. Taking the benefit of these questions, as a part of the swallowing assessment of PD patients, is recommended. PMID:26261810

Saliva and dental erosion.

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Buzalaf, Marília Afonso Rabelo; Hannas, Angélicas Reis; Kato, Melissa Thiemi

2012-01-01

Dental erosion is a multifactorial condition. The consideration of chemical, biological and behavioral factors is fundamental for its prevention and therapy. Among the biological factors, saliva is one of the most important parameters in the protection against erosive wear. This review discusses the role of salivary factors on the development of dental erosion. A search was undertaken on MeDLINe website for papers from 1969 to 2010. The keywords used in the research were "saliva", "acquired pellicle", "salivary flow", "salivary buffering capacity" and "dental erosion". Inclusion of studies, data extraction and quality assessment were undertaken independently and in duplicate by two members of the review team. Disagreements were solved by discussion and consensus or by a third party. Several characteristics and properties of saliva play an important role in dental erosion. Salivary clearance gradually eliminates the acids through swallowing and saliva presents buffering capacity causing neutralization and buffering of dietary acids. Salivary flow allows dilution of the acids. In addition, saliva is supersaturated with respect to tooth mineral, providing calcium, phosphate and fluoride necessary for remineralization after an erosive challenge. Furthermore, many proteins present in saliva and acquired pellicle play an important role in dental erosion. Saliva is the most important biological factor affecting the progression of dental erosion. Knowledge of its components and properties involved in this protective role can drive the development of preventive measures targeting to enhance its known beneficial effects.

Saliva and dental erosion

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Marília Afonso Rabelo Buzalaf

2012-10-01

Full Text Available Dental erosion is a multifactorial condition. The consideration of chemical, biological and behavioral factors is fundamental for its prevention and therapy. Among the biological factors, saliva is one of the most important parameters in the protection against erosive wear. Objective: This review discusses the role of salivary factors on the development of dental erosion. Material and Methods: A search was undertaken on MeDLINe website for papers from 1969 to 2010. The keywords used in the research were "saliva", "acquired pellicle", "salivary flow", "salivary buffering capacity" and "dental erosion". Inclusion of studies, data extraction and quality assessment were undertaken independently and in duplicate by two members of the review team. Disagreements were solved by discussion and consensus or by a third party. Results: Several characteristics and properties of saliva play an important role in dental erosion. Salivary clearance gradually eliminates the acids through swallowing and saliva presents buffering capacity causing neutralization and buffering of dietary acids. Salivary flow allows dilution of the acids. In addition, saliva is supersaturated with respect to tooth mineral, providing calcium, phosphate and fluoride necessary for remineralization after an erosive challenge. Furthermore, many proteins present in saliva and acquired pellicle play an important role in dental erosion. Conclusions: Saliva is the most important biological factor affecting the progression of dental erosion. Knowledge of its components and properties involved in this protective role can drive the development of preventive measures targeting to enhance its known beneficial effects.

Stuttered swallowing: Electric stimulation of the right insula interferes with water swallowing. A case report

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Shoemaker J

2011-02-01

Full Text Available Abstract Background Various functional resonance imaging, magnetoencephalographic and lesion studies suggest the involvement of the insular cortex in the control of swallowing. However, the exact location of insular activation during swallowing and its functional significance remain unclear. Case presentation Invasive electroencephalographic monitoring was performed in a 24-year-old man with medically intractable stereotyped nocturnal hypermotor seizures due to a ganglioglioma. During stimulation of the right inferior posterior insular cortex with depth electrodes the patient spontaneously reported a perception of a "stutter in swallowing". Stimulation of the inferior posterior insular cortex at highest intensity (4 mA was also associated with irregular and delayed swallows. Swallowing was not impaired during stimulation of the superior posterior insular cortex, regardless of stimulation intensity. Conclusions These results indicate that the right inferior posterior insular cortex is involved in the neural circuitry underlying the control of swallowing.

The association between saliva control, silent saliva penetration, aspiration, and videofluoroscopic findings in Parkinson′s disease patients

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Ali Rajaei

2015-01-01

Full Text Available 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. They were asked two questions; one about saliva control and the other about silent saliva penetration and aspiration. Next, they underwent the videofluoroscopic swallowing study (VFSS. Results: The Pearson Correlation coefficient between the Penetration-Aspiration Scale (PAS scores and question 1 scores was 0.48 (P < 0.05, =0.25, and there was a significant correlation between the PAS scores and question 2 scores, and also question 1 scores + question 2 scores (r = 0.589, P < 0.05, =0 and r = 0589, P < 0.05, =0. Conclusions: This study showed a significant correlation between the questions about saliva control, silent saliva penetration, and aspiration, and laryngeal penetration and aspiration during VFSS. Therefore, by using these two questions, the potential silent laryngeal penetration and aspiration during meals could be detected before it led to aspiration pneumonia. Taking the benefit of these questions, as a part of the swallowing assessment of PD patients, is recommended.

Movie MRI at five frames a second for evaluation of speech and swallowing

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Kumada, Masanobu; Mori, Koichi; Nakajima, Yasoichi; Nozaki, Seiji

2004-05-01

Magnetic resonance imaging (MRI) is a noninvasive imaging method that is widely used in the medical field. One of the limitations of MRI is its low time-resolution images of MRI are usually obtained as still images. Here we introduced a newly developed method of ``movie'' MRI with high time-resolution at five images a second. Its good application would include study and evaluation of speech and swallowing. Instrument: MRT-2001 XG with Software ver.5.5. (Toshiba). Coil: head QD coil for the tongue; CTL ARRY coil (3ch) for the neck, Imaging condition: sagital FFE2D; TR=2.8 ms TE=1.2 ms FA=10 deg Matrix=64×128 ST=10 mm NAQ=1 AV FOV=23×35 ; ROAFI; sequential acquisition. Maximum imaging length=51 s. A healthy Japanese male (Tokyo dialect speaker, 39 years). Task: Repetitive utterance of /tenten.../ and intentional swallowing of saliva. Results: In the task of /tenten..../, we could detect, in temporal order, velopharyngeal (VP) closure, opening of the tongue-palate (TP) closure, VP opening, TP closure, VP closure, and so on. In the swallowing task of saliva, we could detect movement of the tongue for conveying saliva to the pharynx, VP closure, backward movement of the tongue root, elevation and descent of the larynx in this temporal order. Our ``Movie MRI'' seemed promising for the noninvasive evaluation of speech and deglutition. Appropriate materials for swallowing evaluation will be presented.

Mastication and swallowing : influence of fluid addition to foods

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Pereira, Luciano Jose; Duarte Gaviao, Maria Beatriz; Engelen, Lina; van der Bilt, Andries

2007-01-01

introduction: The production of sufficient saliva is indispensable for good chewing. Recent research has demonstrated that salivary flow rate has little influence on the swallowing threshold. Objectives: The hypothesis examined in the present study was that adding fluids to foods will influence

Evaluation of an Automated Swallow-Detection Algorithm Using Visual Biofeedback in Healthy Adults and Head and Neck Cancer Survivors.

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Constantinescu, Gabriela; Kuffel, Kristina; Aalto, Daniel; Hodgetts, William; Rieger, Jana

2017-11-02

Mobile health (mHealth) technologies may offer an opportunity to address longstanding clinical challenges, such as access and adherence to swallowing therapy. Mobili-T ® is an mHealth device that uses surface electromyography (sEMG) to provide biofeedback on submental muscles activity during exercise. An automated swallow-detection algorithm was developed for Mobili-T ® . This study evaluated the performance of the swallow-detection algorithm. Ten healthy participants and 10 head and neck cancer (HNC) patients were fitted with the device. Signal was acquired during regular, effortful, and Mendelsohn maneuver saliva swallows, as well as lip presses, tongue, and head movements. Signals of interest were tagged during data acquisition and used to evaluate algorithm performance. Sensitivity and positive predictive values (PPV) were calculated for each participant. Saliva swallows were compared between HNC and controls in the four sEMG-based parameters used in the algorithm: duration, peak amplitude ratio, median frequency, and 15th percentile of the power spectrum density. In healthy participants, sensitivity and PPV were 92.3 and 83.9%, respectively. In HNC patients, sensitivity was 92.7% and PPV was 72.2%. In saliva swallows, HNC patients had longer event durations (U = 1925.5, p performed well with healthy participants and retained a high sensitivity, but had lowered PPV with HNC patients. With respect to Mobili-T ® , the algorithm will next be evaluated using the mHealth system.

Gum chewing improves swallow frequency and latency in Parkinson patients: a preliminary study.

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South, Angela R; Somers, Stephanie M; Jog, Mandar S

2010-04-13

Reduced swallowing frequency affects secretion management in Parkinson disease (PD). Gum chewing increases saliva flow and swallow frequency. This study uses chewing gum to modify swallow frequency and latency between swallows in patients with PD. 1) Assess the frequency and latency of swallow at baseline (BL), during gum chewing (GC), and post gum chewing (PGC) for participants with PD (stage 2-4) nonsymptomatic for prandial dysphagia; and 2) assess carryover after gum is expectorated. Twenty participants were studied across 3 tasks, each of 5 minutes in duration: BL, GC, and PGC. Respiratory and laryngeal signals were continuously recorded using PowerLab (version 5.5.5; ADI Instruments, Castle Hill, Australia). Frequency and latency of swallow events were calculated. Differences (analysis of variance) are reported for frequency (p Parkinson disease. This study provides Class III evidence that chewing gum increases swallow frequency and decreases latency of swallowing in an experiment in patients with stage 2 to 4 Parkinson disease who are nonsymptomatic for significant prandial dysphagia.

Effect of aging on oral and swallowing function after meal consumption

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Hiramatsu T

2015-01-01

Full Text Available Tetsuya Hiramatsu,1,2 Hideyuki Kataoka,3 Mari Osaki,4 Hiroshi Hagino3,4 1Department of Speech Pathology and Audiology, Matsue Co-medical College, Matsue, Japan; 2Graduate School of Medical Sciences, Tottori University, 3School of Health Science, Faculty of Medicine, Tottori University, 4Rehabilitation Division, Tottori University Hospital, Yonago, Japan Background/purpose: Dysphagia may worsen due to fatigue of the infrahyoid and suprahyoid muscle groups as a result of repetitive swallowing during a meal. We investigated the hypothesis that meal consumption may reduce tongue strength and endurance in older adults (OAs.Methods: Tongue–palate pressure, oral diadochokinesis, repetitive saliva swallowing, and surface electromyography activity before and after a meal were measured in 23 young adults (YAs and 23 OA volunteers.Results: There was a statistically significant difference in both tongue pressure and the number of voluntary swallows between YAs and OAs. Peak tongue pressure was significantly lower in OAs than YAs both before and after meal consumption. The most notable finding was that the first time interval (the time from test initiation to the beginning of the first swallow was prolonged after meal consumption only in OAs, whereas the first time interval showed no difference between YAs and OAs before meal consumption with reference to the repetitive saliva swallowing test. The initiation of swallowing was prolonged by both meal consumption and aging; there was a significant interaction between these two factors. The number of repetitions of the monosyllable/pa/was statistically similar between YAs and OAs before meal consumption, but it was significantly lower in OAs after meal consumption.Conclusion: Aging leads to declining tongue pressure and motor function of the lips. It is possible that swallowing function declines in older individuals when meal consumption is prolonged, especially at the end of mealtime, as a result of their

Application of near-infrared spectroscopy to measurement of hemodynamic signals accompanying stimulated saliva secretion.

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Sato, Hiroki; Obata, Akiko N; Moda, Ichiro; Ozaki, Kazutaka; Yasuhara, Takaomi; Yamamoto, Yukari; Kiguchi, Masashi; Maki, Atsushi; Kubota, Kisou; Koizumi, Hideaki

2011-04-01

We aim to test the feasibility of using near-infrared spectroscopy (NIRS) for indirect measurement of human saliva secretion in response to taste stimuli for potential application to organoleptic testing. We use an NIRS system to measure extracranial hemodynamics (Hb-signals around the temples) of healthy participants when taste stimuli are taken in their mouths. First, the Hb-signals and volume of expelled saliva (stimulated by distilled-water or sucrose-solution intake) are simultaneously measured and large Hb-signal changes in response to the taste stimuli (Hb-responses) are found. Statistical analysis show that both the Hb response and saliva volume are larger for the sucrose solution than for the distilled water with a significant correlation between them (r = 0.81). The effects of swallowing on the Hb-signals are investigated. Similar Hb responses, differing from the sucrose solution and distilled water, are obtained even though the participants swallow the mouth contents. Finally, functional magnetic resonance imaging is used to identify possible sources of the Hb signals corresponding to salivation. Statistical analysis indicates similar responses in the extracranial regions, mainly around the middle meningeal artery. In conclusion, the identified correlation between extracranial hemodynamics and the saliva volume suggests that NIRS is applicable to the measurement of hemodynamic signals accompanying stimulated saliva secretion.

Swallowing disorders after ischemic stroke

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Gabriela Camargo Remesso

2011-10-01

Full Text Available OBJECTIVE: To investigate occurrences of swallowing disorders after ischemic stroke. METHOD: This was a retrospective study on 596 medical files. The inclusion criterion was that the patients needed to have been hospitalized with a diagnosis of ischemic stroke; the exclusion criteria were the presence of associated cardiac problems and hospital stay already more than 14 days. RESULTS: 50.5% were men and 49.5% women; mean age 65.3 years (SD=±11.7 (p<0.001. Among the risk factors, 79.4% had hypertension, 36.7% had diabetes (p<0.001 and 42.7% were smokers. 13.3% of the patients died. Swallowing disorders occurred in 19.6%, among whom 91.5% had mild difficulty and 8.5% had severe difficulty. 87.1% had spontaneous recovery after a mean of 2.4 months. A lesion in the brainstem region occurred in 6.8% (p<0.001. CONCLUSION: Swallowing disorders occurred in almost 20% of the population and most of the difficulty in swallowing found was mild. The predictors for swallowing disorders were older age, diabetes mellitus and lesions in the brainstem region.

Ginger Orally Disintegrating Tablets to Improve Swallowing in Older People.

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Hirata, Ayumu; Funato, Hiroki; Nakai, Megumi; Iizuka, Michiro; Abe, Noriaki; Yagi, Yusuke; Shiraishi, Hisashi; Jobu, Kohei; Yokota, Junko; Hirose, Kahori; Hyodo, Masamitsu; Miyamura, Mitsuhiko

2016-01-01

We previously prepared and pharmaceutically evaluated ginger orally disintegrating (OD) tablets, optimized the base formulation, and carried out a clinical trial in healthy adults in their 20 s and 50s to measure their effect on salivary substance P (SP) level and improved swallowing function. In this study, we conducted clinical trials using the ginger OD tablets in older people to clinically evaluate the improvements in swallowing function resulting from the functional components of the tablet. The ginger OD tablets were prepared by mixing the excipients with the same amount of mannitol and sucrose to a concentration of 1% ginger. Eighteen healthy older adult volunteers aged 63 to 90 were included in the swallowing function test. Saliva was collected before and 15 min after administration of the placebo and ginger OD tablets. Swallowing endoscopy was performed by an otolaryngologist before administration and 15 min after administration of the ginger OD tablets. A scoring method was used to evaluate the endoscopic swallowing. Fifteen minutes after taking the ginger OD tablets, the salivary SP amount was significantly higher than prior to ingestion or after taking the placebo (pginger OD tablets. Our findings showed that the ginger OD tablets increased the salivary SP amount and improved swallowing function in older people with appreciably reduced swallowing function.

SWALLOWING DISORDERS IN CLINICAL PRACTICE: FUNCTIONAL ANATOMY, ASSESSMENT AND REHABILITATION STRATEGIES

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STANESCU Ioana

2014-09-01

Full Text Available Swallowing is a complex process consisting in transporting food from mouth to the stomach; it involves voluntary and reflex activity of more than 30 nerves and muscles, requiring complex neuromuscular coordination and brainstem and cortical centers for controle. Dysphagia is defined as a alteration in the swallowing process, which cause difficulty in transporting saliva and aliments from the mouth trough the pharynx and esophagus into the stomach . It is a frequent symptom, affecting especially old people, people with neurological diseases, cancers of head and neck or severe reflux . Dysphagia can result from a wide variety of functional or structural deficits of the oral cavity, pharynx, larynx or esophagus, which could e caused by neurological conditions. Dysphagia carries serious health risks: malnutrition, dehydration, increase risk of infections. Effective dysphagia management requires an interdisciplinary approach; the goal of rehabilitation is to identify and treat abnormalities of swallowing while maintaining safe and efficient nutrition. KEY WORDS: swallowing, dysphagia, functional anatomy, rehabilitation, neuroplasticity

Swallowing and pharyngo-esophageal manometry in obstructive sleep apnea

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Luciana Almeida Moreira da Paz Oliveira

2015-06-01

Full Text Available INTRODUCTION: Upper airway nerve and muscle damage associated with obstructive sleep apnea may impair the strength and dynamics of pharyngeal and esophageal contractions during swallowing. OBJECTIVE: To evaluate the presence of alterations in pharyngoesophageal manometry in patients with obstructive sleep apnea with and without oropharyngeal dysphagia. METHODS: This study prospectively evaluated 22 patients with obstructive sleep apnea without spontaneous complaints of dysphagia, using a questionnaire, fiberoptic endoscopic evaluation of swallowing, and pharyngoesophageal manometry, including measurement of the upper and lower esophageal sphincter pressures and mean pharyngeal pressures at three levels during swallowing. RESULTS: The dysphagia group consisted of 17 patients (77.3% in whom swallowing abnormalities were detected on fiberoptic endoscopic evaluation of swallowing (n = 15; 68.2% and/or in the questionnaire (n = 7; 31.8%. The five remaining cases comprised a control group without oropharyngeal dysphagia. In all cases of abnormalities on fiberoptic endoscopic evaluation of swallowing, there was premature bolus leakage into the pharynx. There was no statistically significant difference between the groups regarding any of the pharyngoesophageal manometry measurements, age, or severity of obstructive sleep apnea. CONCLUSION: Pharyngoesophageal manometry detected no statistically significant difference between the groups with and without oropharyngeal dysphagia.

Correlation of ultrasound imaging of oral swallow with ventilatory alterations in cerebral palsied and normal children: preliminary observations.

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Kenny, D J; Casas, M J; McPherson, K A

1989-01-01

Preliminary results of an investigation that synchronizes the videotaped output of ultrasound camera and the analog data from physiological measurements of swallowing and ventilation in normal and cerebral palsied (CP) children are presented. Four cerebral palsied children and three control children undertook a single sip-swallow of 5 ml of liquid and a solid mastication-swallow sequence on three occasions according to a defined protocol. The CP children exhibited much more variability and less control of the liquid bolus than did the controls. The ultrasound image clearly demonstrates the lack of control of the posterior of the tongue in many CP children. Some parts of the sequence of oral swallow and the time to achieve maximum anterior displacement of the hyoid bone appear to be slowed. The sequential events of swallowing show less variability as the sip-swallow proceeds from the oral voluntary to pharyngeal and lower involuntary phases. This study also identified a short-latency apnea that appears to accompany a saliva (protective) swallow and a long-latency apnea that accompanies semi-solid or liquid bolus (alimentary) swallows. Further investigations of normal and CP children utilizing a combined diagnostic imaging-physiological measurement approach will follow this initial study.

Saliva transit in patients with gastroesophageal reflux disease.

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Cassiani, R A; Mota, G A; Aprile, L R O; Dantas, R O

2015-10-01

Saliva is an important factor in the neutralization of the acidity of the refluxed material that comes from the stomach to the esophagus. The impairment of saliva transit from oral cavity to distal esophagus may be one of the causes of esophagitis and symptoms in gastroesophageal reflux disease (GERD). With the scintigraphic method, the transit of 2 mL of artificial saliva was measured in 30 patients with GERD and 26 controls. The patients with GERD had symptoms of heartburn and acid regurgitation, a 24-hour pH monitoring with more than 4.2% of the time with pH below four, 26 with erosive esophagitis, and four with non-erosive reflux disease. Fourteen had mild dysphagia for solid foods. Twenty-one patients had normal esophageal manometry, and nine had ineffective esophageal motility. They were 15 men and 15 women, aged 21-61 years, mean 39 years. The control group had 14 men and 12 women, aged 19-61 years, mean 35 years. The subjects swallowed in the sitting and supine position 2 mL of artificial saliva labeled with 18 MBq of (99m) Technetium phytate. The time of saliva transit was measured from oral cavity to esophageal-gastric transition, from proximal esophagus to esophageal-gastric transition, and the transit through proximal, middle, and distal esophageal body. There was no difference between patients and controls in the time for saliva to go from oral cavity to esophageal-gastric transition, and from proximal esophagus to esophageal-gastric transition, in the sitting and supine positions. In distal esophagus in the sitting position, the saliva transit duration was shorter in patients with GERD (3.0 ± 0.8 seconds) than in controls (7.6 ± 1.7 seconds, P = 0.03). In conclusion, the saliva transit from oral cavity to the esophageal-gastric transition in patients with GERD has the same duration than in controls. Saliva transit through the distal esophageal body is faster in patients with GERD than controls. © 2014 International Society for Diseases of the

A rare cause of gastric obstruction: Lighters swallowing.

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Aday, Ulas; Tardu, Ali; Yagci, Mehmet Ali; Yonder, Huseyin

2015-01-01

The majority of swallowed foreign bodies are thrown spontaneously without causing complications in the digestive system. Multiple number of foreign bodies may be swallowed by psychiatric patients which delay diagnosis and increase the complication rate. Long and hard objects cannot pass through the pylorus, and may cause obstruction, ulceration, bleeding and perforation. Endoscopy is used as an effective method in such cases. An exploratory laparatomy was performed after unsuccessful endoscopic foreign object removal in a 28-year-old schizophrenic patient with gastric outlet obstruction due to multiple cigarette lighter swallowing. Ten lighters were removed from the stomach through gastrotomy and one more lighter was removed from the descending colon by milking through the anus. The aim of this paper is to discuss encountered difficulties in psychiatric patients who underwent surgery due to intake of foreign bodies.

Swallowing and pharyngo-esophageal manometry in obstructive sleep apnea.

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Oliveira, Luciana Almeida Moreira da Paz; Fontes, Luiz Henrique de Souza; Cahali, Michel Burihan

2015-01-01

Upper airway nerve and muscle damage associated with obstructive sleep apnea may impair the strength and dynamics of pharyngeal and esophageal contractions during swallowing. To evaluate the presence of alterations in pharyngoesophageal manometry in patients with obstructive sleep apnea with and without oropharyngeal dysphagia. This study prospectively evaluated 22 patients with obstructive sleep apnea without spontaneous complaints of dysphagia, using a questionnaire, fiberoptic endoscopic evaluation of swallowing, and pharyngoesophageal manometry, including measurement of the upper and lower esophageal sphincter pressures and mean pharyngeal pressures at three levels during swallowing. The dysphagia group consisted of 17 patients (77.3%) in whom swallowing abnormalities were detected on fiberoptic endoscopic evaluation of swallowing (n=15; 68.2%) and/or in the questionnaire (n=7; 31.8%). The five remaining cases comprised a control group without oropharyngeal dysphagia. In all cases of abnormalities on fiberoptic endoscopic evaluation of swallowing, there was premature bolus leakage into the pharynx. There was no statistically significant difference between the groups regarding any of the pharyngoesophageal manometry measurements, age, or severity of obstructive sleep apnea. Pharyngoesophageal manometry detected no statistically significant difference between the groups with and without oropharyngeal dysphagia. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Characterizing Dysphagia and Swallowing Intervention in the Traumatic Spinal Injury Population

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Valenzano, Teresa J.; Waito, Ashley A.; Steele, Catriona M.

2016-01-01

Dysphagia is reported to be a common secondary complication for individuals with traumatic spinal injuries. Different etiologies of traumatic spinal injuries may lead to different profiles of swallowing impairment. We conducted a systematic review to determine the characteristics of dysphagia after traumatic spinal injury and to describe interventions currently used to improve swallowing function in this population. A comprehensive multi-engine literature search identified 137 articles of which 5 were judged to be relevant. These underwent review for study quality, rating for level of evidence, and data extraction. The literature describing dysphagia after traumatic spinal injury was comprised predominantly of low level evidence and single case reports. Aspiration, pharyngeal residue, and decreased/absent hyolaryngeal elevation were found to be common characteristics of dysphagia in this population. The most commonly used swallowing interventions included tube feeding, compensatory swallowing strategies, and steroids/antibiotics. Improvement in swallowing function following swallowing intervention was reported in all studies, however there was no control for spontaneous recovery. The results demonstrate a need for high-quality research to profile the pathophysiology of dysphagia after traumatic spinal injury and controlled studies to demonstrate the efficacy of swallowing interventions in this population. PMID:27412004

Effects of Change in Tongue Pressure and Salivary Flow Rate on Swallow Efficiency Following Chemoradiation Treatment for Head and Neck Cancer

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Rogus-Pulia, Nicole M.; Larson, Charles; Mittal, Bharat B; Pierce, Marge; Zecker, Steven; Kennelty, Korey; Kind, Amy; Connor, Nadine P.

2016-01-01

Purpose Patients treated with chemoradiation for head and neck cancer frequently develop dysphagia. Tissue damage to the oral tongue causing weakness and decreases in saliva production may contribute to dysphagia. Yet, effects of these variables on swallowing-related measures are unclear. The purpose of this study was (1) to determine effects of chemoradiation on tongue pressures, as a surrogate for strength, and salivary flow rates and (2) to elucidate relationships among tongue pressures, saliva production, and swallowing efficiency by bolus type. Methods and Materials 21 patients with head and neck cancer treated with chemoradiation were assessed before and after treatment and matched with 21 healthy control participants who did not receive chemoradiation. Each participant was given a questionnaire to rate dysphagia symptoms. Videofluoroscopic evaluation of swallowing was used to determine swallowing efficiency; the Saxon test measured salivary flow rate; and the Iowa Oral Performance Instrument (IOPI) was used for oral tongue maximum and endurance measures. Results Results revealed significantly lower tongue endurance measures for patients post-treatment as compared to controls (p=.012). Salivary flow rates also were lower compared to pre-treatment (p=.000) and controls (p=.000). Simple linear regression analyses showed that change in salivary flow rate was predictive of change in swallow efficiency measures from pre- to post-treatment for 1mL thin liquid (p=.017), 3mL nectar-thick liquid (p=.026), and 3mL standard barium pudding (p=.011) boluses. Conclusions Based on these findings, it appears that chemoradiation treatment affects tongue endurance and salivary flow rate and these changes may impact swallow efficiency. These factors should be considered when planning treatment for dysphagia. PMID:27492408

Effects of Change in Tongue Pressure and Salivary Flow Rate on Swallow Efficiency Following Chemoradiation Treatment for Head and Neck Cancer.

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Rogus-Pulia, Nicole M; Larson, Charles; Mittal, Bharat B; Pierce, Marge; Zecker, Steven; Kennelty, Korey; Kind, Amy; Connor, Nadine P

2016-10-01

Patients treated with chemoradiation for head and neck cancer frequently develop dysphagia. Tissue damage to the oral tongue causing weakness along with decreases in saliva production may contribute to dysphagia. Yet, effects of these variables on swallowing-related measures are unclear. The purpose of this study was (1) to determine effects of chemoradiation on tongue pressures, as a surrogate for strength, and salivary flow rates and (2) to elucidate relationships among tongue pressures, saliva production, and swallowing efficiency by bolus type. Twenty-one patients with head and neck cancer treated with chemoradiation were assessed before and after treatment and matched with 21 healthy control participants who did not receive chemoradiation. Each participant was given a questionnaire to rate dysphagia symptoms. Videofluoroscopic Evaluation of Swallowing (VFES) was used to determine swallowing efficiency; the Saxon test measured salivary flow rate; and the Iowa Oral Performance Instrument (IOPI) was used for oral tongue maximum and endurance measures. Results revealed significantly lower tongue endurance measures for patients post-treatment as compared to controls (p = .012). Salivary flow rates also were lower compared to pre-treatment (p = .000) and controls (p = .000). Simple linear regression analyses showed that change in salivary flow rate was predictive of change in swallow efficiency measures from pre- to post-treatment for 1 mL thin liquid (p = .017), 3 mL nectar-thick liquid (p = .026), and 3 mL standard barium pudding (p = .011) boluses. Based on these findings, it appears that chemoradiation treatment affects tongue endurance and salivary flow rate, and these changes may impact swallow efficiency. These factors should be considered when planning treatment for dysphagia.

Bilateral Repetitive Transcranial Magnetic Stimulation Combined with Intensive Swallowing Rehabilitation for Chronic Stroke Dysphagia: A Case Series Study

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Ryo Momosaki

2014-03-01

Full Text Available The purpose of this study was to clarify the safety and feasibility of a 6-day protocol of bilateral repetitive transcranial magnetic stimulation (rTMS combined with intensive swallowing rehabilitation for chronic poststroke dysphagia. In-hospital treatment was provided to 4 poststroke patients (age at treatment: 56-80 years; interval between onset of stroke and treatment: 24-37 months with dysphagia. Over 6 consecutive days, each patient received 10 sessions of rTMS at 3 Hz applied to the pharyngeal motor cortex bilaterally, followed by 20 min of intensive swallowing rehabilitation exercise. The swallowing function was evaluated by the Penetration Aspiration Scale (PAS, Modified Mann Assessment of Swallowing Ability (MMASA, Functional Oral Intake Scale (FOIS, laryngeal elevation delay time (LEDT and Repetitive Saliva-Swallowing Test (RSST on admission and at discharge. All patients completed the 6-day treatment protocol and none showed any adverse reactions throughout the treatment. The combination treatment improved laryngeal elevation delay time in all patients. Our proposed protocol of rTMS plus swallowing rehabilitation exercise seems to be safe and feasible for chronic stroke dysphagia, although its efficacy needs to be confirmed in a large number of patients.

Adolescents' struggles with swallowing tablets: barriers, strategies and learning.

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Hansen, Dana Lee; Tulinius, Ditte; Hansen, Ebba Holme

2008-01-01

To explore adolescents' struggles with taking oral medications. Copenhagen, Denmark. Semi-structured qualitative interviews were conducted with 89 adolescents (33 boys, 56 girls) between the ages of 11 and 20. Adolescents were recruited through four public schools. To identify struggles with taking oral medication, interview transcripts were systematically searched for statements including the terms swallow, chew, crush and eat. Thematic analysis of the identified statements was carried out to reveal dominant themes in the adolescents' accounts. Over one-third of the adolescents spontaneously provided accounts of the difficulties they experienced with taking oral medications, especially with swallowing tablets. Three themes were dominant in their narratives: barriers, strategies and learning. Barriers experienced by the adolescents involved the medications' properties, e.g. taste. Adolescents developed strategies to overcome these barriers, e.g. crushing tablets. Via a process of learning-by-doing and the acquisition of increased experience and autonomy, many adolescents mastered the skill of swallowing tablets. Many adolescents experienced barriers in their attempts to swallow tablets. They developed various strategies to overcome these barriers and gradually mastered taking medicines in a learning-by-doing process.

Functional connectivity and laterality of the motor and sensory components in the volitional swallowing network.

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Lowell, Soren Y; Reynolds, Richard C; Chen, Gang; Horwitz, Barry; Ludlow, Christy L

2012-05-01

Functional neuroimaging has shown that multiple brain regions are active during volitional swallowing. Little is known, however, about which regions integrate motor execution and sensory feedback in the swallowing system. Although unilateral brain lesions in either hemisphere can produce swallowing deficits, some functional neuroimaging studies indicate that the left hemisphere has greater activation in certain sensory and motor-related swallowing regions. In this study, correlation coefficients were computed for five seed regions during volitional saliva swallowing to determine the functional relationships of these regions with the rest of the brain: the anterior and posterior insula, inferior frontal gyrus (BA44), primary sensory cortex (S1), and primary motor cortex (M1). A laterality index (LI) was derived that accounts for relative differences in total, positive connected voxels for the left/right hemisphere seeds. Clusters of significantly connected voxels were greater from the anterior and posterior insula than from the other three seed regions. Interactions of the insula with other brain regions were greater on the left than on the right during volitional swallowing. Group means showed laterality in the anterior insula (LI = 0.25) and the posterior insula (LI = 0.33). BA44 showed a lesser degree of difference in left versus right hemisphere interactions (LI = 0.12) while S1 did not show lateralization (LI = 0.02) and M1 showed some predominance of interactions in the right hemisphere (LI = -0.19). The greater connectivity from the left hemisphere insula to brain regions within and across hemispheres suggests that the insula is a primary integrative region for volitional swallowing in humans.

Effect of saliva on physical food properties in fat texture perception.

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Kupirovič, Urška Pivk; Elmadfa, Ibrahim; Juillerat, Marcel-Alexandre; Raspor, Peter

2017-04-13

Sensory properties of food drive our food choices and it is generally accepted that lipids greatly contribute to the sensory properties of many foods and consequently to eating pleasure. Many studies have investigated the mechanisms of the fat perception. Unfortunately they used a variety of methods and products, thereby making generalization very difficult. The mechanism of fat perception in oral cavity is combined of several processes. Lipid composition and its properties strongly influence food structure. During consumption food is exposed to a range of in-mouth processing steps. Oral sensation of fat texture changes with time, from a first bite to chewing, while mixing with saliva, up to swallowing and even after swallowing. The present work reviews many aspects of fat texture perception from physical chemistry to physiology. Understanding the underlying mechanisms of in-mouth lipid processing would provide new concepts to produce low-fat food products with full-fat perception.

Erosion protection conferred by whole human saliva, dialysed saliva, and artificial saliva

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Baumann, T.; Kozik, J.; Lussi, A.; Carvalho, T. S.

2016-10-01

During dental erosion, tooth minerals are dissolved, leading to a softening of the surface and consequently to irreversible surface loss. Components from human saliva form a pellicle on the tooth surface, providing some protection against erosion. To assess the effect of different components and compositions of saliva on the protective potential of the pellicle against enamel erosion, we prepared four different kinds of saliva: human whole stimulated saliva (HS), artificial saliva containing only ions (AS), human saliva dialysed against artificial saliva, containing salivary proteins and ions (HS/AS), and human saliva dialysed against deionised water, containing only salivary proteins but no ions (HS/DW). Enamel specimens underwent four cycles of immersion in either HS, AS, HS/AS, HS/DW, or a humid chamber (Ctrl), followed by erosion with citric acid. During the cycling process, the surface hardness and the calcium released from the surface of the specimens were measured. The different kinds of saliva provided different levels of protection, HS/DW exhibiting significantly better protection than all the other groups (p < 0.0001). Different components of saliva, therefore, have different effects on the protective properties of the pellicle and the right proportions of these components in saliva are critical for the ability to form a protective pellicle.

The relationship between limit of Dysphagia and average volume per swallow in patients with Parkinson's disease.

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Belo, Luciana Rodrigues; Gomes, Nathália Angelina Costa; Coriolano, Maria das Graças Wanderley de Sales; de Souza, Elizabete Santos; Moura, Danielle Albuquerque Alves; Asano, Amdore Guescel; Lins, Otávio Gomes

2014-08-01

The goal of this study was to obtain the limit of dysphagia and the average volume per swallow in patients with mild to moderate Parkinson's disease (PD) but without swallowing complaints and in normal subjects, and to investigate the relationship between them. We hypothesize there is a direct relationship between these two measurements. The study included 10 patients with idiopathic PD and 10 age-matched normal controls. Surface electromyography was recorded over the suprahyoid muscle group. The limit of dysphagia was obtained by offering increasing volumes of water until piecemeal deglutition occurred. The average volume per swallow was calculated by dividing the time taken by the number of swallows used to drink 100 ml of water. The PD group showed a significantly lower dysphagia limit and lower average volume per swallow. There was a significantly moderate direct correlation and association between the two measurements. About half of the PD patients had an abnormally low dysphagia limit and average volume per swallow, although none had spontaneously related swallowing problems. Both measurements may be used as a quick objective screening test for the early identification of swallowing alterations that may lead to dysphagia in PD patients, but the determination of the average volume per swallow is much quicker and simpler.

A study of brain networks associated with swallowing using graph-theoretical approaches.

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Bo Luan

Full Text Available Functional connectivity between brain regions during swallowing tasks is still not well understood. Understanding these complex interactions is of great interest from both a scientific and a clinical perspective. In this study, functional magnetic resonance imaging (fMRI was utilized to study brain functional networks during voluntary saliva swallowing in twenty-two adult healthy subjects (all females, [Formula: see text] years of age. To construct these functional connections, we computed mean partial correlation matrices over ninety brain regions for each participant. Two regions were determined to be functionally connected if their correlation was above a certain threshold. These correlation matrices were then analyzed using graph-theoretical approaches. In particular, we considered several network measures for the whole brain and for swallowing-related brain regions. The results have shown that significant pairwise functional connections were, mostly, either local and intra-hemispheric or symmetrically inter-hemispheric. Furthermore, we showed that all human brain functional network, although varying in some degree, had typical small-world properties as compared to regular networks and random networks. These properties allow information transfer within the network at a relatively high efficiency. Swallowing-related brain regions also had higher values for some of the network measures in comparison to when these measures were calculated for the whole brain. The current results warrant further investigation of graph-theoretical approaches as a potential tool for understanding the neural basis of dysphagia.

Aspiration in children and adolescents with neurogenic dysphagia: comparison of clinical judgment and fiberoptic endoscopic evaluation of swallowing.

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Beer, Sabrina; Hartlieb, Till; Müller, Arnd; Granel, Michael; Staudt, Martin

2014-12-01

A total of 30 children and adolescents with dysphagia due to various chronic neurological disorders were assessed for their risk of aspiration. This assessment was performed clinically by experienced speech and swallowing therapists, and verified thereafter by fiberoptic endoscopy. We found the clinical judgment to be correct in only 70% (for aspiration of saliva), 55% (of puree), and 67% (of thin liquids). We conclude that, because of this unacceptably high error rate of clinical assessment, a fiberoptic evaluation of swallowing is a necessary diagnostic step both for the planning of therapy and for the development of feeding strategies in children and adolescents with neurogenic dysphagia. Georg Thieme Verlag KG Stuttgart · New York.

Radiation-induced parotid gland changes in oral cancer patients. Correlation between parotid volume and saliva production

International Nuclear Information System (INIS)

Teshima, Keiko; Murakami, Ryuji; Tomitaka, Etsuji

2010-01-01

The objective of this study was to evaluate whether saliva production reflects the parotid volume during the course of radiation therapy (RT) in patients with head-and-neck cancer. Twenty patients with advanced oral squamous cell carcinomas, who were treated with preoperative chemo-RT, underwent morphological assessment with CT or MRI and functional assessment with the Saxon test. For the Saxon test, saliva production was measured by weighing a gauze pad before and 2 min after chewing without swallowing; the low-normal value is 2 g. Saliva production and parotid volumes before and 2 weeks after RT were compared with the paired t-test, the Spearman rank correlation test and the Fisher exact test. After 30 Gy irradiation, mean saliva production was decreased from 4.2 to 1.0 g (P 3 (P<0.01); the post-RT: pre-RT parotid volume ratio ranged from 54% to 85% (mean 71%). Although the initial parotid volume was correlated with initial saliva production (r=0.47, P=0.04), no significant correlation was noted after RT (r=0.08, P=0.71), and there were considerable individual variations. The parotid volume ratio was inversely correlated with the saliva-reduction amount (r=-0.79, P<0.01). There was a correlation between decreased parotid gland volume and decreased saliva production in patients with head-and-neck cancer undergoing RT. Parotid volume reduction may predict parotid gland function. (author)

Saliva tannin interactions.

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Prinz, J F; Lucas, P W

2000-11-01

Many plant foods contain tannins, compounds that bind proteins, such as mammalian enzymes. Although described as tasteless, tannins can be detected orally by their astringency. However, the actual mechanism of oral detection and the effect of tannins on mastication and swallowing have been little investigated. Here, we show from in vitro tests that tannic acid, a common standard in tests used to detect tannins, significantly reduces the lubricating qualities of human saliva both by decreasing its viscosity and increasing friction, both factors lending support to the notion that astringency is a tactile phenomenon. From the literature, it is clear that this effect depends on the presence of salivary proline-rich proteins (PRP). In a mammalian context, ingestion of tannin-rich foods in a species with salivary PRP will be signalled by interference with bolus formation during mastication while the increase in friction may also be detectable and lead to increased tooth wear if the signal is ignored. In a human context, cross-cultural preferences for tannin-rich beverages such as tea, coffee and red wine at the end of meals may be explained by reduction in adhesion of food particles to the oral mucosa allowing their rapid oral clearance.

Dirt - swallowing

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... this page: //medlineplus.gov/ency/article/002840.htm Dirt - swallowing To use the sharing features on this ... article is about poisoning from swallowing or eating dirt. This article is for information only. DO NOT ...

Comparing Properties (Concentration, PH and mutans streptococcus Saliva in Both Status Resting Saliva and Stimulated Saliva in Preschoolers of Kerman city

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Elham Farokh-Gisour,

2016-08-01

Full Text Available This paper aimed to compare the characteristics (concentration, PH and mutans streptococcus saliva in both status resting saliva and stimulated saliva in preschoolers of Kerman city. In this study, 100 children aged 5 years among patients admitted to the pediatric ward of Kerman dental school and dental offices, some experts in Kerman dental school participated. Resting and stimulated saliva (after chewing oral paraffin children collected and in concentrations, PH and the amount of mutans streptococcus was measured. Mc Nemar test to compare the frequency of positive and negative cultures before and after stimulation as well as paired t-test to compare the saliva pH and concentration of not stimulated saliva and stimulated saliva in two modes was used. The significance level was set less than 0.05.The mean resting salivary osmolality of the population: 30.42 ± 87.41 and the average salivary osmolality of the total population were 79.81. Osmolality differences in saliva before and after stimulation with each other was significant (p = 0.009, paired t-test. The mean of resting saliva in the total population PH 0.45 ± 7.78 and the average PH stimulated saliva in the total population was 8.22 and the difference before and after each significant (p = 0.02, paired t-test. In mutans streptococcus in test samples in all 71 patients (71% positive test and 29 patients (29% had a negative test that number of positive cultures are equal before and after stimulation of saliva and thus the difference between the two groups (p> 0.05 was observed. In terms of comparing the properties of resting and stimulated saliva can conclude that salivary stimulated PH was significantly higher than resting saliva. While stimulated saliva osmolality was significantly less than resting saliva and the frequency of positive test mutans streptococcus in saliva before and after stimulation had no significant difference (p> 0.05. This means that test results on samples of mutans

Speech and Swallowing

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... like stuttering. The term for swallowing difficulty is dysphagia. It affects the mechanics of swallowing and quality ... as dining with friends or family. More importantly, dysphagia can lead to malnutrition, dehydration and aspiration (when ...

Evaluation of swallowing ability using swallowing sounds in maxillectomy patients.

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Kamiyanagi, A; Sumita, Y; Ino, S; Chikai, M; Nakane, A; Tohara, H; Minakuchi, S; Seki, Y; Endo, H; Taniguchi, H

2018-02-01

Maxillectomy for oral tumours often results in debilitating oral hypofunction, which markedly decreases quality of life. Dysphagia, in particular, is one of the most serious problems following maxillectomy. This study used swallowing sounds as a simple evaluation method to evaluate swallowing ability in maxillectomy patients with and without their obturator prosthesis placed. Twenty-seven maxillectomy patients (15 men, 12 women; mean age 66.0 ± 12.1 years) and 30 healthy controls (14 men, 16 women; mean age 44.9 ± 21.3 years) were recruited for this study. Participants were asked to swallow 4 mL of water, and swallowing sounds were recorded using a throat microphone. Duration of the acoustic signal and duration of peak intensity (DPI) were measured. Duration of peak intensity was significantly longer in maxillectomy patients without their obturator than with it (P maxillectomy patients without their obturator than in healthy controls (P maxillectomy patients who had undergone soft palate resection than in those who had not (P maxillectomy patients could be improved by wearing an obturator prosthesis, particularly during the oral stage. However, it is difficult to improve the oral stage of swallowing in patients who have undergone soft palate resection even with obturator placement. © 2017 John Wiley & Sons Ltd.

Alterations to Swallowing Physiology as the Result of Effortful Swallowing in Healthy Seniors.

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Molfenter, Sonja M; Hsu, Chuan-Ya; Lu, Ying; Lazarus, Cathy L

2018-06-01

A significant proportion of healthy seniors report difficulty swallowing, thought to result from age-related decline in muscle bulk/function. Effortful Swallowing (ES) is used both as a compensatory maneuver to improve pharyngeal propulsion/clearance and has been proposed as an exercise to improve pharyngeal strength. This study sought to quantify the immediate kinematic, temporal, and functional changes during an ES maneuver to quantify its exercise potential to combat age-related changes in swallowing. Videofluoroscopy data were collected from 44 healthy seniors (21 male) over 65 years old (mean = 76.9, SD = 7.1). Each participant swallowed six 5 ml boluses of Varibar nectar-thick liquids: three with regular effort and three using ES. Individual swallows (n = 260) were measured on pharyngeal constriction, pharyngeal shortening, laryngeal closure duration, hyoid movement duration, UES opening duration, stage transition duration, pharyngeal transit time, pharyngeal response duration, Normalized Residue Ratio Scale (NRRS), and the Penetration-Aspiration Scale (PAS). Non-parametric Wilcoxon Rank Sum for repeated measures tested the effect of ES on each outcome. Exact p-values were calculated based on permutation methods, individual p values < 0.008 was deemed to be significant. The ES maneuver significantly prolonged all temporal variables. While we found no significant differences for pharyngeal constriction, significantly less (i.e., worse) pharyngeal shortening was observed in ES condition compared with regular effort swallows. Further, significantly worse pyriform sinus residue (NRRSv) was observed in the ES condition. No differences between ES and regular effort swallows were noted for pharyngeal constriction, NRRSv or PAS. We speculate that these negative manifestations of worse kinematics (less pharyngeal shortening) and function (increase in NRRSp) may be the result of forced volitional manipulation of swallowing in the ES condition in an otherwise

Dynamic imaging of oropharyngeal swallowing

International Nuclear Information System (INIS)

Fanucci, A.; Cerro, P.; Diotallevi, P.; Metastasio, F.; Fanucci, E.

1991-01-01

Oropharyngeal swallowing is too fast and complex a motion for the human eye to seize its various phases and subsequently evaluate morphology and function of the anatomical structures involved. A chronological subdivision of the swallowing act is needed for e step-by-step analysis. Dinamic evaluation of oropharyngeal swallowing by means of fluoroscopic and US videorecording proved to be a reliable method. Echovideorecording allowed tongue movements to be depicted, together with bolus formation and propulsion. Fluorovideorecording (U-Matic Sony unit, 25-30 images/sec) demonstrated pharyngeal and esophageal phases. A series of chronological and morphological reference points, which characterize oropharyngeal swallowing, were employed to analyze videorecorded images. Slowmotion mode, 'freezed' images, and rewinding allowed an easy and accurate evaluation of swallowing details. Combined chronological and morphological pieces of information allow a comprehensive evaluation of the swallowing act

Water-filtered infrared-A (wIRA overcomes swallowing disorders and hypersalivation – a case report

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Hoffmann, Gerd

2017-08-01

Full Text Available Case description: A patient with a Barrett oesophageal carcinoma and a resection of the oesophagus with gastric pull-up developed swallowing disorders 6 years and 2 months after the operation. Within 1 year and 7 months two recurrences of the tumor at the anastomosis were found and treated with combined chemoradiotherapy or chemotherapy respectively. 7 years and 9 months after the operation local tumor masses and destruction were present with no ability to orally drink or eat (full feeding by jejunal PEG tube: quality of life was poor, as saliva and mucus were very viscous (pulling filaments and could not be swallowed and had to be spat out throughout the day and night resulting in short periods of sleep (awaking from the necessity to spit out. In total the situation was interpreted more as a problem related to a feeling of choking (with food or fluid in the sense of a functional dysphagia rather than as a swallowing disorder from a structural stenosis. At that time acetylcysteine (2 times 200 mg per day, given via the PEG tube and irradiation with water-filtered infrared-A (wIRA, a special form of heat radiation, of the ventral part of the neck and the thorax were added to the therapy. Within 1 day with acetylcysteine saliva and mucus became less viscous. Within 2 days with wIRA (one day with 4 to 5 hours with irradiation with wIRA at home salivation decreased markedly and quality of life clearly improved: For the first time the patient slept without interruption and without the need for sleep-inducing medication. After 5 days with wIRA the patient could eat his first soft dumpling although drinking of fluids was still not possible. After 2½ weeks with wIRA the patient could eat his first minced schnitzel (escalope. Following the commencement of wIRA (with typically approximately 90–150 minutes irradiation with wIRA per day the patient had 8 months with good quality of life with only small amounts of liquid saliva and mucus and without the

Saliva from nymph and adult females of Haemaphysalis longicornis: a proteomic study.

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Tirloni, Lucas; Islam, Mohammad Saiful; Kim, Tae Kwon; Diedrich, Jolene K; Yates, John R; Pinto, Antônio F M; Mulenga, Albert; You, Myung-Jo; Da Silva Vaz, Itabajara

2015-06-24

Haemaphysalis longicornis is a major vector of Theileria spp., Anaplasma phagocytophilum, Babesia spp. and Coxiella burnetti in East Asian countries. All life stages of ixodid ticks have a destructive pool-feeding style in which they create a pool-feeding site by lacerating host tissue and secreting a variety of biologically active compounds that allows the tick to evade host responses, enabling the uptake of a blood meal. The identification and functional characterization of tick saliva proteins can be useful to elucidate the molecular mechanisms involved in tick development and to conceive new anti-tick control methods. H. longicornis tick saliva was collected from fully engorged nymphs and fully engorged adults induced by dopamine or pilocarpine, respectively. Saliva was digested with trypsin for LC-MS/MS sequencing and peptides were searched against tick and rabbit sequences. A total of 275 proteins were identified, of which 135 were tick and 100 were rabbit proteins. Of the tick proteins, 30 proteins were identified exclusively in fully engorged nymph saliva, 74 in fully engorged adult females, and 31 were detected in both stages. The identified tick proteins include heme/iron metabolism-related proteins, oxidation/detoxification proteins, enzymes, proteinase inhibitors, tick-specific protein families, and cytoskeletal proteins. Proteins involved in signal transduction, transport and metabolism of carbohydrate, energy, nucleotide, amino acids and lipids were also detected. Of the rabbit proteins, 13 were present in nymph saliva, 48 in adult saliva, and 30 were present in both. The host proteins include immunoglobulins, complement system proteins, antimicrobial proteins, serum albumin, peroxiredoxin, serotransferrin, apolipoprotein, hemopexin, proteinase inhibitors, and hemoglobin/red blood cells-related products. This study allows the identification of H. longicornis saliva proteins. In spontaneously detached tick saliva various proteins were identified

Absence of effect of nasal continuous positive airway pressure on the esophageal phase of nutritive swallowing in newborn lambs.

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Djeddi, Djamal; Cantin, Danny; Samson, Nathalie; Tian, Hao; Praud, Jean-Paul

2013-08-01

It is presently recommended that oral feeding be started in premature infants as soon as possible, often at an age at which nasal continuous positive airway pressure (nCPAP) is still required for ventilatory support. Our previous data showed that application of nCPAP up to 10 cmH2O in full-term lambs had no deleterious effect on cardiorespiratory safety, feeding efficiency, or on nutritive swallowing-breathing coordination. Besides fear of swallowing-breathing coordination disturbances, esophageal motility disruption by nCPAP could be a reason to delay oral feeding. To our knowledge, no study has focused on the effects of nCPAP on esophageal motility in the neonatal period. The aim of the present study was therefore to further assess the effects of nCPAP on oral feeding by assessing its effects on the esophageal phase of nutritive swallowing (nutritive esophagodeglutition). Six full-term lambs, ages 2 to 3 days, underwent esophageal multichannel intraluminal impedance-pH monitoring. Lambs were bottle-fed under 2 randomized conditions, namely spontaneous breathing and nCPAP 6 cmH(2)O. Beyond confirmation of unaltered feeding efficiency, analysis of multiple variables measured by impedance monitoring revealed that nCPAP 6 does not alter nutritive esophagodeglutition in any way (nCPAP vs spontaneous breathing, P > 0.1 for all variables). offering further support to neonatologists pleading for initiation of oral feeding in infants still on nCPAP, the present results set the foundations for similar clinical studies in preterm human infants to confirm the absence of effects of nCPAP on nutritive swallowing.

Adrenal status assessed by direct radioimmunoassay of cortisol in whole saliva or parotid saliva

International Nuclear Information System (INIS)

Walker, R.F.; Riad-Fahmy, D.; Read, G.F.

1978-01-01

We describe a direct radioimmunoassay for cortisol in 10-μl volumes of parotid saliva or whole saliva. Binding proteins are absent from these fluids, as demonstrated by the excellent correlation between results for samples assayed directly and by a comparison procedure involving extraction with 1,2-dichloroethane. The direct assay is specific, precise, and had a lower limit of sensitivity of 4 pg per assay tube. Comparison of cortisol concentrations in plasma, parotid saliva, and whole saliva in persons undergoing investigations for assessing adrenal function, including stimulation with cosyntropin (Synachthen) and suppression with dexamethasone, indicated that changes in plasma cortisol concentration were accurately and immediately reflected in saliva from either the parotid-gland or whole saliva. A marked circadian rhythm has also been demonstrated for cortisol in parotid-gland saliva and whole saliva. We had to modify the 1,2-dichloroethane extraction procedure for accurate determination of cortisol in parotid saliva and whole saliva of patients undergoing treatment with metyrapone

Identification of Swallowing Tasks from a Modified Barium Swallow Study That Optimize the Detection of Physiological Impairment

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Hazelwood, R. Jordan; Armeson, Kent E.; Hill, Elizabeth G.; Bonilha, Heather Shaw; Martin-Harris, Bonnie

2017-01-01

Purpose: The purpose of this study was to identify which swallowing task(s) yielded the worst performance during a standardized modified barium swallow study (MBSS) in order to optimize the detection of swallowing impairment. Method: This secondary data analysis of adult MBSSs estimated the probability of each swallowing task yielding the derived…

[Dysphagia and swallowing rehabilitation].

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Shigematsu, Takashi; Fujishima, Ichiro

2015-02-01

Dysphagia is a life-threatening disorder caused by many medical conditions such as stroke, neurological disorders, tumors, etc. The symptoms of dysphagia are quite variable and diagnosed by observation or through screening involving instrumental swallowing examinations such as video-fluoroscopy and video-endoscopy, to determine functional severity and treatment-prognosis. Direct- and indirect-therapy is used with and without food, respectively. Swallowing rehabilitation is very effective, and could be used in conjunction with compensatory techniques. Here we present an overview of dysphagia and swallowing rehabilitation.

Prospective phase II study evaluating the efficacy of swallow ability screening tests and pneumonia prevention using a team approach for elderly patients with gastric cancer.

Science.gov (United States)

Miki, Yuichiro; Makuuchi, Rie; Honda, Shinsaku; Tokunaga, Masanori; Tanizawa, Yutaka; Bando, Etsuro; Kawamura, Taiichi; Yurikusa, Takashi; Tanuma, Akira; Terashima, Masanori

2018-03-01

Aging partly impairs swallowing function, which is considered a risk factor for postoperative pneumonia (PP). We evaluated the efficacy of a new team-based strategy to reduce the incidence of PP in elderly patients with gastric cancer. This single-center, prospective phase II study included elderly patients (≥75 years old) with gastric cancer undergoing gastric surgery. The primary endpoint was the incidence of Clavien-Dindo grade II or higher PP. Patients were initially screened using three swallowing function screening tests: a symptom questionnaire, the modified water swallow test (MSWT), and the repetitive saliva swallowing test (RSST). All patients were provided standard preoperative oral checks and care and simple neck muscle training. For patients who screened positive, a videofluorographic swallowing study was performed; if an abnormality was found, the patient was given intensive swallowing rehabilitation both pre- and postoperatively. Of 86 eligible patients enrolled, PP developed in 3 (3.5%). The 60% confidence interval of 1.8-6.3% had an upper limit below the prespecified threshold of 7.8%. Positive screening results were found for 19 patients (22.1%) on the symptom questionnaire, 3 (3.5%) on the MSWT, and 1 (1.2%) on the RSST. PP was not observed in any patients who screened positive. In conclusion, although the screening tests we adopted here were not sufficient to identify patients at high risk of aspiration pneumonia, perioperative interventions using a team approach might be effective in reducing the incidence of PP in elderly patients with gastric cancer.

Do Dysphagic Patients with an Absent Pharyngeal Swallow Have a Shorter Survival than Dysphagic Patients with Pharyngeal Swallow? Prognostic Importance of a Therapeutic Videoradiographic Swallowing Study (TVSS)

International Nuclear Information System (INIS)

Buelow, M.; Olsson, R.; Ekberg, O.

2005-01-01

Purpose: To study survival in two groups of dysphagic patients - one group unable to elicit the pharyngeal stage of swallow (APS) and another group with pharyngeal swallow (WPS) - and to compare recommendations regarding nutrition and therapeutic strategies based on the therapeutic swallowing study. Material and Methods: In this retrospective study, the records of dysphagic patients who have undergone a therapeutic videoradiographic swallowing study (TVSS) were reviewed. Forty patients without pharyngeal swallow were matched for age and gender with 40 patients with pharyngeal swallow; altogether 80 patients were included in the study. Survival was registered at 3, 12, and 72 months after the TVSS. Results: In this study, the APS group had a significantly shorter survival time compared to the WPS group when followed-up at 12 months. In the APS group, most patients (37.5% (15/40)) died within the 3 months after TVSS. At 72 months, 62.5% (25/40) of the patients in the APS group had died. In the WPS group, 5% (2/40) had died within 3 months and 47.4% (19/40) after 12 months. At 72 months, 52.5% (21/40) of the patients in the WPS group had died. Regarding nutritional and therapeutic recommendations based on TVSS, 34/40 in the APS group were recommended no oral intake. Eighteen naso-gastric tubes were placed directly after TVSS. The therapeutic strategies recommended were head-positioning, thermal tactile stimulation, and tongue exercises (in 8 patients). In the WPS group, all patients were recommended oral intake. Diet modification was recommended in 29 patients. The therapeutic strategies recommended were head-positioning, thermal tactile stimulation, tongue exercises, supraglottic swallow, and effortful swallow (in 24 patients). Conclusion: Patients unable to elicit the pharyngeal stage of swallow had a shorter survival time than patients with pharyngeal swallow, probably due to a more severe underlying disease. Tube feeding was more frequent in the APS group. Fewer

Prefrontal cortex activity during swallowing in dysphagia patients.

Science.gov (United States)

Lee, Jun; Yamate, Chisato; Taira, Masato; Shinoda, Masamichi; Urata, Kentaro; Maruno, Mitsuru; Ito, Reio; Saito, Hiroto; Gionhaku, Nobuhito; Iinuma, Toshimitsu; Iwata, Koichi

2018-05-24

Prefrontal cortex activity is modulated by flavor and taste stimuli and changes during swallowing. We hypothesized that changes in the modulation of prefrontal cortex activity by flavor and taste were associated with swallowing movement and evaluated brain activity during swallowing in patients with dysphagia. To evaluate prefrontal cortex activity in dysphagia patients during swallowing, change in oxidized hemoglobin (z-score) was measured with near-infrared spectroscopy while dysphagia patients and healthy controls swallowed sweetened/unsweetened and flavored/unflavored jelly. Total z-scores were positive during swallowing of flavored/unsweetened jelly and negative during swallowing of unflavored/sweetened jelly in controls but negative during swallowing of sweetened/unsweetened and flavored/unflavored jelly in dysphagia patients. These findings suggest that taste and flavor during food swallowing are associated with positive and negative z-scores, respectively. Change in negative and positive z-scores may be useful in evaluating brain activity of dysphagia patients during swallowing of sweetened and unsweetened food.

Difficulty Swallowing After Stroke (Dysphagia)

Science.gov (United States)

... Stroke Heroes Among Us Difficulty Swallowing After Stroke (Dysphagia) Updated:Nov 15,2016 Excerpted and adapted from "Swallowing Disorders After a Stroke," Stroke Connection Magazine July/August ...

Worldwide survey of damage from swallowing multiple magnets

Energy Technology Data Exchange (ETDEWEB)

Oestreich, Alan E. [Cincinnati Children' s Hospital Medical Center, Radiology Department 5031, Cincinnati, OH (United States)

2009-02-15

It is increasingly recognized that in children swallowed multiple magnets cause considerable damage to the gastrointestinal tract. To emphasize that complications from swallowed magnets are extensive worldwide and throughout childhood. The author surveyed radiologists and researched cases of magnet swallowing in the literature and documented age and gender, numbers of magnets, nature of the magnets, reasons for swallowing, and clinical course. A total of 128 instances of magnet swallowing were identified, one fatal. Cases from 21 countries were found. Magnet swallowing occurred throughout childhood, with most children older than 3 years of age. Numbers of swallowed magnets ranged up to 100. Twelve children were known to be autistic. Many reasons were given for swallowing magnets, and a wide range of gastrointestinal damage was encountered. Considerable delay before seeking medical assistance was frequent, as was delay before obtaining radiographs or US imaging. Damage from swallowing multiple magnets is a considerable worldwide problem. More educational and preventative measures are needed. (orig.)

Worldwide survey of damage from swallowing multiple magnets

International Nuclear Information System (INIS)

Oestreich, Alan E.

2009-01-01

It is increasingly recognized that in children swallowed multiple magnets cause considerable damage to the gastrointestinal tract. To emphasize that complications from swallowed magnets are extensive worldwide and throughout childhood. The author surveyed radiologists and researched cases of magnet swallowing in the literature and documented age and gender, numbers of magnets, nature of the magnets, reasons for swallowing, and clinical course. A total of 128 instances of magnet swallowing were identified, one fatal. Cases from 21 countries were found. Magnet swallowing occurred throughout childhood, with most children older than 3 years of age. Numbers of swallowed magnets ranged up to 100. Twelve children were known to be autistic. Many reasons were given for swallowing magnets, and a wide range of gastrointestinal damage was encountered. Considerable delay before seeking medical assistance was frequent, as was delay before obtaining radiographs or US imaging. Damage from swallowing multiple magnets is a considerable worldwide problem. More educational and preventative measures are needed. (orig.)

Pediatric feeding and swallowing rehabilitation: An overview.

Science.gov (United States)

van den Engel-Hoek, Lenie; Harding, Celia; van Gerven, Marjo; Cockerill, Helen

2017-05-16

Children with neurological disabilities frequently have problems with feeding and swallowing. Such problems have a significant impact on the health and well-being of these children and their families. The primary aims in the rehabilitation of pediatric feeding and swallowing disorders are focused on supporting growth, nutrition and hydration, the development of feeding activities, and ensuring safe swallowing with the aim of preventing choking and aspiration pneumonia. Pediatric feeding and swallowing disorders can be divided into four groups: transient, developmental, chronic or progressive.This article provides an overview of the available literature about the rehabilitation of feeding and swallowing disorders in infants and children. Principles of motor control, motor learning and neuroplasticity are discussed for the four groups of children with feeding and swallowing disorders.

How do tablet properties influence swallowing behaviours?

Science.gov (United States)

Yamamoto, Shinya; Taniguchi, Hiroshige; Hayashi, Hirokazu; Hori, Kazuhiro; Tsujimura, Takanori; Nakamura, Yuki; Sato, Hideaki; Inoue, Makoto

2014-01-01

Behavioural performance of tablet swallowing was evaluated with different tablet conditions in terms of size, number and surface coating. Four different types of tablets were prepared: small or large, and with or without a surface coating. Fourteen normal male adults were instructed to swallow the prepared tablets with 15 ml of water. The number of tablets in one trial was changed from one to three. To evaluate swallowing and tablet transport, electromyographic activity was recorded in the left suprahyoid muscles, and videofluorographic images were examined. All tablet conditions (size, number and surface coating) affected the swallowing performance in terms of total number of swallows, electromyographic burst patterns and location of remaining tablets. Increases in the size and number of tablets increased the number of swallows and electromyographic burst area and duration. In addition, all of these parameters increased while swallowing tablets without a coating compared with tablets with a coating. Location of the remaining tablets was mainly within the mouth. This study only clarified the normal pattern of tablet swallowing under several conditions in healthy subjects, but the results may facilitate comprehensive evaluation and treatment planning in terms of administering medication to dysphagic patients. © 2013 Royal Pharmaceutical Society.

Saliva Preservative for Diagnostic Purposes

Science.gov (United States)

Pierson, Duane L.; Mehta, Satish K.

2012-01-01

Saliva is an important body fluid for diagnostic purposes. Glycoproteins, glucose, steroids, DNA, and other molecules of diagnostic value are found in saliva. It is easier to collect as compared to blood or urine. Unfortunately, saliva also contains large numbers of bacteria that can release enzymes, which can degrade proteins and nucleic acids. These degradative enzymes destroy or reduce saliva s diagnostic value. This innovation describes the formulation of a chemical preservative that prevents microbial growth and inactivates the degradative enzymes. This extends the time that saliva can be stored or transported without losing its diagnostic value. Multiple samples of saliva can be collected if needed without causing discomfort to the subject and it does not require any special facilities to handle after it is collected.

Diagnosis of Spasmodic Dysphonia Manifested by Swallowing Difficulty in Videofluoroscopic Swallowing Study

Science.gov (United States)

Yeo, Han Gyeol; Lee, Seong Jae; Hyun, Jung Keun

2015-01-01

Spasmodic dysphonia is defined as a focal laryngeal disorder characterized by dystonic spasms of the vocal cord during speech. We described a case of a 22-year-old male patient who presented complaining of idiopathic difficulty swallowing that suddenly developed 6 months ago. The patient also reported pharyngolaryngeal pain, throat discomfort, dyspnea, and voice change. Because laryngoscopy found no specific problems, an electrodiagnostic study and videofluoroscopic swallowing study (VFSS) were performed to find the cause of dysphagia. The VFSS revealed continuous twitch-like involuntary movement of the laryngeal muscle around the vocal folds. Then, he was diagnosed with spasmodic dysphonia by VFSS, auditory-perceptual voice analysis, and physical examination. So, we report the first case of spasmodic dysphonia accompanied with difficulty swallowing that was confirmed by VFSS. PMID:25932430

Mastication and swallowing in patients with postirradiation xerostomia

International Nuclear Information System (INIS)

Hamlet, Sandra; Faull, Jennifer; Klein, Barbara; Aref, Amr; Fontanesi, James; Stachler, Robert; Shamsa, Falah; Jones, Lewis; Simpson, Mark

1997-01-01

Purpose: Very little objective data has been reported on mastication and swallowing in xerostomic patients, which would substantiate presumed causal relationships between xerostomia and patient complaints. The purpose was to elucidate which components of mastication and swallowing were abnormal, and most directly related to xerostomia, and which appeared unaffected. Methods and Materials: A retrospective analysis of timing events in mastication and swallowing was done using videofluoroscopic data for 15 cancer patients with xerostomia, and 20 normal controls. Scintigraphy was also used to determine oropharyngeal residue after a water swallow. Cancer treatment modalities included radiation therapy or chemoradiation therapy. Results: For barium liquid and paste substances, timing measures were equivalent for controls and patients. Xerostomic patients took 46% longer to masticate a shortbread cookie, and timing for the initiation of swallowing was shorter, but duration of swallowing appeared unaffected. Oral and pharyngeal residues following the swallow were greater in the patient group. Conclusions: Xerostomia primarily affected mastication and oral manipulation of a dry, absorbent food material. Increased oral and pharyngeal residues after a water swallow are ambiguously related to xerostomia. The initiation and duration of the pharyngeal swallow was not abnormal

Saliva and wound healing.

Science.gov (United States)

Brand, Henk S; Ligtenberg, Antoon J M; Veerman, Enno C I

2014-01-01

Oral wounds heal faster and with less scar formation than skin wounds. One of the key factors involved is saliva, which promotes wound healing in several ways. Saliva creates a humid environment, thus improving the survival and functioning of inflammatory cells that are crucial for wound healing. In addition, saliva contains several proteins which play a role in the different stages of wound healing. Saliva contains substantial amounts of tissue factor, which dramatically accelerates blood clotting. Subsequently, epidermal growth factor in saliva promotes the proliferation of epithelial cells. Secretory leucocyte protease inhibitor inhibits the tissue-degrading activity of enzymes like elastase and trypsin. Absence of this protease inhibitor delays oral wound healing. Salivary histatins in vitro promote wound closure by enhancing cell spreading and cell migration, but do not stimulate cell proliferation. A synthetic cyclic variant of histatin exhibits a 1,000-fold higher activity than linear histatin, which makes this cyclic variant a promising agent for the development of a new wound healing medication. Conclusively, recognition of the many roles salivary proteins play in wound healing makes saliva a promising source for the development of new drugs involved in tissue regeneration.

Swallowing Disorders in Schizophrenia.

Science.gov (United States)

Kulkarni, Deepika P; Kamath, Vandan D; Stewart, Jonathan T

2017-08-01

Disorders of swallowing are poorly characterized but quite common in schizophrenia. They are a source of considerable morbidity and mortality in this population, generally as a result of either acute asphyxia from airway obstruction or more insidious aspiration and pneumonia. The death rate from acute asphyxia may be as high as one hundred times that of the general population. Most swallowing disorders in schizophrenia seem to fall into one of two categories, changes in eating and swallowing due to the illness itself and changes related to psychotropic medications. Behavioral changes related to the illness are poorly understood and often involve eating too quickly or taking inappropriately large boluses of food. Iatrogenic problems are mostly related to drug-induced extrapyramidal side effects, including drug-induced parkinsonism, dystonia, and tardive dyskinesia, but may also include xerostomia, sialorrhea, and changes related to sedation. This paper will provide an overview of common swallowing problems encountered in patients with schizophrenia, their pathophysiology, and management. While there is a scarcity of quality evidence in the literature, a thorough history and examination will generally elucidate the predominant problem or problems, often leading to effective management strategies.

Does Barium Influence Tongue Behaviors during Swallowing?

Science.gov (United States)

Steele, Catriona M.; van Lieshout, Pascal H. H. M.

2005-01-01

The validity of videofluoroscopic swallowing assessments rests on the understanding that thin, nectar-, honey-, and spoon-thick radiopaque liquids resemble nonopaque liquids, both in their consistency and in the variations in swallowing that they elicit. Tongue movements during sequential swallows of opaque and nonopaque liquids were studied in 8…

Swallowing frequency in elderly people during daily life.

Science.gov (United States)

Tanaka, N; Nohara, K; Kotani, Y; Matsumura, M; Sakai, T

2013-10-01

Disuse atrophy of swallowing-related organs due to an excessive decrease in swallowing frequency is suspected to occur in patients with poor oral intake, especially elderly people. However, swallowing frequency in daily life has not previously been examined in the elderly. This study examined swallowing frequency in elderly people and compared these findings to those in a younger population and differences in the degree of activity in daily life. (i) We compared swallowing frequency in 20 elderly people (82·0 ± 8·3 year) and 15 healthy young people (26·5 ± 3·5 year). (ii) 20 elderly people were divided into two groups according to the degree of activity in daily life: a semi-bedridden group and bedridden group; the swallowing frequency was compared between these groups. (i) The swallowing frequency in the elderly people was 2-19 times per hour and the mean was 9·4 ± 4·9, and that in the healthy young people was 16-76 times per hour and the mean was 40·7 ± 19·5. Swallowing frequency in elderly people was significantly lower than that in young healthy people (P bedridden group was 2-11 times per hour and the mean was 6·8 ± 3·3, and that in semi-bedridden group was 3-19 times per hour and the mean was 11·9 ± 5·1. Swallowing frequency in bedridden group was significantly lower than that in semi-bedridden group (P elderly people tend to swallow less frequently than young people. In addition, swallowing frequency was lower in elderly subjects with a low degree of activity in daily life. © 2013 John Wiley & Sons Ltd.

Swallowing disorders in Parkinson's disease.

Science.gov (United States)

Mamolar Andrés, Sandra; Santamarina Rabanal, María Liliana; Granda Membiela, Carla María; Fernández Gutiérrez, María José; Sirgo Rodríguez, Paloma; Álvarez Marcos, César

Parkinson's disease is a type of chronic neurodegenerative pathology with a typical movement pattern, as well as different, less studied symptoms such as dysphagia. Disease-related disorders in efficacy or safety in the process of swallowing usually lead to malnutrition, dehydration or pneumonias. The aim of this study was identifying and analyzing swallowing disorders in Parkinson's disease. The initial sample consisted of 52 subjects with Parkinson's disease to whom the specific test for dysphagia SDQ was applied. Nineteen participants (36.5%) with some degree of dysphagia in the SDQ test were selected to be evaluated by volume-viscosity clinical exploration method and fiberoptic endoscopic evaluation of swallowing. Disorders in swallowing efficiency and safety were detected in 94.7% of the selected sample. With regards to efficiency, disorders were found in food transport (89.5%), insufficient labial closing (68.4%) and oral residues (47.4%), relating to duration of ingestion. Alterations in security were also observed: pharynx residues (52.7%), coughing (47.4%), penetration (31.64%), aspiration and decrease of SaO 2 (5.3%), relating to the diagnosis of respiratory pathology in the previous year. The SDQ test detected swallowing disorders in 36.5% of the subjects with Parkinson's disease. Disorders in swallowing efficiency and safety were demonstrated in 94.7% of this subset. Disorders of efficiency were more frequent than those of safety, establishing a relationship with greater time in ingestion and the appearance of respiratory pathology and pneumonias. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Diagnosis of Swallowing Disorders: How We Interpret Pharyngeal Manometry.

Science.gov (United States)

Cock, Charles; Omari, Taher

2017-03-01

We provide an overview of the clinical application of novel pharyngeal high-resolution impedance manometry (HRIM) with pressure flow analysis (PFA) in our hands with example cases. In our Centre, we base our interpretation of HRIM recordings upon a qualitative assessment of pressure-impedance waveforms during individual swallows, as well as a quantitative assessment of averaged PFA swallow function variables. We provide a description of two global swallowing efficacy measures, the swallow risk index (SRI), reflecting global swallowing dysfunction (higher SRI = greater aspiration risk) and the post-swallow impedance ratio (PSIR) detecting significant post-swallow bolus residue. We describe a further eight swallow function variables specific to the hypopharynx and upper esophageal sphincter (UES), assessing hypo-pharyngeal distension pressure, contractility, bolus presence and flow timing, and UES basal tone, relaxation, opening and contractility. Pharyngeal HRIM has now come of age, being applicable for routine clinical practice to assess the biomechanics of oropharyngeal swallowing dysfunction. In the future, it may guide treatment strategies and allow more objective longitudinal follow-up on clinical outcomes.

Effects of pollution on swallowing: how little we know

Energy Technology Data Exchange (ETDEWEB)

Palmer, J.B.; Silver, K.H. (Division of Rehabilitation Medicine, Johns Hopkins University, Baltimore, MD (United States))

1992-06-01

Swallowing is an essential function of the upper alimentary tract. It is highly complex, requiring precise coordination of numerous nerves and muscles of the oral cavity, pharynx, larynx, and esophagus. Swallowing is integrated with other physiologic functions, including mastication and respiration. Impairments of swallowing may result from many different structural or physiologic disorders. Little is currently known about the direct effects of pollution on swallowing. Structures critical to swallowing, however, are vulnerable to damage by environmental hazards such as exposure to ionizing radiation or intake of toxins by ingestion or inhalation. The relationship of swallowing to environmental lung disease is an area of particular interest because impaired swallowing may result in aspiration of food particles into the lung, and because pollutants may hamper airway defense mechanisms. In this article, we discuss the possible impact of selected environmental agents on swallowing and suggest future directions for research.26 references.

Swallowing difficulties in Duchenne muscular dystrophy: indications for feeding assessment and outcome of videofluroscopic swallow studies

DEFF Research Database (Denmark)

Aloysius, A.; Born, P.; Kinali, M.

2008-01-01

were performed. Prolonged chewing and effortful bolus transport for solids increased with age. Swallow trigger was normal in the majority of cases. All patients had some post-swallow pharyngeal residue around the laryngeal inlet increasing in volume with age. Although this residue did not result...... on VFSS. It is the oral phase of swallowing that is most significantly affected in DMD. The pharyngeal phase is well triggered but is weak with incomplete pharyngeal clearance leaving pharyngeal residue. Insufficient or effortful chewing coupled with weak clearance may predispose them to choking episodes...

Drooling in Parkinson's Disease: Evidence of a Role for Divided Attention.

Science.gov (United States)

Reynolds, Hannah; Miller, Nick; Walker, Richard

2018-05-21

Drooling is a frequently reported symptom in Parkinson's Disease (PD) with significant psychosocial impact and negative health consequences including silent aspiration of saliva with the associated risk of respiratory infections. It is suggested that in PD drooling is associated with inefficient oropharyngeal swallowing which reduces the effective clearance of saliva rather than hyper-salivation. This is compounded by unintended mouth opening and flexed posture increasing anterior loss of saliva. It is reported to occur most frequently during cognitively distracting concurrent tasks suggesting an impact from divided attention in a dual-task situation. However, this supposition has not been systematically examined. This study assessed whether frequency of saliva swallows reduced, and drooling severity and frequency increased, when people with PD engaged in a cognitively distracting task. 18 patients with idiopathic PD reporting daytime drooling on the Unified Parkinson's Disease Rating Scale (UPDRS) were recruited. They completed the Radboud Oral Motor Inventory for PD saliva questionnaire and the Montreal Cognitive Assessment. UPDRS drooling score, disease stage, duration, gender, and age were recorded. Swallow frequency and drooling severity and frequency were measured at rest and during a distracting computer-based language task. There was no significant difference between drooling severity at rest and during distraction (Wilcoxon signed rank test z = - 1.724, p = 0.085). There was a significant difference between at rest and distraction conditions for both drooling frequency (Wilcoxon signed rank test z = - 2.041, p = 0.041) and swallow frequency (Wilcoxon signed rank test z = - 3.054, p = 0.002). Participants swallowed less frequently and drooled more often during the distraction task. The frequency of saliva swallows and drooling are affected by divided attention in a dual-task paradigm. Further studies are needed to explore the

Longitudinal Study of Hepatitis A Infection by Saliva Sampling: The Kinetics of HAV Markers in Saliva Revealed the Application of Saliva Tests for Hepatitis A Study

Science.gov (United States)

Amado Leon, Luciane Almeida; de Almeida, Adilson José; de Paula, Vanessa Salete; Tourinho, Renata Santos; Villela, Daniel Antunes Maciel; Gaspar, Ana Maria Coimbra; Lewis-Ximenez, Lia Laura; Pinto, Marcelo Alves

2015-01-01

Despite the increasing numbers of studies investigating hepatitis A diagnostic through saliva, the frequency and the pattern of hepatitis A virus (HAV) markers in this fluid still remains unknown. To address this issue, we carried on a longitudinal study to examine the kinetics of HAV markers in saliva, in comparison with serum samples. The present study followed-up ten patients with acute hepatitis A infection during 180 days post diagnosis (dpd). Total anti-HAV was detected in paired serum and saliva samples until the end of the follow-up, showing a peak titer at 90th. However, total anti-HAV level was higher in serum than in saliva samples. This HAV marker showed a probability of 100% to be detected in both serum and saliva during 180 dpd. The IgM anti-HAV could be detected in saliva up to 150 dpd, showing the highest frequency at 30th, when it was detected in all individuals. During the first month of HAV infection, this acute HAV marker showed a detection probability of 100% in paired samples. The detection of IgM anti-HAV in saliva was not dependent on its level in serum, HAV-RNA detection and/or viral load, since no association was found between IgM anti-HAV positivity in saliva and any of these parameter (p>0.05). Most of the patients (80%) were found to contain HAV-RNA in saliva, mainly at early acute phase (30th day). However, it was possible to demonstrate the HAV RNA presence in paired samples for more than 90 days, even after seroconversion. No significant relationship was observed between salivary HAV-RNA positivity and serum viral load, demonstrating that serum viral load is not predictive of HAV-RNA detection in saliva. Similar viral load was seen in paired samples (on average 104 copies/mL). These data demonstrate that the best diagnostic coverage can be achieved by salivary anti-HAV antibodies and HAV-RNA tests during 30–90 dpd. The long detection and high probability of specific-HAV antibodies positivity in saliva samples make the assessment of

Cervical auscultation as an adjunct to the clinical swallow examination: a comparison with fibre-optic endoscopic evaluation of swallowing.

Science.gov (United States)

Bergström, Liza; Svensson, Per; Hartelius, Lena

2014-10-01

This prospective, single-blinded study investigated the validity and reliability of cervical auscultation (CA) under two conditions; (1) CA-only, using isolated swallow-sound clips, and (2) CSE + CA, using extra clinical swallow examination (CSE) information such as patient case history, oromotor assessment, and the same swallow-sound clips as condition one. The two CA conditions were compared against a fibre-optic endoscopic evaluation of swallowing (FEES) reference test. Each CA condition consisted of 18 swallows samples compiled from 12 adult patients consecutively referred to the FEES clinic. Patients' swallow sounds were simultaneously recorded during FEES via a Littmann E3200 electronic stethoscope. These 18 swallow samples were sent to 13 experienced dysphagia clinicians recruited from the UK and Australia who were blinded to the FEES results. Samples were rated in terms of (1) if dysphagic, (2) if the patient was safe on consistency trialled, and (3) dysphagia severity. Sensitivity measures ranged from 83-95%, specificity measures from 50-92% across the conditions. Intra-rater agreement ranged from 69-97% total agreement. Inter-rater reliability for dysphagia severity showed substantial agreement (rs = 0.68 and 0.74). Results show good rater reliability for CA-trained speech-language pathologists. Sensitivity and specificity for both CA conditions in this study are comparable to and often better than other well-established CSE components.

A comparative analysis of DBSCAN, K-means, and quadratic variation algorithms for automatic identification of swallows from swallowing accelerometry signals.

Science.gov (United States)

Dudik, Joshua M; Kurosu, Atsuko; Coyle, James L; Sejdić, Ervin

2015-04-01

Cervical auscultation with high resolution sensors is currently under consideration as a method of automatically screening for specific swallowing abnormalities. To be clinically useful without human involvement, any devices based on cervical auscultation should be able to detect specified swallowing events in an automatic manner. In this paper, we comparatively analyze the density-based spatial clustering of applications with noise algorithm (DBSCAN), a k-means based algorithm, and an algorithm based on quadratic variation as methods of differentiating periods of swallowing activity from periods of time without swallows. These algorithms utilized swallowing vibration data exclusively and compared the results to a gold standard measure of swallowing duration. Data was collected from 23 subjects that were actively suffering from swallowing difficulties. Comparing the performance of the DBSCAN algorithm with a proven segmentation algorithm that utilizes k-means clustering demonstrated that the DBSCAN algorithm had a higher sensitivity and correctly segmented more swallows. Comparing its performance with a threshold-based algorithm that utilized the quadratic variation of the signal showed that the DBSCAN algorithm offered no direct increase in performance. However, it offered several other benefits including a faster run time and more consistent performance between patients. All algorithms showed noticeable differentiation from the endpoints provided by a videofluoroscopy examination as well as reduced sensitivity. In summary, we showed that the DBSCAN algorithm is a viable method for detecting the occurrence of a swallowing event using cervical auscultation signals, but significant work must be done to improve its performance before it can be implemented in an unsupervised manner. Copyright © 2015 Elsevier Ltd. All rights reserved.

Isometric and swallowing tongue strength in healthy adults.

Science.gov (United States)

Todd, J Tee; Lintzenich, Catherine Rees; Butler, Susan G

2013-10-01

The tongue contributes to a safe swallow. It facilitates bolus control during mastication, maintains a bolus in the oral cavity to prevent premature entry of the bolus into the hypopharynx, and helps generate pressure in the hypopharynx during swallowing. This study examined isometric tongue strength and tongue pressure measured during swallowing in healthy young and older adults. Prospective group design. One hundred twenty-six healthy individuals who were recruited as part of a larger study on swallowing participated in this study. Participants were divided into three age groups: 20 to 40 years, 41 to 60 years, and ≥61 years. A KayPentax Digital Swallowing Workstation with an air-filled bulb array was placed on the tongue of each participant (anterior to posterior). Participants completed three isometric tongue presses and three swallows. Repeated measures analyses of variance revealed a significant main effect of age (P = .01) and gender by tongue bulb location interaction (P = .02) for isometric tongue strength. That is, older adults had lower isometric tongue strength than young adults, and females had a greater difference between anterior and posterior tongue strength than males. Tongue strength during swallowing yielded significantly greater anterior versus posterior tongue pressure. This study comprises one of the largest in terms of number of healthy participants reported to date and confirms previous findings that isometric tongue strength decreases with age. Furthermore, given young and older adults generate similar swallowing pressures, swallowing is a submaximal strength activity, yet older adults have less functional reserve. 4. Copyright © 2013 The American Laryngological, Rhinological, and Otological Society, Inc.

A device for the collection of submandibular saliva.

Science.gov (United States)

Hanning, Sara; Motoi, Lidia; Medlicott, Natalie; Swindells, Stephen

2012-03-01

The objective of this study was to describe the construction of a non-invasive device for the collection of submandibular saliva. Preliminary tests were carried out on saliva collected from a single donor in order to determine whether the rheological properties of submandibular saliva collected using the device were comparable to whole saliva collected using the expectoration (or 'spit') method. The device collected a lower quantity of saliva than that collected using the expectoration method. Stimulated saliva collected using the device had a pH close to that of unstimulated saliva because the sealed collection unit in the device minimised contamination. Saliva exhibited shear-thinning behaviour regardless of the method of collection, although that collected using the device was more viscous. The viscoelasticity of saliva collected using the two methods was different, probably as a result of differences in composition. This difference was greater with stimulated saliva. Despite the discrepancies between whole saliva and submandibular saliva, the device provides a non-invasive method for the collection of high-quality saliva over extended periods.

Chemical Sensing Regulates Mastication/Swallowing.

Science.gov (United States)

Yamamura, Kensuke; Kurose, Masayuki; Okamoto, Keiichiro

2016-01-01

Mastication and swallowing are the first stage of digestion involving several motor processes such as food intake, intra-oral food transport, bolus formation and chewing and swallowing reflex. These complicated motor functions are accomplished by the well-coordinated activities in the jaw, hyoid, tongue, facial and pharyngeal muscles. Although the basic activity patterns of these movements are controlled by the brainstem pattern generators, these movements generate various peripheral sensory inputs. Among the sensory inputs, it is well-known that somatic sensory inputs play important roles in reflexively modulating the movements so that the final motor outputs fit the environmental demand. However, little is known about the effects of chemical sensory inputs such as taste and olfaction originating from the ingested foods by these movements. A possible reason could be raised that cognition of the chemical sensory inputs at the higher brain also influences the movements, so it is difficult to discuss the neural mechanisms underlying the observed effect. In this review, we focus on the effects of chemical sensory inputs on the masticatory movements and initiation of swallowing. We first summarize chemical sensory inputs occurring during mastication and swallowing, and their receptive mechanisms. In addition, we will introduce the effect of application of monosodium L-glutamate (MSG) solution as an umami taste to the oropharynx on the swallow initiation which is involuntary controlled and the possible neural mechanisms underlying this effect is discussed.

Risk factors for swallowing dysfunction in stroke patients

Directory of Open Access Journals (Sweden)

Anna Flávia Ferraz Barros Baroni

2012-06-01

Full Text Available CONTEXT: Stroke is a frequent cause of dysphagia. OBJECTIVE: To evaluate in a tertiary care hospital the prevalence of swallowing dysfunction in stroke patients, to analyze factors associated with the dysfunction and to relate swallowing dysfunction to mortality 3 months after the stroke. METHODS: Clinical evaluation of deglutition was performed in 212 consecutive patients with a medical and radiologic diagnosis of stroke. The occurrence of death was determined 3 months after the stroke. RESULTS: It was observed that 63% of the patients had swallowing dysfunction. The variables gender and specific location of the lesion were not associated with the presence or absence of swallowing dysfunction. The patients with swallowing dysfunction had more frequently a previous stroke, had a stroke in the left hemisphere, motor and/or sensitivity alterations, difficulty in oral comprehension, alteration of oral expression, alteration of the level of consciousness, complications such as fever and pneumonia, high indexes on the Rankin scale, and low indexes on the Barthel scale. These patients had a higher mortality rate. CONCLUSIONS: Swallowing evaluation should be done in all patients with stroke, since swallowing dysfunction is associated with complications and an increased risk of death.

STAMPS: development and verification of swallowing kinematic analysis software.

Science.gov (United States)

Lee, Woo Hyung; Chun, Changmook; Seo, Han Gil; Lee, Seung Hak; Oh, Byung-Mo

2017-10-17

Swallowing impairment is a common complication in various geriatric and neurodegenerative diseases. Swallowing kinematic analysis is essential to quantitatively evaluate the swallowing motion of the oropharyngeal structures. This study aims to develop a novel swallowing kinematic analysis software, called spatio-temporal analyzer for motion and physiologic study (STAMPS), and verify its validity and reliability. STAMPS was developed in MATLAB, which is one of the most popular platforms for biomedical analysis. This software was constructed to acquire, process, and analyze the data of swallowing motion. The target of swallowing structures includes bony structures (hyoid bone, mandible, maxilla, and cervical vertebral bodies), cartilages (epiglottis and arytenoid), soft tissues (larynx and upper esophageal sphincter), and food bolus. Numerous functions are available for the spatiotemporal parameters of the swallowing structures. Testing for validity and reliability was performed in 10 dysphagia patients with diverse etiologies and using the instrumental swallowing model which was designed to mimic the motion of the hyoid bone and the epiglottis. The intra- and inter-rater reliability tests showed excellent agreement for displacement and moderate to excellent agreement for velocity. The Pearson correlation coefficients between the measured and instrumental reference values were nearly 1.00 (P software is expected to be useful for researchers who are interested in the swallowing motion analysis.

Oestrogens in saliva

International Nuclear Information System (INIS)

Rothschild, R.S.; Levine, L.S.; Hattingh, J.

1981-01-01

Matched plasma and saliva samples were obtained from a non-pregnant and pregnant group (last trimester) of female caucasians. Using a sensitive radioimmunoassay, 17β-oestradiol was measured, and the gingival index system of Loe (1967) was used to assess the gingival condition of each patient. The results showed that 17β-oestradiol could be measured in saliva but that the levels were extremely low and a very sensitive immunoassay was necessary. In the pregnant group, saliva represented 3 per cent of the plasma level. This was not the case in the non-pregnant group, probably because of the constantly changing free: bound plasma ratio. The results are discussed in relation to the fact that oestrogens are known to bind to the oral epithelium [af

Swallowing Trouble

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... throat discomfort in the throat or chest (when gastro esophageal reflux is present) a sensation of a foreign body ... to the particular cause of the swallowing disorder. Gastro esophageal reflux can often be treated by changing eating and ...

Interjudge agreement in videofluoroscopic studies of swallowing.

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Wilcox, F; Liss, J M; Siegel, G M

1996-02-01

Videofluoroscopic swallowing examinations of 3 patients with dysphagia were reviewed independently by 10 speech-language pathologists. Prior to viewing each video, clinicians were provided with information about the patient's history, the results of a bedside swallow examination, and oral-facial and oral motor control examinations. Clinicians completed a swallowing observation protocol as they viewed each video. They then recommended, from a list of treatment strategies, intervention techniques that would be most appropriate for each patient. Interjudge agreement was calculated by determining how many clinicians observed a given swallowing event or deficit, and how many recommended a given treatment strategy. Results suggest that the level of interjudge agreement for videofluoroscopic evaluations is not encouragingly high.

Aspirating and Nonaspirating Swallow Sounds in Children: A Pilot Study.

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Frakking, Thuy; Chang, Anne; O'Grady, Kerry; David, Michael; Weir, Kelly

2016-12-01

Cervical auscultation (CA) may be used to complement feeding/swallowing evaluations when assessing for aspiration. There are no published pediatric studies that compare the properties of sounds between aspirating and nonaspirating swallows. To establish acoustic and perceptual profiles of aspirating and nonaspirating swallow sounds and determine if a difference exists between these 2 swallowing types. Aspiration sound clips were obtained from recordings using CA simultaneously undertaken with videofluoroscopic swallow study. Aspiration was determined using the Penetration-Aspiration Scale. The presence of perceptual swallow/breath parameters was rated by 2 speech pathologists who were blinded to the type of swallow. Acoustic data between groups were compared using Mann Whitney U-tests, while perceptual differences were determined by a test of 2 proportions. Combinations of perceptual parameters of 50 swallows (27 aspiration, 23 no aspiration) from 47 children (57% male) were statistically analyzed using area under a receiver operating characteristic (aROC), sensitivity, specificity, and positive and negative predictive values to determine predictors of aspirating swallows. The combination of post-swallow presence of wet breathing and wheeze and absence of GRS and normal breathing was the best predictor of aspiration (aROC = 0.82, 95% CI, 0.70-0.94). There were no significant differences between these 2 swallow types for peak frequency, duration, and peak amplitude. Our pilot study has shown that certain characteristics of swallow obtained using CA may be useful in the prediction of aspiration. However, further research comparing the acoustic swallowing sound profiles of normal children to children with dysphagia (who are aspirating) on a larger scale is required. © The Author(s) 2016.

ARSENIC SPECIATION ANALYSIS IN HUMAN SALIVA

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Background: Determination of arsenic species in human saliva is potentially useful for biomonitoring of human exposure to arsenic and for studying arsenic metabolism. However, there is no report on the speciation analysis of arsenic in saliva. Methods: Arsenic species in saliva ...

Seed germination behavior of swallow wort

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amir hosein pahlavani

2009-06-01

Full Text Available The exotic plant, Swallow- wort, a twining perennial of the Milkweed family, has become increasingly invasive in some place of Iran, especially orchards. Increased knowledge of wort germination biology would facilitate development of an optimum control program. Germination of Swallow wort seeds as affected by environmental factors was studied under controlled-environment growth chamber conditions. The following studies were conducted in plant Pests & Diseases Research Institute during the years 2003-4: 1- Effect of constant temperature on germination that including 10, 15, 18, 20, 25, 30, 35 and 40˚C; 2- Effect of light on constant germination; 3- Effect of temperature fluctuations on seed germination: 15/7, 20/12, 25/17 and 30/22˚C. All experiments were conducted with 8 replications. Swallow wort seeds showed no dormancy when detachment from mother plant. Seed germination was strongly influenced by temperature. Light did not play a crucial role on seed germination of this weed. Therefore Swallow wort seeds were not photoblastic and temperature fluctuations did not increase seed germination of Swallow wort. The above characteristics are very important in making swallowwort an invasive weed. Having precise information of these traits enables us to a better management and control of this troublesome weed.

Motor imagery and swallowing: a systematic literature review

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Ada Salvetti Cavalcanti Caldas

Full Text Available ABSTRACT Objetive: to identify, in the literature, studies that address the use of motor imagery of swallowing. Methods: a systematic review in SCOPUS databases, Science Direct and Medline, with descriptors and free terms "Motor Imagery"; "Swallow"; "Feeding"; "Stomatognathic System"; "mastication ", "Chew "; "Deglutition "; "Deglutition Disorders "; and "Mental Practice". Original articles using the motor imagery of swallowing were included, while reviews were excluded. For data analysis, at the first and second steps, the reading of titles and abstracts of the studies was carried out. In the third step, all studies that were not excluded were read in full. Results: four manuscripts were selected. The use of motor imagery in the rehabilitation of swallowing shows to be a recent proposal (2014-2015. The sample was reduced and comprised mainly healthy individuals. The EMG of the supra-hyoid muscles was used in two manuscripts. The most used neuroimaging technique was the Near-Infrared Spectroscopy, demonstrating the occurrence of hemodynamic changes during motor imagery and motor execution of swallowing. Conclusion: the motor imagery produces brain response in the motor area of the brain, suggesting that mentalization of actions related to swallowing is effective. However, further studies are needed for the application of this approach in the swallowing rehabilitation.

The pH changes of artificial saliva after interaction with oral of artificial saliva after interaction with oral micropathogen

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Basri A. Gani

2012-12-01

Full Text Available Backgorund: Saliva contains several protein elements, exocrine proteins and antibodies, such as lactoferrin, sIgA, peroxidase, albumin, polypeptides, and oligopeptides that contribute to the defense of oral mucosa and dental pellicle to prevent infection caused by oral micropathogen, such as Candida albicans, Streptococcus mutans and Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans. Those micropathogens have a role to change salivary pH as an indicator of oral disease activities. Purpose: This study was aimed to analyze the changes of artificial saliva pH after interaction with S. mutans, C. albicans, and A. Actinomycetemcpmitans. Methods: The materials used in this study consist of S. mutans (ATCC 31987, C. albicans (ATCC 10231, A. actinomycetemcomitans (ATTC 702 358, and artificial saliva. To examine the pH changes of artificial saliva, those three microbiotas were cultured and incubated for 24 hours. Results: The results showed that the interactions of S. mutans, C. albicans, and A. actinomycetemcomitans in the artificial saliva can change the salivary on neutral. There were no significant difference with the control treatment salivary pH 4, 5, 6, 8, and 9 (p>0.05. Similarly, there was also no significant difference when those three microorganism interacted each other in the artificial saliva (p<0.05. Conclusion: It can be concluded that the biological activity of S. mutans, C. albicans, and A. actinomycetemcomitans in artificial saliva can change the salivary pH into neutral. It indicates that those microbiotas mutually supported and cooperated in influencing the biological cycle of the oral cavity with salivary pH as an indicator.Latar belakang: Saliva merupakan cairan eksokrin yang mengandung unsur protein dan antibodi seperti sIgA laktoferin peroksidase, albumin, polipeptida dan oligopeptida yang berperan pada pertahanan mukosa rongga mulut dan gigi guna mencegah infeksi oral mikropatogen seperti C. albicans, S. mutans, dan

Lutzomyia longipalpis saliva or salivary protein LJM19 protects against Leishmania braziliensis and the saliva of its vector, Lutzomyia intermedia.

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Natalia M Tavares

Full Text Available BACKGROUND: Leishmania transmission occurs in the presence of insect saliva. Immunity to Phlebotomus papatasi or Lutzomyia longipalpis saliva or salivary components confers protection against an infection by Leishmania in the presence of the homologous saliva. However, immunization with Lutzomyia intermedia saliva did not protect mice against Leishmania braziliensis plus Lu. intermedia saliva. In the present study, we have studied whether the immunization with Lu. longipalpis saliva or a DNA plasmid coding for LJM19 salivary protein would be protective against L. braziliensis infection in the presence of Lu. intermedia saliva, the natural vector for L. braziliensis. METHODOLOGY/PRINCIPAL FINDINGS: Immunization with Lu. longipalpis saliva or with LJM19 DNA plasmid induced a Delayed-Type Hypersensitivity (DTH response against Lu. longipalpis as well as against a Lu. intermedia saliva challenge. Immunized and unimmunized control hamsters were then intradermally infected in the ears with L. braziliensis in the presence of Lu. longipalpis or Lu. intermedia saliva. Animals immunized with Lu. longipalpis saliva exhibited smaller lesion sizes as well as reduced disease burdens both at lesion site and in the draining lymph nodes. These alterations were associated with a significant decrease in the expression levels of IL-10 and TGF-β. Animals immunized with LJM19 DNA plasmid presented similar findings in protection and immune response and additionally increased IFN-γ expression. CONCLUSIONS/SIGNIFICANCE: Immunization with Lu. longipalpis saliva or with a DNA plasmid coding LJM19 salivary protein induced protection in hamsters challenged with L. braziliensis plus Lu. intermedia saliva. These findings point out an important role of immune response against saliva components, suggesting the possibility to develop a vaccine using a single component of Lu. longipalpis saliva to generate protection against different species of Leishmania, even those

A simple bedside test to assess the swallowing dysfunction in Parkinson′s disease

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S Vinoth Kanna

2014-01-01

Full Text Available Background: Swallowing changes are common in Parkinson′s disease (PD. Early identification is essential to avoid complications of aspiration. Objectives: To evaluate the swallowing ability of the PD patients and to correlate it with the indicators of disease progression. Materials and Methods: A total of 100 PD patients (70 males and 30 females aged between 50 years and 70 years with varying stage, duration, and severity were enrolled in a cross-sectional study carried out between January and May 2012. A simple bedside water swallowing test was performed using standard 150 ml of water. Swallowing process was assessed under three categories-swallowing speeds (ml/s, swallowing volume (ml/swallow and swallowing duration (s/swallow. Equal number of age and sex matched controls were also evaluated. Results: All of them completed the task of swallowing. A mean swallowing speed (27.48 ml/s, swallowing volume (28.5 ml/s, and swallowing duration (1.05 s/swallow was established by the control group. The PD patients showed decreased swallowing speed (7.15 ml/s in males and 6.61 ml/s in females, decreased swallowing volume (14.59 ml/swallow and 14 ml/swallow in females, and increased swallowing duration (2.37 s/swallow and 2.42 s/swallow which are statistically significant. There was a significant positive correlation between the severity, duration, and staging of the disease with the swallowing performance and a poor correlation between the subjective reports of dysphagia and the objective performance on water swallow test. Conclusion: The water swallowing test is a simple bedside test to identify the swallowing changes early in PD. It is recommended to do the test in all PD Patients to detect dysphagia early and to intervene appropriately.

Adding Endoscopist-Directed Flexible Endoscopic Evaluation of Swallowing to the Videofluoroscopic Swallowing Study Increased the Detection Rates of Penetration, Aspiration, and Pharyngeal Residue.

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Park, Won Young; Lee, Tae Hee; Ham, Nam Seok; Park, Ji Woong; Lee, Yang Gyun; Cho, Sang Jin; Lee, Joon Seong; Hong, Su Jin; Jeon, Seong Ran; Kim, Hyun Gun; Cho, Joo Young; Kim, Jin Oh; Cho, Jun Hyung; Lee, Ji Sung

2015-09-23

Currently, the videofluoroscopic swallowing study (VFSS) is the standard tool for evaluating dysphagia. We evaluated whether the addition of endoscopist-directed flexible endoscopic evaluation of swallowing (FEES) to VFSS could improve the detection rates of penetration, aspiration, and pharyngeal residue, compared the diagnostic efficacy between VFSS and endoscopist-directed FEES and assessed the adverse events of the FEES. In single tertiary referral center, a retrospective analysis of prospectively collected data was conducted. Fifty consecutive patients suspected of oropharyngeal dysphagia were enrolled in this study between January 2012 and July 2012. The agreement in the detection of penetration and aspiration between VFSS and FEES of viscous food (κ=0.34; 95% confidence interval [CI], 0.15 to 0.53) and liquid food (κ=0.22; 95% CI, 0.02 to 0.42) was "fair." The agreement in the detection of pharyngeal residue between the two tests was "substantial" with viscous food (κ=0.63; 95% CI, 0.41 to 0.94) and "fair" with liquid food (κ=0.37; 95% CI, 0.10 to 0.63). Adding FEES to VFSS significantly increased the detection rates of penetration, aspiration, and pharyngeal residue. No severe adverse events were noted during FEES, except for two cases of epistaxis, which stopped spontaneously without requiring any packing. This study demonstrated that the addition of endoscopist-directed FEES to VFSS increased the detection rates of penetration, aspiration, and pharyngeal residue.

Prevalence of swallowing dysfunction screened in Swedish cohort of COPD patients

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Gonzalez Lindh, Margareta; Blom Johansson, Monica; Jennische, Margareta; Koyi, Hirsh

2017-01-01

Background COPD is a common problem associated with morbidity and mortality. COPD may also affect the dynamics and coordination of functions such as swallowing. A misdirected swallow may, in turn, result in the bolus entering the airway. A growing body of evidence suggests that a subgroup of people with COPD is prone to oropharyngeal dysphagia. The aim of this study was to evaluate swallowing dysfunction in patients with stable COPD and to determine the relation between signs and symptoms of swallowing dysfunction and lung function (forced expiratory volume in 1 second percent predicted). Methods Fifty-one patients with COPD in a stable phase participated in a questionnaire survey, swallowing tests, and spirometry. A post-bronchodilator ratio of the forced expiratory volume in 1 second/best of forced vital capacity and vital capacity <0.7 was used to define COPD. Swallowing function was assessed by a questionnaire and two swallowing tests (water and cookie swallow tests). Results Sixty-five percent of the patients reported subjective signs and symptoms of swallowing dysfunction in the questionnaire and 49% showed measurable ones in the swallowing tests. For the combined subjective and objective findings, 78% had a coexisting swallowing dysfunction. No significant difference was found between male and female patients. Conclusion Swallowing function is affected in COPD patients with moderate to severe airflow limitation, and the signs and symptoms of this swallowing dysfunction were subjective, objective, or both. PMID:28176891

Acoustic analysis of swallowing sounds: a new technique for assessing dysphagia.

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Santamato, Andrea; Panza, Francesco; Solfrizzi, Vincenzo; Russo, Anna; Frisardi, Vincenza; Megna, Marisa; Ranieri, Maurizio; Fiore, Pietro

2009-07-01

To perform acoustic analysis of swallowing sounds, using a microphone and a notebook computer system, in healthy subjects and patients with dysphagia affected by neurological diseases, testing the positive/negative predictive value of a pathological pattern of swallowing sounds for penetration/aspiration. Diagnostic test study, prospective, not blinded, with the penetration/aspiration evaluated by fibreoptic endoscopy of swallowing as criterion standard. Data from a previously recorded database of normal swallowing sounds for 60 healthy subjects according to gender, age, and bolus consistency was compared with those of 15 patients with dysphagia from a university hospital referral centre who were affected by various neurological diseases. Mean duration of the swallowing sounds and post-swallowing apnoea were recorded. Penetration/aspiration was verified by fibreoptic endoscopy of swallowing in all patients with dysphagia. The mean duration of swallowing sounds for a liquid bolus of 10 ml water was significantly different between patients with dysphagia and healthy patients. We also described patterns of swallowing sounds and tested the negative/positive predictive values of post-swallowing apnoea for penetration/aspiration verified by fibreoptic endoscopy of swallowing (sensitivity 0.67 (95% confidence interval 0.24-0.94); specificity 1.00 (95% confidence interval 0.56-1.00)). The proposed technique for recording and measuring swallowing sounds could be incorporated into the bedside evaluation, but it should not replace the use of more diagnostic and valuable measures.

Effect of body posture on involuntary swallow in healthy volunteers.

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Shiino, Yoshitaka; Sakai, Shogo; Takeishi, Ryosuke; Hayashi, Hirokazu; Watanabe, Masahiro; Tsujimura, Takanori; Magara, Jin; Ito, Kayoko; Tsukada, Tetsu; Inoue, Makoto

2016-03-01

Clinically, reclining posture has been reported to reduce risk of aspiration. However, during involuntary swallow in reclining posture, changes in orofacial and pharyngeal movement before and during pharyngeal swallow should be considered. Further, the mechanisms underlying the effect of body posture on involuntary swallow remain unclear. The aim of the present study was to determine the effect of body posture on activity patterns of the suprahyoid muscles and on patterns of bolus transport during a natural involuntary swallow. Thirteen healthy male adults participated in a water infusion test and a chewing test. In the water infusion test, thickened water was delivered into the pharynx at a very slow rate until the first involuntary swallow was evoked. In the chewing test, subjects were asked to eat 10 g of gruel rice. In both tests, the recording was performed at four body postures between upright and supine positions. Results showed that reclining changed the location of the bolus head at the start of swallow and prolonged onset latency of the swallowing initiation. Muscle burst duration and whiteout time measured by videoendoscopy significantly increased with body reclining and prolongation of the falling time. In the chewing test, reclining changed the location of the bolus head at the start of swallow, and the frequency of bolus residue after the first swallow increased. Duration and area of EMG burst and whiteout time significantly increased with body reclining. These data suggest that body reclining may result in prolongation of pharyngeal swallow during involuntary swallow. Copyright © 2015 Elsevier Inc. All rights reserved.

Soft-robotic esophageal swallowing as a clinically-inspired bolus rheometry technique

International Nuclear Information System (INIS)

Dirven, Steven; Allen, Jacqueline; Xu, Weiliang; Cheng, Leo K

2017-01-01

To investigate the impact of viscosity and peristaltic transport parameters on manometric pressure signatures, a reproducible swallowing process is required. Due to inter- and intra-subject variability from swallow to swallow, the human body does not represent an optimal mechanism for such an investigation. A smooth and continuous swallowing soft-robot has been developed to produce biomimetic swallowing trajectories, and is proposed to operate as a bench-top bolus rheometric investigation method. The method compares conventional viscometry and pressure signature findings from robotic swallowing experiments. The robotic aspect of experimentation involved 450 biomimetic swallows (10 repetitions of 45 unique experiments). The method examined swallowing transport in three dimensions: bolus formulation, peristaltic wavelength, and peristaltic velocity, each of which are known to contribute to safe and effective swallowing in vivo . It is found that the pressure gradients and magnitudes are commensurate with clinical reports on biological swallowing, on the order of 100 mmHg peak, however, the relationship between viscosity and pressure signatures is less clear. Bolus transport cannot be predicted as a function of bolus viscosity alone. Traditional viscometric data at 50 s −1 , as used in clinical practice, may not be a strong indicator of swallow effort, safety, or efficacy in vivo . (paper)

Investigation of mixed saliva by optoelectronic methods

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Savchenko, Ekaterina; Nepomnyashchaya, Elina; Baranov, Maksim; Velichko, Elena; Aksenov, Evgenii; Bogomaz, Tatyana

2018-04-01

At present, saliva and its properties are being actively studied. Human saliva is a unique biological material that has potential in clinical practice. A detailed analysis of the characteristics and properties of saliva is relevant for diagnostic purposes. In this paper, the properties and characteristics of saliva are studied using optoelectronic methods: dynamic light scattering, electrophoretic light scattering and optical microscopy. Mixed saliva from a healthy patient and patient with diabetes mellitus type 2 was used as an object of the study. The dynamics of the behavior of a healthy and patient with diabetes mellitus type 2 is visible according to the results obtained. All three methods confirm hypothesis of structural changes in mixed saliva in the disease of diabetes mellitus type 2.

Swallowing dysfunction as a factor that should be remembered in recurrent pneumonia: videofluoroscopic swallow study.

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Kaymaz, Nazan; Özçelik, Uğur; Demir, Numan; Cinel, Güzin; Yalçin, Ebru; Ersöz, Deniz D; Kiper, Nural

2017-10-01

The swallow function is one of the strong defense mechanism against aspiration. Aspiration and pneumonia are unavoidable in patients with defective mechanism of swallowing. The aim of this study was to evaluate patients with recurrent pneumonia in terms of videofluoroscopic examination results. The study comprised fifty pediatric cases (22 boys, 28 girls) with an average age of 2.9 years (2 months-7.5 years) who were referred to our clinic due to suffering from recurrent pneumonia. The videofluoroscopic swallow study (VFSS) was performed on all patients. The presence of a correlation with pneumonia was investigated. In 45 of the children, VFSS results were not normal. Of the children, 41 had mental-motor retardation. The results of the videofluoroscopic study show that silent aspiration was the most common pathology in participants with the percentage of 40 (27.5% mild, 17.5% severe). Patients in the study had pneumonia with an incidence of 2.6 illnesses per year. Having one than more results on VFSS was found to be associated with more number of annual pneumonia episodes. Children with neurological impairments are at risk of recurrent acute pneumonia due to aspiration. Disturbances of swallowing phases should be remembered as a cause of pneumonia in these patients.

Effects of barium concentration on oropharyngeal swallow timing measures.

Science.gov (United States)

Stokely, Shauna L; Molfenter, Sonja M; Steele, Catriona M

2014-02-01

Videofluoroscopy is commonly used for evaluating oropharyngeal swallowing but requires radiopaque contrast (typically barium). Prior studies suggest that some aspects of swallowing, including timing measures of oral and pharyngeal bolus transit, vary depending on barium concentration. The aim of our study was to identify timing differences in healthy swallowing between "thin" (40 % w/v concentration) and "ultrathin" (22 % w/v concentration) barium solutions. Twenty healthy adults (Ten women; mean age = 31 years) each performed a series of three noncued 5-ml swallows each of ultrathin and thin liquid barium solutions in videofluoroscopy. Timing measures were compared between barium concentrations using a mixed-model ANOVA. The measures of interest were stage transition duration, pharyngeal transit time, and duration of upper esophageal sphincter opening. Significant differences were observed in the timing measures of swallowing with respect to barium concentration. In all cases, longer durations were seen with the higher barium concentration. Barium concentration influences timing parameters in healthy swallowing, even between ultrathin and thin concentrations. Clinicians need to understand and control for the impact of different barium stimuli on swallowing physiology.

Prevalence of swallowing dysfunction screened in Swedish cohort of COPD patients

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Gonzalez Lindh M

2017-01-01

Full Text Available Margareta Gonzalez Lindh,1,2 Monica Blom Johansson,1 Margareta Jennische,1 Hirsh Koyi2,3 1Department of Neuroscience, Speech and Language Pathology, Uppsala University, Uppsala, Sweden; 2Centre for Research and Development (CFUG, Uppsala University, County Council of Gävleborg, Gävle, Sweden; 3Department of Respiratory Medicine, Gävle Hospital, Gävle, Sweden Background: COPD is a common problem associated with morbidity and mortality. COPD may also affect the dynamics and coordination of functions such as swallowing. A misdirected swallow may, in turn, result in the bolus entering the airway. A growing body of evidence suggests that a subgroup of people with COPD is prone to oropharyngeal dysphagia. The aim of this study was to evaluate swallowing dysfunction in patients with stable COPD and to determine the relation between signs and symptoms of swallowing dysfunction and lung function (forced expiratory volume in 1 second percent predicted.Methods: Fifty-one patients with COPD in a stable phase participated in a questionnaire survey, swallowing tests, and spirometry. A post-bronchodilator ratio of the forced expiratory volume in 1 second/best of forced vital capacity and vital capacity <0.7 was used to define COPD. Swallowing function was assessed by a questionnaire and two swallowing tests (water and cookie swallow tests.Results: Sixty-five percent of the patients reported subjective signs and symptoms of swallowing dysfunction in the questionnaire and 49% showed measurable ones in the swallowing tests. For the combined subjective and objective findings, 78% had a coexisting swallowing dysfunction. No significant difference was found between male and female patients.Conclusion: Swallowing function is affected in COPD patients with moderate to severe airflow limitation, and the signs and symptoms of this swallowing dysfunction were subjective, objective, or both. Keywords: deglutition, deglutition disorders, swallowing, COPD, speech

Enhancement of Cellulose Degradation by Cattle Saliva

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Seki, Yasutaka; Kikuchi, Yukiko; Kimura, Yoshihiro; Yoshimoto, Ryo; Takahashi, Masatoshi; Aburai, Kenichi; Kanai, Yoshihiro; Ruike, Tatsushi; Iwabata, Kazuki; Sugawara, Fumio; Sakai, Hideki; Abe, Masahiko; Sakaguchi, Kengo

2015-01-01

Saccharification of cellulose is a promising technique for producing alternative source of energy. However, the efficiency of conversion of cellulose into soluble sugar using any currently available methodology is too low for industrial application. Many additives, such as surfactants, have been shown to enhance the efficiency of cellulose-to-sugar conversion. In this study, we have examined first whether cattle saliva, as an additive, would enhance the cellulase-catalyzed hydrolysis of cellulose, and subsequently elucidated the mechanism by which cattle saliva enhanced this conversion. Although cattle saliva, by itself, did not degrade cellulose, it enhanced the cellulase-catalyzed degradation of cellulose. Thus, the amount of reducing sugar produced increased approximately 2.9-fold by the addition of cattle saliva. We also found that non-enzymatic proteins, which were present in cattle saliva, were responsible for causing the enhancement effect. Third, the mechanism of cattle saliva mediated enhancement of cellulase activity was probably similar to that of the canonical surfactants. Cattle saliva is available in large amounts easily and cheaply, and it can be used without further purification. Thus, cattle saliva could be a promising additive for efficient saccharification of cellulose on an industrial scale. PMID:26402242

Dysphagia progression and swallowing management in Parkinson's disease: an observational study

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Karen Fontes Luchesi

2015-02-01

Full Text Available Introduction: Dysphagia is relatively common in individuals with neurological disorders. Objective: To describe the swallowing management and investigate associated factors with swallowing in a case series of patients with Parkinson's disease. Methods: It is a long-term study with 24 patients. The patients were observed in a five-year period (2006-2011. They underwent Fiberoptic Endoscopic Evaluation of Swallowing, Functional Oral Intake Scale and therapeutic intervention every three months. In the therapeutic intervention they received orientation about exercises to improve swallowing. The Chi-square, Kruskal-Wallis and Fisher's tests were used. The period of time for improvement or worsening of swallowing was described by Kaplan-Meier analysis. Results: During the follow-up, ten patients improved, five stayed the same and nine worsened their swallowing functionality. The median time for improvement was ten months. Prior to the worsening there was a median time of 33 months of follow-up. There was no associated factor with improvement or worsening of swallowing. The maneuvers frequently indicated in therapeutic intervention were: chin-tuck, bolus consistency, bolus effect, strengthening-tongue, multiple swallows and vocal exercises. Conclusion: The swallowing management was characterized by swallowing assessment every three months with indication of compensatory and rehabilitation maneuvers, aiming to maintain the oral feeding without risks. There was no associated factor with swallowing functionality in this case series.

Roosts and migrations of swallows

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Winkler, David W.

2006-01-01

Swallows of the north temperate zone display a wide variety of territorial behaviour during the breeding season, but as soon as breeding is over, they all appear to adopt a pattern of independent diurnal foraging interleaved with aggregation every night in dense roosts. Swallows generally migrate during the day, feeding on the wing. On many stretches of their annual journeys, their migrations can thus be seen as the simple spatial translation of nocturnal roost sites with foraging routes stra...

Coordination of cough and swallow: a meta-behavioral response to aspiration.

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Pitts, Teresa; Rose, Melanie J; Mortensen, Ashley N; Poliacek, Ivan; Sapienza, Christine M; Lindsey, Bruce G; Morris, Kendall F; Davenport, Paul W; Bolser, Donald C

2013-12-01

Airway protections is the prevention and/or removal of material by behaviors such as cough and swallow. We hypothesized these behaviors are coordinated to respond to aspiration. Anesthetized animals were challenged with simulated aspiration that induced both coughing and swallowing. Electromyograms of upper airway and respiratory muscles together with esophageal pressure were recorded to identify and evaluate cough and swallow. During simulated aspiration, both cough and swallow intensity increased and swallow duration decreased consistent with rapid pharyngeal clearance. Phase restriction between cough and swallow was observed; swallow was restricted to the E2 phase of cough. These results support three main conclusions: 1) the cough and swallow pattern generators are tightly coordinated so as to generate a protective meta-behavior; 2) the trachea provides feedback on swallow quality, informing the brainstem about aspiration incidences; and 3) the larynx and upper esophageal sphincter act as two separate valves controlling the direction of positive and negative pressures from the upper airway into the thorax. Copyright © 2013 Elsevier B.V. All rights reserved.

Variability of the pharyngeal phase of swallow in the cat.

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Daniel G Spearman

Full Text Available The pharyngeal phase of swallow has been thought to be a stereotypical motor behavior.This is a prospective, preclinical, hypothesis driven, one group by three-task design.We sought to compare the effects of pharyngeal swabbing, water only, and water plus punctate mechanical stimulation on the spatiotemporal features of the pharyngeal phase of swallow in the cat. Swallow was elicited under these three conditions in six anaesthetized cats. Electromyographic activity was recorded from seven muscles used to evaluate swallow: mylohyoid, geniohyoid, thyrohyoid, thyroarytenoid, thyropharyngeus, cricopharyngeus, and parasternal.Pharyngeal swabbing in comparison to the other stimulus conditions, results in decreases in post-swallow cricopharyngeus activity (upper esophageal sphincter; a significant increase in parasternal (schluckatmung; swallow breath activity; and increases in thyrohyoid (laryngeal elevator, thyroarytenoid (laryngeal adductor and parasternal muscles burst duration. Pearson correlations were found of moderate strength between 19% of burst duration comparisons and weak to moderate relationships between 29% of burst amplitude comparisons. However, there were no positive significant relationships between phase durations and electromyogram amplitudes between any of the muscles studied during swallow.The results support the concept that a stereotypical behavior, such as pharyngeal swallowing in animal models, can be modified by sensory feedback from pharyngeal mucosal mechanoreceptors. Furthermore, differences in swallow phase durations and amplitudes provide evidence that separate regulatory mechanisms exist which regulate spatial and temporal aspects of the behavior.

Hyolaryngeal excursion as the physiological source of swallowing accelerometry signals

International Nuclear Information System (INIS)

Zoratto, D C B; Chau, T; Steele, C M

2010-01-01

Swallowing dysfunction, or dysphagia, is a serious condition that can result from any structural or neurological impairment (such as stroke, neurodegenerative disease or brain injury) that affects the swallowing mechanism. The gold-standard method of instrumental swallowing assessment is an x-ray examination known as the videofluoroscopic swallowing study, which involves radiation exposure. Consequently, there is interest in exploring the potential of less invasive methods, with lesser risks of biohazard, to accurately detect swallowing abnormalities. Accelerometry is one such technique, which measures the epidermal vibration signals on a patient's neck during swallowing. Determining the utility of accelerometry signals for detecting dysphagia requires an understanding of the physiological source of the vibrations that are measured on the neck during swallowing. The purpose of the current study was to determine the extent to which movement of the hyoid bone and larynx contributes to the vibration signal that is registered during swallowing accelerometry. This question was explored by mapping the movement trajectories of the hyoid bone and the arytenoid cartilages from lateral videofluoroscopy recordings collected during thin liquid swallowing, and comparing these trajectories to time-linked signals obtained from a dual-axis accelerometer placed on the neck, just anterior to the cricoid cartilage. Participants for this study included 43 adult patients referred for videofluoroscopic swallowing studies to characterize the nature and severity of suspected neurogenic dysphagia. A software program was created to allow frame-by-frame tracking of structural movement on the videofluoroscopy recordings. These movement data were then compared to the integrated acceleration data using multiple linear regressions. The results concur with previous studies, implicating hyolaryngeal excursion as the primary physiological source of swallowing accelerometry signals, with both

Prophylactic Swallowing Exercises in Head and Neck Cancer Radiotherapy

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Mortensen, H R; Jensen, Kenneth; Aksglæde, K

2015-01-01

Many head and neck cancer (HNC) survivors experience reduced quality of life due to radiotherapy (RT)-related dysphagia. The aim of this prospective randomized trial was to evaluate the impact of prophylactic swallowing exercises on swallowing-related outcomes in HNC patients treated with curative...... of the dysphagia outcomes during and after treatment. Adherence to exercises was poor and dropouts due to especially fatigue were very frequent in both groups. Systematic swallowing exercises had no impact on swallowing outcomes within the first year after RT. Despite repeated supervised sessions, adherence...

Spontaneous rupture of the esophagus associated with intramural rupture caused by ingestion of weeding medicine (Lasso)

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Kim, Jong Keon; Park, Heung Il; Kwun, Chung Sik [Chun Nam University College of Medicine, Kwangju (Korea, Republic of)

1975-06-15

This is a report of a case of spontaneous rupture of the esophagus associated with intramural rupture caused by ingestion of weeding medicine for the purpose of suicide in a 27 year old Korean male whose chief complaints were dyspnea, epigastric pain, swallowing disturbance, and hoarseness for 3 days prior to admission. A review of literature is submitted.

Dysphagia progression and swallowing management in Parkinson's disease: an observational study.

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Luchesi, Karen Fontes; Kitamura, Satoshi; Mourão, Lucia Figueiredo

2015-01-01

Dysphagia is relatively common in individuals with neurological disorders. To describe the swallowing management and investigate associated factors with swallowing in a case series of patients with Parkinson's disease. It is a long-term study with 24 patients. The patients were observed in a five-year period (2006-2011). They underwent Fiberoptic Endoscopic Evaluation of Swallowing, Functional Oral Intake Scale and therapeutic intervention every three months. In the therapeutic intervention they received orientation about exercises to improve swallowing. The Chi-square, Kruskal-Wallis and Fisher's tests were used. The period of time for improvement or worsening of swallowing was described by Kaplan-Meier analysis. During the follow-up, ten patients improved, five stayed the same and nine worsened their swallowing functionality. The median time for improvement was ten months. Prior to the worsening there was a median time of 33 months of follow-up. There was no associated factor with improvement or worsening of swallowing. The maneuvers frequently indicated in therapeutic intervention were: chin-tuck, bolus consistency, bolus effect, strengthening-tongue, multiple swallows and vocal exercises. The swallowing management was characterized by swallowing assessment every three months with indication of compensatory and rehabilitation maneuvers, aiming to maintain the oral feeding without risks. There was no associated factor with swallowing functionality in this case series. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

A comparison between swallowing sounds and vibrations in patients with dysphagia

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Movahedi, Faezeh; Kurosu, Atsuko; Coyle, James L.; Perera, Subashan

2017-01-01

The cervical auscultation refers to the observation and analysis of sounds or vibrations captured during swallowing using either a stethoscope or acoustic/vibratory detectors. Microphones and accelerometers have recently become two common sensors used in modern cervical auscultation methods. There are open questions about whether swallowing signals recorded by these two sensors provide unique or complementary information about swallowing function; or whether they present interchangeable information. The aim of this study is to present a broad comparison of swallowing signals recorded by a microphone and a tri-axial accelerometer from 72 patients (mean age 63.94 ± 12.58 years, 42 male, 30 female), who underwent videofluoroscopic examination. The participants swallowed one or more boluses of thickened liquids of different consistencies, including thin liquids, nectar-thick liquids, and pudding. A comfortable self-selected volume from a cup or a controlled volume by the examiner from a 5ml spoon was given to the participants. A comprehensive set of features was extracted in time, information-theoretic, and frequency domains from each of 881 swallows presented in this study. The swallowing sounds exhibited significantly higher frequency content and kurtosis values than the swallowing vibrations. In addition, the Lempel-Ziv complexity was lower for swallowing sounds than those for swallowing vibrations. To conclude, information provided by microphones and accelerometers about swallowing function are unique and these two transducers are not interchangeable. Consequently, the selection of transducer would be a vital step in future studies. PMID:28495001

Detection of phencyclidine usage by radioimmunoassay of saliva

International Nuclear Information System (INIS)

McCarron, M.M.; Walberg, C.B.; Soares, J.R.; Gross, S.J.; Baselt, R.C.

1984-01-01

Paired serum and saliva samples, obtained from 100 emergency department patients suspected of phencyclidine (PCP) intoxication, were analyzed using a specific PCP radioimmunoassay (RIA). Seventy-four of the 100 saliva samples and 75 of the paired serum samples were positive for PCP. The final clinical diagnosis was PCP intoxication in 79 cases. Of these, both serum and saliva tests were positive in 70 cases, only serum was positive in two cases, and both serum and saliva samples were negative in seven cases. The concentration of PCP in the samples did not correlate with the severity of PCP intoxication. In the remaining 21 cases, with no clinical evidence of PCP intoxication, PCP assays were negative in both serum and saliva in 17 cases, three patients had positive saliva and serum tests, and one other patient had a positive PCP saliva assay. Thus, saliva would appear to be as reliable as serum as a specimen for PCP analysis

Posture of the head and pharyngeal swallowing

International Nuclear Information System (INIS)

Ekberg, O.

1986-01-01

Closure of the laryngeal vestibule during swallowing is important for protection of the airways. The present investigation included 53 patients with dysphagia examined cineradiographically with the head held in resting posture, flexion and extension. The ability to protect the airways by the downward movement of the epiglottis and by obliteration of the laryngeal vestibule was studied in different postures of the head. Of 35 patients with normal laryngeal obliteration with the head in resting position 10 showed a defective closure at swallowing in extension. In 18 patients with defective closure of the laryngeal vestibule in resting position 9 were improved on flexion and two on extension of the head. In one patient with defectie closure of the laryngeal vestibule in resting position swallowing in flexion showed an aggravated dysfunction. In our other patients the defective closure became more marked on extension. Four patients had less effective downward movement of the epiglottis with the head in extension. Of 10 patients with defective epiglottic movement with the head in resting position two were improved on tilting the head forwards. The results show that the position of the head influences the closure of the airways during swallowing. Patients with defective protection of the laryngeal vestibule should be instructed to swallow with the head tilted forwards. (orig.)

Swallow Event Sequencing: Comparing Healthy Older and Younger Adults.

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Herzberg, Erica G; Lazarus, Cathy L; Steele, Catriona M; Molfenter, Sonja M

2018-04-23

Previous research has established that a great deal of variation exists in the temporal sequence of swallowing events for healthy adults. Yet, the impact of aging on swallow event sequence is not well understood. Kendall et al. (Dysphagia 18(2):85-91, 2003) suggested there are 4 obligatory paired-event sequences in swallowing. We directly compared adherence to these sequences, as well as event latencies, and quantified the percentage of unique sequences in two samples of healthy adults: young ( 65). The 8 swallowing events that contribute to the sequences were reliably identified from videofluoroscopy in a sample of 23 healthy seniors (10 male, mean age 74.7) and 20 healthy young adults (10 male, mean age 31.5) with no evidence of penetration-aspiration or post-swallow residue. Chi-square analyses compared the proportions of obligatory pairs and unique sequences by age group. Compared to the older subjects, younger subjects had significantly lower adherence to two obligatory sequences: Upper Esophageal Sphincter (UES) opening occurs before (or simultaneous with) the bolus arriving at the UES and UES maximum distention occurs before maximum pharyngeal constriction. The associated latencies were significantly different between age groups as well. Further, significantly fewer unique swallow sequences were observed in the older group (61%) compared with the young (82%) (χ 2  = 31.8; p < 0.001). Our findings suggest that paired swallow event sequences may not be robust across the age continuum and that variation in swallow sequences appears to decrease with aging. These findings provide normative references for comparisons to older individuals with dysphagia.

SALIVA AS A DIAGNOSTIC FLUID

Directory of Open Access Journals (Sweden)

Pezelj-Ribarić Sonja

2015-12-01

Full Text Available Saliva is a readily available oral fluid with many functions, from digestion, maintenance of oral tissues' integrity, to caries prevention. Changes regarding its secretion may be divided into qualitative and quantitative: both of them are a consequence of certain conditions/diseases (e.g. internal factors or nutrients/drugs ingested (e.g. external factors. During the last 15 years, technological advances gave a significant momentum to utilization of saliva as a diagnostic tool. Analysis of saliva, just like the blood analysis, has two main objectives: to identify the subjects suffering from a certain disorder, and to follow the development and progress of therapy. This paper provides an overview of possibilities for the use of saliva for diagnostic purposes and gives specific examples of some clinical investigations, with the final aim to stimulate the use of this noninvasive means for the health care promotion.

Voice- and swallow-related quality of life in idiopathic Parkinson's disease.

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van Hooren, Michel R A; Baijens, Laura W J; Vos, Rein; Pilz, Walmari; Kuijpers, Laura M F; Kremer, Bernd; Michou, Emilia

2016-02-01

This study explores whether changes in voice- and swallow-related QoL are associated with progression of idiopathic Parkinson's disease (IPD). Furthermore, it examines the relationship between patients' perception of both voice and swallowing disorders in IPD. Prospective clinical study, quality of life (QoL). One-hundred mentally competent IPD patients with voice and swallowing complaints were asked to answer four QoL questionnaires (Voice Handicap Index, MD Anderson Dysphagia Inventory, Visual Analog Scale [VAS] voice, and Dysphagia Severity Scale [DSS]). Differences in means for the QoL questionnaires and their subscales within Hoehn and Yahr stage groups were calculated using one-way analysis of variance. The relationship between voice- and swallow-related QoL questionnaires was determined with the Spearman correlation coefficient. Scores on both voice and swallow questionnaires suggest an overall decrease in QoL with progression of IPD. A plateau in QoL for VAS voice and the DSS was seen in the early Hoehn and Yahr stages. Finally, scores on voice-related QoL questionnaires were significantly correlated with swallow-related QoL outcomes. Voice- and swallow-related QoL decreases with progression of IPD. A significant association was found between voice- and swallow-related QoL questionnaires. Healthcare professionals can benefit from voice- and swallow-related QoL questionnaires in a multidimensional voice- or swallow-assessment protocol. The patient's perception of his/her voice and swallowing disorders and its impact on QoL in IPD should not be disregarded. 2b. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Involvement of hypoglossal and recurrent laryngeal nerves on swallowing pressure.

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Tsujimura, Takanori; Suzuki, Taku; Yoshihara, Midori; Sakai, Shogo; Koshi, Naomi; Ashiga, Hirokazu; Shiraishi, Naru; Tsuji, Kojun; Magara, Jin; Inoue, Makoto

2018-05-01

Swallowing pressure generation is important to ensure safe transport of an ingested bolus without aspiration or leaving residue in the pharynx. To clarify the mechanism, we measured swallowing pressure at the oropharynx (OP), upper esophageal sphincter (UES), and cervical esophagus (CE) using a specially designed manometric catheter in anesthetized rats. A swallow, evoked by punctate mechanical stimulation to the larynx, was identified by recording activation of the suprahyoid and thyrohyoid muscles using electromyography (EMG). Areas under the curve of the swallowing pressure at the OP, UES, and CE from two trials indicated high intrasubject reproducibility. Effects of transecting the hypoglossal nerve (12N) and recurrent laryngeal nerve (RLN) on swallowing were investigated. Following bilateral hypoglossal nerve transection (Bi-12Nx), OP pressure was significantly decreased, and time intervals between peaks of thyrohyoid EMG bursts and OP pressure were significantly shorter. Decreased OP pressure and shortened times between peaks of thyrohyoid EMG bursts and OP pressure following Bi-12Nx were significantly increased and longer, respectively, after covering the hard and soft palates with acrylic material. UES pressure was significantly decreased after bilateral RLN transection compared with that before transection. These results suggest that the 12N and RLN play crucial roles in OP and UES pressure during swallowing, respectively. We speculate that covering the palates with a palatal augmentation prosthesis may reverse the reduced swallowing pressure in patients with 12N or tongue damage by the changes of the sensory information and of the contact between the tongue and a palates. NEW & NOTEWORTHY Hypoglossal nerve transection reduced swallowing pressure at the oropharynx. Covering the hard and soft palates with acrylic material may reverse the reduced swallowing function caused by hypoglossal nerve damage. Recurrent laryngeal nerve transection reduced upper

Self-perception of swallowing by patients with benign nonsurgical thyroid disease.

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Pernambuco, Leandro; Silva, Marlisson Pinheiro da; Almeida, Marluce Nascimento de; Costa, Erika Beatriz de Morais; Souza, Lourdes Bernadete Rocha de

2017-02-23

To verify the frequency of swallowing complaints in patients with benign nonsurgical thyroid disease and compare the self-perception of swallowing disorder intensity between different types of thyroid disease. The study sample comprised 39 women aged 19-58 years (38.54 ± 10.74) with hypothyroidism (n=22; 56.4%) or thyroid nodules (n=17; 43.6%). Presence and type of swallowing complaint and self-perception of swallowing disorder intensity were investigated by means of self-ratings recorded on a 100-millimeter visual analog scale. The data were analyzed by descriptive measures and the Mann-Whitney nonparametric test was used to compare the self-perception of swallowing disorder intensity between both clinical diagnoses of thyroid disease. The level of 5% was adopted for statistical significance. Twenty-six (66.7%) individuals reported the following swallowing complaints: pharyngolaryngeal stasis sensation (37.15%), chocking (34.29%), and odynophagia (28.57%). The mean value of self-perception of swallowing disorder intensity by the visual analog scale was 59.35 (± 27.38) millimeters. No difference in self-perception was reported between the clinical diagnoses of thyroid disease. In this sample, swallowing complaint was frequently observed in patients with benign nonsurgical thyroid disease. Moderate self-perception of swallowing disorder intensity was reported regardless of the clinical diagnosis of thyroid disease.

Nonimaging clinical assessment of impaired swallowing in community-dwelling older adults in Taiwan.

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Chen, Miao-Yen; Lin, Li-Chan

2012-12-01

Impaired swallowing is common in elderly patients as well as those with neurological disorders and degenerative diseases. Convenient and accurate assessments should be available to community-dwelling older adults to diagnose and provide early management and care of swallowing difficulties, an important factor of influence on elderly life quality. This study used convenient nonimaging methods to assess swallowing functions in community-dwelling older adults and estimated the prevalence of swallowing difficulties. The study adopted a survey method and recruited 216 community-dwelling older adults over 65 years old in northern Taiwan. Researchers used tools including a swallowing test, questionnaire, water test, peripheral arterial pulse oximeter, and laryngeal S-EMG to assess participant swallowing functions and the prevalence of impaired swallowing. We found a 9.5% prevalence of impaired swallowing based on swallow questionnaire and water test results. Age correlated negatively with swallowing speed. A one-way ANOVA showed a significant difference in swallowing speed among the four age groups (F = 6.478, p < .00). A post hoc Scheffe comparison showed significant differences in swallowing time between the 60- to 69- and 70- to 79-year-old groups and 60- to 69- and 80- to 89-year-old groups. Multiple regression of impaired swallowing on various independent variables showed a significant standardized coefficient of 0.163 for age (t = 2.328, p = .021). Logistic regression showed a significant Wals test value for age (p = .007). The Kappa value was 0.307 for agreement analysis between impaired swallowing and SaO(2) value reduction of more than 2%. Swallowing function deteriorates with age. Results of this study provide an assessment of the prevalence of impaired swallowing in community-dwelling older adults in Taiwan. Results can help guide clinical nurses to enhance their objective assessment of impaired swallowing to improve patient quality of life.

Treatment of post-stroke dysphagia by vitalstim therapy coupled with conventional swallowing training.

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Xia, Wenguang; Zheng, Chanjuan; Lei, Qingtao; Tang, Zhouping; Hua, Qiang; Zhang, Yangpu; Zhu, Suiqiang

2011-02-01

To investigate the effects of VitalStim therapy coupled with conventional swallowing training on recovery of post-stroke dysphagia, a total of 120 patients with post-stroke dysphagia were randomly and evenly divided into three groups: conventional swallowing therapy group, VitalStim therapy group, and VitalStim therapy plus conventional swallowing therapy group. Prior to and after the treatment, signals of surface electromyography (sEMG) of swallowing muscles were detected, swallowing function was evaluated by using the Standardized Swallowing Assessment (SSA) and Videofluoroscopic Swallowing Study (VFSS) tests, and swallowing-related quality of life (SWAL-QOL) was evaluated using the SWAL-QOL questionnaire. There were significant differences in sEMG value, SSA, VFSS, and SWAL-QOL scores in each group between prior to and after treatment. After 4-week treatment, sEMG value, SSA, VFSS and SWAL-QOL scores were significantly greater in the VitalStim therapy plus conventional swallowing training group than in the conventional swallowing training group and VitalStim therapy group, but no significant difference existed between conventional swallowing therapy group and VitalStim therapy group. It was concluded that VitalStim therapy coupled with conventional swallowing training was conducive to recovery of post-stroke dysphagia.

Solid bolus swallowing in the radiologic evaluation of dysphagia

International Nuclear Information System (INIS)

Westen, D. van; Ekberg, O.

1993-01-01

Patients with dysphagia, heartburn and chest pain are regularly referred for radiologic evaluation of swallowing. The liquid barium swallow has been of great value for the biphasic evaluation of the pharynx and esophagus. Though many patients complain of dysphagia specifically for solids, solid bolus swallow is ususally not part of the evaluation. For the present study we therefore included the use of a solid bolus with a diameter of 13 mm and interviewed the patients carefully for any symptoms during this tablet swallow. Of 200 patients examined, the tablet passed through the esophagus without delay in 102. In the 98 patients with delayed passage, the solid bolus arrest occurred in the pharynx in 5 and in the esophagus in 93. Arrest in the esophagus was due to esophageal dysmotility in 48 patients. Twenty of these were symptomatic during the tablet swallow. A narrowing was the cause in 45, of whom 9 had symptoms. In 18 patients (9%) the solid bolus added key information to the radiologic evaluation. We therefore recommend that the solid bolus is included in the routine radiologic work-up of patients with dysphagia. Careful attention to symptoms during the tablet swallow is important. (orig.)

Solid bolus swallowing in the radiologic evaluation of dysphagia

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Westen, D. van (Dept. of Diagnostic Radiology, Malmoe General Hospital, Univ. Lund (Sweden)); Ekberg, O. (Dept. of Diagnostic Radiology, Malmoe General Hospital, Univ. Lund (Sweden))

1993-07-01

Patients with dysphagia, heartburn and chest pain are regularly referred for radiologic evaluation of swallowing. The liquid barium swallow has been of great value for the biphasic evaluation of the pharynx and esophagus. Though many patients complain of dysphagia specifically for solids, solid bolus swallow is ususally not part of the evaluation. For the present study we therefore included the use of a solid bolus with a diameter of 13 mm and interviewed the patients carefully for any symptoms during this tablet swallow. Of 200 patients examined, the tablet passed through the esophagus without delay in 102. In the 98 patients with delayed passage, the solid bolus arrest occurred in the pharynx in 5 and in the esophagus in 93. Arrest in the esophagus was due to esophageal dysmotility in 48 patients. Twenty of these were symptomatic during the tablet swallow. A narrowing was the cause in 45, of whom 9 had symptoms. In 18 patients (9%) the solid bolus added key information to the radiologic evaluation. We therefore recommend that the solid bolus is included in the routine radiologic work-up of patients with dysphagia. Careful attention to symptoms during the tablet swallow is important. (orig.).

Swallowing difficulties for cerebellar stroke may recover beyond three years.

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Périé, S; Wajeman, S; Vivant, R; St Guily, J L

1999-01-01

Swallowing disorders after stroke or skull base surgery can be life threatening. Although late recovery can occur, it remains poorly documented. We report a case of a 54-year-old woman with dysphagia resulting from a cerebellar stroke with hemorrhage that was evacuated through craniotomy. Swallowing difficulties were assessed by a videoendoscopic swallowing study. She presented with disruption of swallow initiation and impairment of the pharyngeal stage, resulting in hypopharyngeal stasis and penetration with aspiration. Supportive swallowing therapy was conducted with careful reeducation to assist initiation of the pharyngeal stage as well as development of compensatory postural technique. Initial improvement was very slow but became rapidly progressive from the 31st month after the stroke. By the 34th month, oral feeding was possible without aspiration. This case demonstrates that improvement in swallowing function can be expected even 3 years after stroke or skull base surgery. Determination of predictive factors for late functional recovery is of great importance and should be the focus of further investigation.

Senescent Swallowing: Impact, Strategies and Interventions

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Ney, Denise; Weiss, Jennifer; Kind, Amy; Robbins, JoAnne

2010-01-01

The risk for disordered oropharyngeal swallowing (dysphagia) increases with age. Loss of swallowing function can have devastating health implications including dehydration, malnutrition, and pneumonia, as well as reduced quality of life. Age-related changes place older adults at risk for dysphagia for two major reasons: One is that natural, healthy aging takes its toll on head and neck anatomy and physiologic and neural mechanisms underpinning swallowing function. This progression of change contributes to alterations in the swallowing in healthy older adults and is termed presbyphagia, naturally diminishing functional reserve. Second, disease prevalence increases with age and dysphagia is a co-morbidity of many age-related diseases and/or their treatments. Sensory changes, medication, sarcopenia and age-related diseases are discussed herein. Relatively recent findings that health complications are associated with dysphagia are presented. Nutrient requirements, fluid intake and nutritional assessment for older adults are reviewed relative to their relations to dysphagia. Dysphagia screening and the pros and cons of tube feeding as a solution are discussed. Optimal intervention strategies for elders with dysphagia ranging from compensatory interventions to more rigorous exercise approaches are presented. Compelling evidence of improved functional swallowing and eating outcomes resulting from active rehabilitation focusing on increasing strength of head and neck musculature is provided. In summary, while oropharyngeal dysphagia may be life-threatening, so are some of the traditional alternatives, particularly for frail, elderly patients. While the state of the evidence calls for more research, this review indicates the behavioral, dietary and environmental modifications emerging in this past decade are compassionate, promising and in many cases preferred alternatives to the always present option of tube feeding. PMID:19483069

White Light Generation in Human Saliva

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Santhosh, C.; Dharmadhikari, A. K.; Dharmadhikari, J. A.; Alti, K.; Mathur, D.

2011-07-01

Interaction of intense, femto-second pulses of infrared light (800 nm) with water generates white light supercontinuum due to nonlinear optical effects. This supercontinuum was found to be suppressed by the addition of alpha amylase, a major protein in the human saliva. We have studied the suppression of supper continuum by human saliva, collected from healthy subjects with and without smoking habits. Suppression of the blue-sided components was observed significantly in non-smokers saliva than chain smokers.

Swallowing in moderate and severe phases of Alzheimer's disease

Directory of Open Access Journals (Sweden)

Sheilla de Medeiros Correia

2010-12-01

Full Text Available OBJECTIVE: To characterize the problems of feeding and swallowing in individuals with moderate and severe Alzheimer´s disease (AD and to correlate these with functional aspects. METHOD: Fifty patients with AD and their caregivers participated in this study. The instruments used were: Clinical Dementia Rating (CDR, Mini-Mental State Examination, Index of Activities of Daily Living, Assessment of Feeding and Swallowing Difficulties in Dementia, Functional Outcome Questionnaire for Aphasia, and Swallowing Rating Scale. RESULTS: Problems with passivity, distraction and refusal to eat were encountered in the CDR2 group. Distraction, passivity and inappropriate feeding velocity were predominant in the CDR3 group. The problems were correlated with communication, swallowing severity of AD individuals and caregiver schooling. CONCLUSION: Given the inexorable functional alterations during the course of the disease, it is vital to observe these in patients with a compromised feeding and swallowing mechanism. The present study supplies the instruments to orient caregivers and professionals.

A procedure for denoising dual-axis swallowing accelerometry signals

International Nuclear Information System (INIS)

Sejdić, Ervin; Chau, Tom; Steele, Catriona M

2010-01-01

Dual-axis swallowing accelerometry is an emerging tool for the assessment of dysphagia (swallowing difficulties). These signals however can be very noisy as a result of physiological and motion artifacts. In this note, we propose a novel scheme for denoising those signals, i.e. a computationally efficient search for the optimal denoising threshold within a reduced wavelet subspace. To determine a viable subspace, the algorithm relies on the minimum value of the estimated upper bound for the reconstruction error. A numerical analysis of the proposed scheme using synthetic test signals demonstrated that the proposed scheme is computationally more efficient than minimum noiseless description length (MNDL)-based denoising. It also yields smaller reconstruction errors than MNDL, SURE and Donoho denoising methods. When applied to dual-axis swallowing accelerometry signals, the proposed scheme exhibits improved performance for dry, wet and wet chin tuck swallows. These results are important for the further development of medical devices based on dual-axis swallowing accelerometry signals. (note)

Parameters of Instrumental Swallowing Evaluations: Describing a Diagnostic Dilemma.

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Pisegna, Jessica M; Langmore, Susan E

2016-06-01

The aim of this study was to compare selected parameters of two swallow evaluations: fiberoptic endoscopic evaluation of swallowing (FEES) and the modified barium swallow (MBS) study. This was a cross-sectional, descriptive study. Fifty-five clinicians were asked to watch video recordings of swallow evaluations of 2 patients that were done using fluoroscopy and endoscopy simultaneously. In a randomized order, clinicians viewed 4 edited videos from simultaneous evaluations: the FEES and MBS videos of patient 1 and 2 each taking one swallow of 5 mL applesauce. Clinicians filled out a questionnaire that asked (1) which anatomical sites they could visualize on each video, (2) where they saw pharyngeal residue after a swallow, (3) their overall clinical impression of the pharyngeal residue, and (4) their opinions of the evaluation styles. Clinicians reported a significant difference in the visualization of anatomical sites, 11 of the 15 sites were reported as better-visualized on the FEES than on the MBS video (p < 0.05). Clinicians also rated residue to be present in more locations on the FEES than on the MBS. Clinicians' overall impressions of the severity of residue on the same exact swallow were significantly different depending on the evaluation type (FEES vs. MBS for patient 1 χ(2) = 20.05, p < 0.0001; patient 2 χ(2) = 7.52, p = 0.006), with FEES videos rated more severely. FEES advantages were: more visualization of pharyngeal and laryngeal swallowing anatomy and residue. However, as a result, clinicians provided more severe impressions of residue amount on FEES. On one hand, this suggests that FEES is a more sensitive tool than MBS studies, but on the other hand, clinicians might provide more severe interpretations on FEES.

Neural network pattern recognition of lingual-palatal pressure for automated detection of swallow.

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Hadley, Aaron J; Krival, Kate R; Ridgel, Angela L; Hahn, Elizabeth C; Tyler, Dustin J

2015-04-01

We describe a novel device and method for real-time measurement of lingual-palatal pressure and automatic identification of the oral transfer phase of deglutition. Clinical measurement of the oral transport phase of swallowing is a complicated process requiring either placement of obstructive sensors or sitting within a fluoroscope or articulograph for recording. Existing detection algorithms distinguish oral events with EMG, sound, and pressure signals from the head and neck, but are imprecise and frequently result in false detection. We placed seven pressure sensors on a molded mouthpiece fitting over the upper teeth and hard palate and recorded pressure during a variety of swallow and non-swallow activities. Pressure measures and swallow times from 12 healthy and 7 Parkinson's subjects provided training data for a time-delay artificial neural network to categorize the recordings as swallow or non-swallow events. User-specific neural networks properly categorized 96 % of swallow and non-swallow events, while a generalized population-trained network was able to properly categorize 93 % of swallow and non-swallow events across all recordings. Lingual-palatal pressure signals are sufficient to selectively and specifically recognize the initiation of swallowing in healthy and dysphagic patients.

[Telemonitoring of swallowing function: technologies in speech therapy practice.

Science.gov (United States)

Tedesco, Angela; Lavermicocca, Valentina; Notarnicola, Marilina; De Francesco, Luca; Dellomonaco, Anna Rita

2018-02-01

The process of medical-healthcare technological revolution represents an advantage for the patient and for the care provider, in terms of costs and distances reduction. The telehomecare approach could be useful for monitoring the swallowing disorder in neurodegenerative diseases, preventing complications. In this study the applicability of telemedicine techniques for the monitoring of swallowing function, in patients affected by Huntington's disease (HD), was evaluated through the acquisition and analysis of the sound of swallowing. Two patients with HD were outpatient screened for dysphagia through the Bedside Swallowing Assessment Scale (BSAS) sensitized with pulse oximetry and cervical auscultation. Subsequently, the swallowing functionality was telemonitored for three months with Skype. The swallowing sounds were acquired with a detection microphone attached to the lateral edge of the trachea during fluid intake. The sounds were instantly processed and graphically represented through the Praat software. The analysis of the acoustic signal acquired remotely has made it possible to identify the situations that required immediate speech therapy intervention, suggesting to the patients further modifications of food consistencies, and saving frequent moving to the hospital even in the absence of critical situations. Remote assistance applied to speech therapy could represent a benefit for patients and their carers and a more efficient use of medical and health resources.

Effects of Barium Concentration on Oropharyngeal Swallow Timing Measures

OpenAIRE

Stokely, Shauna L.; Molfenter, Sonja M.; Steele, Catriona M.

2013-01-01

Videofluoroscopy is commonly used for evaluating oropharyngeal swallowing but requires radiopaque contrast (typically barium). Prior studies suggest that some aspects of swallowing, including timing measures of oral and pharyngeal bolus transit, vary depending on barium concentration. The aim of our study was to identify timing differences in healthy swallowing between “thin” (40 % w/v concentration) and “ultrathin” (22 % w/v concentration) barium solutions. Twenty healthy adults (Ten women; ...

Factors That Influence the Extensional Rheological Property of Saliva.

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Amrita Vijay

Full Text Available The spinnbarkeit of saliva reflects the ability of saliva to adhere to surfaces within the mouth, thereby serving as a protective role and aiding in lubrication. Therefore, alterations in the extensional rheology of saliva may result in the loss in adhesiveness or the ability to bind onto surfaces. Mucin glycoproteins and their structures are known to be important factors for the extensional rheological properties of saliva. The conformation of mucin depends on factors such as pH and ionic strength. Chewing is one of the main stimuli for salivary secretion but creates significant sheer stress on the salivary film which could influence mouthfeel perceptions. The current study investigates the possible factors which affect the extensional rheological properties of saliva by comparing submandibular/sublingual saliva with different oral stimuli within the same group of subjects. Unstimulated and stimulated saliva (chew, smell and taste salivas were collected primarily from submandibular/sublingual glands. The saliva samples were measured for Spinnbarkeit followed by the measuring mucin, total protein, total calcium and bicarbonate concentrations. The results indicated correlations between rheological properties and mucin/ion concentrations. However, chewing stimulated submandibular/sublingual saliva is shown to have significantly lower Spinnbarkeit, but factors such as mucin, protein and calcium concentrations did not account for this variation. Analysis of the concentration of bicarbonate and pH appears to suggest that it has a prominent effect on extensional rheology of saliva.

Evidence for adaptive cortical changes in swallowing in Parkinson's disease.

Science.gov (United States)

Suntrup, Sonja; Teismann, Inga; Bejer, Joke; Suttrup, Inga; Winkels, Martin; Mehler, David; Pantev, Christo; Dziewas, Rainer; Warnecke, Tobias

2013-03-01

Dysphagia is a relevant symptom in Parkinson's disease, whose pathophysiology is poorly understood. It is mainly attributed to degeneration of brainstem nuclei. However, alterations in the cortical contribution to deglutition control in the course of Parkinson's disease have not been investigated. Here, we sought to determine the patterns of cortical swallowing processing in patients with Parkinson's disease with and without dysphagia. Swallowing function in patients was objectively assessed with fiberoptic endoscopic evaluation. Swallow-related cortical activation was measured using whole-head magnetoencephalography in 10 dysphagic and 10 non-dysphagic patients with Parkinson's disease and a healthy control group during self-paced swallowing. Data were analysed applying synthetic aperture magnetometry, and group analyses were done using a permutation test. Compared with healthy subjects, a strong decrease of cortical swallowing activation was found in all patients. It was most prominent in participants with manifest dysphagia. Non-dysphagic patients with Parkinson's disease showed a pronounced shift of peak activation towards lateral parts of the premotor, motor and inferolateral parietal cortex with reduced activation of the supplementary motor area. This pattern was not found in dysphagic patients with Parkinson's disease. We conclude that in Parkinson's disease, not only brainstem and basal ganglia circuits, but also cortical areas modulate swallowing function in a clinically relevant way. Our results point towards adaptive cerebral changes in swallowing to compensate for deficient motor pathways. Recruitment of better preserved parallel motor loops driven by sensory afferent input seems to maintain swallowing function until progressing neurodegeneration exceeds beyond the means of this adaptive strategy, resulting in manifestation of dysphagia.

Cortisol in urine and saliva

DEFF Research Database (Denmark)

Hurwitz Eller, N; Netterstrøm, B; Hansen, Åse Marie

2001-01-01

The objective of the study was to analyse the relations between excretion of cortisol in urine and saliva and the intima media thickness (IMT) of the artery carotis communis.......The objective of the study was to analyse the relations between excretion of cortisol in urine and saliva and the intima media thickness (IMT) of the artery carotis communis....

Spontaneous Resolution of Primary Hyperparathyroidism in Parathyroid Adenoma

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Sara J. Micale

2012-01-01

Full Text Available A 71 yo woman with primary hyperparathyroidism awaiting surgery because of significant hypercalcemia and hypercalciuria presented to the local emergency department with the chief complaints of discomfort in her neck, sore throat, and difficulty swallowing. She was found to be hypocalcemic with a calcium level of 8.1 mg/dL. She was seen by her endocrinologist three days later at which time serum calcium, iPTH, and serum phosphate levels were all within normal limits. Based on history and a series of ultrasounds the patient was diagnosed with spontaneous infarction of her parathyroid adenoma, which resulted in resolution of her primary hyperparathyroidism.

Automatic discrimination between safe and unsafe swallowing using a reputation-based classifier

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Nikjoo Mohammad S

2011-11-01

Full Text Available Abstract Background Swallowing accelerometry has been suggested as a potential non-invasive tool for bedside dysphagia screening. Various vibratory signal features and complementary measurement modalities have been put forth in the literature for the potential discrimination between safe and unsafe swallowing. To date, automatic classification of swallowing accelerometry has exclusively involved a single-axis of vibration although a second axis is known to contain additional information about the nature of the swallow. Furthermore, the only published attempt at automatic classification in adult patients has been based on a small sample of swallowing vibrations. Methods In this paper, a large corpus of dual-axis accelerometric signals were collected from 30 older adults (aged 65.47 ± 13.4 years, 15 male referred to videofluoroscopic examination on the suspicion of dysphagia. We invoked a reputation-based classifier combination to automatically categorize the dual-axis accelerometric signals into safe and unsafe swallows, as labeled via videofluoroscopic review. From these participants, a total of 224 swallowing samples were obtained, 164 of which were labeled as unsafe swallows (swallows where the bolus entered the airway and 60 as safe swallows. Three separate support vector machine (SVM classifiers and eight different features were selected for classification. Results With selected time, frequency and information theoretic features, the reputation-based algorithm distinguished between safe and unsafe swallowing with promising accuracy (80.48 ± 5.0%, high sensitivity (97.1 ± 2% and modest specificity (64 ± 8.8%. Interpretation of the most discriminatory features revealed that in general, unsafe swallows had lower mean vibration amplitude and faster autocorrelation decay, suggestive of decreased hyoid excursion and compromised coordination, respectively. Further, owing to its performance-based weighting of component classifiers, the static

Recuperación de veillonellas a partir de saliva Recovery of Veillonella from saliva

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M.I. Gutiérrez De Ferro

2005-03-01

Full Text Available Las veillonellas son cocos gram-negativos anaerobios asociados con salud oral. Para su aislamiento, se han reportado diferentes medios de cultivo. Las colonias de Veillonella spp. producen fluorescencia roja visible con luz ultravioleta, que desaparece en contacto con oxígeno. Esta propiedad sería útil para su identificación presuntiva rápida. Los objetivos de este trabajo fueron: 1- comparar el medio selectivo para Veillonella de Rogosa con los medios de cultivo recomendados por diferentes autores para determinar en cual de ellos se obtiene una mejor recuperación de veillonellas a partir de saliva, ya que esta muestra es generalmente utilizada para determinar la presencia y predominio de esta bacteria; 2- detectar la producción de fluorescencia en estos medios de cultivo como método rápido de identificación. Los medios de cultivo estudiados fueron: medio selectivo para Veillonella, agar Schaedler para anaerobios con vitamina K, agar tioglicolato, agar infusión cerebro corazón, agar Brucella, agar tripteína soja y agar Columbia con y sin el agregado de vancomicina y sangre lacada. La muestra ensayada fue un pool de saliva. Se hicieron recuentos de colonias de veillonellas y de microorganismos totales expresados en UFC/ml de saliva. La mayor recuperación de veillonellas en saliva se obtuvo en el medio selectivo para Veillonella con vancomicina y sangre lacada. Sólo se observó producción de fluorescencia en este medio.Veillonella spp. are anaerobic gram-negative cocci associated to oral health. Different types of cultures have been reported for the isolation of these microorganisms. Veillonella spp. colonies produce a red fluorescence, which is made visible through ultraviolet light and disappears in contact with oxygen. This feature would be very useful for rapid presumptive identification. The aims of this study were: 1. to compare the Rogosa selective medium for Veillonella with the cultures recommended by different authors in

Tactile thermal oral stimulation increases the cortical representation of swallowing

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Suntrup Sonja

2009-06-01

Full Text Available Abstract Background Dysphagia is a leading complication in stroke patients causing aspiration pneumonia, malnutrition and increased mortality. Current strategies of swallowing therapy involve on the one hand modification of eating behaviour or swallowing technique and on the other hand facilitation of swallowing with the use of pharyngeal sensory stimulation. Thermal tactile oral stimulation (TTOS is an established method to treat patients with neurogenic dysphagia especially if caused by sensory deficits. Little is known about the possible mechanisms by which this interventional therapy may work. We employed whole-head MEG to study changes in cortical activation during self-paced volitional swallowing in fifteen healthy subjects with and without TTOS. Data were analyzed by means of synthetic aperture magnetometry (SAM and the group analysis of individual SAM data was performed using a permutation test. Results Compared to the normal swallowing task a significantly increased bilateral cortical activation was seen after oropharyngeal stimulation. Analysis of the chronological changes during swallowing suggests facilitation of both the oral and the pharyngeal phase of deglutition. Conclusion In the present study functional cortical changes elicited by oral sensory stimulation could be demonstrated. We suggest that these results reflect short-term cortical plasticity of sensory swallowing areas. These findings facilitate our understanding of the role of cortical reorganization in dysphagia treatment and recovery.

Swallow Characteristics in Patients with Oculopharyngeal Muscular Dystrophy

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Palmer, Phyllis M.; Neel, Amy T.; Sprouls, Gwyneth; Morrison, Leslie

2010-01-01

Purpose: This prospective investigation evaluates oral weakness and its impact on swallow function, weight, and quality of life in patients with oculopharyngeal muscular dystrophy (OPMD). Method: Intraoral pressure, swallow pressure, and endurance were measured using an Iowa Oral Performance Instrument in participants with OPMD and matched…

SWALLOWING IN PATIENTS WITH LARYNGITIS

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Isabela MODA

Full Text Available ABSTRACT BACKGROUND: Dysphagia is described as a complaint in 32% of patients with laryngitis. OBJECTIVE: The objective of this investigation was to evaluate oral and pharyngeal transit of patients with laryngitis, with the hypothesis that alteration in oral-pharyngeal bolus transit may be involved with dysphagia. METHODS: Videofluoroscopic evaluation of the swallowing of liquid, paste and solid boluses was performed in 21 patients with laryngitis, 10 of them with dysphagia, and 21 normal volunteers of the same age and sex. Two swallows of 5 mL liquid bolus, two swallows of 5 mL paste bolus and two swallows of a solid bolus were evaluated in a random sequence. The liquid bolus was 100% liquid barium sulfate and the paste bolus was prepared with 50 mL of liquid barium and 4 g of food thickener (starch and maltodextrin. The solid bolus was a soft 2.2 g cookie coated with liquid barium. Durations of oral preparation, oral transit, pharyngeal transit, pharyngeal clearance, upper esophageal sphincter opening, hyoid movement and oral-pharyngeal transit were measured. All patients performed 24-hour distal esophageal pH evaluation previous to videofluoroscopy. RESULTS: The evaluation of 24-hour distal esophageal pH showed abnormal gastroesophageal acid reflux in 10 patients. Patients showed longer oral preparation for paste bolus and a faster oral transit time for solid bolus than normal volunteers. Patients with laryngitis and dysphagia had longer preparation for paste and solid boluses, and a faster oral transit time with liquid, paste and solid boluses. CONCLUSION: A longer oral preparation for paste and solid boluses and a faster transit through the mouth are associated with dysphagia in patients with laryngitis.

SWALLOWING IN PATIENTS WITH LARYNGITIS.

Science.gov (United States)

Moda, Isabela; Ricz, Hilton Marcos Alves; Aguiar-Ricz, Lilian Neto; Dantas, Roberto Oliveira

2018-01-01

Dysphagia is described as a complaint in 32% of patients with laryngitis. The objective of this investigation was to evaluate oral and pharyngeal transit of patients with laryngitis, with the hypothesis that alteration in oral-pharyngeal bolus transit may be involved with dysphagia. Videofluoroscopic evaluation of the swallowing of liquid, paste and solid boluses was performed in 21 patients with laryngitis, 10 of them with dysphagia, and 21 normal volunteers of the same age and sex. Two swallows of 5 mL liquid bolus, two swallows of 5 mL paste bolus and two swallows of a solid bolus were evaluated in a random sequence. The liquid bolus was 100% liquid barium sulfate and the paste bolus was prepared with 50 mL of liquid barium and 4 g of food thickener (starch and maltodextrin). The solid bolus was a soft 2.2 g cookie coated with liquid barium. Durations of oral preparation, oral transit, pharyngeal transit, pharyngeal clearance, upper esophageal sphincter opening, hyoid movement and oral-pharyngeal transit were measured. All patients performed 24-hour distal esophageal pH evaluation previous to videofluoroscopy. The evaluation of 24-hour distal esophageal pH showed abnormal gastroesophageal acid reflux in 10 patients. Patients showed longer oral preparation for paste bolus and a faster oral transit time for solid bolus than normal volunteers. Patients with laryngitis and dysphagia had longer preparation for paste and solid boluses, and a faster oral transit time with liquid, paste and solid boluses. A longer oral preparation for paste and solid boluses and a faster transit through the mouth are associated with dysphagia in patients with laryngitis.

The anatomy and physiology of normal and abnormal swallowing in oropharyngeal dysphagia.

Science.gov (United States)

Sasegbon, A; Hamdy, S

2017-11-01

Eating and drinking are enjoyable activities that positively impact on an individual's quality of life. The ability to swallow food and fluid is integral to the process of eating. Swallowing occupies a dual role being both part of the enjoyment of eating and being a critically important utilitarian activity to enable adequate nutrition and hydration. Any impairment to the process of swallowing can negatively affect a person's perception of their quality of life. The process of swallowing is highly complex and involves muscles in the mouth, pharynx, larynx, and esophagus. The oropharynx is the anatomical region encompassing the oral cavity and the pharynx. Food must be masticated, formed into a bolus and transported to the pharynx by the tongue whereas fluids are usually held within the mouth before being transported ab-orally. The bolus must then be transported through the pharynx to the esophagus without any matter entering the larynx. The muscles needed for all these steps are coordinated by swallowing centers within the brainstem which are supplied with sensory information by afferent nerve fibers from several cranial nerves. The swallowing centers also receive modulatory input from higher centers within the brain. Hence, a swallow has both voluntary and involuntary physiologic components and the term dysphagia is given to difficult swallowing while oropharyngeal dysphagia is difficult swallowing due to pathology within the oropharynx. Problems affecting any point along the complex swallowing pathway can result in dysphagia. This review focuses on the anatomy and physiology behind normal and abnormal oropharyngeal swallowing. It also details the common diseases and pathology causing oropharyngeal dysphagia. © 2017 John Wiley & Sons Ltd.

Swallowing Dysfunctions in Parkinson's Disease.

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Simons, Janine A

2017-01-01

Dysphagia is a very frequent and highly relevant symptom in Parkinson's disease (PD) for quality of life, morbidity, and remaining lifetime, which is unfortunately widely underdiagnosed and underestimated regarding patients' centered care. Especially in early stages, the causal association between disease and swallowing disabilities remains unnoticed, which may be accounted for by the inability of caregivers and physicians to detect subtle swallowing problems and by the low self-awareness among PD patients. In order to prevent patients from serious negative consequences for health issues (e.g., aspiration pneumonia or malnutrition) as well as for negative impact on their quality of life, it is on the highest importance of managing dysphagia timely and working closely together in a multidisciplinary team, who all are involved in the patients' care system. This chapter includes background information on epidemiology, pathophysiology, and symptomatology of swallowing disorders in PD. This is followed by a summary of the clinical course and health treats, adequate diagnostic procedures for early identification of dysphagia as well as effective treatment strategies. The conclusion provides recommendations for clinical practice routine. © 2017 Elsevier Inc. All rights reserved.

VIDEOFLUOROSCOPIC EVALUATION OF SWALLOWS IN ANOREXIA NERVOSA.

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Santos, Carla Manfredi; Cassiani, Rachel Aguiar; Dantas, Roberto Oliveira

2016-01-01

There are some studies in the literature about the feeding behavior and masticatory process in patients with feeding disorders; however, it is not very well known if there are alterations in oral-pharyngeal swallowing dynamics in subjects with anorexia nervosa. To evaluate the oral and pharyngeal bolus transit in patients with anorexia nervosa. The study was conducted with 8 individuals clinically diagnosed and in treatment for restricting-type anorexia nervosa (seven women and one man), and 14 healthy individuals with no digestive or neurological symptoms (10 women, 4 men). Swallows were evaluated by videofluoroscopy with three swallows of 5 mL liquid bolus and three swallows of 5 mL paste bolus consistency, given in a random sequence. The participants were asked after each swallow about the sensation of the bolus passage. In the analysis of oral-pharyngeal transit duration, the mean duration of pharyngeal transit with paste bolus in patients with anorexia was shorter than in healthy volunteers (P=0.02). In the duration of movement of the hyoid bone, longer movement was observed in anorexia than in healthy volunteers with liquid bolus (P=0.01). With liquid bolus, five (62.5%) patients and one (7.1%) control had sensation of the bolus passage (Panorexia nervosa, although the results suggest that pharyngeal transit has shorter duration than that seen in healthy volunteers and the hyoid movement duration is longer in patients than in healthy volunteers. Fast pharyngeal transit may be the cause of bolus transit perception in patients with anorexia nervosa.

Observation the swallowing mechanism in elderly patients with pharyngeal dysphagia

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Claudia Ximena Campo-Cañar

2010-09-01

Full Text Available Observation of the swallowing dynamics is an issue that demands close attention by the health professionals involved in the diagnosis and management of patients with dysphagia. This article is a review of the literature aimed to enhance the knowledge regarding the speech therapy assessment of pharyngeal dysphagia in elder adults. The disorder of the swallowing is called dysphagia and it is defined as difficulty swallowing. The dysphagia is often caused by affectation of mechanical or neuromuscular components of the swallowing mechanism. This type of disorder is likely to impact the the oral, pharyngeal and esophageal phases of the swallowing. The speech therapist should take into account assessing aspects such as level of consciousness, vital signs, whether or not the patient is ventilator dependent, means of feeding, if intubated what type of cannula, whether or not the patient uses a speaking valve (if a trach tube is present, nutritional status, the patient’s expressive and receptive language, the anatomical and physiological state of the oral motor structures. When assessing swallowing clinicians should also make sure to develop an adequate beside clinical, voice assessment and videofluoroscopy.

Comparison of Plasma, Saliva, and Hair Levetiracetam Concentrations.

Science.gov (United States)

Karaś-Ruszczyk, Katarzyna; Kuczyńska, Julita; Sienkiewicz-Jarosz, Halina; Kurkowska-Jastrzębska, Iwona; Bienkowski, Przemyslaw; Restel, Magdalena; Samochowiec, Jerzy; Mierzejewski, Pawel

2017-06-01

Previous findings revealed high correlations between serum/plasma and saliva levetiracetam concentrations, indicating saliva as an alternative matrix for monitoring levetiracetam therapy. Levetiracetam concentration in the hair, which could reflect long-term drug exposure and patients' compliance, has not been systematically tested, as yet. The aim of this study was to determine the correlation between plasma, saliva, and hair levetiracetam concentrations in 47 patients with epilepsy. Plasma, saliva, and hair levetiracetam concentrations were measured by liquid chromatography-tandem mass spectrometry with positive ionization. Levetiracetam saliva and plasma concentrations were highly correlated (r = 0.93). Plasma concentrations were not influenced by sex, age, and other concomitant antiepileptic drugs. Levetiracetam hair concentrations correlated with plasma concentrations (r = 0.36) but not daily dose (mg/kg). Drug hair concentrations were not influenced by hair color or treatment (dyed). The results tend to indicate that saliva may be a reliable alternative to plasma for monitoring levetiracetam concentrations. Levetiracetam can also be detected in human hair.

Cortical recovery of swallowing function in wound botulism

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Ringelstein Erich B

2008-05-01

Full Text Available Abstract Background Botulism is a rare disease caused by intoxication leading to muscle weakness and rapidly progressive dysphagia. With adequate therapy signs of recovery can be observed within several days. In the last few years, brain imaging studies carried out in healthy subjects showed activation of the sensorimotor cortex and the insula during volitional swallowing. However, little is known about cortical changes and compensation mechanisms accompanying swallowing pathology. Methods In this study, we applied whole-head magnetoencephalography (MEG in order to study changes in cortical activation in a 27-year-old patient suffering from wound botulism during recovery from dysphagia. An age-matched group of healthy subjects served as control group. A self-paced swallowing paradigm was performed and data were analyzed using synthetic aperture magnetometry (SAM. Results The first MEG measurement, carried out when the patient still demonstrated severe dysphagia, revealed strongly decreased activation of the somatosensory cortex but a strong activation of the right insula and marked recruitment of the left posterior parietal cortex (PPC. In the second measurement performed five days later after clinical recovery from dysphagia we found a decreased activation in these two areas and a bilateral cortical activation of the primary and secondary sensorimotor cortex comparable to the results seen in a healthy control group. Conclusion These findings indicate parallel development to normalization of swallowing related cortical activation and clinical recovery from dysphagia and highlight the importance of the insula and the PPC for the central coordination of swallowing. The results suggest that MEG examination of swallowing can reflect short-term changes in patients suffering from neurogenic dysphagia.

Soft Electronics Enabled Ergonomic Human-Computer Interaction for Swallowing Training

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Lee, Yongkuk; Nicholls, Benjamin; Sup Lee, Dong; Chen, Yanfei; Chun, Youngjae; Siang Ang, Chee; Yeo, Woon-Hong

2017-04-01

We introduce a skin-friendly electronic system that enables human-computer interaction (HCI) for swallowing training in dysphagia rehabilitation. For an ergonomic HCI, we utilize a soft, highly compliant (“skin-like”) electrode, which addresses critical issues of an existing rigid and planar electrode combined with a problematic conductive electrolyte and adhesive pad. The skin-like electrode offers a highly conformal, user-comfortable interaction with the skin for long-term wearable, high-fidelity recording of swallowing electromyograms on the chin. Mechanics modeling and experimental quantification captures the ultra-elastic mechanical characteristics of an open mesh microstructured sensor, conjugated with an elastomeric membrane. Systematic in vivo studies investigate the functionality of the soft electronics for HCI-enabled swallowing training, which includes the application of a biofeedback system to detect swallowing behavior. The collection of results demonstrates clinical feasibility of the ergonomic electronics in HCI-driven rehabilitation for patients with swallowing disorders.

Swallowing sound detection using hidden markov modeling of recurrence plot features

International Nuclear Information System (INIS)

Aboofazeli, Mohammad; Moussavi, Zahra

2009-01-01

Automated detection of swallowing sounds in swallowing and breath sound recordings is of importance for monitoring purposes in which the recording durations are long. This paper presents a novel method for swallowing sound detection using hidden Markov modeling of recurrence plot features. Tracheal sound recordings of 15 healthy and nine dysphagic subjects were studied. The multidimensional state space trajectory of each signal was reconstructed using the Taken method of delays. The sequences of three recurrence plot features of the reconstructed trajectories (which have shown discriminating capability between swallowing and breath sounds) were modeled by three hidden Markov models. The Viterbi algorithm was used for swallowing sound detection. The results were validated manually by inspection of the simultaneously recorded airflow signal and spectrogram of the sounds, and also by auditory means. The experimental results suggested that the performance of the proposed method using hidden Markov modeling of recurrence plot features was superior to the previous swallowing sound detection methods.

Swallowing sound detection using hidden markov modeling of recurrence plot features

Energy Technology Data Exchange (ETDEWEB)

Aboofazeli, Mohammad [Faculty of Engineering, Department of Electrical and Computer Engineering, University of Manitoba, Winnipeg, Manitoba, R3T 5V6 (Canada)], E-mail: umaboofa@cc.umanitoba.ca; Moussavi, Zahra [Faculty of Engineering, Department of Electrical and Computer Engineering, University of Manitoba, Winnipeg, Manitoba, R3T 5V6 (Canada)], E-mail: mousavi@ee.umanitoba.ca

2009-01-30

Automated detection of swallowing sounds in swallowing and breath sound recordings is of importance for monitoring purposes in which the recording durations are long. This paper presents a novel method for swallowing sound detection using hidden Markov modeling of recurrence plot features. Tracheal sound recordings of 15 healthy and nine dysphagic subjects were studied. The multidimensional state space trajectory of each signal was reconstructed using the Taken method of delays. The sequences of three recurrence plot features of the reconstructed trajectories (which have shown discriminating capability between swallowing and breath sounds) were modeled by three hidden Markov models. The Viterbi algorithm was used for swallowing sound detection. The results were validated manually by inspection of the simultaneously recorded airflow signal and spectrogram of the sounds, and also by auditory means. The experimental results suggested that the performance of the proposed method using hidden Markov modeling of recurrence plot features was superior to the previous swallowing sound detection methods.

The proteome of human saliva

Science.gov (United States)

Griffin, Timothy J.

2013-05-01

Human saliva holds tremendous potential for transforming disease and health diagnostics given its richness of molecular information and non-invasive collection. Enumerating its molecular constituents is an important first step towards reaching this potential. Among the molecules in saliva, proteins and peptides arguably have the most value: they can directly indicate biochemical functions linked to a health condition/disease state, and they are attractive targets for biomarker assay development. However, cataloging and defining the human salivary proteome is challenging given the dynamic, chemically heterogeneous and complex nature of the system. In addition, the overall human saliva proteome is composed of several "sub-proteomes" which include: intact full length proteins, proteins carrying post-translational modifications (PTMs), low molecular weight peptides, and the metaproteome, derived from protein products from nonhuman organisms (e.g. microbes) present in the oral cavity. Presented here will be a summary of communal efforts to meet the challenge of characterizing the multifaceted saliva proteome, focusing on the use of mass spectrometry as the proteomic technology of choice. Implications of these efforts to characterize the salivary proteome in the context of disease diagnostics will also be discussed.

Changes in the frequency of swallowing during electrical stimulation of superior laryngeal nerve in rats.

Science.gov (United States)

Tsuji, Kojun; Tsujimura, Takanori; Magara, Jin; Sakai, Shogo; Nakamura, Yuki; Inoue, Makoto

2015-02-01

The aim of the present study was to investigate the adaptation of the swallowing reflex in terms of reduced swallowing reflex initiation following continuous superior laryngeal nerve stimulation. Forty-four male Sprague Dawley rats were anesthetized with urethane. To identify swallowing, electromyographic activity of the left mylohyoid and thyrohyoid muscles was recorded. To evoke the swallowing response, the superior laryngeal nerve (SLN), recurrent laryngeal nerve, or cortical swallowing area was electrically stimulated. Repetitive swallowing evoked by continuous SLN stimulation was gradually reduced, and this reduction was dependent on the resting time duration between stimulations. Prior SLN stimulation also suppressed subsequent swallowing initiation. The reduction in evoked swallows induced by recurrent laryngeal nerve or cortical swallowing area stimulation was less than that following superior laryngeal nerve stimulation. Decerebration had no effect on the reduction in evoked swallows. Prior subthreshold stimulation reduced subsequent initiation of swallowing, suggesting that there was no relationship between swallowing movement evoked by prior stimulation and the subsequent reduction in swallowing initiation. Overall, these data suggest that reduced sensory afferent nerve firing and/or trans-synaptic responses, as well as part of the brainstem central pattern generator, are involved in adaptation of the swallowing reflex following continuous stimulation of swallow-inducing peripheral nerves and cortical areas. Copyright © 2014 Elsevier Inc. All rights reserved.

Leaf swallowing behavior in chimpanzees (Pan troglodytes): biased learning and the emergence of group level cultural differences.

Science.gov (United States)

Huffman, Michael A; Spiezio, Caterina; Sgaravatti, Andrea; Leca, Jean-Baptiste

2010-11-01

Demonstrating the ability to 'copy' the behavior of others is an important aspect in determining whether social learning occurs and whether group level differences in a given behavior represent cultural differences or not. Understanding the occurrence of this process in its natural context is essential, but can be a daunting task in the wild. In order to test the social learning hypothesis for the acquisition of leaf swallowing (LS), a self-medicative behavior associated with the expulsion of parasites, we conducted semi-naturalistic experiments on two captive groups of parasite-free, naïve chimpanzees (Pan troglodytes). Individuals in the group were systematically provided appropriate stimuli (rough hispid leaves) identical to those used by chimpanzees in the wild. Individuals initially responded in a variety of ways, ranging from total aversion to normal chewing and swallowing. Over time, however, the two groups adopted different variants for inserting and folding the leaves in the mouth prior to swallowing them (complete and partial LS), following the specific method spontaneously displayed by the first and primary LS models in their respective groups. These variants were similar to LS displayed by chimpanzees in the wild. Using the option-bias method, we found evidence for social learning leading to group-level biased transmission and group-level stabilization of these two variants. This is the first report on two distinct cultural variants innovated in response to the introduction of natural stimuli that emerged and spread spontaneously and concurrently within two adjacent groups of socially housed primates. These observations support the assertion that LS may reflect a generalized propensity for ingesting rough hispid leaves, which can be socially induced and transmitted within a group. Ingesting an adequate number of these leaves induces increased gut motility, which is responsible for the subsequent expulsion of particular parasite species in the wild

Is parotid saliva sterile on entry to the oral cavity?

DEFF Research Database (Denmark)

Schrøder, Stine A; Bardow, Allan; Eickhardt-Dalbøge, Steffen

2017-01-01

CONCLUSION: The present study indicates that parotid saliva is sterile on entry to the oral cavity. OBJECTIVES: The objective was to investigate if parotid saliva is sterile on entry to the oral cavity and, thus, prior to contamination by oral bacteria. METHOD: Forty healthy volunteers were...... included in sterile parotid saliva collection. Parotid saliva was collected using a sterile Lashley cup, placed over the papilla of the Stensen´s duct, as well as sterile tubes and syringes for collection. All collections were followed by collection of a positive control sample where some of the sterile...... obtained parotid saliva had been exposed to the contralateral mucosal membranes. All samples parotid saliva, as well as the positive controls, were cultivated, and 10 randomly selected parotid saliva samples underwent polymerase chain reaction (PCR) analyses. RESULTS: In 33 of 40 parotid saliva samples...

Quality of life related to swallowing in Parkinson's disease.

Science.gov (United States)

Carneiro, Danielle; das Graças Wanderley de Sales Coriolano, Maria; Belo, Luciana Rodrigues; de Marcos Rabelo, Aneide Rocha; Asano, Amdore Guescel; Lins, Otávio Gomes

2014-10-01

Swallowing difficulties in Parkinson's disease can result in decreased quality of life. The swallowing quality of life questionnaire (SWAL-QOL) is an instrument for specifically assessing quality of life with respect to swallowing, which has been little explored in patients with Parkinson's disease (PD). The goal of this study was to evaluate the quality of life with respect to swallowing in persons with PD compared to controls and at several stages of the disease using the SWAL-QOL. The experimental group was composed of 62 persons with PD at stages 1-4. Forty-one age-matched healthy subjects constituted the control group. The SWAL-QOL scores were significantly lower for the patients with PD than for the controls in all SWAL-QOL domains. Eating duration had the largest difference in score between persons with PD and the controls and the lowest mean score, followed by communication, fatigue, fear, sleep, and food selection. The scores of most domains were lower at later stages of the disease. The scores for eating duration, symptom frequency, and sleep were significantly lower at stage 4 than stages 1 and 2. In conclusion, patients with PD have significantly lower scores in all domains of the SWAL-QOL than normal controls. This means swallowing difficulties occurring in patients with PD negatively affect their QOL. Progression of the disease worsens swallowing QOL, more specifically in the domains of eating duration, symptom frequency, and sleep. This occurs mostly at later stages of the disease.

Human Saliva Collection Devices for Proteomics: An Update

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Zohaib Khurshid

2016-06-01

Full Text Available There has been a rapid growth in the interest and adaptation of saliva as a diagnostic specimen over the last decade, and in the last few years in particular, there have been major developments involving the application of saliva as a clinically relevant specimen. Saliva provides a “window” into the oral and systemic health of an individual, and like other bodily fluids, saliva can be analyzed and studied to diagnose diseases. With the advent of new, more sensitive technologies to detect smaller concentrations of analytes in saliva relative to blood levels, there have been a number of critical developments in the field that we will describe. In particular, recent advances in standardized saliva collection devices that were not available three to four years ago, have made it easy for safe, simple, and non-invasive collection of samples to be carried out from patients. With the availability of these new technologies, we believe that in the next decade salivary proteomics will make it possible to predict and diagnose oral as well as systemic diseases, cancer, and infectious diseases, among others. The aim of this article is to review recent developments and advances in the area of saliva specimen collection devices and applications that will advance the field of proteomics.

Saliva as a diagnostic fluid: literature review

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Martí Álamo, Silvia; Mancheño Franch, Aisha; Marzal Gamarra, Cristina

2012-01-01

There is a growing interest in diagnosis based on the analysis of saliva. This is a simple, non-invasive method of obtaining oral samples which is safe for both the health worker and the patient, not to mention allowing for simple and cost-efficient storage. The majority of studies use general saliva samples in their entirety, complex fluids containing both local and systemic sources and whose composition corresponds to that of the blood. General saliva contains a considerable ...

A Targeted Swallow Screen for the Detection of Postoperative Dysphagia.

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Gee, Erica; Lancaster, Elizabeth; Meltzer, Jospeh; Mendelsohn, Abie H; Benharash, Peyman

2015-10-01

Postoperative dysphagia leads to aspiration pneumonia, prolonged hospital stay, and is associated with increased mortality. A simple and sensitive screening test to identify patients requiring objective dysphagia evaluation is presently lacking. In this study, we evaluated the efficacy of a novel targeted swallow screen evaluation. This was a prospective trial involving all adult patients who underwent elective cardiac surgery with cardiopulmonary bypass at our institution over an 8-week period. Within 24 hours of extubation and before the initiation of oral intake, all postsurgical patients were evaluated using the targeted swallow screen. A fiberoptic endoscopic evaluation of swallowing was requested for failed screenings. During the study, 50 postcardiac surgery patients were screened. Fifteen (30%) failed the targeted swallow screen, and ten of the fifteen (66%) failed the subsequent fiberoptic endoscopic evaluation of swallowing exam and were confirmed to have dysphagia. The screening test had 100 per cent sensitivity for detecting dysphagia in our patient population, and a specificity of 87.5 per cent. The overall incidence of dysphagia was 20 per cent. We have shown that a targeted swallow evaluation can efficiently screen patients during the postcardiac surgery period. Furthermore, we have shown that the true incidence of dysphagia after cardiac surgery is significantly higher than previously recognized in literature.

Swallowing Quality of Life After Zona Incerta Deep Brain Stimulation.

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Sundstedt, Stina; Nordh, Erik; Linder, Jan; Hedström, Johanna; Finizia, Caterina; Olofsson, Katarina

2017-02-01

The management of Parkinson's disease (PD) has been improved, but management of signs like swallowing problems is still challenging. Deep brain stimulation (DBS) alleviates the cardinal motor symptoms and improves quality of life, but its effect on swallowing is not fully explored. The purpose of this study was to examine self-reported swallowing-specific quality of life before and after caudal zona incerta DBS (cZI DBS) in comparison with a control group. Nine PD patients (2 women and 7 men) completed the self-report Swallowing Quality of Life questionnaire (SWAL-QOL) before and 12 months after cZI DBS surgery. The postoperative data were compared to 9 controls. Median ages were 53 years (range, 40-70 years) for patients and 54 years (range, 42-72 years) for controls. No significant differences were found between the pre- or postoperative scores. The SWAL-QOL total scores did not differ significantly between PD patients and controls. The PD patients reported significantly lower scores in the burden subscale and the symptom scale. Patients with PD selected for cZI DBS showed good self-reported swallowing-specific quality of life, in many aspects equal to controls. The cZI DBS did not negatively affect swallowing-specific quality of life in this study.

[Age-related changes in swallowing. Physiology and pathophysiology].

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Muhle, P; Wirth, R; Glahn, J; Dziewas, R

2015-04-01

The term presbyphagia refers to all changes of swallowing physiology that are manifested with increasing age. Alterations in the pattern of deglutition that are part of healthy aging are called primary presbyphagia. Primary presbyphagia is not an illness in itself but contributes to a more pervasive naturally diminished functional reserve, making older adults more susceptible to dysphagia. If disorders in swallowing occur in the elderly as a comorbidity of a specific disease, for example stroke or neurodegenerative disorders, this is called secondary presbyphagia. Increasing age has an impact on each stage of deglutition. In the oral preparatory phase a diminished input for smell and taste as well as a usually multifactorial cause of dry mouth are the most important influencing factors. Sarcopenia, the degenerative loss of skeletal muscle mass, strength and quality associated with aging, interferes in particular with the oropharyngeal phase. A decreased sensory feedback from the oropharyngeal mucosa leads to a delayed triggering of the swallowing reflex. Finally, a reduction in connective tissue elasticity and changes of the axial skeleton lead to various modifications of the swallowing pattern with advanced age.

[Concentration of calcium ions in the saliva and the value of the pH of the saliva in female and male smokers].

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Nakonieczna-Rudnicka, Marta; Bachanek, Teresa; Rogowska, Wanda

2009-01-01

Dental decay is a pathological process of extrasomatic origin which leads to demineralization and proteolytic degradation of hard surfaces of a tooth susceptible to this disease. Saliva composition, including calcium ion concentration and its pH value, is of importance in the development of the carious process. Tobacco smoke contains toxic compounds which negatively influence oral health. The aim of the study was evaluation of the selected saliva components: protein concentration, Ca2+ concentration, pH value both in male and female smokers. The investigated group included 65 patients reporting for the treatment to the Department of Conservative Dentistry of Medical University in Lublin. In the investigated group male smokers constituted 15.38%, female smokers--20.00%, male nicotine abstinents 21.54% and female nicotine abstinent 43.08%. The study included both survey examinations of patients and biochemical examinations of the saliva. Mixed, non-stimulated saliva was used as a material for biochemical examinations. Ca2+ concentration and pH of the saliva were assayed with the use of Rapidlab 348 analyzer. Protein in the saliva was assayed with calorimetric method according to Lowry. Saliva was collected from smokers 10-120 minutes after smoking of several cigarettes. It was stated that Ca2+ and protein concentration as well as pH of the saliva were not correlated with sex and cigarette smoking or non-smoking.

Assessment of swallowing and its disorders—A dynamic MRI study

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Vijay Kumar, K.V., E-mail: vijaykumarkv@yahoo.in [Department of Speech, Language and Hearing Sciences, SRU (India); Shankar, V., E-mail: drshankarv@yahoo.co.in [Department of Neurology, SRU (India); Santosham, Roy, E-mail: santoshamroy@yahoo.com [Department of Radiology and Imaging Sciences, SRU (India)

2013-02-15

Magnetic resonance imaging overcomes the limitations of videofluoroscopy in assessing without radiation exposure. The clinical utility of dynamic MRI for swallowing disorders is not well documented. This study demonstrates the feasibility of using dynamic MRI in assessment of swallowing disorders. Ten normal and three brainstem lesion patients participated in this study. GE Signa HDxt 1.5 Tesla MRI scanner with head-and-neck coil as a receiver and fast imaging employing steady state acquisition sequence was used. The swallow was analyzed in terms of symmetry and amplitude of movements of velum, faucial pillars, tongue, epiglottis and cricopharyngeous and images from the sagittal, coronal and axial planes. In sagittal plane posterior movement of tongue and its compression on velum, elevation of hyoid bone, elevation of larynx and lid action of epiglottis, in the coronal view the symmetrical movements of the faucial pillars and pharyngeal constrictor muscles and in axial plane three anatomical landmarks were targeted based on their role in swallowing, viz. velum, epiglottis and cricopharyngeous were studied. In brainstem lesion individuals, posterior movement of tongue, and elevation of larynx were not seen. Asymmetrical movements of faucial pillars and cricopharyngeous muscle were appreciated in the dynamic MRI. This demonstrates that, dynamic MRI is an efficient tool to understand the swallowing physiology and helps the speech language pathologist in modifying the swallowing maneuvers. Dynamic MRI is an effective tool in assessing swallowing and its disorders. This muscle specific information is not appreciated in videofluoroscopy and this information is necessary to modify the therapy maneuvers.

Assessment of swallowing and its disorders—A dynamic MRI study

International Nuclear Information System (INIS)

Vijay Kumar, K.V.; Shankar, V.; Santosham, Roy

2013-01-01

Magnetic resonance imaging overcomes the limitations of videofluoroscopy in assessing without radiation exposure. The clinical utility of dynamic MRI for swallowing disorders is not well documented. This study demonstrates the feasibility of using dynamic MRI in assessment of swallowing disorders. Ten normal and three brainstem lesion patients participated in this study. GE Signa HDxt 1.5 Tesla MRI scanner with head-and-neck coil as a receiver and fast imaging employing steady state acquisition sequence was used. The swallow was analyzed in terms of symmetry and amplitude of movements of velum, faucial pillars, tongue, epiglottis and cricopharyngeous and images from the sagittal, coronal and axial planes. In sagittal plane posterior movement of tongue and its compression on velum, elevation of hyoid bone, elevation of larynx and lid action of epiglottis, in the coronal view the symmetrical movements of the faucial pillars and pharyngeal constrictor muscles and in axial plane three anatomical landmarks were targeted based on their role in swallowing, viz. velum, epiglottis and cricopharyngeous were studied. In brainstem lesion individuals, posterior movement of tongue, and elevation of larynx were not seen. Asymmetrical movements of faucial pillars and cricopharyngeous muscle were appreciated in the dynamic MRI. This demonstrates that, dynamic MRI is an efficient tool to understand the swallowing physiology and helps the speech language pathologist in modifying the swallowing maneuvers. Dynamic MRI is an effective tool in assessing swallowing and its disorders. This muscle specific information is not appreciated in videofluoroscopy and this information is necessary to modify the therapy maneuvers

Efek Pengunyahan Permen Karet Gula dan Xylitol terhadap Status Saliva

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Lisna Kurnia Rezky

2016-11-01

Full Text Available Latar belakang. Rongga mulut sebagai pintu masuk makanan ke dalam tubuh selalu dibasahi oleh saliva setiap harinya. Saat ini banyak produk permen karet yang beredar di masyarakat yang mengandung gula dan xylitol. Banyak orang yang gemar mengunyah permen karet dengan kurang memperhatikan komposisinya baik yang mengandung gula ataupun xylitol sehingga kurang mengetahui efek masing-masing jenis permen karet tersebut terhadap kesehatan rongga mulut. Tujuan. Penelitian ini bertujuan untuk mengetahui efek pengunyahan permen karet gula dengan permen karet xylitol terhadap status saliva yang terdiri dari volume, pH, dan viskositas saliva. Metode penelitian. Subjek penelitian berjumlah 30 orang dibagi menjadi 3 kelompok masing-masing 10 orang, terdiri dari kelompok mengunyah permen karet gula, xylitol, dan kontrol dengan mengunyah apel. Pengambilan saliva dilakukan pagi hari dan siang hari. Subjek mengunyah 2 butir permen karet dan tidak diperbolehkan untuk makan dan minum 1 jam sebelum mengunyah. Subjek diinstruksikan meludah ke dalam pot saliva selama 10 menit dalam interval setiap 1 menit. Pengukuran volume saliva menggunakan pipet volume, pH saliva dengan menggunakan pH meter, dan viskositas saliva dengan menggunakan viskometer Ostwald hari ke-1 dan ke-4. Analisis data dengan uji statistik Mann-Whitney. Hasil. penelitian menunjukkan adanya peningkatan bermakna volume dan viskositas saliva pada pengunyahan permen karet xylitol dan gula. Derajat keasaman (pH saliva menurun setelah mengunyah permen karet gula sedangkan pada perm en karet xylitol relatif stabil. Disimpulkan bahwa permen karet xylitollebih baik untuk kestabilan status saliva dibandingkan permen karet gula.

Volitional chewing with a conscious effort alters and facilitates swallowing during feeding sequence.

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Furuya, J; Hara, A; Nomura, T; Kondo, H

2014-03-01

The key objective of mastication is to form a food bolus suitable for smooth swallowing. However, chewing is usually performed without a conscious effort. Poor bolus formation can cause pharyngeal residue and suffocation in elderly individuals with reduced swallowing function. Therefore, chewing with a conscious effort may help the bolus to more easily pass the pharynx. This study aimed to clarify the impact of mastication with a conscious effort on the feeding sequence. Subjects included 25 dentulous volunteers who were informed and provided written consent. Lateral videofluoroscopy was performed during the feeding of solid agar jelly under two conditions: chewing naturally in their usual manner (without volition) and chewing with a conscious effort (with volition). Temporal evaluation was performed for mastication, stage II transport (STII), swallow onset and oropharyngeal transit time. Moreover, bolus volume at swallow onset and subjective evaluation of swallowing easiness were measured. Volitional chewing with a conscious effort lengthened the duration of the chewing sequence before and after STII and delayed the swallow onset despite the fact that the bolus volume in the vallecula and hypopharynx (HYP) had significantly increased. Furthermore, with volition, the bolus transit time from swallow onset in the oral cavity, upper oropharynx and HYP was reduced, and subjective evaluation of swallowing easiness demonstrated significant improvement. These results suggest that volitional chewing with a conscious effort can alter bolus transport and swallowing, resulting in easier swallowing. © 2014 John Wiley & Sons Ltd.

Disposable Collection Kit for Rapid and Reliable Collection of Saliva

OpenAIRE

Yamaguchi, Masaki; Tezuka, Yuki; Takeda, Kazunori; Shetty, Vivek

2015-01-01

Objectives To describe and evaluate disposable saliva collection kit for rapid, reliable, and reproducible collection of saliva samples. Methods The saliva collection kit comprised of a saliva absorbent swab and an extractor unit was used to retrieve whole saliva samples from 10 subjects. The accuracy and precision of the extracted volumes (3, 10, and 30 ?l) were compared to similar volumes drawn from control samples obtained by passive drool. Additionally, the impact of kit collection method...

VIDEOFLUOROSCOPIC SWALLOWING STUDY: esophageal alterations in patients with dysphagia

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Betina SCHEEREN

2014-09-01

Full Text Available Context Videofluoroscopic swallowing study is a dynamic exam and allows the evaluation of the complete swallowing process. However, most published studies have only reported alterations in the oropharynx and pharyngoesophageal transition, leaving the analysis of the esophagus as a secondary goal. Objectives The goal of this study was to investigate the prevalence of alterations in the esophageal phase thorough videofluoroscopic swallowing study in patients with dysphagia. Methods Consecutive patients with dysphagia who underwent videofluoroscopic swallowing study including esophageal analysis between May 2010 and May 2012 had their exams retrospectively reviewed. Patients were classified into two groups: Group I - without a pre-established etiological diagnosis and Group II - with neurological disease. During the exam, the patients ingested three different consistencies of food (liquid, pasty and solid contrasted with barium sulfate and 19 items were analyzed according to a protocol. The esophageal phase was considered abnormal when one of the evaluated items was compromised. Results Three hundred and thirty-three (n = 333 consecutive patients were studied - 213 (64% in Group I and 120 (36% in Group II. Esophageal alterations were found in 104 (31% patients, with a higher prevalence in Group I (36.2%, especially on the items esophageal clearance (16.9% and tertiary contractions (16.4%. It was observed that 12% of individuals in Group I only presented alterations on the esophageal phase. Conclusion Evaluation of the esophageal phase of swallowing during videofluoroscopic swallowing study detects abnormalities in patients with cervical dysphagia, especially in the group without pre-established etiological diagnosis.

Lost and found…Tracking a swallowed denture: Role of radiology

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Yogita Khalekar

2017-01-01

Full Text Available Denture ingestion or aspiration is a problem requiring awareness of different specialists including dentists, surgeons, otolaryngologists, and anesthesiologists for prevention, early diagnosis and adequate treatment. Complications of swallowed dentures include hollow viscous necrosis, perforation, and penetration to neighbouring organs leading to fistulae, bleeding and obstruction. Here, we present the case of a 65 year old female patient who swallowed the denture, which was detected by barium swallow and removed by endoscopy. Hence, the management of swallowed denture needs a multidisciplinary approach with the help of a dentist, otolaryngologist and anesthesiologists. Dentists should recommend patients to visit them for planned check ups or revisit them in case of denture dislodgement or loosening as soon as possible to prevent such life threatening events.

Swallowing function after laryngeal cleft repair: more than just fixing the cleft.

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Osborn, Alexander J; de Alarcon, Alessandro; Tabangin, Meredith E; Miller, Claire K; Cotton, Robin T; Rutter, Michael J

2014-08-01

To evaluate and describe the swallowing function in children after laryngeal cleft repair. Ten-year (2002-2012) retrospective chart review. Academic tertiary care pediatric otolaryngology practice. Records of 60 children who had surgical repair of laryngeal cleft (ages 2 weeks-14 years) and postoperative functional endoscopic evaluation of swallowing or videofluoroscopic swallow studies were examined retrospectively. Twenty-nine children had one postoperative swallow evaluation, 19 children had two, 4 children had three, 5 children had four, and 3 children had five. Median time to the first evaluation was 10.8 weeks (interquartile range [IQR]: 36.5, 231). On the final swallow evaluation, 34 (57%) children demonstrated normal swallowing parameters, 12 (20%) children showed penetration, and 14 (23%) children showed aspiration. Forty-three (72%) children were able to take everything by mouth normally or with minor behavioral modifications, 11 (18%) children required thickened fluids, and six (10%) children were kept nil per os (NPO). Mean improvement on the penetration-aspiration (pen-asp) scale was 2.13. On multivariable analysis, neurodevelopmental issues and gastronomy tube use were associated with the need for NPO status. Despite a high rate of surgical success, a substantial minority of children have persistent swallowing dysfunction after laryngeal cleft repair. Swallowing dysfunction after repair is multifactorial and arises from concomitant neurologic, anatomic, or other comorbidities that contribute to oropharyngeal and pharyngeal dysphagia. Based on our results, we recommend a testing schedule for postoperative swallowing evaluations after cleft repair. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

The Videofluorographic Swallowing Study in Rheumatologic Diseases: A Comprehensive Review

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Di Piazza, Ambra; Costanzo, Massimo; Scopelliti, Laura; Salvaggi, Francesco; Cupido, Francesco; Salerno, Sergio; Lo Casto, Antonio; Midiri, Massimo; Lo Re, Giuseppe; Lagalla, Roberto

2017-01-01

Autoimmune connective tissue diseases are a heterogeneous group of pathologies that affect about 10% of world population with chronic evolution in 20%–80%. Inflammation in autoimmune diseases may lead to serious damage to other organs including the gastrointestinal tract. Gastrointestinal tract involvement in these patients may also due to both a direct action of antibodies against organs and pharmacological therapies. Dysphagia is one of the most important symptom, and it is caused by failure of the swallowing function and may lead to aspiration pneumonia, malnutrition, dehydration, weight loss, and airway obstruction. The videofluorographic swallowing study is a key diagnostic tool in the detection of swallowing disorders, allowing to make an early diagnosis and to reduce the risk of gastrointestinal and pulmonary complications. This technique helps to identify both functional and structural anomalies of the anatomic chain involved in swallowing function. The aim of this review is to systematically analyze the basis of the pathological involvement of the swallowing function for each rheumatological disease and to show the main features of the videofluorographic study that may be encountered in these patients. PMID:28706536

Pulmonary function in infants with swallowing dysfunction.

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James D Tutor

Full Text Available Swallowing dysfunction can lead to recurring aspiration and is frequently associated with chronic symptoms such as cough and wheezing in infants. Our objective was to describe the characteristics of infants with swallowing dysfunction, determine if pulmonary function abnormalities are detectable, and if they improve after therapy.We studied 38 infants with a history of coughing and wheezing who had pulmonary function tests performed within two weeks of their diagnosis of swallowing dysfunction. The raised lung volume rapid thoracoabdominal compression technique was used. After 6 months of therapy, 17 of the infants repeated the tests.Initially, 25 had abnormal spirometry, 18 had abnormal plethysmography, and 15 demonstrated bronchodilator responsiveness. Six months later test were repeated for seventeen patients. Ten patients had continued abnormal spirometry, two patients remained normal, three patients' abnormal spirometry had normalized, and two patients' previously normal studies became abnormal. Eight of the 17 patients had continued abnormal plethysmography, six had continued normal plethysmography, and three patients' normal plethysmography became abnormal. After 6 months of treatment, eight patients demonstrated bronchodilator responsiveness, of which five continued to demonstrate bronchodilator responsiveness and three developed responsiveness. The remainder either continued to be non- bronchodilator responsive (two or lost responsiveness (three. The findings of the abnormal tests in most infants tested is complicated by frequent occurrence of other co-morbidities in this population, including gastroesophageal reflux in 23 and passive smoke exposure in 13 of the infants.The interpretation of lung function changes is complicated by the frequent association of swallowing dysfunction with gastroesophageal reflux and passive smoke exposure in this population. Six months of medical therapy for swallowing dysfunction/gastroesophageal reflux

Coordination of respiration and swallowing: functional pattern and relevance of vocal folds closure

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Milton Melciades Barbosa Costa

2010-03-01

Full Text Available CONTEXT: Breathing and swallowing coordination, despite the expressive number of study, remain as theme deserving further research. OBJECTIVE: To identify a coordination pattern between swallowing and the natural breathing pause that occur in association with it (swallowing apnea and also the relevance of the vocal folds closure in this process. METHODS: Sixty-six adults, male and female, including normal health people, post-laryngectomy individuals and patients with digestive complaints without dysphagia were analyzed. The respiratory air flux interruptions produced by wet requested swallows and dry, requested and spontaneous swallows, were registered using thermo and piezoelectric receptors coupled to synectics medical manometry equipment, using Polygram upper 4.21 software. The results were analyzed with the Chi-square (3×2 and (2×2 nonparametric independency test with P = 0.05. RESULTS: Swallowing apnea is a preventive breathing stop that start just before and stay present during all deglutition pharyngeal phase. It is a well coordinated phenomena that occur as pattern in association with low elastic resistance of the lung, on the expiratory final phase until inspiration initial phase. This breathing stoppage it is usually followed by a short expiraton preceding a new breathing cycle. The swallow apnea and vocal folds closure are both independents mechanisms. CONCLUSION: It is possible to suppose that in the subconscious condition, swallowing apnea is integrated under coordination of the same control mechanism that also involves the elastic resistance of the lung.CONTEXTO: Apesar do expressivo número de estudos sobre a coordenação da respiração com a deglutição, o tema permanece aberto à pesquisa. OBJETIVO: Identificar um padrão de coordenação entre a pausa respiratória e a deglutição que ocorre em associação a esta usual apneia (apneia de deglutição e estabelecer a importância do fechamento das pregas vocais que ocorre

Development of chair-side evaluation system of swallowing discomfort of denture wearers

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Matsumoto, Keisuke; Ikuta, Ryuhei; Kataoka, Kanako; Ono, Yumie; Tamaki, Katsushi

2018-02-01

We investigated the appropriate hemodynamic parameters of functional near-infrared spectroscopy (fNIRS) to best differentiate the discomfort intensity related to swallowing in healthy subjects wearing different types of simulated dentures. Thirty-one subjects performed 4 sessions of water-swallowing task in a sitting position without or with wearing any one of the 3 simulated dentures under continuous fNIRS monitoring of the prefrontal cortex. The simulated dentures were consisted of a flat maxillary palatal bar and bilateral support attachment to the teeth and gum. The palatal bar positions were arranged along with the anterior, middle, or posterior areas of the upper jaw. The cumulative values of oxyhemoglobin and deoxyhemoglobin concentration changes were calculated for periods of 5 - 10 s from completion of swallowing. Subjective rating of swallowing-discomfort was the lowest without wearing denture and increased along with the palatal bar position placed from anterior to posterior. Cumulated deoxyhemoglobin signals calculated for 10 s post-swallowing event in the left frontopolar prefrontal cortex showed the best correlation with the subjective rating of discomfort in swallowing with dentures. These neurological signatures would be beneficial to detect swallowing discomfort in elderly denture wearers who have difficulty in communicating with dentists.

The digastric muscle is less involved in pharyngeal swallowing in rabbits.

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Tsujimura, Takanori; Yamada, Aki; Nakamura, Yuki; Fukuhara, Takako; Yamamura, Kensuke; Inoue, Makoto

2012-06-01

The swallowing reflex is centrally programmed by the lower brain stem, the so-called swallowing central pattern generator (CPG), and once the reflex is initiated, many muscles in the oral, pharyngeal, laryngeal, and esophageal regions are systematically activated. The mylohyoid (MH) muscle has been considered to be a "leading muscle" according to previous studies, but the functional role of the digastric (DIG) muscle in the swallowing reflex remains unclear. In the present study, therefore, the activities of single units of MH and DIG neurons were recorded extracellularly, and the functional involvement of these neurons in the swallowing reflex was investigated. The experiments were carried out on eight adult male Japanese white rabbits anesthetized with urethane. To identify DIG and MH neurons, the peripheral nerve (either DIG or MH) was stimulated to evoke action potentials of single motoneurons. Motoneurons were identified as such if they either (1) responded to antidromic nerve stimulation of DIG or MH in an all-or-none manner at threshold intensities and (2) followed stimulation frequencies of up to 0.5 kHz. As a result, all 11 MH neurons recorded were synchronously activated during the swallowing reflex, while there was no activity in any of the 7 DIG neurons recorded during the swallowing reflex. All neurons were anatomically localized ventromedially at the level of the caudal portion of the trigeminal motor nucleus, and there were no differences between the MH and DIG neuron sites. The present results strongly suggest that at least in the rabbit, DIG motoneurons are not tightly controlled by the swallowing CPG and, hence, the DIG muscle is less involved in the swallowing reflex.

Benefícios da aplicação de toxina botulínica associada à fonoterapia em pacientes disfágicos graves Benefits of botulinum toxin associated to swallowing therapy in patients with severe dysphagia

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Fernanda Teixeira Menezes

2012-06-01

Full Text Available Estudo de casos para caracterizar os benefícios da aplicação de toxina botulínica em glândulas salivares, associada à fonoterapia em pacientes disfágicos graves. Foram analisados cinco prontuários de pacientes neurológicos, em uso exclusivo de via alternativa de alimentação, com idades entre 17 e 70 anos, sendo quatro do gênero masculino e um do gênero feminino. Do total, quatro pacientes eram traqueostomizados. Foi considerado como critério de inclusão apresentar disfagia grave, com manifestações clínicas de escape extra oral e/ou acúmulo de saliva em cavidade oral e aspiração traqueal maciça de saliva, com limitação da fonoterapia. Quanto à avaliação clínica da deglutição, foram coletados dados pré e pós-fonoterapia associada à aplicação de toxina botulínica, quanto aos seguintes aspectos: mobilidade e força das estruturas orofaríngeas (lábios, língua, bochechas, elevação laríngea, grau da disfagia, uso de via alternativa de alimentação e traqueostomia. Quanto aos resultados pós- fonoterapia foi observado, em quatro pacientes, melhora da mobilidade e força de lábios, língua, bochechas e laringe. Quatro pacientes apresentaram deglutição funcional e um teve modificação do grau de gravidade da disfagia. Desta forma, a maioria foi capaz de receber dieta exclusiva por via oral e apenas um permaneceu com dieta mista, ou seja, gastrostomia e dieta via oral na consistência pastosa. Todos os pacientes traqueostomizados tiveram a cânula de traqueostomia removida. O estudo mostrou que o tratamento descrito acima contribui para a reabilitação da deglutição, reintrodução de alimentos por via oral e retirada da cânula de traqueostomia.Case report with the aim to characterize the benefits of botulinum toxin injection into salivary glands in association with swallowing therapy in patients with severe dysphagia. The medical records of five neurological patients (four male and one female, aged

Swallowing function in pediatric patients with bilateral vocal fold immobility.

Science.gov (United States)

Hsu, Jeffrey; Tibbetts, Kathleen M; Wu, Derek; Nassar, Michel; Tan, Melin

2017-02-01

Infants with bilateral vocal fold immobility (BVFI) often have poor swallow function in addition to potential airway compromise. While there are several reports on BVFI and its effect on patients' airway status, little is known about long term swallow function. We aim to characterize the swallowing function over time in pediatric patients with bilateral vocal fold immobility. A retrospective review of medical records of infants diagnosed with BVFI at a tertiary care children's hospital between 2005 and 2014 was conducted. Patient demographics, nature and etiology of immobility, laryngoscopy findings, comorbidities, and swallow outcomes at diagnosis and follow-up were recorded. Swallowing outcomes as measured by presence or absence of a gastrostomy tube were compared by etiology, vocal fold status, and normal or developmentally delay using the Fisher's exact test. 110 patients with a diagnosis of vocal fold immobility were identified. Twenty-nine (26%) had BVFI and twenty-three had complete medical records. Etiologies of vocal fold immobility include cardiac related in 13% (3/23), idiopathic in 30% (7/23) prolonged intubation in 26% (6/23) central neurologic in 22% (5/23), trauma in 4% (1/23), and infection in 4% (1/23). Average follow-up time was 44 months (range 5-94 months). Ten patients (56.5%) required a gastrostomy tube at time of diagnosis. Of this cohort who received gastrostomy tubes, three (30%) ultimately transitioned to complete oral feeds. Return of vocal fold mobility did not correlate with swallow function. In those with non-neurologic etiologies, the need for gastrostomy tube at end of follow up was unlikely. There was a statistically significant difference in the percentage of gastrostomy tube-free children at most recent follow up in patients who were normally developed (86%) versus those who were developmentally delayed (33%) (p = 0.02). We characterized the swallowing function of 23 pediatric patients with BVFI. Comorbidities are significant

Assessment of the swallowing function in older individuals referred to myocardial revascularization surgery.

Science.gov (United States)

Dantas, Mara de Oliveira Rodrigues Luiz; Auler, José Otávio Costa; Andrade, Claudia Regina Furquim de

2010-01-01

Swallowing evaluation of older individuals with coronary disease referred to heart surgery. To identify the characteristics of the swallowing function in older individuals referred to myocardial revascularization surgery (MR), using an evaluating protocol composed by a water test, cervical auscultation and pulse oximetry. The Assessment Protocol for Dysphagia Risk through a Combined Swallowing test and Vital Signs monitoring was used (PADTC)--measurements of HR and SpO2 (heart rate and oxygen saturation), water swallowing test with 1, 3, 5, 10, 15 e 20 ml, measurement of respiratory rate and cervical auscultation. The electronic stethoscope was used to analyze the number of swallows, response time and swallowing sound classification. In the Research Group (RG) older individuals with heart disease who were referred to MR were included. In the Control Group (CG) healthy older individuals were included. 38 older individuals were evaluated in the RG (mean age 68 years). In the CG, 30 older individuals were evaluated (mean age 70 years). There was a significant difference for the swallowing response time in older individuals with heart disease who presented HR below 60: swallowing response was shorter for 3 ml, 10 ml, 15 ml e 20 ml. HR was lower for individuals with heart disease. No significant difference was found between the groups for the other analyzed parameters. Older individuals with heart disease presented differences in the swallowing function when compared to healthy older individuals. Older individuals with heart disease presented alterations in the temporal coordination between breathing and swallowing, thus indicating risk for dysphagia.

Bank Swallow - Monitoring [ds6

Data.gov (United States)

California Natural Resource Agency — The data set represents the annual count of bank swallow burrows at nesting colonies located along the Sacramento River. The data set contains two databases which...

Etiology and long-term functional swallow outcomes in pediatric unilateral vocal fold immobility.

Science.gov (United States)

Tibbetts, Kathleen M; Wu, Derek; Hsu, Jeffrey V; Burton, William B; Nassar, Michel; Tan, Melin

2016-09-01

Unilateral vocal fold immobility (UVFI) results in deficits in phonatory, respiratory, and swallow function of the pediatric patient. Little is known about long-term functional swallow outcomes. Medical records of children diagnosed with UVFI between 2005 and 2014 at a tertiary children's hospital were retrospectively reviewed. Etiology, laryngoscopy findings, and swallow status at diagnosis and follow-up were recorded. Swallow outcomes were compared by etiology using Fisher's exact test. McNemar's test was used to identify correlations between return of mobility and swallow recovery. Rates of pneumonia were compared with initial swallow evaluation results using a two-tailed t-test. Eighty-eight patients with UVFI were identified and 73 patients (47% female, mean age 14.4 months, standard deviation (SD) 26.7 months) had complete medical records. Mean follow up time was 52.7 months (SD 36.8 months). Etiologies included cardiothoracic surgery (68.5%), idiopathic (12.3%), prolonged intubation (11.0%), central nervous system (CNS) abnormality (5.5%), and non-cardiac iatrogenic injury to the recurrent laryngeal nerve (2.7%). Forty-seven patients underwent a follow up laryngoscopy, and recovery of vocal fold (VF) mobility was documented in 42.6% (20/47). At diagnosis, 31.5% fed orally, compared with 79.5% at follow-up. Direct correlation between recovery of VF mobility and swallow recovery was not demonstrated. Cardiac etiologies demonstrated higher rates of swallow recovery than CNS abnormalities (p = 0.0393). Twenty-five children aspirated on initial modified barium swallow (MBS) and 10 children developed pneumonias at some point during the follow up period. There was no significant difference in rates of pneumonia in patients with and without aspiration on MBS. Recovery of swallow in children with UVFI does not directly parallel return of VF mobility. Long-term swallow outcome is favorable in this population. Initial MBS does not indicate ultimate swallow outcome

Role of Barium Swallow in Diagnosing Clinically Significant Anastomotic Leak following Esophagectomy

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Simon Roh

2016-04-01

Full Text Available Background: Barium swallow is performed following esophagectomy to evaluate the anastomosis for detection of leaks and to assess the emptying of the gastric conduit. The aim of this study was to evaluate the reliability of the barium swallow study in diagnosing anastomotic leaks following esophagectomy. Methods: Patients who underwent esophagectomy from January 2000 to December 2013 at our institution were investigated. Barium swallow was routinely done between days 5–7 to detect a leak. These results were compared to clinically determined leaks (defined by neck wound infection requiring jejunal feeds and or parenteral nutrition during the postoperative period. The sensitivity and specificity of barium swallow in diagnosing clinically significant anastomotic leaks was determined. Results: A total of 395 esophagectomies were performed (mean age, 62.2 years. The indications for the esophagectomy were as follows: malignancy (n=320, high-grade dysplasia (n=14, perforation (n=27, benign stricture (n=7, achalasia (n=16, and other (n=11. A variety of techniques were used including transhiatal (n=351, McKeown (n=35, and Ivor Lewis (n=9 esophagectomies. Operative mortality was 2.8% (n=11. Three hundred and sixty-eight patients (93% underwent barium swallow study after esophagectomy. Clinically significant anastomotic leak was identified in 36 patients (9.8%. Barium swallow was able to detect only 13/36 clinically significant leaks. The sensitivity of the swallow in diagnosing a leak was 36% and specificity was 97%. The positive and negative predictive values of barium swallow study in detecting leaks were 59% and 93%, respectively. Conclusion: Barium swallow is an insensitive but specific test for detecting leaks at the cervical anastomotic site after esophagectomy.

The Andean Swallow (Orochelidon andecola) in Argentina

OpenAIRE

Mazar Barnett, Juan; Pugnali, Germán D.; Pearman Morrison, Mark; Bodrati, Alejandro; Moschione, Flavio; Clark, Ricardo; Roesler, Carlos Ignacio; Monteleone, Diego; Casañas, Hernán; Burgos Gallardo, Freddy; Segovia, José; Pagano, Luis; Povedano, Hernán; Areta, Juan Ignacio

2016-01-01

During ornithological studies in the provinces of Jujuy, Salta, and San Juan, we recorded the Andean Swallow Orochelidon andecola at 40 localities. These are the first records in Argentina, and also represent the southernmost for the species. Some of these localities are up to 1500 m lower than the previously known elevational limit (now 800 masl), and up to 1100 km southwards. This is a relatively poorly known swallow, and we present novel natural history data. We found evidence of breeding ...

Effect of Bolus Viscosity on the Safety and Efficacy of Swallowing and the Kinematics of the Swallow Response in Patients with Oropharyngeal Dysphagia: White Paper by the European Society for Swallowing Disorders (ESSD).

Science.gov (United States)

Newman, Roger; Vilardell, Natàlia; Clavé, Pere; Speyer, Renée

2016-04-01

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. 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. A systematic search was performed using the electronic Pubmed and Embase databases. Articles in English available up to July 2015 were considered. The inclusion criteria swallowing studies on adults over 18 years of age; healthy people or patients with oropharyngeal dysphagia; bolus modification; effects of bolus modification on swallow safety (penetration/aspiration) and efficacy; and/or physiology and original articles written in English. The exclusion criteria consisted of oesophageal dysphagia and conference abstracts or presentations. The quality of the selected papers and the level of research evidence were assessed by standard quality assessments. At the end of the selection process, 33 articles were considered. The quality of all included studies was assessed using systematic, reproducible, and quantitative tools (Kmet and NHMRC) concluding that all the selected articles reached a valid level of evidence. The literature search gathered data from various sources, ranging from double-blind randomised control trials to systematic reviews focused on changes occurring in swallowing physiology caused by thickened fluids. Main results suggest that increasing bolus viscosity (a) results in increased safety of swallowing, (b) also results in increased amounts of oral and/or pharyngeal residue which may result in post-swallow airway invasion, (c) impacts the physiology with increased lingual pressure patterns, no major changes in impaired

Methods for excluding cliff swallows from nesting on highway structures.

Science.gov (United States)

2009-08-01

Cliff swallows (Petrochelidon pyrrhonota) are colonially breeding migratory birds that frequently nest on highway : structures. Protected by the Migratory Bird Treaty Act of 1918, nesting control methods cannot harm swallows or active : nests. This c...

Saliva: Physiology and Diagnostic Potential in Health and Disease

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Sebastien J. C. Farnaud

2010-01-01

Full Text Available Saliva has been described as the mirror of the body. In a world of soaring healthcare costs and an environment where rapid diagnosis may be critical to a positive patient outcome, saliva is emerging as a viable alternative to blood sampling. In this review, we discuss the composition and various physiological roles of saliva in the oral cavity, including soft tissue protection, antimicrobial activities, and oral tissue repair. We then explore saliva as a diagnostic marker of local oral disease and focus particularly on oral cancers. The cancer theme continues when we focus on systemic disease diagnosis from salivary biomarkers. Communicable disease is the focus of the next section where we review the literature relating to the direct and indirect detection of pathogenic infections from human saliva. Finally, we discuss hormones involved in appetite regulation and whether saliva is a viable alternative to blood in order to monitor hormones that are involved in satiety.

A therapeutic maneuver for oropharyngeal dysphagia in patients with Parkinson's disease.

Science.gov (United States)

Felix, Valter Nilton; Corrêa, Sabrina Mello Alves; Soares, Renato José

2008-10-01

This study investigates resources to provide better conditions for oropharyngeal swallowing for improvement in the quality of life of Parkinson's disease patients. Three men and one woman with an average age of 70.25 years had been afflicted with Parkinson's disease for an average of 9.25 years. The patients were submitted to a rehabilitation program for oropharyngeal dysphagia after a clinical evaluation of swallowing. The rehabilitation program consisted of daily sessions for two consecutive weeks during which a biofeedback resource adapted especially for this study was used. The patients were then reevaluated for swallowing ability at follow-up. The patients presenting difficulties with swallowing water displayed no such problems after rehabilitation. Only one patient exhibited slow oral transit of food and other discrete oropharyngeal food remnants when swallowing a biscuit. The sample variance was used to analyze the pressure measurements, demonstrating a numerical similarity of the results obtained with the swallowing of saliva or of biscuits (VAR = 4.41). A statistical difference was observed between the swallowing of saliva and biscuits, showing a significant pressure increase at the end of the rehabilitation program (p dysphagia in Parkinson's disease patients.

Results of fiberoptic endoscopic evaluation of swallowing vs. radiation dose in the swallowing muscles after radiotherapy of cancer in the oropharynx

International Nuclear Information System (INIS)

Teguh, David N.; Levendag, Peter C.; Sewnaik, Aniel; Hakkesteegt, Marieke M.; Noever, Inge; Voet, Peter; Est, Henrie van der; Sipkema, Dick; Rooij, Peter van; Baatenburg de Jong, Robert Jan; Schmitz, Paul I.M.

2008-01-01

Background and purpose: Dysphagia is a serious complaint but frequently underreported. This paper assesses for oropharyngeal cancer (OPC) the relationship between the dose received by the swallowing structures, and the findings of a fiberoptic endoscopic evaluation of the swallowing process (FEES). Materials and methods: Between 2000 and 2005, 60 of 67 OPC patients local-regionally NED for at least one year following treatment responded to three types of QoL questionnaires; i.e. Performance Status Scales, EORTC H and N35, and M.D. Anderson Dysphagia Inventory. Twenty-four patients agreed to the FEES procedure. The main swallowing muscles were delineated, with the mean dose per muscle calculated using the original 3D CT-based treatment plans. Regression analysis was performed between FEES variables and the doses in the different swallowing muscles and the dysphagia related questionnaires. Results: A significant relationship was found between the results of FEES and the mean dose in the superior constrictor muscle (SCM). Some of the subjective dysphagia complaints were significantly correlated with the FEES variables in this retrospectively study. Conclusion: A higher dose in the SCM generally results in worsening of the findings obtained by the FEES examination

Determination of acetone in saliva by reversed-phase liquid chromatography with fluorescence detection and the monitoring of diabetes mellitus patients with ketoacidosis.

Science.gov (United States)

Fujii, Shinya; Maeda, Toshio; Noge, Ichiro; Kitagawa, Yutaka; Todoroki, Kenichiro; Inoue, Koichi; Min, Jun Zhe; Toyo'oka, Toshimasa

2014-03-20

In diabetes mellitus (DM) patients with ketoacidosis, ketone bodies, i.e., acetone, acetoacetic acid (AA) and β-hydroxybutyric acid (HA), are increased in the blood and urine. Acetone is also excreted by breathing due to the spontaneous decomposition of AA. Thus, the increase in acetone has been considered as one of the biomarkers for the diagnosis of DM. However, the determination of acetone in one's breath is not recommended because of the sample handling difficulty. We measured acetone in saliva by reversed-phase liquid chromatography (LC) with fluorescence (FL) detection. The proposed method was applied to the determination of acetone in the saliva of healthy volunteers and DM patients with and without ketoacidosis. 3-Pentanone (I.S.) and DBD-H in acetonitrile were added to freshly collected saliva and reacted at room temperature for 20 min in the presence of trifluoroacetic acid. After the reaction, the solution was centrifuged at 10,000 × g and 4 °C for 5 min. The supernatant was separated by reversed-phase LC and the FL detected at 550 nm (excitation at 460 nm). The concentrations of acetone in the DM patients with ketoacidosis were significantly higher than those of the normal subjects and DM patients without ketoacidosis. Furthermore, the total contents of the ketone bodies in the blood correlated with acetone in the saliva of the DM patients. The concentrations of acetone in the saliva of an emergency patient also correlated with the ketone bodies in the blood at each sampling time. The proposed method using LC-FL seems to be useful for the determination of acetone in the saliva of DM patients with ketoacidosis. The method offers a new option for the diagnosis and monitoring of DM patients with ketoacidosis. Copyright © 2014 Elsevier B.V. All rights reserved.

HEPATITIS B VIRUS DNA IN SALIVA FROM CHILDREN WITH CHRONIC HEPATITIS B INFECTION IMPLICATIONS FOR SALIVA AS A POTENTIAL MODE OF HORIZONTAL TRANSMISSION

NARCIS (Netherlands)

Heiberg, Ida Louise; Hoegh, Mette; Ladelund, Steen; Niesters, Hubert G. M.; Hogh, Birthe

2010-01-01

To explore the mechanism of horizontal transmission of hepatitis B virus (HBV) among children, we investigated the quantitative relationship between HBV in saliva and blood from 46 children with chronic hepatitis B. We found high levels of HBV DNA in saliva of HBeAg (+) children, suggesting saliva

Hepatitis B virus DNA in saliva from children with chronic hepatitis B infection: implications for saliva as a potential mode of horizontal transmission

DEFF Research Database (Denmark)

Heiberg, Ida Louise; Hoegh, Mette; Ladelund, Steen

2010-01-01

To explore the mechanism of horizontal transmission of hepatitis B virus (HBV) among children, we investigated the quantitative relationship between HBV in saliva and blood from 46 children with chronic hepatitis B. We found high levels of HBV DNA in saliva of HBeAg (+) children, suggesting saliva...

Anti-inflammatory and antinociceptive activities of Rhipicephalus microplus saliva

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D F Buccini

2018-01-01

Full Text Available Objective: To evaluate the antinociceptive and anti-inflammatory activities and the toxic effects of Rhipicephalus microplus saliva for elucidating the modulation mechanism between arthropod saliva and host. Methods: For saliva collection, engorged ticks were obtained from a controlled bovine infestation and collected by natural fall. The ticks were fixed and injected pilocarpine 0.2% for induction of salivation. Saliva was collected, lyophilized and stored at - 80 °C. Cytotoxic activity was assessed by the hemolysis method (25, 50, 100, 200 and 300 μ g/mL and MTT cell viability assay (2.5, 5, 10, 20 and 40 μ g/mL for 24, 48 and 72 h. Anti-inflammatory activity was evaluated using the method of neutrophil migration to the peritoneal cavity of mice at doses of 10, 15 and 20 mg/kg; antinociceptive activity was assessed using the acetic acid-induced writhing test, and formalin-induced paw-licking in mice at dose of 15 mg/kg. Results: Saliva did not cause erythrocytes hemolysis at any concentration tested, as well as did not decrease cell viability in the MTT assay. Saliva inhibited neutrophil migration by 87% and 73% at doses of 15 and 20 mg/kg, respectively. In the nociceptive tests, saliva presented analgesic activity of 69.96% in the abdominal writhing test, and of 84.41% in the formalin test. Conclusions: The study proves that Rhipicephalus microplus saliva has significant in vivo anti-inflammatory and antinociceptive activities. The data presented herein support the development of further studies to elucidate the active principles of Rhipicephalus microplus saliva and its mechanism of action and, in future, to develop novel anti-inflammatory and analgesic drugs.

Aspiration and swallowing in Parkinson disease and rehabilitation with EMST: a randomized trial.

Science.gov (United States)

Troche, M S; Okun, M S; Rosenbek, J C; Musson, N; Fernandez, H H; Rodriguez, R; Romrell, J; Pitts, T; Wheeler-Hegland, K M; Sapienza, C M

2010-11-23

Dysphagia is the main cause of aspiration pneumonia and death in Parkinson disease (PD) with no established restorative behavioral treatment to date. Reduced swallow safety may be related to decreased elevation and excursion of the hyolaryngeal complex. Increased submental muscle force generation has been associated with expiratory muscle strength training (EMST) and subsequent increases in hyolaryngeal complex movement provide a strong rationale for its use as a dysphagia treatment. The current study's objective was to test the treatment outcome of a 4-week device-driven EMST program on swallow safety and define the physiologic mechanisms through measures of swallow timing and hyoid displacement. This was a randomized, blinded, sham-controlled EMST trial performed at an academic center. Sixty participants with PD completed EMST, 4 weeks, 5 days per week, for 20 minutes per day, using a calibrated or sham, handheld device. Measures of swallow function including judgments of swallow safety (penetration-aspiration [PA] scale scores), swallow timing, and hyoid movement were made from videofluoroscopic images. No pretreatment group differences existed. The active treatment (EMST) group demonstrated improved swallow safety compared to the sham group as evidenced by improved PA scores. The EMST group demonstrated improvement of hyolaryngeal function during swallowing, findings not evident for the sham group. EMST may be a restorative treatment for dysphagia in those with PD. The mechanism may be explained by improved hyolaryngeal complex movement. This intervention study provides Class I evidence that swallow safety as defined by PA score improved post EMST.

Dynamic changes in saliva after acute mental stress

Science.gov (United States)

Naumova, Ella A.; Sandulescu, Tudor; Bochnig, Clemens; Khatib, Philipp Al; Lee, Wing-Kee; Zimmer, Stefan; Arnold, Wolfgang H.

2014-01-01

Stress-related variations of fluoride concentration in supernatant saliva and salivary sediment, salivary cortisol, total protein and pH after acute mental stress were assessed. The hypothesis was that stress reactions have no influence on these parameters. Thirty-four male students were distributed into two groups: first received the stress exposure followed by the same protocol two weeks later but without stress exposure, second underwent the protocol without stress exposure followed by the stress exposure two weeks later. The stressor was a public speech followed by tooth brushing. Saliva was collected before, immediately after stress induction and immediately, at 10, 30 and 120 min. after tooth brushing. Cortisol concentrations, total protein, intraoral pH, and fluoride content in saliva were measured. The data were analyzed statistically. Salivary sediment was ca 4.33% by weight of whole unstimulated saliva. Fluoride bioavailability was higher in salivary sediment than in supernatant saliva. The weight and fluoride concentration was not altered during 2 hours after stress exposure. After a public speech, the salivary cortisol concentration significantly increased after 20 minutes compared to the baseline. The salivary protein concentration and pH also increased. Public speaking influences protein concentration and salivary pH but does not alter the fluoride concentration of saliva. PMID:24811301

Non-invasive assessment determine the swallowing and respiration dysfunction in early Parkinson's disease.

Science.gov (United States)

Wang, Chin-Man; Shieh, Wann-Yun; Weng, Yi-Hsin; Hsu, Yi-Hsuan; Wu, Yih-Ru

2017-09-01

Dysphagia is common among patients with Parkinson's disease. Swallowing and its coordination with respiration is extremely important to achieve safety swallowing. Different tools have been used to assess this coordination, however the results have been inconsistent. We aimed to investigate this coordination in patients with Parkinson's disease using a non-invasive method. Signals of submental muscle activity, thyroid cartilage excursion, and nasal airflow during swallowing were recorded simultaneously. Five different water boluses were swallowed three times, and the data were recorded and analyzed. Thirty-seven controls and 42 patients with early-stage Parkinson's disease were included. The rates of non-expiratory/expiratory pre- and post-swallowing respiratory phase patterns were higher in the patients than in the controls (P Parkinson's disease, and safety compensation mechanisms were used more than efficiency during swallowing. The results of this study may serve as a baseline for further research into new treatment regimens and to improve the management of swallowing in patients with Parkinson's disease. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Swallowing in patients with Parkinson's disease: a surface electromyography study.

Science.gov (United States)

Ws Coriolano, Maria das Graças; R Belo, Luciana; Carneiro, Danielle; G Asano, Amdore; Al Oliveira, Paulo José; da Silva, Douglas Monteiro; G Lins, Otávio

2012-12-01

Our goal was to study deglutition of Parkinson's disease (PD) patients and normal controls (NC) using surface electromyography (sEMG). The study included 15 patients with idiopathic PD and 15 age-matched normal controls. Surface electromyography was collected over the suprahyoid muscle group. Conditions were the following: swallow at once 10 and 20 ml of water and 5 and 10 ml of yogurt of firm consistency, and freely drink 100 ml of water. During swallowing, durations of sEMG were significantly longer in PD patients than in normal controls but no significant differences of amplitudes were found. Eighty percent of the PD patients and 20 % of the NC needed more than one swallow to consume 20 ml of water, while 70 % of the PD patients and none of the NC needed more than one swallow to consume 5 ml of yogurt. PD patients took significantly more time and needed significantly more swallows to drink 100 ml of water than normal controls. We conclude that sEMG might be a simple and useful tool to study and monitor deglutition in PD patients.

Evaluating Swallowing Muscles Essential for Hyolaryngeal Elevation by Using Muscle Functional Magnetic Resonance Imaging

International Nuclear Information System (INIS)

Pearson, William G.; Hindson, David F.; Langmore, Susan E.; Zumwalt, Ann C.

2013-01-01

Purpose: Reduced hyolaryngeal elevation, a critical event in swallowing, is associated with radiation therapy. Two muscle groups that suspend the hyoid, larynx, and pharynx have been proposed to elevate the hyolaryngeal complex: the suprahyoid and longitudinal pharyngeal muscles. Thought to assist both groups is the thyrohyoid, a muscle intrinsic to the hyolaryngeal complex. Intensity modulated radiation therapy guidelines designed to preserve structures important to swallowing currently exclude the suprahyoid and thyrohyoid muscles. This study used muscle functional magnetic resonance imaging (mfMRI) in normal healthy adults to determine whether both muscle groups are active in swallowing and to test therapeutic exercises thought to be specific to hyolaryngeal elevation. Methods and Materials: mfMRI data were acquired from 11 healthy subjects before and after normal swallowing and after swallowing exercise regimens (the Mendelsohn maneuver and effortful pitch glide). Whole-muscle transverse relaxation time (T2 signal, measured in milliseconds) profiles of 7 test muscles were used to evaluate the physiologic response of each muscle to each condition. Changes in effect size (using the Cohen d measure) of whole-muscle T2 profiles were used to determine which muscles underlie swallowing and swallowing exercises. Results: Post-swallowing effect size changes (where a d value of >0.20 indicates significant activity during swallowing) for the T2 signal profile of the thyrohyoid was a d value of 0.09; a d value of 0.40 for the mylohyoid, 0.80 for the geniohyoid, 0.04 for the anterior digastric, and 0.25 for the posterior digastric-stylohyoid in the suprahyoid muscle group; and d values of 0.47 for the palatopharyngeus and 0.28 for the stylopharyngeus muscles in the longitudinal pharyngeal muscle group. The Mendelsohn maneuver and effortful pitch glide swallowing exercises showed significant effect size changes for all muscles tested, except for the thyrohyoid. Conclusions

Evaluating Swallowing Muscles Essential for Hyolaryngeal Elevation by Using Muscle Functional Magnetic Resonance Imaging

Energy Technology Data Exchange (ETDEWEB)

Pearson, William G., E-mail: bp1@bu.edu [Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts (United States); Hindson, David F. [Department of Radiology, Boston Medical Center, Boston, Massachusetts (United States); Langmore, Susan E. [Department of Otolaryngology, Boston Medical Center, Boston, Massachusetts (United States); Speech and Hearing Sciences, Boston University, Boston, Massachusetts (United States); Zumwalt, Ann C. [Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts (United States)

2013-03-01

Purpose: Reduced hyolaryngeal elevation, a critical event in swallowing, is associated with radiation therapy. Two muscle groups that suspend the hyoid, larynx, and pharynx have been proposed to elevate the hyolaryngeal complex: the suprahyoid and longitudinal pharyngeal muscles. Thought to assist both groups is the thyrohyoid, a muscle intrinsic to the hyolaryngeal complex. Intensity modulated radiation therapy guidelines designed to preserve structures important to swallowing currently exclude the suprahyoid and thyrohyoid muscles. This study used muscle functional magnetic resonance imaging (mfMRI) in normal healthy adults to determine whether both muscle groups are active in swallowing and to test therapeutic exercises thought to be specific to hyolaryngeal elevation. Methods and Materials: mfMRI data were acquired from 11 healthy subjects before and after normal swallowing and after swallowing exercise regimens (the Mendelsohn maneuver and effortful pitch glide). Whole-muscle transverse relaxation time (T2 signal, measured in milliseconds) profiles of 7 test muscles were used to evaluate the physiologic response of each muscle to each condition. Changes in effect size (using the Cohen d measure) of whole-muscle T2 profiles were used to determine which muscles underlie swallowing and swallowing exercises. Results: Post-swallowing effect size changes (where a d value of >0.20 indicates significant activity during swallowing) for the T2 signal profile of the thyrohyoid was a d value of 0.09; a d value of 0.40 for the mylohyoid, 0.80 for the geniohyoid, 0.04 for the anterior digastric, and 0.25 for the posterior digastric-stylohyoid in the suprahyoid muscle group; and d values of 0.47 for the palatopharyngeus and 0.28 for the stylopharyngeus muscles in the longitudinal pharyngeal muscle group. The Mendelsohn maneuver and effortful pitch glide swallowing exercises showed significant effect size changes for all muscles tested, except for the thyrohyoid. Conclusions

A model experiment to study swallowing of spherical and elongated particles

Directory of Open Access Journals (Sweden)

Marconati Marco

2017-01-01

Full Text Available Swallowing disorders are not uncommon among elderly and people affected by neurological diseases. For these patients the ingestion of solid grains, such as pharmaceutical oral solid formulations, could result in choking. This generally results in a low compliance in taking solid medications. The effect of the solid medication size on the real or perceived ease of swallowing is still to be understood from the mechanistic viewpoint. The interplay of the inclusion shape and the rheology of the liquid being swallowed together with the medication is also not fully understood. In this study, a model experiment was developed to study the oropharyngeal phase of swallowing, replicating the dynamics of the bolus flow induced by the tongue (by means of a roller driven by an applied force. Experiments were performed using a wide set of solid inclusions, dispersed in a thick Newtonian liquid. Predictions for a simple theory are compared with experiments. Results show that an increase in the grain size results in a slower dynamics of the swallowing. Furthermore, the experiments demonstrated the paramount role of shape, as flatter and more streamlined inclusions flow faster than spherical. This approach can support the design of new oral solid formulations that can be ingested more easily and effectively also by people with mild swallowing disorders.

Assessment of extracellular dehydration using saliva osmolality.

Science.gov (United States)

Ely, Brett R; Cheuvront, Samuel N; Kenefick, Robert W; Spitz, Marissa G; Heavens, Kristen R; Walsh, Neil P; Sawka, Michael N

2014-01-01

When substantial solute losses accompany body water an isotonic hypovolemia (extracellular dehydration) results. The potential for using blood or urine to assess extracellular dehydration is generally poor, but saliva is not a simple ultra-filtrate of plasma and the autonomic regulation of salivary gland function suggests the possibility that saliva osmolality (Sosm) may afford detection of extracellular dehydration via the influence of volume-mediated factors. This study aimed to evaluate the assessment of extracellular dehydration using Sosm. In addition, two common saliva collection methods and their effects on Sosm were compared. Blood, urine, and saliva samples were collected in 24 healthy volunteers during paired euhydration and dehydration trials. Furosemide administration and 12 h fluid restriction were used to produce extracellular dehydration. Expectoration and salivette collection methods were compared in a separate group of eight euhydrated volunteers. All comparisons were made using paired t-tests. The diagnostic potential of body fluids was additionally evaluated. Dehydration (3.1 ± 0.5% loss of body mass) decreased PV (-0.49 ± 0.12 L; -15.12 ± 3.94% change), but Sosm changes were marginal ( 0.05). Extracelluar dehydration was not detectable using plasma, urine, or saliva measures. Salivette and expectoration sampling methods produced similar, consistent results for Sosm, suggesting no methodological influence on Sosm.

DNA methylation analysis from saliva samples for epidemiological studies.

Science.gov (United States)

Nishitani, Shota; Parets, Sasha E; Haas, Brian W; Smith, Alicia K

2018-06-18

Saliva is a non-invasive, easily accessible tissue, which is regularly collected in large epidemiological studies to examine genetic questions. Recently, it is becoming more common to use saliva to assess DNA methylation. However, DNA extracted from saliva is a mixture of both bacterial and human DNA derived from epithelial and immune cells in the mouth. Thus, there are unique challenges to using salivary DNA in methylation studies that can influence data quality. This study assesses: (1) quantification of human DNA after extraction; (2) delineation of human and bacterial DNA; (3) bisulfite conversion (BSC); (4) quantification of BSC DNA; (5) PCR amplification of BSC DNA from saliva and; (6) quantitation of DNA methylation with a targeted assay. The framework proposed will allow saliva samples to be more widely used in targeted epigenetic studies.

Current distribution and population size of the Blue Swallow Hirundo ...

African Journals Online (AJOL)

, the crops, natural pastures, livestock and their dung possibly provide the food source for the aerial arthropods on which the Blue Swallows feed. In total, 151 Blue Swallows were recorded consisting of 62 males, 68 females and 21 unsexed ...

Binding of corroded ions to human saliva.

Science.gov (United States)

Mueller, H J

1985-05-01

Employing equilibrium dialysis, the binding abilities of Cu, Al, Co and Cr ions from corroded Cu-Al and Co-Cr dental casting alloys towards human saliva and two of its gel chromatographic fractions were determined. Results indicate that both Cu and Co bind to human saliva i.e. 0.045 and 0.027 mg/mg protein, respectively. Besides possessing the largest binding ability, Cu also possessed the largest binding capacity. The saturation of Cu binding was not reached up to the limit of 0.35 mg protein/ml employed in the tests, while Co reached full saturation at about 0.2 mg protein/ml. Chromium showed absolutely no binding to human saliva while Al ions did not pass through the dialysis membranes. Compared to the binding with solutions that were synthetically made up to contain added salivary-type proteins, it is shown that the binding to human saliva is about 1 order of magnitude larger, at least for Cu ions.

Swallowing rehabilitation before and during concurrent chemoradiotherapy for oropharyngeal cancer

International Nuclear Information System (INIS)

Tsuneyuki, Miki; Yonezawa, Kouichiro; Morimoto, Koichi; Tanimoto, Hitoshi; Saito, Miki; Otsuki, Naoki; Nibu, Ken-ichi

2011-01-01

Recently, oropharyngeal cancer is more frequently being managed with concurrent chemoradiotherapy (CCRT). As more patients receive CCRT, there is increasing attention on dysphagia. Since 2009, speech therapists in our hospital have performed swallowing rehabilitation for dysphagia associated with CCRT. We evaluated dysphagia after CCRT and examined the relationship between swallowing rehabilitation and swallowing disability. A total of 26 patients (22 males and 4 females) with a mean age of 63 years (range, 41 to 79), underwent CCRT between March 2008 and March 2010. Dysphagia after treatment was graded at the end of CCRT and discharge according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 and Fujishima dysphagia grade. Ten of the 26 patients underwent swallowing rehabilitation, exercise and education on muscle strengthening programs before and during CCRT. They tended not to have severe dysphagia, but there were no significant differences. (author)

Successful treatment of pill-swallowing difficulties with head posture practice.

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Kaplan, Bonnie J; Steiger, Roberta A; Pope, Jamie; Marsh, Ashley; Sharp, Maegan; Crawford, Susan G

2010-05-01

Clinics often encounter neurologically intact patients who are unable to swallow pills. All of the interventions published previously have used traditional behavioural techniques, which are time consuming and often not helpful. To determine whether children who had never been able to swallow a whole pill could become successful as a result of an intervention based on head posture. A novel intervention was developed based on published research showing that changing head position alters swallowing dynamics. The method was developed in two studies of 240 adults and children, pilot tested in a study of 108 university students with very mild pill-swallowing discomfort, and then evaluated in a study of 41 children who had never successfully swallowed a pill in spite of much instruction and coaxing. Children were recruited from a tertiary paediatric hospital: 34 were clinic patients, four were their siblings or friends, and three were children of hospital staff. The primary intervention involved teaching five head positions (centre, up, down, left and right) followed by a two-week period of daily practice. EIGHT CHILDREN (ALL CLINIC REFERRALS) WITHDREW WITHOUT PRACTICING: four were too ill to practice (primarily due to sedation or nausea) and four simply refused to do the homework practice. All 33 of the children who were able and willing to practice daily were successful. Practice with head posture variations was successful in treating pill-swallowing difficulties in all 33 children who practiced for 14 days. A training video can be viewed at www.ucalgary.ca/research4kids/pillswallowing.

Hepatitis B virus DNA in saliva from children with chronic hepatitis B infection: implications for saliva as a potential mode of horizontal transmission

DEFF Research Database (Denmark)

Heiberg, Ida Louise; Hoegh, Mette; Ladelund, Steen

2010-01-01

To explore the mechanism of horizontal transmission of hepatitis B virus (HBV) among children, we investigated the quantitative relationship between HBV in saliva and blood from 46 children with chronic hepatitis B. We found high levels of HBV DNA in saliva of HBeAg (+) children, suggesting saliva...... as a vehicle for horizontal transmission of HBV among children....

Objective Measures of Swallowing Function Applied to the Dysphagia Population: A One Year Experience.

Science.gov (United States)

Kendall, Katherine A; Ellerston, Julia; Heller, Amanda; Houtz, Daniel R; Zhang, Chong; Presson, Angela P

2016-08-01

Quantitative, reliable measures of swallowing physiology can be made from an modified barium swallowing study. These quantitative measures have not been previously employed to study large dysphagic patient populations. The present retrospective study of 139 consecutive patients with dysphagia seen in a university tertiary voice and swallowing clinic sought to use objective measures of swallowing physiology to (1) quantify the most prevalent deficits seen in the patient population, (2) identify commonly associated diagnoses and describe the most prevalent swallowing deficits, and (3) determine any correlation between objective deficits and Eating Assessment Tool (EAT-10) scores and body mass index. Poor pharyngeal constriction (34.5 %) and airway protection deficits (65.5 %) were the most common swallowing abnormalities. Reflux-related dysphagia (36 %), nonspecific pharyngeal dysphagia (24 %), Parkinson disease (16 %), esophageal abnormality (13 %), and brain insult (10 %) were the most common diagnoses. Poor pharyngeal constriction was significantly associated with an esophageal motility abnormality (p dysphagia symptoms as determined by the EAT-10 did not correlate with swallowing function abnormalities. This preliminary study indicates that reflux disease is common in patients with dysphagia and that associated esophageal abnormalities are common in dysphagic populations and may be associated with specific pharyngeal swallowing abnormalities. However, symptom scores from the EAT-10 did not correspond to swallowing pathophysiology.

Radiation doses to children during modified barium swallow studies

International Nuclear Information System (INIS)

Weir, Kelly A.; McMahon, Sandra M.; Long, Gillian; Bunch, Judith A.; Pandeya, Nirmala; Coakley, Kerry S.; Chang, Anne B.

2007-01-01

There are minimal data on radiation doses to infants and children undergoing a modified barium swallow (MBS) study. To document screening times, dose area product (DAP) and effective doses to children undergoing MBS and to determine factors associated with increased screening times and effective dose. Fluoroscopic data (screening time, DAP, kVp) for 90 consecutive MBS studies using pulse fluoroscopy were prospectively recorded; effective dose was calculated and data were analyzed for effects of behavior, number of swallow presentations, swallowing dysfunction and medical problems. Mean effective dose for the entire group was 0.0826 ± 0.0544 mSv, screening time 2.48 ± 0.81 min, and DAP 28.79 ± 41.72 cGy cm 2 . Significant differences were found across three age groups (≤1.0, >1.0-3.0 and >3.0 years) for effective dose (mean 0.1188, 0.0651 and 0.0529 mSv, respectively; P < 0.001), but not for screening time or DAP. Effective dose was correlated with screening time (P 0.007), DAP (P < 0.001), number of swallow presentations (P = 0.007), lower age (P = 0.017), female gender (P = 0.004), and height (P < 0.001). Screening time was correlated with total number of swallow presentations (P < 0.001) and DAP (P < 0.001). Screening times, DAP, effective dose, and child and procedural factors associated with higher effective doses are presented for children undergoing MBS studies. (orig.)

Visual and auditory stimuli associated with swallowing. An fMRI study

International Nuclear Information System (INIS)

Kawai, Takeshi; Watanabe, Yutaka; Tonogi, Morio; Yamane, Gen-yuki; Abe, Shinichi; Yamada, Yoshiaki; Callan, Akiko

2009-01-01

We focused on brain areas activated by audiovisual stimuli related to swallowing motions. In this study, three kinds of stimuli related to human swallowing movement (auditory stimuli alone, visual stimuli alone, or audiovisual stimuli) were presented to the subjects, and activated brain areas were measured using functional MRI (fMRI) and analyzed. When auditory stimuli alone were presented, the supplementary motor area was activated. When visual stimuli alone were presented, the premotor and primary motor areas of the left and right hemispheres and prefrontal area of the left hemisphere were activated. When audiovisual stimuli were presented, the prefrontal and premotor areas of the left and right hemispheres were activated. Activation of Broca's area, which would have been characteristic of mirror neuron system activation on presentation of motion images, was not observed; however, activation of brain areas related to swallowing motion programming and performance was verified for auditory, visual and audiovisual stimuli related to swallowing motion. These results suggest that audiovisual stimuli related to swallowing motion could be applied to the treatment of patients with dysphagia. (author)

Videofluoroscopic evaluation of mastication and swallowing in individuals with TMD.

Science.gov (United States)

Maffei, Carla; Mello, Marçal Motta de; Biase, Noemi Grigoletto de; Pasetti, Lilian; Camargo, Paulo A Monteiro; Silvério, Kelly Cristina Alves; Gonçalves, Maria Inês Rebelo

2012-01-01

To study mastication and swallowing disorders in patients with temporomandibular disorders (TMD). To investigate mastication and swallowing disorders in patients with severe TMD referred to surgery. Clinical and experimental study involving ten individuals with TMD submitted to deglutition videofluoroscopy. These patients did not have posterior teeth, mastication pain and food replacement in favor of pasty consistence food. The assessment of the oral and pharyngeal phases approached the following aspects: side of onset and preferential side for chewing, premature escape, remains of food residues in the oral cavity or in the pharyngeal recesses, number of necessary swallowing efforts, laryngeal penetration and/or tracheal aspiration. During mastication and the oral phase we observed tongue compensatory movements upon chewing (n = 7; 70%), premature escape (n = 4; 40%), food remains in the cavity after swallowing (n = 5; 50%) and an excessive number of deglutition efforts (n = 5; 50%). On the pharyngeal phase we observed food remains in the valleculae (n = 6; 60%), in the pyriform sinuses (n = 4; 40%); laryngeal penetration (n = 1; 10%) and tracheal aspiration (n = 4; 40%). TMD patients may have alterations in their chewing and swallowing patterns, with laryngeal penetration and/or tracheal aspiration. The study indicates the need for a multidisciplinary assessment because of dysphagia in TMD patients.

SU-D-BRA-01: Feasibility Study for Swallowing Prediction Using Pressure Sensors

International Nuclear Information System (INIS)

Cho, M; Kim, T; Kim, D; Kang, S; Kim, K; Shin, D; Noh, Y; Suh, T; Kim, S

2016-01-01

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. While the signal from the thyroid cartilage region informs the action of swallowing, the signal from the submental muscle region is utilized as a precursor for swallowing. Since the duration of swallowing is relatively short, using such precursor (or warning) signals for machine control is considered more beneficial. A volunteer study was conducted to evaluate the feasibility of the system. In this volunteer study, we intended to verify that the system could predict the pharyngeal stage of the swallowing. We measured time gaps between obtaining the warning signals in the SPS and starting points of the pharyngeal stage of swallowing. Results: The measured data was examined whether the time gaps were in reasonable order to be easily utilized. The mean and standard deviation values of these time gaps were 0.550 s ± 0.183 s. in 8 volunteers. Conclusion: The proposed method was able to predict the on-set of swallowing of human subjects inside the thermoplastic mask, which has never been possible with other monitoring systems such as camera-based monitoring system. With the prediction ability of swallowing incorporated into the machine control mechanism (in the future), beam delivery can be controlled to skip swallowing periods and significant dosimetric gain is expected in head & neck cancer treatments. This work was supported by the Radiation Technology R&D program (No. 2015M

SU-D-BRA-01: Feasibility Study for Swallowing Prediction Using Pressure Sensors

Energy Technology Data Exchange (ETDEWEB)

Cho, M; Kim, T; Kim, D; Kang, S; Kim, K; Shin, D; Noh, Y; Suh, T [The Catholic University of Korea College of Medicine, Department of Biomedical Engineering, Research Institute of Biomedical Engineering, Seoul (Korea, Republic of); Kim, S [Virginia Commonwealth University, Richmond, VA (United States)

2016-06-15

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. While the signal from the thyroid cartilage region informs the action of swallowing, the signal from the submental muscle region is utilized as a precursor for swallowing. Since the duration of swallowing is relatively short, using such precursor (or warning) signals for machine control is considered more beneficial. A volunteer study was conducted to evaluate the feasibility of the system. In this volunteer study, we intended to verify that the system could predict the pharyngeal stage of the swallowing. We measured time gaps between obtaining the warning signals in the SPS and starting points of the pharyngeal stage of swallowing. Results: The measured data was examined whether the time gaps were in reasonable order to be easily utilized. The mean and standard deviation values of these time gaps were 0.550 s ± 0.183 s. in 8 volunteers. Conclusion: The proposed method was able to predict the on-set of swallowing of human subjects inside the thermoplastic mask, which has never been possible with other monitoring systems such as camera-based monitoring system. With the prediction ability of swallowing incorporated into the machine control mechanism (in the future), beam delivery can be controlled to skip swallowing periods and significant dosimetric gain is expected in head & neck cancer treatments. This work was supported by the Radiation Technology R&D program (No. 2015M

Facilitated saliva secretion and reduced oral inflammation by a novel artificial saliva system in the treatment of salivary hypofunction

Directory of Open Access Journals (Sweden)

Kang M

2017-01-01

Full Text Available Minkyung Kang,1 Hyounggeun Park,1 Joon-Ho Jun,1 Miwon Son,1 Myung Joo Kang2 1Pharmaceutical Product Research Laboratories, Dong-A ST Research Institute, Gyeonggi, 2Division of Pharmaceutical Sciences, College of Pharmacy, Dankook University, Cheonan, Chungnam, Korea Abstract: Saliva substitutes and/or lubricants are commonly employed to lessen dry mouth symptoms by stimulating and/or substituting for the secretion of saliva. In this study, a novel artificial saliva containing inorganic salts, including sodium chloride and potassium chloride, and bactericidal agents, including potassium thiocyanate and lactoperoxidase, was formulated in the form of a solution (DM-sol or gel (DM-gel. Those in vivo therapeutic efficacies were assessed in terms of saliva secretion and anti-inflammatory activity in rats and mice, respectively. Salivary secretion was promoted by mucosal application of DM-formulations in normal rats. In particular, DM-gel resulted in 2.5- and 1.9-fold greater salivary flow rates compared to normal saline and DM-sol, respectively. In an in vivo efficacy evaluation in diabetic mice with salivary hypofunction, repeated application of DM-formulations alleviated histopathological changes in the buccal mucosa in terms of atrophy and thinning of the epithelium, compared to vehicle, after 4 weeks. Moreover, the DM-sol and DM-gel were comparably effective for relieving periodontal gingivitis, reducing infiltration of inflammatory cells, and normalizing the neutrophil level in the gingival gingiva, after 4 weeks. Therefore, the novel artificial saliva is expected to facilitate salivary secretion and restore physiological conditions in the mouth of patients with salivary hypofunction. Keywords: saliva substitute, carbopol gel, hypothiocyanite–hydrogen peroxide mixture, antimicrobial activity, diabetic rats

Pengaruh Stimulus Pengunyahan dan Pengecapan Terhadap Kecepatan Aliran dan pH Saliva

Directory of Open Access Journals (Sweden)

Hj. Edeh Rolette Haroen

2015-09-01

Full Text Available The aim of the research were to describe how salivary flow rate and pH vary with time during use of chewing and gustatory stimulation. Fifty young adult subjects collected unstimulated saliva by spitting method, and then collected stimulated saliva by chewing paraffin wax, and a few drops of citric acid are usually placed on the subject’s tongue. The mean of saliva flow rate that unstimulated: 0.50 cc/minute; stimulated saliva by chewing paraffin wax: 1.57 cc/minute, and drops of citric acid stimulation showed that saliva flow rate: 2.98 cc/minute; and pH saliva that unstimulated 6.39; stimulated saliva by chewing paraffin wax 7.2; and stimulated saliva by citric acid: 7.55. Statistical paired t test showed that t lower than t table. The conclusion of the research showed that there were significant influences in the unstimulated salivary flow rates and pH with stimulated saliva elicited by chewing and gustatory stimulation.

Swallowing Disorders in Sjögren's Syndrome: Prevalence, Risk Factors, and Effects on Quality of Life.

Science.gov (United States)

Pierce, Jenny L; Tanner, Kristine; Merrill, Ray M; Miller, Karla L; Kendall, Katherine A; Roy, Nelson

2016-02-01

This epidemiological investigation examined the prevalence, risk factors, and quality-of-life effects of swallowing disorders in Sjögren's syndrome (SS). One hundred and one individuals with primary or secondary SS (94 females, 7 males; mean age 59.4, SD = 14.1) were interviewed regarding the presence, nature, and impact of swallowing disorders and symptoms. Associations among swallowing disorders and symptoms, select medical and social history factors, SS disease severity, and the M.D. Anderson Dysphagia Inventory (MDADI) and Short Form 36 Health Survey (SF-36) were examined. The prevalence of a current self-reported swallowing disorder was 64.4 %. SS disease severity was the strongest predictor of swallowing disorders, including significant associations with the following swallow symptoms: taking smaller bites, thick mucus in the throat, difficulty placing food in the mouth, and wheezing while eating (p esophageal reflux, current exposure to secondary tobacco smoke, frequent neck or throat tension, frequent throat clearing, chronic post-nasal drip, and stomach or duodenal ulcers. Swallowing disorders did not differ on the basis of primary or secondary SS. Swallowing disorders and specific swallowing symptoms were uniquely associated with reduced quality of life. Among those with swallowing disorders, 42 % sought treatment, with approximately half reporting improvement. Patient-perceived swallowing disorders are relatively common in SS and increase with disease severity. Specific swallowing symptoms uniquely and significantly reduce swallow and health-related quality of life, indicating the need for increased identification and management of dysphagia in this population.

Feeding and Swallowing Disorders in Pediatric Neuromuscular Diseases: An Overview.

Science.gov (United States)

van den Engel-Hoek, Lenie; de Groot, Imelda J M; de Swart, Bert J M; Erasmus, Corrie E

2015-11-20

Feeding and swallowing problems in infants and children have a great impact on health and wellbeing. The aim of this study was to provide an overview of recognized feeding and swallowing problems in different groups of children with neuromuscular diseases, based on relevant literature and expert opinion, and to propose recommendations for the assessment and treatment of these problems. Almost all pediatric neuromuscular diseases are accompanied by feeding and swallowing problems during the different phases of deglutition, problems that give rise to a wide variety of signs and symptoms, which emphasizes the importance of a comprehensive feeding and swallowing assessment by a speech and language therapist.

Disposable collection kit for rapid and reliable collection of saliva.

Science.gov (United States)

Yamaguchi, Masaki; Tezuka, Yuki; Takeda, Kazunori; Shetty, Vivek

2015-01-01

To describe and evaluate disposable saliva collection kit for rapid, reliable, and reproducible collection of saliva samples. The saliva collection kit comprised of a saliva absorbent swab and an extractor unit was used to retrieve whole saliva samples from 10 subjects. The accuracy and precision of the extracted volumes (3, 10, and 30 μl) were compared to similar volumes drawn from control samples obtained by passive drool. Additionally, the impact of kit collection method on subsequent immunoassay results was verified by assessing salivary cortisol levels in the samples and comparing them to controls. The recovered volumes for the whole saliva samples were 3.85 ± 0.28, 10.79 ± 0.95, and 31.18 ± 1.72 μl, respectively (CV = 8.76%) and 2.91 ± 0.19, 9.75 ± 0.43, and 29.64 ± 0.91 μl, respectively, (CV = 6.36%) for the controls. There was a close correspondence between the salivary cortisol levels from the saliva samples obtained by the collection kit and the controls (R(2)  > 0.96). The disposable saliva collection kit allows accurate and repeatable collection of fixed amounts of whole saliva and does not interfere with subsequent measurements of salivary cortisol. The simple collection process, lack of elaborate specimen recovery steps, and the short turnaround time (<3 min) should render the kit attractive to test subjects and researchers alike. © 2015 Wiley Periodicals, Inc.

Changes in Swallowing Symptoms and Esophageal Motility After Thyroid Surgery

DEFF Research Database (Denmark)

Sorensen, Jesper Roed; Markoew, Simone; Døssing, Helle

2018-01-01

INTRODUCTION: Swallowing difficulties, the pathophysiology behind which is incompletely understood, have been reported in 47-83% of goiter patients referred for thyroidectomy. We aimed at examining the influence of thyroid surgery on swallowing symptoms and esophageal motility. METHODS: Thirty-th...... to esophageal motility disturbances. This information is essential when interpreting dysphagia in patients with nodular goiter, and when balancing patients' expectations to surgical goiter therapy. REGISTRATION NUMBER: NCT03100357 ( www.clinicaltrials.org ).......INTRODUCTION: Swallowing difficulties, the pathophysiology behind which is incompletely understood, have been reported in 47-83% of goiter patients referred for thyroidectomy. We aimed at examining the influence of thyroid surgery on swallowing symptoms and esophageal motility. METHODS: Thirty......-three patients with benign nodular goiter undergoing thyroid surgery were included. All completed high-resolution esophageal manometry examinations and the goiter symptom scale score, assessed by the thyroid-specific patient-reported outcome measure. The evaluations were performed before and 6 months after...

Swallow syncope caused by third-degree atrioventricular block

DEFF Research Database (Denmark)

Roust Aaberg, Anne Marie; Eriksson, Anna Elin; Madsen, Per Lav

2015-01-01

We report a case of a patient with more than 30 years of repeated syncopes, always following food intake. The patient was diagnosed with a swallow-related third-degree atrioventricular block and successfully treated with an artificial pacemaker.......We report a case of a patient with more than 30 years of repeated syncopes, always following food intake. The patient was diagnosed with a swallow-related third-degree atrioventricular block and successfully treated with an artificial pacemaker....

Fluoride in dental biofilm and saliva

DEFF Research Database (Denmark)

Larsen, Line Staun

Dette ph.d.-projekt bidrager med ny viden om fordelingen af fluorid i dental biofilm og saliva. For at udforske koncentrationen af fluorid i naturlig (in vivo) biofilmvæske, biofilmsediment og i saliva, blev der udført to meget forskellige kliniske studier. Resultaterne fra tværsnitsstudiet (Studie...... I), hos en stor gruppe mennesker (n=42) der konsulterede en tandklinik for behandling, bekræfter tidligere viden, at der findes en naturlig biologisk variation i fluoridkoncentrationerne i biofilm fra forskellige intra-orale regioner samt mellem biofilmvæske, biofilmsediment og saliva...... fluoridkoncentrationer i underkæbefronten, intermediære koncentrationer i alle tre overkæberegioner og de laveste koncentrationer i underkæbemolarregionerne. Begge studier viser at biofilmsedimentet indeholder størstedelen af fluorid i biofilm. Set i et bredere perspektiv viser fundene at der er et omvendt forhold...

Association between swallow perception and esophageal bolus clearance in patients with globus sensation.

Science.gov (United States)

Chen, Chien-Lin; Yi, Chih-Hsun; Liu, Tso-Tsai

2013-04-01

Globus sensation is common, but its pathogenesis is not yet clear. Our purpose was to investigate subjective perception of swallowing and esophageal motility by combined multichannel intraluminal impedance and manometry (MII-EM) for patients with globus sensation. Combined MII-EM was performed for 25 globus patients and 15 healthy controls. Swallows were abnormal if hypocontractivity or simultaneous contractions occurred. Esophageal bolus transit was incomplete if bolus exit was not found at one or more of all measurement sites. Perception of each swallow was assessed by use of a standardized scoring system, and was enhanced if the score was >1. Few globus patients reported enhanced perception during viscous or solid swallows. Incomplete bolus transit and enhanced perception occurred similarly between viscous and solid boluses. Agreement between enhanced perception and proximal bolus clearance was greater during solid swallows (κ = 0.45, 95 % CI: 0.32-0.58) than during viscous swallows (κ = 0.13, 95 % CI: 0-0.25) (P perception and total bolus clearance was greater during solid swallows (κ = 0.46, 95 % CI: 0.34-0.58) than during viscous swallows (κ = 0.11, 95 % CI: 0-0.22) (P perception is uncommon in patients with globus sensation, although there is a significant association between enhanced esophageal perception and solid bolus clearance. Application of a solid bolus may help better delineation of the interrelationship between the subjective perception of bolus passage and the objective measurement of bolus clearance.

Trace element measurement in Saliva by NAA and PIXE techniques

Energy Technology Data Exchange (ETDEWEB)

Hamidian, M.R.; Vahid Golpayegani, M.; Shojai, S. (Shahid Beheshti Medical Science Univ., Shemiran, Tehran (Iran, Islamic Republic of))

1993-01-01

The activity of salivary glands and the chemical and physical properties of saliva, especially in some illnesses in which the activity of salivary glands and the chemical and physical properties alter, sometimes have severe effects on sedimentation and tooth decay. Long-standing investigations have shown the relationship between salivary gland activity and saliva composition in dental carries. Many modern techniques have been employed to measure important elements in saliva. The major elements in saliva include sodium, potassium, calcium, magnesium, chlorine, phosphorus, iodine, and fluorine. It should be pointed out that the amount of minerals changes when the diet changes. The major constituent of saliva is water with a density of 1.007 g/cm[sup 3] in which 0.6% is solid, 0.3% organic material and 0.3% inorganic material. In addition to other effects, the acidity (pH) of saliva has a strong effect on tooth sedimentation. Type of work, degree of stress, and mental condition affect salivary gland activity. When the acidity of salivary fluid in the mouth and consequently over the teeth drops, sedimentation increases. In this paper, the results of trace element measurement in saliva are presented.

Effect of transcranial direct current stimulation on swallowing apraxia and cortical excitability in stroke patients.

Science.gov (United States)

Yuan, Ying; Wang, Jie; Wu, Dongyu; Huang, Xiaobo; Song, Weiqun

2017-10-01

Swallowing apraxia is characterized by impaired volitional swallowing but relatively preserved reflexive swallowing. Few studies are available on the effectiveness of behavioral therapy and management of the condition. This study aimed to investigate the effect of transcranial direct current stimulation (tDCS) on swallowing apraxia and cortical activation in stroke patients. The study included three inpatients (age 48-70 years; 1 male, 2 females; duration of stroke, 35-55 d) with post-stroke swallowing apraxia and six age-matched healthy subjects (age 45-65 years; 3 males, 3 females). Treatments were divided into two phases: Phase A and Phase B. During Phase A, the inpatients received three weeks of sham tDCS and conventional treatments. During Phase B, these patients received three weeks of anodal tDCS over the bilateral primary sensorimotor cortex (S 1 M 1 ) of swallowing and conventional treatments. Swallowing apraxia assessments were measured in three inpatients before Phase A, before Phase B, and after Phase B. The electroencephalography (EEG) nonlinear index of approximate entropy (ApEn) was calculated for three patients and six healthy subjects. After tDCS, scores of swallowing apraxia assessments increased, and ApEn indices increased in both stimulated and non-stimulated areas. Anodal tDCS might provide a useful means for recovering swallowing apraxia, and the recovery could be related to increased excitability of the swallowing cortex. Further investigations should explore the relationship between lesion size and/or lesion site and the prognosis of swallowing apraxia. Clinical trial registry: http://www.chictr.org Registration Number: ChiCTR-TRC-14004955.

Swallowing and deep brain stimulation in Parkinson’s disease: A systematic review

Science.gov (United States)

Troche, Michelle S.; Brandimore, Alexandra E.; Foote, Kelly D.; Okun, Michael S.

2013-01-01

The purpose of this review is to assess the current state of the literature on the topic of deep brain stimulation (DBS) and its effects on swallowing function in Parkinson’s disease (PD). Pubmed, Cochrane review, and web of science searches were completed on all articles addressing DBS that contained a swallowing outcome measure. Outcome measures included the penetration/aspiration scale, pharyngeal transit time, oropharyngeal residue, drooling, aspiration pneumonia, death, hyolaryngeal excursion, epiglottic inversion, UPDRS scores, and presence of coughing/throat clearing during meals. The search identified 13 studies specifically addressing the effects of DBS on swallowing. Critical assessment of the 13 identified peer-reviewed publications revealed nine studies employing an experimental design, (e.g. “on” vs. “off”, pre- vs. post-DBS) and four case reports. None of the nine experimental studies were found to identify clinically significant improvement or decline in swallowing function with DBS. Despite these findings, several common threads were identified across experimental studies and will be examined in this review. Additionally, available data demonstrate that, although subthalamic nucleus (STN) stimulation has been considered to cause more impairment to swallowing function than globus pallidus internus (GPi) stimulation, there are no experimental studies directly comparing swallowing function in STN vs. GPi. Moreover, there has been no comparison of unilateral vs. bilateral DBS surgery and the coincident effects on swallowing function. This review includes a critical analysis of all experimental studies and discusses methodological issues that should be addressed in future studies. PMID:23726461

Unilateral Superior Laryngeal Nerve Lesion in an Animal Model of Dysphagia and Its Effect on Sucking and Swallowing

Science.gov (United States)

Campbell-Malone, Regina; Holman, Shaina D.; Lukasik, Stacey L.; Fukuhara, Takako; Gierbolini-Norat, Estela M.; Thexton, Allan J.; German, Rebecca Z.

2013-01-01

We tested two hypotheses relating to the sensory deficit that follows a unilateral superior laryngeal nerve (SLN) lesion in an infant animal model. We hypothesized that it would result in (1) a higher incidence of aspiration and (2) temporal changes in sucking and swallowing. We ligated the right-side SLN in six 2–3-week-old female pigs. Using videofluoroscopy, we recorded swallows in the same pre- and post-lesion infant pigs. We analyzed the incidence of aspiration and the duration and latency of suck and swallow cycles. After unilateral SLN lesioning, the incidence of silent aspiration during swallowing increased from 0.7 to 41.5 %. The durations of the suck containing the swallow, the suck immediately following the swallow, and the swallow itself were significantly longer in the post-lesion swallows, although the suck prior to the swallow was not different. The interval between the start of the suck containing a swallow and the subsequent epiglottal movement was longer in the post-lesion swallows. The number of sucks between swallows was significantly greater in post-lesion swallows compared to pre-lesion swallows. Unilateral SLN lesion increased the incidence of aspiration and changed the temporal relationships between sucking and swallowing. The longer transit time and the temporal coordinative dysfunction between suck and swallow cycles may contribute to aspiration. These results suggest that swallow dysfunction and silent aspiration are common and potentially overlooked sequelae of unilateral SLN injury. This validated animal model of aspiration has the potential for further dysphagia studies. PMID:23417250

Routine Use of Contrast Swallow After Total Gastrectomy and Esophagectomy: Is it Justified?

Science.gov (United States)

El-Sourani, Nader; Bruns, Helge; Troja, Achim; Raab, Hans-Rudolf; Antolovic, Dalibor

2017-01-01

After gastrectomy or esophagectomy, esophagogastrostomy and esophagojejunostomy are commonly used for reconstruction. Water-soluble contrast swallow is often used as a routine screening to exclude anastomotic leakage during the first postoperative week. In this retrospective study, the sensitivity and specificity of oral water-soluble contrast swallow for the detection of anastomotic leakage and its clinical symptoms were analysed. Records of 104 consecutive total gastrectomies and distal esophagectomies were analysed. In all cases, upper gastrointestinal contrast swallow with the use of a water-soluble contrast agent was performed on the 5 th postoperative day. Extravasation of the contrast agent was defined as anastomotic leakage. When anastomotic insufficiency was suspected but no extravasation was present, a computed tomography (CT) scan and upper endoscopy were performed. Oral contrast swallow detected 7 anastomotic leaks. Based on CT-scans and upper endoscopy, the true number of anastomotic leakage was 15. The findings of the oral contrast swallow were falsely positive in 4 and falsely negative in 12 patients, respectively. The sensitivity and specificity of the oral contrast swallow was 20% and 96%, respectively. Routine radiological contrast swallow following total gastrectomy or distal esophagectomy cannot be recommended. When symptoms of anastomotic leakage are present, a CT-scan and endoscopy are currently the methods of choice.

Radioimmunological method for determination of cortisol in saliva

International Nuclear Information System (INIS)

Maleeva, A.; Mileva, Zh.; Kekhajova, M.

1989-01-01

A method was developed for determination of cortisol in saliva after being previously extracted with dichlormethane. Cortisol concentration in saliva of 19 subjects was determined by this method. The saliva cortisol levels were compared with those of blood plasma. No statistically significant difference was found. The method finds acceptance primarily when frequent measurements of cortisol level are neccessary as a screening technique and when strongly abnormally high levels should be differentiated from the normal ones: in this latter case determination of plasma cortisol is mandatory. 5 tabs., 8 refs

Children with central and peripheral neurologic disorders have distinguishable patterns of dysphagia on videofluoroscopic swallow study.

Science.gov (United States)

van den Engel-Hoek, Lenie; Erasmus, Corrie E; van Hulst, Karen C M; Arvedson, Joan C; de Groot, Imelda J M; de Swart, Bert J M

2014-05-01

To determine whether findings on videofluoroscopic swallow studies reveal different patterns of dysphagia between children with central and peripheral neurologic disorders, a retrospective study of 118 videofluoroscopic swallow studies was completed. There were 3 groups: cerebral palsy with only spastic features (n = 53), cerebral palsy with dyskinetic features (n = 34), and neuromuscular disorders (myotonic dystrophy I, n = 5; spinal muscular atrophy I-II, n = 8; Duchenne muscular dystrophy, n = 8; other neuromuscular disorder, n = 10). Interpretation of the videofluoroscopic swallow studies was not blinded. The video fluoroscopic swallow study findings were compared dichotomously between the groups. Children with cerebral palsy demonstrated dysphagia in 1 or all phases of swallowing. In neuromuscular disorder, muscle weakness results in pharyngeal residue after swallow. The underlying swallowing problem in neuromuscular disorder is muscle weakness whereas that in cerebral palsy is more complex, having to do with abnormal control of swallowing. This study serves as a first exploration on specific characteristics of swallowing in different neurologic conditions and will help clinicians anticipate what they might expect.

Effects of saliva collection using cotton swab on cortisol enzyme immunoassay.

Science.gov (United States)

Kozaki, Tomoaki; Hashiguchi, Nobuko; Kaji, Yumi; Yasukouchi, Akira; Tochihara, Yutaka

2009-12-01

Cotton swabs are among the most commonly used devices for collecting saliva, but various studies have reported that their use impacts the results of salivary cortisol assays. These studies, however, estimated this impact by comparing the average of the concentration and/or scatter plots. In the present study, we estimated the impact of cotton swabs on the results of salivary cortisol enzyme immunoassay (EIA) by Bland-Altman plot. Eight healthy males (aged 20-23 years) provided four saliva samples on different days to yield a total of 32 samples. Saliva samples were collected directly in plastic tubes using plastic straws and then pipetted onto cotton swabs (cotton saliva collection) and into clear sterile tubes (passive saliva collection). There was a lower correlation between cotton and passive saliva collection. Individually, four subjects showed a negative correlation between passive and cotton saliva collection. A Bland-Altman plot indicated that cotton swabs causes a proportional bias on the EIA assay result. Our findings indicate a considerable effect of using cotton swabs for saliva collection, and subject-specific variability in the impact. A Bland-Altman plot further suggests possible reasons for this effect.

Clinical trial participant characteristics and saliva and DNA metrics

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Richards Julie

2009-10-01

Full Text Available Abstract Background Clinical trial and epidemiological studies need high quality biospecimens from a representative sample of participants to investigate genetic influences on treatment response and disease. Obtaining blood biospecimens presents logistical and financial challenges. As a result, saliva biospecimen collection is becoming more frequent because of the ease of collection and lower cost. This article describes an assessment of saliva biospecimen samples collected through the mail, trial participant demographic and behavioral characteristics, and their association with saliva and DNA quantity and quality. Methods Saliva biospecimens were collected using the Oragene® DNA Self-Collection Kits from participants in a National Cancer Institute funded smoking cessation trial. Saliva biospecimens from 565 individuals were visually inspected for clarity prior to and after DNA extraction. DNA samples were then quantified by UV absorbance, PicoGreen®, and qPCR. Genotyping was performed on 11 SNPs using TaqMan® SNP assays and two VNTR assays. Univariate, correlation, and analysis of variance analyses were conducted to observe the relationship between saliva sample and participant characteristics. Results The biospecimen kit return rate was 58.5% among those invited to participate (n = 967 and 47.1% among all possible COMPASS participants (n = 1202. Significant gender differences were observed with males providing larger saliva volume (4.7 vs. 4.5 ml, p = 0.019, samples that were more likely to be judged as cloudy (39.5% vs. 24.9%, p 0.21, P Conclusion Findings from this study show that demographic and behavioral characteristics of smoking cessation trial participants have significant associations with saliva and DNA metrics, but not with the performance of TaqMan® SNP or VNTR genotyping assays. Trial registration COMPASS; registered as NCT00301145 at clinicaltrials.gov.

Swallowing impairment and pulmonary dysfunction in Parkinson's disease: the silent threats.

Science.gov (United States)

Monteiro, Larissa; Souza-Machado, Adelmir; Pinho, Patrícia; Sampaio, Marília; Nóbrega, Ana Caline; Melo, Ailton

2014-04-15

Swallowing disorders and respiratory impairment are frequent in Parkinson's disease (PD) patients, and aspiration pneumonia remains the leading cause of death among these subjects. The objective of this study was to investigate whether there is an association between pulmonary impairment and swallowing dysfunction in PD patients. A cross-sectional study with a comparison group was conducted with PD patients. Subjects were submitted to demographic questionnaires and underwent spirometric and videofluorographic assessments. Significance level was considered at 95% (p<0.05). Among 35 PD patients, 40% presented with swallowing complaints. However, 22% of the clinically asymptomatic patients presented airway food penetration when submitted to videofluoroscopy. In 20% of PD patients material entered the airways and there was contact with the vocal folds in 7%. However, there was an efficient cleaning with residue deglutition in almost all patients. No penetration/aspiration was detected among the controls. Respiratory parameters were below the normal predicted values in PD patients when compared to the healthy controls. These data suggest an association between pulmonary dysfunction and swallowing impairment in PD patients; even in patients without swallowing complaints, impaired pulmonary function can be detected. Copyright © 2014 Elsevier B.V. All rights reserved.

Effect of exercise therapy on cytokine secretion in the saliva of bedridden patients.

Science.gov (United States)

Iki, Hidemasa; Sawa, Shunji; Teranishi, Toshio; Tomita, Masao; Nishii, Kazuhiro; Yamada, Kouji

2016-10-01

[Purpose] The number of bedridden patients requiring nursing care in Japan has increased sharply in recent years because of its aging population and advances in medical care and has become a major social issue. Because bedridden patients are susceptible to nursing and healthcare-associated pneumonia, it is very important to improve their immunocompetence. Therefore, the effect of exercise therapy on stimulation of cytokine secretion in the saliva of bedridden patients was investigated. [Subjects and Methods] The subjects of this study were bedridden patients admitted to nursing care facilities. They were instructed to perform active assistive movement in the supine and sitting positions, with vital signs used as an index of the exercise load. Thirty-five patients fulfilled the inclusion criteria, which included cerebrovascular disease as the main cause of being bedridden and at least 6 months since onset. Interleukins were measured by enzyme-linked immunosorbent assay as immune mediators. [Results] Vital signs improved significantly after therapeutic exercise intervention, and the IL-6, IL-8, IL-15, and IL-17 levels also increased significantly after the intervention. [Conclusion] The results demonstrated that measurement of saliva samples may offer a safe minimally invasive method of measuring immune response in bedridden patients. This study suggests that exercise therapy may hold promise as an effective means of improving immunity in bedridden patients and may contribute to preventing aspiration pneumonia and promoting spontaneous recovery.

The Food Contaminant Mycotoxin Deoxynivalenol Inhibits the Swallowing Reflex in Anaesthetized Rats.

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Anne Abysique

Full Text Available Deoxynivalenol (DON, one of the most abundant mycotoxins found on cereals, is known to be implicated in acute and chronic illnesses in both humans and animals. Among the symptoms, anorexia, reduction of weight gain and decreased nutrition efficiency were described, but the mechanisms underlying these effects on feeding behavior are not yet totally understood. Swallowing is a major motor component of ingestive behavior which allows the propulsion of the alimentary bolus from the mouth to the esophagus. To better understand DON effects on ingestive behaviour, we have studied its effects on rhythmic swallowing in the rat, after intravenous and central administration. Repetitive electrical stimulation of the superior laryngeal nerve or of the tractus solitarius, induces rhythmic swallowing that can be recorded using electromyographic electrodes inserted in sublingual muscles. Here we provide the first demonstration that, after intravenous and central administration, DON strongly inhibits the swallowing reflex with a short latency and in a dose dependent manner. Moreover, using c-Fos staining, a strong neuronal activation was observed in the solitary tract nucleus which contains the central pattern generator of swallowing and in the area postrema after DON intravenous injection. Our data show that DON modifies swallowing and interferes with central neuronal networks dedicated to food intake regulation.

Noninvasive glucose monitoring using saliva nano-biosensor

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Wenjun Zhang

2015-06-01

Full Text Available Millions of people worldwide live with diabetes and several millions die from it each year. A noninvasive, painless method of glucose testing would highly improve compliance and glucose control while reducing complications and overall disease management costs. To provide accurate, low cost, and continuous glucose monitoring, we have developed a unique, disposable saliva nano-biosensor. More than eight clinical trials on real-time noninvasive salivary glucose monitoring were carried out on two healthy individuals (a 2–3 h-period for each trial, including both regular food and standard glucose beverage intake with more than 35 saliva samples obtained. Excellent clinical accuracy was revealed as compared to the UV Spectrophotometer. By measuring subjects’ salivary glucose and blood glucose in parallel, we found the two generated profiles share the same fluctuation trend but the correlation between them is individual dependent. There is a time lag between the peak glucose values from blood and from saliva. However, the correlation between the two glucose values at fasting is constant for each person enabling noninvasive diagnosis of diabetes through saliva instead of blood. Furthermore, a good correlation of glucose levels in saliva and in blood before and 2 h after glucose intake was observed. Glucose monitoring before and 2 h after meals is usually prescribed by doctors for diabetic patients. Thus, this disposable biosensor will be an alternative for real-time salivary glucose tracking at any time.

Deleterious sucking habits and atypical swallowing in children with otitis media with effusion.

Science.gov (United States)

Ralli, Giovanni; Ruoppolo, Giovanni; Mora, Renzo; Guastini, Luca

2011-10-01

The aim of this study was to investigate the possible correlation between otitis media with effusion, bad sucking habits and atypical swallowing in children affected by otitis media with effusion. 65 children, aged from 7 to 12 years, observed in the ENT Department of the "La Sapienza" University of Rome, were enrolled in the study group (group A). All children were affected by otitis media with effusion for more than 3 months. As control group, 60 healthy children, aged from 7 to 12 years were identified (group B). All the children underwent medical history, with evaluation of the sucking habits, ENT examination, tympanometry, orthodontic examination and evaluation of swallowing. In the orthodontic examination the variables analyzed were: maximum mouth opening, right and left mandibular lateral movements and mandibular protrusion. Atypical swallowing was considered to occur when lip activity produced strong tension in the perioral musculature, and/or the tip of the tongue was placed or pushed against the anterior teeth during swallowing. In the group A, atypical swallowing was found in 33/65 subjects out of the 65 children (50.7%). In the control group (group B) 16/60 children (26.6%) showed atypical swallowing. Compared with group B, deleterious sucking habits were significantly higher (phabits were present in almost all children with atypical swallowing (28/33 in group A and 12/16 in group B). Our data suggest a correlation between otitis media with effusion, deleterious sucking habits and prevalence of atypical swallowing. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Tongue Pressure Modulation during Swallowing: Water versus Nectar-Thick Liquids

Science.gov (United States)

Steele, Catriona M.; Bailey, Gemma L.; Molfenter, Sonja M.

2010-01-01

Purpose: Evidence of tongue-palate pressure modulation during swallowing between thin and nectar-thick liquids stimuli has been equivocal. This mirrors a lack of clear evidence in the literature of tongue and hyoid movement modulation between nectar-thick and thin liquid swallows. In the current investigation, the authors sought to confirm whether…

Saliva as a future potential predictor for various periodontal diseases

Directory of Open Access Journals (Sweden)

Zahreni Hamzah

2011-06-01

Full Text Available Background: There are many diagnostic biomarkers have been found in saliva. Saliva contains a wide variety of proteins, including bacteria and products, enzymes, inflammatory mediators and host response modifiers, products of tissue breakdown. Purpose: The purpose of the study was studied current development of diagnostic biomarkers in saliva that will lead to the development of simple and accurate diagnostic tools for periodental disease. Reviews: Specifically, the salivary biomarkers divided for three aspects of periodontitis i.e. inflammation, collagen degradation and bone turnover, correlated with clinical features of periodontal disease. The diagnostic biomarkers is in saliva, such as enzyme, immunoglobulin, cytokines, bacteria and bacterial products, hormones. For the past two decades, oral health researchers have been developing salivary diagnostic tools to monitor oral diseases. Conclusion: The indicators of acute periodontitis can detect with ß-glucuronidase and AST, IL-1β, and MMP-8, whereas indicators for chronic periodontitis can detect with ALP. The indicators for collagen degradation and bone turnover suggest ICTP, fibronectin fragments, and osteonectin. The indicators of severity of periodontitis especially can be predict by B. forsythus.Latar belakang: Banyak biomarker telah ditemukan dalam saliva. Saliva terdiri dari berbagai protein unik meliputi bakteri dan produk bakteri, enzim, mediator inflamasi dan modifikasi respon host (immunoglobulin, sitokin, produk kerusakan jaringan (telopeptida kolagen, osteokalsin, proteoglikan, fragmen fibronectin. Tujuan: Mengkaji biomarker dalam saliva untuk pengembangan metode diagnostik sederhana dan akurat untuk penyakit periodontal. Tinjauan Pustaka: Secara khusus, biomarker saliva pada periodontitis dibagi dalam tiga aspek yaitu inflamasi, dan degradasi kolagen serta pergantian tulang. Biomarker diagnostik dalam saliva, meliputi enzim, imunoglobulin, sitokin, bakteri dan produk

Saliva-catalyzed hydrolysis of a ketobemidone ester prodrug

DEFF Research Database (Denmark)

Hansen, L.B.; Christrup, Lona Louring; Bundgaard, H.

1992-01-01

Saliva enzyme-catalysed hydrolysis of ester prodrugs or drugs containing sensitive ester groups may be a limiting factor for the buccal absorption of such compounds. Using the isopropyl carbonate ester of ketobemidone as a model substance of a hydrolysis-sensitive prodrug the esterase activity...... of human saliva has been characterized as a function of various factors. The esterase activity was found to decrease rapidly upon storage of the saliva at 37°C. The activity increased with increasing pH in the range 4.5-7.4 and with increasing salivation flow rate up to a rate of 0.9 ml min. Under resting...... conditions, the flow rate was about 0.2 ml min which implied a greatly decreased esterase activity. The activity was highest after fasting and decreased after intake of a meal. The intraindividual variation in the saliva esterase activity was small whereas a larger interindividual variation was found....

Therapeutic singing as an early intervention for swallowing in persons with Parkinson's disease.

Science.gov (United States)

Stegemöller, E L; Hibbing, P; Radig, H; Wingate, J

2017-04-01

For persons with Parkinson's disease (PD), secondary motor symptoms such as swallow impairment impact the quality of life and are major contributors to mortality. There is a present need for therapeutic interventions aimed at improving swallow function during the early stages of PD. The purpose of this pilot study was to examine the effects of a group therapeutic singing intervention on swallowing in persons with PD with no significant dysphagia symptoms. Cohort study. University in the United States. Twenty-four participants with PD. Eight weeks of group therapeutic singing. Electromyography (EMG) was used to assess muscle activity associated with swallow pre and post the group singing intervention. Swallow quality of life (SWAL-QOL) and the Unified Parkinson's Disease Rating Scale (UPDRS) were also obtained pre- and post-intervention. Participants reported minimal difficulty with swallowing, yet results revealed a significant increase in EMG outcome measures, as well as significant improvement in UPDRS total and UPDRS motor scores. No significant differences were revealed for SWAL-QOL. Increases in EMG timing measures may suggest that group singing results in the prolongation of laryngeal elevation, protecting the airway from foreign material for longer periods of time during swallow. Combined with the improvement in UPDRS clinical measures, therapeutic singing may be an engaging early intervention strategy to address oropharyngeal dysphagia while also benefiting additional clinical symptoms of PD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Computational Analysis of Pharyngeal Swallowing Mechanics in Patients with Motor Neuron Disease: A Pilot Investigation.

Science.gov (United States)

Garand, K L; Schwertner, Ryan; Chen, Amy; Pearson, William G

2018-04-01

Swallowing impairment (dysphagia) is a common sequela in patients with motor neuron disease (MND). The purpose of this retrospective, observational pilot investigation was to characterize how pharyngeal swallowing mechanics are impacted in patients with MND using a comparison with healthy, non-dysphagic control group. Computational analysis of swallowing mechanics (CASM) was used to determine covariate biomechanics of pharyngeal swallowing from videofluoroscopic assessment in 15 patients with MND and 15 age- and sex-matched healthy controls. Canonical variant analysis with post hoc discriminate function analysis (DFA) was performed on coordinate data mapping functional muscle groups underlying pharyngeal swallowing. Differences in swallowing mechanics associated with group (MND; control), motor neuron predominance (upper; lower), onset (bulbar; spinal), and swallow task (thin, pudding) were evaluated and visualized. Pharyngeal swallowing mechanics differed significantly in patients with MND compared with healthy controls (D = 2.01, p mechanics by motor neuron predominance (D = 5.03, p mechanics of patients with MND differ from and are more heterogeneous than healthy controls. These findings suggest patients with MND may compensate reductions in pharyngeal shortening and tongue base retraction by extending the head and neck and increasing hyolaryngeal excursion. This work and further CASM investigations will lead to further insights into development and evaluation of targeted clinical treatments designed to prolong safe and efficient swallowing function in patients with MND.

Electrochemical Behaviour and Galvanic Effects of Titanium Implants Coupled to Metallic Suprastructures in Artificial Saliva

Science.gov (United States)

Mellado-Valero, Ana; Igual Muñoz, Anna; Guiñón Pina, Virginia

2018-01-01

The aim of the present study is to analyze the electrochemical behavior of five different dental alloys: two cobalt-chromium alloys (CoCr and CoCr-c), one nickel-chromium-titanium alloy (NiCrTi), one gold-palladium alloy (Au), and one titanium alloy (Ti6Al4V), and the galvanic effect when they are coupled to titanium implants (TiG2). It was carried out by electrochemical techniques (open circuit measurements, potentiodynamic curves and Zero-Resistance Ammetry) in artificial saliva (AS), with and without fluorides in different acidic conditions. The studied alloys are spontaneously passivated, but NiCrTi alloy has a very narrow passive domain and losses its passivity in presence of fluorides, so is not considered as a good option for implant superstructures. Variations of pH from 6.5 to 3 in artificial saliva do not change the electrochemical behavior of Ti, Ti6Al4V, and CoCr alloys, and couples, but when the pH of the artificial saliva is below 3.5 and the fluoride content is 1000 ppm Ti and Ti6Al4V starts actively dissolving, and CoCr-c superstructures coupled to Ti show acceleration of corrosion due to galvanic effects. Thus, NiCrTi is not recommended for implant superstructures because of risk of Ni ion release to the body, and fluorides should be avoided in acidic media because Ti, Ti6Al4V, and CoCr-c superstructures show galvanic corrosion. The best combinations are Ti/Ti6Al4V and Ti/CoCr as alternative of noble gold alloys. PMID:29361767

Dose-dependent deterioration of swallowing function after induction chemotherapy and definitive chemoradiotherapy for laryngopharyngeal cancer

Energy Technology Data Exchange (ETDEWEB)

Haderlein, M.; Semrau, S.; Ott, O.; Speer, S.; Fietkau, R. [University Hospital Erlangen, Department of Radiation Oncology, Erlangen (Germany); Bohr, C. [University Hospital Erlangen, Department of Otorhinolaryngology, Head and Neck Surgery, Erlangen (Germany)

2014-02-15

To evaluate the influence of clinical, treatment- and dose-dependent factors on posttreatment swallowing function after induction chemotherapy and definitive chemoradiotherapy in a group of homogeneously treated laryngopharyngeal cancer patients. From 28 May 2008 to 15 February 2013, 45 patients with borderline inoperable laryngopharyngeal cancer that had responded well to induction chemotherapy were treated with definitive chemoradiotherapy. Median follow-up was 22 months. Swallowing function and clinical data were prospectively analyzed using the EORTC QLQ-C30 questionnaire. Swallowing structures were retrospectively delineated on the original treatment planning CT. Dose-volume histograms were calculated for swallowing structures and D{sub mean}, D{sub max} and V50-V64 values (in 2 Gy increments) were determined for each patient. Tumor volume and infiltration of the swallowing apparatus was defined by CT before induction chemotherapy. Of the 45 patients, 26 (57.8 %) fully regained swallowing function after chemoradiotherapy. A further 12 patients (26.7 %) were able to manage soft, pureed and/or liquid foods; the remaining 7 (15.6 %) were completely dependent on percutaneous endoscopic gastrostomy (PEG). Posttreatment swallowing function was significantly influenced by D{sub mean} to the superior pharyngeal constrictor muscle (PCM, p = 0.041). Correlations between late dysphagia and dose-volume relationships in the superior PCM and soft palate were also observed, which were significant from V60 (p = 0.043) and V58 for the soft palate and superior PCM, respectively. Of the evaluated clinical and tumor-related factors, only alcohol abuse (p = 0.024) had an influence on posttreatment swallowing function. Almost 50 % of patients had deterioration of swallowing function after definitive chemoradiotherapy for laryngopharyngeal cancer. The dose to anatomical structures responsible for swallowing function appears to play a role. Therefore, in selected patients, target

Dose-dependent deterioration of swallowing function after induction chemotherapy and definitive chemoradiotherapy for laryngopharyngeal cancer

International Nuclear Information System (INIS)

Haderlein, M.; Semrau, S.; Ott, O.; Speer, S.; Fietkau, R.; Bohr, C.

2014-01-01

To evaluate the influence of clinical, treatment- and dose-dependent factors on posttreatment swallowing function after induction chemotherapy and definitive chemoradiotherapy in a group of homogeneously treated laryngopharyngeal cancer patients. From 28 May 2008 to 15 February 2013, 45 patients with borderline inoperable laryngopharyngeal cancer that had responded well to induction chemotherapy were treated with definitive chemoradiotherapy. Median follow-up was 22 months. Swallowing function and clinical data were prospectively analyzed using the EORTC QLQ-C30 questionnaire. Swallowing structures were retrospectively delineated on the original treatment planning CT. Dose-volume histograms were calculated for swallowing structures and D mean , D max and V50-V64 values (in 2 Gy increments) were determined for each patient. Tumor volume and infiltration of the swallowing apparatus was defined by CT before induction chemotherapy. Of the 45 patients, 26 (57.8 %) fully regained swallowing function after chemoradiotherapy. A further 12 patients (26.7 %) were able to manage soft, pureed and/or liquid foods; the remaining 7 (15.6 %) were completely dependent on percutaneous endoscopic gastrostomy (PEG). Posttreatment swallowing function was significantly influenced by D mean to the superior pharyngeal constrictor muscle (PCM, p = 0.041). Correlations between late dysphagia and dose-volume relationships in the superior PCM and soft palate were also observed, which were significant from V60 (p = 0.043) and V58 for the soft palate and superior PCM, respectively. Of the evaluated clinical and tumor-related factors, only alcohol abuse (p = 0.024) had an influence on posttreatment swallowing function. Almost 50 % of patients had deterioration of swallowing function after definitive chemoradiotherapy for laryngopharyngeal cancer. The dose to anatomical structures responsible for swallowing function appears to play a role. Therefore, in selected patients, target volume

Understanding of xerostomia and strategies for the development of artificial saliva.

Science.gov (United States)

Kho, Hong-Seop

2014-01-01

Xerostomia is becoming a major issue in dental and medical clinics with an increase of aged population. Medication is the most common etiology of xerostomia, while the most severe xerostomia generally occurs in patients with a history of head and neck radiotherapy. Xerostomic patients usually suffer from diminished quality of life due to various symptoms and complications. Decreased salivary output is a definite objective sign, but oral mucosal wetness is a more reliable factor for the evaluation of xerostomia. At present there are no effective therapeutic methods for the treatment of xerostomia. Sialogogues may have problematic side effects and their therapeutic effects last only brief duration. Artificial saliva typically does not produce satisfactory results in therapeutic efficacy. Therefore, further research and development of better therapeutic modalities are necessary. The basic concept for the development of ideal and functional artificial saliva is the mimicry of natural human saliva. We need proper candidate molecules and antimicrobial supplements to simulate the rheological and biological properties of human saliva. We also need better understanding of the interactions between the ingredients of artificial saliva themselves and between the ingredients and components of human saliva both in solution and on surface phases. In addition, we need accepted measures to evaluate the efficacy of artificial saliva. In conclusion, for the development of ideal artificial saliva, research based on the understanding of pathophysiology of xerostomia and knowledge about rheological and biological functions of human saliva are necessary.

Periodontitis diagnostics using resonance Raman spectroscopy on saliva

Science.gov (United States)

Gonchukov, S.; Sukhinina, A.; Bakhmutov, D.; Biryukova, T.; Tsvetkov, M.; Bagratashvily, V.

2013-07-01

In view of its wealth of molecular information, Raman spectroscopy has been the subject of active biomedical research. The aim of this work is Raman spectroscopy (RS) application for the determination of molecular biomarkers in saliva with the objective of early periodontitis detection. As was shown in our previous study, carotenoids contained in saliva can be molecular fingerprint information for the periodontitis level. It is shown here that the carotenoid RS lines at wavenumbers of 1156 and 1524 cm-1 can be easily detected and serve as reliable biomarkers of periodontitis using resonance Raman spectroscopy of dry saliva.

Periodontitis diagnostics using resonance Raman spectroscopy on saliva

International Nuclear Information System (INIS)

Gonchukov, S; Sukhinina, A; Bakhmutov, D; Biryukova, T; Tsvetkov, M; Bagratashvily, V

2013-01-01

In view of its wealth of molecular information, Raman spectroscopy has been the subject of active biomedical research. The aim of this work is Raman spectroscopy (RS) application for the determination of molecular biomarkers in saliva with the objective of early periodontitis detection. As was shown in our previous study, carotenoids contained in saliva can be molecular fingerprint information for the periodontitis level. It is shown here that the carotenoid RS lines at wavenumbers of 1156 and 1524 cm −1 can be easily detected and serve as reliable biomarkers of periodontitis using resonance Raman spectroscopy of dry saliva. (letter)

Nitric Oxide - Its Importance in Swallowing, Inflammatory Bowel Disease and Cirrhotic Cardiomyopathy

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ABR Thomson

2001-01-01

Full Text Available Nitric oxide is a neurotransmitter found in the central and peripheral nervous systems. Nitric oxide synthase (NOS is localized in the central nervous system, including the nucleus of the solitary tract, nucleus ambiguus and dorsal motor nucleus of the vagus. These are regions that are implicated in the central control of swallowing and esophageal motility. In rats and rabbits, NOS has been shown to be present in the nucleus subcentralis of the nucleus of the solitary tract, and is thought to be responsible for the central programming of the striated muscle component of esophageal peristalsis. Beyak and co-workers from the University of Toronto, Toronto, Ontario provided evidence that the L-arginine-nitric oxide pathway is implicated in the central control of swallowing and esophageal motility. They studied oropharyngeal swallowing as well as esophageal peristalsis, and determined the functional role of brain stem nitric oxide by examining the effects of blockade of central nervous system NOS on swallowing, and on primary and secondary peristalsis. Administering NOS inhibitors intravenously or intracerebroventricularly into the fourth ventricle produced a number of oropharyngeal swallows and induced primary peristalsis in the smooth muscle portion of the esophageal body. NOS reduced the number of oropharyngeal swallows and the incidence of primary peristalsis in both smooth and striated muscle, and reduced the amplitude of peristalsis and smooth muscle contraction. This suggests that nitric oxide is a functional neurotransmitter in the central pattern generator responsible for swallowing and the central control of esophageal peristalsis. Peripherally administered NOS inhibitor can access structures within the blood-brain barrier to affect neuronal activity and physiological function. The central pattern generated for swallowing and esophageal peristalsis is suggested to be a serial network of linked neurons within the nucleus of the solitary

Relationships between air swallowing, intragastric air, belching and gastro-oesophageal reflux

NARCIS (Netherlands)

Bredenoord, AJ; Weusten, BLAM; Timmer, R; Akkermans, LMA; Smout, AJPM

Background: With each swallow a certain amount of air is transported to the stomach. The stomach protects itself against excessive distention by swallowed air through belching (gas reflux). The mechanism of belching (transient lower oesophageal sphincter relaxation) is also one of the mechanisms

Relationships between air swallowing, intragastric air, belching and gastro-oesophageal reflux

NARCIS (Netherlands)

Bredenoord, A. J.; Weusten, B. L. A. M.; Timmer, R.; Akkermans, L. M. A.; Smout, A. J. P. M.

2005-01-01

BACKGROUND: With each swallow a certain amount of air is transported to the stomach. The stomach protects itself against excessive distention by swallowed air through belching (gas reflux). The mechanism of belching (transient lower oesophageal sphincter relaxation) is also one of the mechanisms

Inorganic component of saliva during fasting and after fast break

OpenAIRE

Samad, Rasmidar

2016-01-01

Oral health is closely related to salivary components. Saliva consists of water, inorganic and organic materials. Fasting changes one???s meal and drinking time that in turn can affect the environment in oral cavity, including inorganic componenet of saliva. The purpose of this study is to determine the inorganic component of saliva during fasting and after fast break.

Dynamic evaluation of swallowing disorders with electron-beam tomography

International Nuclear Information System (INIS)

Raith, J.; Lindbichler, F.; Kern, R.; Groell, R.; Rienmueller, R.

1996-01-01

Three cases preselected by videofluorography were studied to evaluate whether electron beam tomography (EBT) permits more detailed dynamic imaging of swallowing disorders focusing on the mesonasopharyngeal segment, the hypopharynx and the upper esophageal sphincter (UES). Immediately after videofluorographic examination of the oropharyngeal deglutition, EBT is performed. The patient is in a supine position and while the patient swallows a 20 ml bolus of water or diluted iodine containing contrast agent, a sequence of 20 images per level is scanned. The levels, which are determined by using the scout view, are oriented parallel to the hard palate either at the level of the hard palate to image the mesonasopharyngel segment or just above the hyoid bone to focus on the hypopharynx or at the location of the USE. The scan technique is a single-slice cinemode with a slice thickness of 3 mm (exposure time 100 ms, interscan delay 16 ms, 130 kV, 620 mA). The following structural interactions that we have so far been unable to image can be clearly demonstrated with EBT: During normal swallowing, the mesonasopharyngeal segment is completely and symmetrically closed by the soft palate and Passavant's cushion; lateral hypopharyngeal pouches can be located more precisely; and disorders of the UES can be differentiated into functional or morphologically caused disorders (e.g., goiter or cervical osteophytes). Videofluorography and cinematography are still the gold standard in functional evaluation of swallowing disorders. However, EBT permits dynamic imaging of pharyngeal deglutition in a preselected transverse plane and can give useful additional information concerning functional anatomical changes in the pharynx during swallowing. Further clinical evaluation is needed. (orig.) [de

INFLUENCE OF AGE ON SWALLOWS OF A HIGHLY VISCOUS LIQUID BOLUS

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Weslania Viviane NASCIMENTO

2015-03-01

Full Text Available Background Swallow function has a decline with aging, mainly in those over 80 years old. In the population over 69 years, about 11% of subjects reported symptoms indicative of significant dysphagia. Objectives Our objective was to evaluate the hypothesis that older asymptomatic subjects before 80 years old have compensations to sustain a safe and efficient swallow, at least with swallows of liquid bolus. Methods We performed videofluoroscopic evaluation of swallows in 55 normal volunteers, a younger group with 33 subjects (16 men and 17 women aged 19 to 55 years, mean 35.5±9.8 years, and an older group with 22 subjects (15 men and 7 women aged 56 to 77 years, mean 64.8±6.8 years. The subjects swallowed in duplicate 5 mL and 10 mL of liquid barium with a pH of 7.9, density of 1.82 g/cm3, and viscosity of 895 cp. Results The mean duration of pharyngeal transit, pharyngeal clearance, upper esophageal sphincter opening, hyoid movement and oral-pharyngeal transit were longer in the younger group compared with the older group. The relation between pharyngeal clearance duration and hyoid movement duration was similar in younger and older subjects, for 5 mL and 10 mL bolus volumes. Conclusions On average, a highly viscous liquid bolus crosses the pharynx faster in older subjects (56-77 years old than in younger subjects (19-55 years old, which suggested an adaptation to the aging process to maintain a safe swallow.

A Novel Imaging Analysis Method for Capturing Pharyngeal Constriction During Swallowing.

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Schwertner, Ryan W; Garand, Kendrea L; Pearson, William G

2016-01-01

Videofluoroscopic imaging of swallowing known as the Modified Barium Study (MBS) is the standard of care for assessing swallowing difficulty. While the clinical purpose of this radiographic imaging is to primarily assess aspiration risk, valuable biomechanical data is embedded in these studies. Computational analysis of swallowing mechanics (CASM) is an established research methodology for assessing multiple interactions of swallowing mechanics based on coordinates mapping muscle function including hyolaryngeal movement, pharyngeal shortening, tongue base retraction, and extension of the head and neck, however coordinates characterizing pharyngeal constriction is undeveloped. The aim of this study was to establish a method for locating the superior and middle pharyngeal constrictors using hard landmarks as guides on MBS videofluoroscopic imaging, and to test the reliability of this new method. Twenty de-identified, normal, MBS videos were randomly selected from a database. Two raters annotated landmarks for the superior and middle pharyngeal constrictors frame-by-frame using a semi-automated MATLAB tracker tool at two time points. Intraclass correlation coefficients were used to assess test-retest reliability between two raters with an ICC = 0.99 or greater for all coordinates for the retest measurement. MorphoJ integrated software was used to perform a discriminate function analysis to visualize how all 12 coordinates interact with each other in normal swallowing. The addition of the superior and middle pharyngeal constrictor coordinates to CASM allows for a robust analysis of the multiple components of swallowing mechanics interacting with a wide range of variables in both patient specific and cohort studies derived from common use imaging data.

IMPLICATIONS OF MOUTH BREATHING AND ATYPICAL SWALLOWING IN BODY POSTURE

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Veronique Sousa

2017-07-01

Conclusion: Statistically significant associations were established between the breathing pattern and the horizontal alignment of acromions, as well as the horizontal and vertical alignment of the head; between the pattern of breathing and swallowing with occlusal relationship anteroposterior and occlusal relationship vertical and also between breathing pattern and swallowing with digital sucking habits and pacifier use.

Contemporary management of voice and swallowing disorders in patients with advanced lung cancer.

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Brady, Grainne C; Carding, Paul N; Bhosle, Jaishree; Roe, Justin W G

2015-06-01

Advanced lung cancer can cause changes to swallowing and communication function. Direct tumour invasion, dyspnoea and deconditioning can all impact on swallowing function and communication. Cancer treatment, if administered, may cause or compound symptoms. In this study, the nature of swallowing and communication difficulties in patients with advanced lung cancer will be discussed, and management options including medical management, speech and language therapy (SLT) intervention, and surgical interventions will be considered. Advanced lung cancer can result in voice and swallowing difficulties, which can increase symptom burden and significantly impact on quality of life (QOL). There is a growing evidence base to support the use of injection laryngoplasty under local anaesthetic to offer immediate improvement in voice, swallowing and overall QOL. There is limited literature on the nature and extent of voice and swallowing impairment in patients with lung cancer. Well designed studies with robust and sensitive multidimensional dysphagia and dysphonia assessments are required. Outcome studies examining interventions with clearly defined treatment goals are required. These studies should include both functional and patient-reported outcome measures to develop the evidence base and to ensure that interventions are both timely and appropriate.

Involvement of ERK phosphorylation in brainstem neurons in modulation of swallowing reflex in rats

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Tsujimura, Takanori; Kondo, Masahiro; Kitagawa, Junichi; Tsuboi, Yoshiyuki; Saito, Kimiko; Tohara, Haruka; Ueda, Koichiro; Sessle, Barry J; Iwata, Koichi

2009-01-01

In order to evaluate the neuronal mechanisms underlying functional abnormalities of swallowing in orofacial pain patients, this study investigated the effects of noxious orofacial stimulation on the swallowing reflex, phosphorylated extracellular signal-regulated kinase (pERK) and γ-aminobutyric acid (GABA) immunohistochemical features in brainstem neurons, and also analysed the effects of brainstem lesioning and of microinjection of GABA receptor agonist or antagonist into the nucleus tractus solitarii (NTS) on the swallowing reflex in anaesthetized rats. The swallowing reflex elicited by topical administration of distilled water to the pharyngolaryngeal region was inhibited after capsaicin injection into the facial (whisker pad) skin or lingual muscle. The capsaicin-induced inhibitory effect on the swallowing reflex was itself depressed after the intrathecal administration of MAPK kinase (MEK) inhibitor. No change in the capsaicin-induced inhibitory effect was observed after trigeminal spinal subnucleus caudalis lesioning, but the inhibitory effect was diminished by paratrigeminal nucleus (Pa5) lesioning. Many pERK-like immunoreactive neurons in the NTS showed GABA immunoreactivity. The local microinjection of the GABAA receptor agonist muscimol into the NTS produced a significant reduction in swallowing reflex, and the capsaicin-induced depression of the swallowing reflex was abolished by microinjection of the GABAA receptor antagonist bicuculline into the NTS. The present findings suggest that facial skin–NTS, lingual muscle–NTS and lingual muscle–Pa5–NTS pathways are involved in the modulation of swallowing reflex by facial and lingual pain, respectively, and that the activation of GABAergic NTS neurons is involved in the inhibition of the swallowing reflex following noxious stimulation of facial and intraoral structures. PMID:19124539

Involvement of ERK phosphorylation in brainstem neurons in modulation of swallowing reflex in rats.

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Tsujimura, Takanori; Kondo, Masahiro; Kitagawa, Junichi; Tsuboi, Yoshiyuki; Saito, Kimiko; Tohara, Haruka; Ueda, Koichiro; Sessle, Barry J; Iwata, Koichi

2009-02-15

In order to evaluate the neuronal mechanisms underlying functional abnormalities of swallowing in orofacial pain patients, this study investigated the effects of noxious orofacial stimulation on the swallowing reflex, phosphorylated extracellular signal-regulated kinase (pERK) and gamma-aminobutyric acid (GABA) immunohistochemical features in brainstem neurons, and also analysed the effects of brainstem lesioning and of microinjection of GABA receptor agonist or antagonist into the nucleus tractus solitarii (NTS) on the swallowing reflex in anaesthetized rats. The swallowing reflex elicited by topical administration of distilled water to the pharyngolaryngeal region was inhibited after capsaicin injection into the facial (whisker pad) skin or lingual muscle. The capsaicin-induced inhibitory effect on the swallowing reflex was itself depressed after the intrathecal administration of MAPK kinase (MEK) inhibitor. No change in the capsaicin-induced inhibitory effect was observed after trigeminal spinal subnucleus caudalis lesioning, but the inhibitory effect was diminished by paratrigeminal nucleus (Pa5) lesioning. Many pERK-like immunoreactive neurons in the NTS showed GABA immunoreactivity. The local microinjection of the GABA(A) receptor agonist muscimol into the NTS produced a significant reduction in swallowing reflex, and the capsaicin-induced depression of the swallowing reflex was abolished by microinjection of the GABA(A) receptor antagonist bicuculline into the NTS. The present findings suggest that facial skin-NTS, lingual muscle-NTS and lingual muscle-Pa5-NTS pathways are involved in the modulation of swallowing reflex by facial and lingual pain, respectively, and that the activation of GABAergic NTS neurons is involved in the inhibition of the swallowing reflex following noxious stimulation of facial and intraoral structures.

Microbial community profiling of human saliva using shotgun metagenomic sequencing.

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Nur A Hasan

Full Text Available Human saliva is clinically informative of both oral and general health. Since next generation shotgun sequencing (NGS is now widely used to identify and quantify bacteria, we investigated the bacterial flora of saliva microbiomes of two healthy volunteers and five datasets from the Human Microbiome Project, along with a control dataset containing short NGS reads from bacterial species representative of the bacterial flora of human saliva. GENIUS, a system designed to identify and quantify bacterial species using unassembled short NGS reads was used to identify the bacterial species comprising the microbiomes of the saliva samples and datasets. Results, achieved within minutes and at greater than 90% accuracy, showed more than 175 bacterial species comprised the bacterial flora of human saliva, including bacteria known to be commensal human flora but also Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae, and Gamma proteobacteria. Basic Local Alignment Search Tool (BLASTn analysis in parallel, reported ca. five times more species than those actually comprising the in silico sample. Both GENIUS and BLAST analyses of saliva samples identified major genera comprising the bacterial flora of saliva, but GENIUS provided a more precise description of species composition, identifying to strain in most cases and delivered results at least 10,000 times faster. Therefore, GENIUS offers a facile and accurate system for identification and quantification of bacterial species and/or strains in metagenomic samples.

Standardization of a Videofluoroscopic Swallow Study Protocol to Investigate Dysphagia in Dogs.

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Harris, R A; Grobman, M E; Allen, M J; Schachtel, J; Rawson, N E; Bennett, B; Ledyayev, J; Hopewell, B; Coates, J R; Reinero, C R; Lever, T E

2017-03-01

Videofluoroscopic swallow study (VFSS) is the gold standard for diagnosis of dysphagia in veterinary medicine but lacks standardized protocols that emulate physiologic feeding practices. Age impacts swallow function in humans but has not been evaluated by VFSS in dogs. To develop a protocol with custom kennels designed to allow free-feeding of 3 optimized formulations of contrast media and diets that address limitations of current VFSS protocols. We hypothesized that dogs evaluated by a free-feeding VFSS protocol would show differences in objective swallow metrics based on age. Healthy juvenile, adult, and geriatric dogs (n = 24). Prospective, experimental study. Custom kennels were developed to maintain natural feeding behaviors during VFSS. Three food consistencies (thin liquid, pureed food, and dry kibble) were formulated with either iohexol or barium to maximize palatability and voluntary prehension. Dogs were evaluated by 16 swallow metrics and compared across age groups. Development of a standardized VFSS protocol resulted in successful collection of swallow data in healthy dogs. No significant differences in swallow metrics were observed among age groups. Substantial variability was observed in healthy dogs when evaluated under these physiologic conditions. Features typically attributed to pathologic states, such as gastric reflux, were seen in healthy dogs. Development of a VFSS protocol that reflects natural feeding practices may allow emulation of physiology resulting in clinical signs of dysphagia. Age did not result in significant changes in swallow metrics, but additional studies are needed, particularly in light of substantial normal variation. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Saliva Polymerase-Chain-Reaction Assay for Cytomegalovirus Screening in Newborns

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Boppana, Suresh B.; Ross, Shannon A.; Shimamura, Masako; Palmer, April L.; Ahmed, Amina; Michaels, Marian G.; Sánchez, Pablo J.; Bernstein, David I.; Tolan, Robert W.; Novak, Zdenek; Chowdhury, Nazma; Britt, William J.; Fowler, Karen B.

2011-01-01

BACKGROUND Congenital cytomegalovirus (CMV) infection is an important cause of hearing loss, and most infants at risk for CMV-associated hearing loss are not identified early in life because of failure to test for the infection. The standard assay for newborn CMV screening is rapid culture performed on saliva specimens obtained at birth, but this assay cannot be automated. Two alternatives — real-time polymerase-chain-reaction (PCR)–based testing of a liquid-saliva or dried-saliva specimen obtained at birth — have been developed. METHODS In our prospective, multicenter screening study of newborns, we compared real-time PCR assays of liquid-saliva and dried-saliva specimens with rapid culture of saliva specimens obtained at birth. RESULTS A total of 177 of 34,989 infants (0.5%; 95% confidence interval [CI], 0.4 to 0.6) were positive for CMV, according to at least one of the three methods. Of 17,662 newborns screened with the use of the liquid-saliva PCR assay, 17,569 were negative for CMV, and the remaining 85 infants (0.5%; 95% CI, 0.4 to 0.6) had positive results on both culture and PCR assay. The sensitivity and specificity of the liquid-saliva PCR assay were 100% (95% CI, 95.8 to 100) and 99.9% (95% CI, 99.9 to 100), respectively, and the positive and negative predictive values were 91.4% (95% CI, 83.8 to 96.2) and 100% (95% CI, 99.9 to 100), respectively. Of 17,327 newborns screened by means of the dried-saliva PCR assay, 74 were positive for CMV, whereas 76 (0.4%; 95% CI, 0.3 to 0.5) were found to be CMV-positive on rapid culture. Sensitivity and specificity of the dried-saliva PCR assay were 97.4% (95% CI, 90.8 to 99.7) and 99.9% (95% CI, 99.9 to 100), respectively. The positive and negative predictive values were 90.2% (95% CI, 81.7 to 95.7) and 99.9% (95% CI, 99.9 to 100), respectively. CONCLUSIONS Real-time PCR assays of both liquid- and dried-saliva specimens showed high sensitivity and specificity for detecting CMV infection and should be

Lecithin-based emulsions for potential use as saliva substitutes in patients with xerostomia--viscoelastic properties.

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Hanning, Sara M; Yu, Tao; Jones, David S; Andrews, Gavin P; Kieser, Jules A; Medlicott, Natalie J

2013-11-18

The purpose of the present study was to investigate lecithin-rice bran oil rheological properties with the view to consider these as potential saliva substitutes in patients with severe xerostomia and salivary hypofunction. Pseudo-ternary phase diagrams of rice bran oil, lecithin and water mixtures were constructed and characterised using polarising light microscopy. Viscoelastic properties, which we hypothesise are important determinants in product performance, were analysed using both flow and oscillatory rheology. Rheological properties were influenced by composition, frequency and shear stress. Frequency-dependent viscoelasticity was observed in some formulations where viscosity dominated (tanδ>1) at frequencies under 5 Hz and elasticity dominated (tanδ<1) at higher frequencies. Threshold frequencies were determined for each formulation, where a peak in loss tangent was observed, coinciding with a reduction in the storage modulus and increase in loss modulus. The frequency-dependent behaviour of emulsions are of interest because these combinations exhibit viscous behaviour at low frequencies, which may improve lubrication of the oral cavity at rest, whereas increased elasticity at higher frequencies may improve retention during higher-shear tasks such as swallowing and speaking. Copyright © 2013 Elsevier B.V. All rights reserved.

Effects of saliva collection using cotton swabs on melatonin enzyme immunoassay.

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Kozaki, Tomoaki; Lee, Soomin; Nishimura, Takayuki; Katsuura, Tetsuo; Yasukouchi, Akira

2011-01-10

Although various acceptable and easy-to-use devices have been used for saliva collection, cotton swabs are among the most common ones. Previous studies reported that cotton swabs yield a lower level of melatonin detection. However, this statistical method is not adequate for detecting an agreement between cotton saliva collection and passive saliva collection, and a test for bias is needed. Furthermore, the effects of cotton swabs have not been examined at lower melatonin level, a level at which melatonin is used for assessment of circadian rhythms, namely dim light melatonin onset (DLMO). In the present study, we estimated the effect of cotton swabs on the results of salivary melatonin assay using the Bland-Altman plot at lower level. Nine healthy males were recruited and each provided four saliva samples on a single day to yield a total of 36 samples. Saliva samples were directly collected in plastic tubes using plastic straws, and subsequently pipetted onto cotton swabs (cotton saliva collection) and into clear sterile tubes (passive saliva collection). The melatonin levels were analyzed in duplicate using commercially available ELISA kits. The mean melatonin concentration in cotton saliva collection samples was significantly lower than that in passive saliva collection samples at higher melatonin level (>6 pg/mL). The Bland-Altman plot indicated that cotton swabs causes relative and proportional biases in the assay results. For lower melatonin level (<6 pg/mL), although the BA plots didn't show proportional and relative biases, there was no significant correlation between passive and cotton saliva collection samples. Our findings indicate an interference effect of cotton swabs on the assay result of salivary melatonin at lower melatonin level. Cotton-based collection devices might, thus, not be suitable for assessment of DLMO.

INFRARED STUDIES OF HUMAN SALIVA. IDENTIFICATION OF A FACTOR IN HUMAN SALIVA PRODUCING AN INFRARED ABSORBANCE MAXIMUM AT 4.9 MICRONS

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An absorption maximum was observed at 4.9 microns in infrared spectra of human parotid saliva. The factor causing this absorbance was found to be a...nitrate, and heat stability. Thiocyanate was then determined in 16 parotid saliva samples by a spectrophotometric method, which involved formation of

Quantification of anti-Leishmania antibodies in saliva of dogs.

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Cantos-Barreda, Ana; Escribano, Damián; Bernal, Luis J; Cerón, José J; Martínez-Subiela, Silvia

2017-08-15

Detection of serum anti-Leishmania antibodies by quantitative or qualitative techniques has been the most used method to diagnose Canine Leishmaniosis (CanL). Nevertheless, saliva may represent an alternative to blood because it is easy to collect, painless and non-invasive in comparison with serum. In this study, two time-resolved immunofluorometric assays (TR-IFMAs) for quantification of anti-Leishmania IgG2 and IgA antibodies in saliva were developed and validated and their ability to distinguish Leishmania-seronegative from seropositive dogs was evaluated. The analytical study was performed by evaluation of assay precision, sensitivity and accuracy. In addition, serum from 48 dogs (21 Leishmania-seropositive and 27 Leishmania-seronegative) were analyzed by TR-IFMAs. The assays were precise, with an intra- and inter-assay coefficients of variation lower than 11%, and showed high level of accuracy, as determined by linearity under dilution (R 2 =0.99) and recovery tests (>88.60%). Anti-Leishmania IgG2 antibodies in saliva were significantly higher in the seropositive group compared with the seronegative (pLeishmania IgA antibodies between both groups were observed. Furthermore, TR-IFMA for quantification of anti-Leishmania IgG2 antibodies in saliva showed higher differences between seropositive and seronegative dogs than the commercial assay used in serum. In conclusion, TR-IFMAs developed may be used to quantify anti-Leishmania IgG2 and IgA antibodies in canine saliva with an adequate precision, analytical sensitivity and accuracy. Quantification of anti-Leishmania IgG2 antibodies in saliva could be potentially used to evaluate the humoral response in CanL. However, IgA in saliva seemed not to have diagnostic value for this disease. For future studies, it would be desirable to evaluate the ability of the IgG2 assay to detect dogs with subclinical disease or with low antibody titers in serum and also to study the antibodies behaviour in saliva during the

Swallowing abnormalities in multiple sclerosis: correlation between videofluoroscopy and subjective symptoms

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Wiesner, W.; Steinbrich, W. [Institute of Diagnostic Radiology, University Hospital of Basel (Switzerland); Wetzel, S.G.; Radue, E.W. [Institute of Neuroradiology, University Hospital Basel (Switzerland); Kappos, L.; Hoshi, M.M. [Department of Neurology, University Hospital of Basel (Switzerland); Witte, U. [Section of Logopedia, University Hospital of Basel (Switzerland)

2002-04-01

The purpose of this study was to evaluate if subjective symptoms indicating an impaired deglutition correlate with videofluoroscopic findings in patients with multiple sclerosis (MS). Videofluoroscopic examinations of 18 MS patients were analyzed by a radiologist and a logopedist and compared with the symptoms of these patients. Four patients complained about permanent dysphagia. Six patients reported mild and intermittent difficulties in swallowing, but were asymptomatic at the time of videofluoroscopy. Eight patients had no symptoms regarding their deglutition. All patients (n=4) who complained of permanent dysphagia showed aspiration. All patients (n=6) with mild and intermittent difficulties in swallowing showed undercoating of the epiglottis and/or laryngeal penetration. Of those 8 patients without any swallowing symptoms, only 2 had a normal videofluoroscopy. Swallowing abnormalities seem to be much more frequent in patients with MS than generally believed and they may easily be missed clinically as long as the patients do not aspirate. (orig.)

Factors determining the passage of drugs from blood into saliva.

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Stephen, K W; McCrossan, J; Mackenzie, D; Macfarlane, C B; Speirs, C F

1980-01-01

1. Following single oral dosing of ampicillin, cephalexin, tetracycline, erythromycin estolate, clindamycin and rifampicin to six normal volunteers, antibacterial activity was measured at 1, 3 and 6 h in serum, gingival fluid and minor gland saliva from all subjects and in parotid and submandiabular saliva from three. 2. pH values of all gingival fluid and saliva specimens were noted. 3. Partition coefficients between n-octanol and water were measured for erythromycin, clindamycin and rifampicin. Published data were used for ampicillin, cephalexin and tetracycline. 4. All antibiotics, but particularly rifampicin, were detected in gingival fluid. Only rifampicin and to a lesser degree, clindamycin were present in the other salivary constituents. 5. In studies of secretion of drugs in saliva, both the physico-chemical characteristics of the drugs and the physiological differences between individual salivary components should be considered. 6. Parotid saliva samples are likely to be of greatest value. PMID:7356893

Role of physical bolus properties as sensory inputs in the trigger of swallowing.

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Peyron, Marie-Agnès; Gierczynski, Isabelle; Hartmann, Christoph; Loret, Chrystel; Dardevet, Dominique; Martin, Nathalie; Woda, Alain

2011-01-01

Swallowing is triggered when a food bolus being prepared by mastication has reached a defined state. However, although this view is consensual and well supported, the physical properties of the swallowable bolus have been under-researched. We tested the hypothesis that measuring bolus physical changes during the masticatory sequence to deglutition would reveal the bolus properties potentially involved in swallowing initiation. Twenty normo-dentate young adults were instructed to chew portions of cereal and spit out the boluses at different times in the masticatory sequence. The mechanical properties of the collected boluses were measured by a texture profile analysis test currently used in food science. The median particle size of the boluses was evaluated by sieving. In a simultaneous sensory study, twenty-five other subjects expressed their perception of bolus texture dominating at any mastication time. Several physical changes appeared in the food bolus as it was formed during mastication: (1) in rheological terms, bolus hardness rapidly decreased as the masticatory sequence progressed, (2) by contrast, adhesiveness, springiness and cohesiveness regularly increased until the time of swallowing, (3) median particle size, indicating the bolus particle size distribution, decreased mostly during the first third of the masticatory sequence, (4) except for hardness, the rheological changes still appeared in the boluses collected just before swallowing, and (5) physical changes occurred, with sensory stickiness being described by the subjects as a dominant perception of the bolus at the end of mastication. Although these physical and sensory changes progressed in the course of mastication, those observed just before swallowing seem to be involved in swallowing initiation. They can be considered as strong candidates for sensory inputs from the bolus that are probably crucially involved in the triggering of swallowing, since they appeared in boluses prepared in various

Role of physical bolus properties as sensory inputs in the trigger of swallowing.

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Marie-Agnès Peyron

Full Text Available BACKGROUND: Swallowing is triggered when a food bolus being prepared by mastication has reached a defined state. However, although this view is consensual and well supported, the physical properties of the swallowable bolus have been under-researched. We tested the hypothesis that measuring bolus physical changes during the masticatory sequence to deglutition would reveal the bolus properties potentially involved in swallowing initiation. METHODS: Twenty normo-dentate young adults were instructed to chew portions of cereal and spit out the boluses at different times in the masticatory sequence. The mechanical properties of the collected boluses were measured by a texture profile analysis test currently used in food science. The median particle size of the boluses was evaluated by sieving. In a simultaneous sensory study, twenty-five other subjects expressed their perception of bolus texture dominating at any mastication time. FINDINGS: Several physical changes appeared in the food bolus as it was formed during mastication: (1 in rheological terms, bolus hardness rapidly decreased as the masticatory sequence progressed, (2 by contrast, adhesiveness, springiness and cohesiveness regularly increased until the time of swallowing, (3 median particle size, indicating the bolus particle size distribution, decreased mostly during the first third of the masticatory sequence, (4 except for hardness, the rheological changes still appeared in the boluses collected just before swallowing, and (5 physical changes occurred, with sensory stickiness being described by the subjects as a dominant perception of the bolus at the end of mastication. CONCLUSIONS: Although these physical and sensory changes progressed in the course of mastication, those observed just before swallowing seem to be involved in swallowing initiation. They can be considered as strong candidates for sensory inputs from the bolus that are probably crucially involved in the triggering of

Stricture location predicts swallowing outcomes following endoscopic rendezvous procedures.

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Adams, Katherine N; Shah, Rupali N; Buckmire, Robert A

2017-06-01

Complete pharyngoesophageal strictures may be encountered by the otolaryngologist as a consequence of radiation/chemoradiotherapy therapies for head and neck cancer. A combined anterograde and retrograde dilation procedure (rendezvous procedure) has proven to be a useful surgical intervention in these cases. We assess the long-term swallowing outcomes of this patient cohort including gastrostomy tube (G-tube) reliance, swallowing quality of life, and variables that contribute to improved swallowing outcomes. Retrospective chart review. A retrospective chart review of 18 consecutive patients treated with rendezvous procedures between April 2007 and May 2015 was carried out. Data were collected from chart review and follow-up telephone calls including demographics, surgical/postoperative course details, and Eating Assessment Tool (EAT-10) (swallowing quality of life) scores. The completion rate of the procedure was 83% (15 completed/3 procedures aborted). Average follow-up was 22 months. Thirteen of 15 (86.7%) achieved an oral diet, and 7/15 (46.7%) had their G-tube removed. G-tube-independent (GTI) patients had an average stricture length of 2.33 cm and an average distance from the incisors of 17.4 cm compared to G-tube dependent-(GTD) patients who had an average stricture length of 2.63 cm and 14.6 cm mean distance from the incisors (P = .66 and .0343, respectively). Final EAT-10 scores averaged 20.1 in GTI patients and 33.8 in GTD patients (P = .022). Stricture/incisor distance and EAT-10 scores demonstrated a moderate to strong negative correlation (r = -0.67). Following the endoscopic rendezvous procedure, swallowing outcomes and G-tube status is related to the distance of the stricture from the incisors. 2b Laryngoscope, 127:1388-1391, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Analysis of vocal and swallowing functions after horizontal glottectomy.

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Topaloğlu, İlhan; Bal, Muhlis; Salturk, Ziya; Berkiten, Güler; Atar, Yavuz

2016-08-01

We conducted a cross-sectional study to assess vocal and swallowing functions after horizontal glottectomy. Our study population was made up of 22 men aged 45 to 72 years (mean: 58.3) who underwent horizontal glottectomy and completed at least 1 year of follow-up. To compare postoperative results, 20 similarly aged men were included as a control group; all glottectomy patients and all controls were smokers. We used three methods-acoustic and aerodynamic voice analyses, the GRBAS (grade, roughness, breathiness, asthenicity, and strain) scale, and the voice handicap index-30 (VHI-30)-to assess vocal function objectively, perceptually, and subjectively, respectively. We also assessed swallowing function objectively by fiberoptic endoscopic evaluation of swallowing (FEES) and subjectively with the M.D. Anderson dysphagia inventory (MDADI). The 22 patients were also subcategorized into three groups according to the extent of their arytenoid cartilage resection, and their outcomes were compared. Acoustic and aerodynamic analyses showed that the mean maximum phonation time was significantly shorter and the fundamental frequency was significantly lower in the glottectomy group than in the controls (p = 0.001 for both), and that the mean jitter and shimmer values and the mean harmonics-to-noise ratio were all significantly higher (p = 0.001 for all); there were no significant differences among the three arytenoid subgroups. Self-assessments revealed that there were no statistically significant differences among the three subgroups in GRBAS scale scores except for the breathiness score (p = 0.045), which was lower in the arytenoid preservation subgroup than in the total resection subgroup; there were no statistically significant differences among the three subgroups in VHI-30 scores. Finally, swallow testing found no statistically significant differences in FEES scores or MDADI scores. We conclude that horizontal glottectomy caused a deterioration in vocal function, but

Effects of saliva collection using cotton swabs on melatonin enzyme immunoassay

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Katsuura Tetsuo

2011-01-01

Full Text Available Abstract Background Although various acceptable and easy-to-use devices have been used for saliva collection, cotton swabs are among the most common ones. Previous studies reported that cotton swabs yield a lower level of melatonin detection. However, this statistical method is not adequate for detecting an agreement between cotton saliva collection and passive saliva collection, and a test for bias is needed. Furthermore, the effects of cotton swabs have not been examined at lower melatonin level, a level at which melatonin is used for assessment of circadian rhythms, namely dim light melatonin onset (DLMO. In the present study, we estimated the effect of cotton swabs on the results of salivary melatonin assay using the Bland-Altman plot at lower level. Methods Nine healthy males were recruited and each provided four saliva samples on a single day to yield a total of 36 samples. Saliva samples were directly collected in plastic tubes using plastic straws, and subsequently pipetted onto cotton swabs (cotton saliva collection and into clear sterile tubes (passive saliva collection. The melatonin levels were analyzed in duplicate using commercially available ELISA kits. Results The mean melatonin concentration in cotton saliva collection samples was significantly lower than that in passive saliva collection samples at higher melatonin level (>6 pg/mL. The Bland-Altman plot indicated that cotton swabs causes relative and proportional biases in the assay results. For lower melatonin level ( Conclusion Our findings indicate an interference effect of cotton swabs on the assay result of salivary melatonin at lower melatonin level. Cotton-based collection devices might, thus, not be suitable for assessment of DLMO.

Improvement of swallowing function in patients with esophageal cancer treated by radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Sugahara, Shinji; Nakajima, Kotaro; Nozawa, Kumiko [Hitachi Ltd., Ibaraki (Japan). Hitachi General Hospital; Ohara, Kiyoshi; Yoshioka, Hiroshi; Tatsuzaki, Hideo; Tanaka, Naomi; Fukao, Katashi; Itai, Yuji

1996-12-01

This study investigated the impact of radiotherapy on swallowing function in 152 patients with esophageal cancer. Swallowing function was retrospectively assessed in these patients using a swallowing-function scoring system. Total tumor dose ranged from 22.5 Gy in 14 fractions to 104.4 Gy in 50 fractions. Improvement in dysphagia was noted in 62.3% of these patients, with a median time to improvement of 6 weeks. Improvement rate of patients irradiated with 20.0 to 34.9 Gy, 35.0 to 59.9 Gy and 60.0 Gy or more was 23.1%, 58.3% and 71.6%, respectively. Patients with T1-3 showed, a greater improvement rate than patients with T4 cancer (72.2% versus 54.1%). On multivariate analysis, the initial score, total dose and T factor correlated with improvements in swallowing function. Our results suggest that 35.0 Gy or more is necessary to improve swallowing function. The median duration in which patients could swallow soft or solid foods, was 8 months in patients receiving 60.0 Gy or more and 2 months in patients receiving 50.0 to 59.9 Gy, respectively. There was a significant difference between these periods (p<0.01). Regarding duration of palliation, median duration for patients receiving 60.0 Gy or more was 30 weeks, while it was 22 weeks for patients treated with lesser doses (p=0.053). We recommend 60.0 Gy or more as the optimal dosage for improving dysphagia. (author)

Swallowing dysfunction in patients with unilateral vocal fold paralysis: aetiology and outcomes.

Science.gov (United States)

Ollivere, B; Duce, K; Rowlands, G; Harrison, P; O'Reilly, B J

2006-01-01

Although unilateral vocal fold palsy (UVFP) is a common problem, data relating to swallowing dysfunction are sparse. We reviewed the clinical findings (method of presentation, underlying diagnosis and position of the vocal folds) of 30 patients and conducted a follow-up telephone survey. Outcome measures used were direct visualization of fold function, position and compensation. In addition, standardized speech and language assessments for swallowing dysfunction and dysphonia were noted and compared to presentation. Our study indicates that 56 per cent of patients with UVFP have associated dysphagia. Outcome with speech therapy is significant, with 73 per cent showing improvement. These data indicate a significant link between UVFP and swallowing dysfunction. There is a marked therapeutic benefit from voice therapy. Further work is required to evaluate the long-term outcomes and establish the mechanism of swallowing dysfunction in these patients.

Barn swallows nesting near radioactive leaching ponds in southeastern Idaho

International Nuclear Information System (INIS)

Millard, J.B.; Whicker, F.W.; Markham, O.D.

1978-01-01

Seasonally occurring populations of barn swallows nest near the Test Reactor Area (TRA) radioactive leaching ponds on the Idaho National Engineering Laboratory (INEL) Site. These birds utilize leaching pond arthropods and are therefore capable of accumulating radioactive materials and exporting them from the INEL Site during migration. The breeding biology is discussed for these swallows and a control group located 100 km away. Total nestling mortality for the controls and a 1977 TRA population was found to be statistically identical. Over 20 fission and activation products have been detected in immature and adult TRA birds. Mean concentrations of detectable radionuclides were used to calculate internal dose rates, and results showed that Na-24 contributed about 72% of the total average of 21.9 mrad/d for adult birds. Concentration factors were also calculated for predominant radionuclides in swallows relative to filtered pond water. Data from LiF dosimeters in swallow nests constructed with contaminated mud indicated average dose rates were 84 mrad/d for eggs and 220 mrad/d for nestlings. Growth curves were constructed for the immature TRA birds and controls. The first clutch of TRA swallows was found to have a significantly lower mean growth rate constant than the first clutch of controls. The statistical difference in growth rate between the control and TRA first clutch populations may have resulted from differences in climate, nesting site habitat, or available food sources, and cannot be solely attributed to radiation exposure as a causative factor. Growth rate parameters for TRA birds were within the range of values reported in the literature

Functional MRI study of cerebral cortical activation during volitional swallowing

International Nuclear Information System (INIS)

Wakasa, Toru; Aiga, Hideki; Yanagi, Yoshinobu; Kawai, Noriko; Sugimoto, Tomosada; Kuboki, Takuo; Kishi, Kanji

2002-01-01

The purpose of this study was to investigate the somatotropic distribution and lateralization of motor and sensory cortical activity during swallowing in healthy adult human subjects using functional MR imaging. Nine healthy right-handed adult volunteers (6 men, 3 women; ages 22-38) were examined. Their cortical activities were evoked by having them swallow, five times, a small bolus of water (3 ml) supplied through a plastic catheter. As a positive control, the subjects performed five repetitions of right-handed grasping tasks. Blood oxygenation level-dependent images were obtained using a 1.5 Tesla MR system (Magnetom Vision, Siemens Germany; repetition time/echo time (TR/TE)=0.96/0.66, flip angle (FA)=90 deg). T1 weighted anatomical images were obtained for the same slices in each subject. Cerebral activity was observed most notably in the primary motor cortex and primary somatosensory cortex, followed by the premotor cortex, anterior cingulate cortex, frontal operculum, and insula. The hand-grasping task activated relatively superior parts of the primary motor and somatosensory cortices. The swallowing task, on the other hand, activated the inferior parts of the pre- and postcentral gyri. The hand-grasping activation of motor and sensory cortices was localized absolutely on the contralateral side, whereas swallowing activated the motor cortex either bilaterally or unilaterally. Swallowing activated the sensory cortex almost always bilaterally. This study suggested that fMRI could be used to identify the specific areas of cortical activation caused by various tasks, and to differentiate the locations of cortical activation between tasks. (author)

Functional MRI study of cerebral cortical activation during volitional swallowing

Energy Technology Data Exchange (ETDEWEB)

Wakasa, Toru; Aiga, Hideki; Yanagi, Yoshinobu; Kawai, Noriko; Sugimoto, Tomosada; Kuboki, Takuo; Kishi, Kanji [Okayama Univ. (Japan). Graduate School of Medicine and Dentistry

2002-12-01

The purpose of this study was to investigate the somatotropic distribution and lateralization of motor and sensory cortical activity during swallowing in healthy adult human subjects using functional MR imaging. Nine healthy right-handed adult volunteers (6 men, 3 women; ages 22-38) were examined. Their cortical activities were evoked by having them swallow, five times, a small bolus of water (3 ml) supplied through a plastic catheter. As a positive control, the subjects performed five repetitions of right-handed grasping tasks. Blood oxygenation level-dependent images were obtained using a 1.5 Tesla MR system (Magnetom Vision, Siemens Germany; repetition time/echo time (TR/TE)=0.96/0.66, flip angle (FA)=90 deg). T1 weighted anatomical images were obtained for the same slices in each subject. Cerebral activity was observed most notably in the primary motor cortex and primary somatosensory cortex, followed by the premotor cortex, anterior cingulate cortex, frontal operculum, and insula. The hand-grasping task activated relatively superior parts of the primary motor and somatosensory cortices. The swallowing task, on the other hand, activated the inferior parts of the pre- and postcentral gyri. The hand-grasping activation of motor and sensory cortices was localized absolutely on the contralateral side, whereas swallowing activated the motor cortex either bilaterally or unilaterally. Swallowing activated the sensory cortex almost always bilaterally. This study suggested that fMRI could be used to identify the specific areas of cortical activation caused by various tasks, and to differentiate the locations of cortical activation between tasks. (author)

Effect of posture on swallowing.

African Journals Online (AJOL)

Ertekin C, Keskin A, Kiylioglu N, Kirazli Y, On AY,. Tarlaci S, et al. The effect of head and neck positions on oropharyngeal swallowing: a clinical and electrophysio- logic study. Archives of physical medicine and rehabilita- tion. 2001;829:1255-60. Epub 2001/09/12. 17. Logemann JA, Pauloski BR, Rademaker AW, Kahrilas.

Protein components in saliva and plaque fluid from irradiated primates

Energy Technology Data Exchange (ETDEWEB)

Edgar, W.M.; Bowen, W.H.; Cole, M.F. (Caries Prevention and Research Branch, National Caries Program, NIDR, Bethesda, Maryland, USA)

1982-01-01

Irradiation of the major salivary glands of monkeys (Macaca mulatta) fed cariogenic diets leads to caries clinically indistinguishable from radiation caries in man. This study compares the organic compostion of individual samples of plaque fluid and saliva from irradiated and control monkeys receiving the same cariogenic diet. Plaque and saliva were collected from fasting, tranquillised animals. Four irradiated animals were sampled repeatedly as were non-irradiated controls. Total protein, albumin, immunoglobulins A, G, and M, and the third component of complement (C'3) were quantitated in plaque fluid and whole saliva. Salivary amylase and peroxidase activities were also determined. Plaque fluid and saliva samples were also subjected to polyacrylamide gel electrophoresis. The total viable anaerobic count and numbers of Streptococcus mutans were determined in samples of plaque. The results suggest that the major effect of irradiation leading to increased numbers of S. mutans and caries susceptibility is in the amount, and not the composition, of the saliva produced by the residual gland tissue. The scanty flow of saliva may reduce the effectiveness of cleansing, buffering and lubrication mechanisms as well as resulting in a marked reduction in the total amount of specific and non-specific immune factors entering the mouth.

Protein components in saliva and plaque fluid from irradiated primates

International Nuclear Information System (INIS)

Edgar, W.M.; Bowen, W.H.; Cole, M.F.

1982-01-01

Irradiation of the major salivary glands of monkeys (Macaca mulatta) fed cariogenic diets leads to caries clinically indistinguishable from radiation caries in man. This study compares the organic compostion of individual samples of plaque fluid and saliva from irradiated and control monkeys receiving the same cariogenic diet. Plaque and saliva were collected from fasting, tranquillised animals. Four irradiated animals were sampled repeatedly as were non-irradiated controls. Total protein, albumin, immunoglobulins A, G, and M, and the third component of complement (C'3) were quantitated in plaque fluid and whole saliva. Salivary amylase and peroxidase activities were also determined. Plaque fluid and saliva samples were also subjected to polyacrylamide gel electrophoresis. The total viable anaerobic count and numbers of Streptococcus mutans were determined in samples of plaque. The results suggest that the major effect of irradiation leading to increased numbers of S. mutans and caries susceptibility is in the amount, and not the composition, of the saliva produced by the residual gland tissue. The scanty flow of saliva may reduce the effectiveness of cleansing, buffering and lubrication mechanisms as well as resulting in a marked reduction in the total amount of specific and non-specific immune factors entering the mouth. (author)

Protein components in saliva and plaque fluid from irradiated primates

Energy Technology Data Exchange (ETDEWEB)

Edgar, W M; Bowen, W H; Cole, M F [Caries Prevention and Research Branch, National Caries Program, NIDR, Bethesda, Maryland, USA

1982-01-01

Irradiation of the major salivary glands of monkeys (Macaca mulatta) fed cariogenic diets leads to caries clinically indistinguishable from radiation caries in man. This study compares the organic compostion of individual samples of plaque fluid and saliva from irradiated and control monkeys receiving the same cariogenic diet. Plaque and saliva were collected from fasting, tranquillised animals. Four irradiated animals were sampled repeatedly as were non-irradiated controls. Total protein, albumin, immunoglobulins A, G, and M, and the third component of complement (C'3) were quantitated in plaque fluid and whole saliva. Salivary amylase and peroxidase activities were also determined. Plaque fluid and saliva samples were also subjected to polyacrylamide gel electrophoresis. The total viable anaerobic count and numbers of Streptococcus mutans were determined in samples of plaque. The results suggest that the major effect of irradiation leading to increased numbers of S. mutans and caries susceptibility is in the amount, and not the composition, of the saliva produced by the residual gland tissue. The scanty flow of saliva may reduce the effectiveness of cleansing, buffering and lubrication mechanisms as well as resulting in a marked reduction in the total amount of specific and non-specific immune factors entering the mouth.

Microbial Community Profiling of Human Saliva Using Shotgun Metagenomic Sequencing

OpenAIRE

Hasan, Nur A.; Young, Brian A.; Minard-Smith, Angela T.; Saeed, Kelly; Li, Huai; Heizer, Esley M.; McMillan, Nancy J.; Isom, Richard; Abdullah, Abdul Shakur; Bornman, Daniel M.; Faith, Seth A.; Choi, Seon Young; Dickens, Michael L.; Cebula, Thomas A.; Colwell, Rita R.

2014-01-01

Human saliva is clinically informative of both oral and general health. Since next generation shotgun sequencing (NGS) is now widely used to identify and quantify bacteria, we investigated the bacterial flora of saliva microbiomes of two healthy volunteers and five datasets from the Human Microbiome Project, along with a control dataset containing short NGS reads from bacterial species representative of the bacterial flora of human saliva. GENIUS, a system designed to identify and quantify ba...

Factors determining the passage of drugs from blood into saliva.

OpenAIRE

Stephen, K W; McCrossan, J; Mackenzie, D; Macfarlane, C B; Speirs, C F

1980-01-01

1. Following single oral dosing of ampicillin, cephalexin, tetracycline, erythromycin estolate, clindamycin and rifampicin to six normal volunteers, antibacterial activity was measured at 1, 3 and 6 h in serum, gingival fluid and minor gland saliva from all subjects and in parotid and submandiabular saliva from three. 2. pH values of all gingival fluid and saliva specimens were noted. 3. Partition coefficients between n-octanol and water were measured for erythromycin, clindamycin and rifampi...

Saliva of obese patients – is it different?

Directory of Open Access Journals (Sweden)

Katarzyna Choromańska

2015-01-01

Full Text Available Obesity is a major public health concern that increases the risk of cardiovascular disease, type 2 diabetes and cancer. The incidence of obesity has increased significantly in recent years, not only in adults, but also in adolescents and children. This is evidenced by rapidly developing bariatric surgery, the most effective method of treating morbid obesity. Obesity is a multifactorial disease, and its pathogenesis is not completely understood. Numerous studies have been performed to clarify pathogenetic mechanisms, based mostly on blood and sometimes urine samples. Saliva is easily accessible and can be obtained non-invasively. Our aim was to review studies performed on saliva obtained from obese subjects in order to answer the title question.Obese people have different composition of salivary bacteria. Changes in the concentration of sialic acid, phosphorus and peroxidase activity as well as a lower flow rate of stimulated whole saliva promote dental caries and periodontal disease. Concentrations of salivary uric acid, endocannabinoids and CRP are increased in obesity and may provide a useful index of cardiometabolic risk. Assessment of fasting salivary ghrelin might facilitate choosing the best type of bariatric surgery for a specific patient. A significant decrease in salivary cortisol in women with morbid obesity also seems interesting.There is sufficient evidence to state that the saliva of obese and lean subjects is different. Saliva as an easily accessible research material seems promising, as shown by the few studies performed so far.

[Evaluation of swallowing function with surface electromyography before and after tonsillectomy].

Science.gov (United States)

Gürkan, Emre; Veyseller, Bayram; Açıkalın, Reşit Murat; Elbistanlı, Suphi; Yurtsever, Serveren; Acar, Hürtan

2011-01-01

In this study, we evaluated the swallowing function with surface electromyography before and after tonsillectomy. Twenty patients (12 males, 8 females; mean age 23.8 years; range 17 to 30 years) who had tonsillectomy indication as study group, and 10 healthy individuals (8 males, 2 females; mean age 26 years; range 18 to 35 years) as control group were included in this prospective study between October 2008 and February 2009. Due to their significant role on oral and faringeal phases of swallowing; the surface electromyography prosedure is performed on the masseter muscle, the submental-submandibular muscle group and the infrahyoid muscles to measure their electrical activity and duration of contraction. For this purpose, single swallow and continuous drinking of 100 cc water tests were applied to each patient preoperatively and; in the postoperative 1st week and the 1st month. The preoperative duration of drinking periods were significanly longer in the study group compared to the control group (p<0.05). At the end of the first postoperative week the duration of drinking 100 cc water test was significantly longer than the preoperative mean of the study group (p<0.05). After one month single- swallow durations of study group were significantly shorter then the preoperative mean (p<0.05). The electrical activity of the masseter and infrahyoid muscles were significantly higher in study group compared with control group (p<0.05). The close proximity of the surgical area to the muscles affects swallowing after tonsillectomy. The surface electromyography is a simple, non-invasive and reliable method for postoperative evaluation of the swallowing functions of the throat muscles and thereby allows monitoring of the recovery and functional improvement of these muscles.

Demography of invasive black and pale swallow-wort populations in New York

Science.gov (United States)

Vincetoxicum nigrum (Black Swallow-wort) and Vincetoxicum rossicum (Pale Swallow-wort) are perennial twining vines introduced from Europe. Both species have become invasive in northeastern North America in a variety of habitats. To develop parameters for a population model for evaluating potential b...

Bilateral Killian-Jamieson diverticula demonstrated by videofluoroscopic swallowing study: case report

Directory of Open Access Journals (Sweden)

Betina Scheeren

2013-06-01

Full Text Available The authors report the case of a 56-year-old male patient complaining of dysphagia for solids and food impaction, submitted to videofluoroscopic swallowing study that demonstrated the presence of two esophageal diverticula. The videofluoroscopic swallowing study was critical in the identification and diagnosis of the diverticula, an esophageal cause of dysphagia.

Time-Frequency Analysis and Hermite Projection Method Applied to Swallowing Accelerometry Signals

Directory of Open Access Journals (Sweden)

Ervin Sejdić

2010-01-01

Full Text Available Fast Hermite projections have been often used in image-processing procedures such as image database retrieval, projection filtering, and texture analysis. In this paper, we propose an innovative approach for the analysis of one-dimensional biomedical signals that combines the Hermite projection method with time-frequency analysis. In particular, we propose a two-step approach to characterize vibrations of various origins in swallowing accelerometry signals. First, by using time-frequency analysis we obtain the energy distribution of signal frequency content in time. Second, by using fast Hermite projections we characterize whether the analyzed time-frequency regions are associated with swallowing or other phenomena (vocalization, noise, bursts, etc.. The numerical analysis of the proposed scheme clearly shows that by using a few Hermite functions, vibrations of various origins are distinguishable. These results will be the basis for further analysis of swallowing accelerometry to detect swallowing difficulties.

Application of botulinum toxin to reduce the saliva in patients with amyotrophic lateral sclerosis.

Science.gov (United States)

Manrique, Dayse

2005-01-01

To demonstrate the effect of local application of Botox(R) in patients with amyotrophic lateral sclerosis (ALS), following our 2002 institutional protocol of sialorrhea treatment. Clinical prospective. Five patients with ALS assisted at Clinic of Otolaryngology of AACD (Associação de Assistência à Criança Deficiente). They were all submitted to local application of Botox in salivary glands and followed up for a year. The protocol consisted of clinical questionnaire about the inability of swallowing saliva and its repercussions in quality of life. Patients were submitted to previous odontological treatment, had intolerance to the adverse effects of anti-cholinergic agents and had not used Botox for at least six months. The application was guided by ultrasound and the doses were 30U in one point for submandibular gland, and 20U in two points for each parotid gland, after topic anesthetic with prilocaine. Five patients with ALS with sialorrhea, aged 45 to 59 years, were submitted to Botox salivary glands application. We observed that the symptoms of sialorrhea changed dramatically in four patients. Three patients stayed almost four months without complaints with repercussion in quality of life. No patient presented local or systemic effects with local injection of Botox.

Fiberoptic endoscopic evaluation of swallowing (FEES): proposal for informed consent

OpenAIRE

Nacci, A; Ursino, F; La Vela, R; Matteucci, F; Mallardi, V; Fattori, B

2008-01-01

Fiberoptic endoscopic evaluation of swallowing (FEES) is now a first choice method for studying swallowing disorders on account of the various advantages it offers: easy to use, very well tolerated, allows bedside examination and is economic. Nevertheless, this diagnostic procedure is not without risks, the most probable consequences of which include discomfort, gagging and/or vomiting, vasovagal syncope, epistaxis, mucosal perforation, adverse reactions to topical anaesthetics and laryngospa...

Travel of a mis-swallowed long spoon to the jejunum

Science.gov (United States)

Song, Yan; Guo, Hua; Wu, Jian-Yong

2009-01-01

Foreign-body ingestion is a relatively common presentation at emergency departments, but long metallic spoon swallowing is an infrequent occurrence. Unlike most cases of foreign-body ingestion, there have been no reported cases of long foreign bodies reaching the jejunum. We report a rare case of a coffee spoon that was swallowed accidentally and passed through the pylorus and duodenal loop and reached the jejunum, with no complications. PMID:19842235

The Effects of Oral-Motor Exercises on Swallowing in Children: An Evidence-Based Systematic Review

Science.gov (United States)

Arvedson, Joan; Clark, Heather; Lazarus, Cathy; Schooling, Tracy; Frymark, Tobi

2010-01-01

Aim: The aim of this unregistered evidence-based systematic review was to determine the state and quality of evidence on the effects of oral motor exercises (OME) on swallowing physiology, pulmonary health, functional swallowing outcomes, and drooling management in children with swallowing disorders. Method: A systematic search of 20 electronic…

Rapid antemortem detection of CWD prions in deer saliva.

Directory of Open Access Journals (Sweden)

Davin M Henderson

Full Text Available Chronic wasting disease (CWD is an efficiently transmitted prion disease of cervids, now identified in 22 United States, 2 Canadian provinces and Korea. One hallmark of CWD is the shedding of infectious prions in saliva, as demonstrated by bioassay in deer. It is also clear that the concentration of prions in saliva, blood, urine and feces is much lower than in the nervous system or lymphoid tissues. Rapid in vitro detection of CWD (and other prions in body fluids and excreta has been problematic due to the sensitivity limits of direct assays (western blotting, ELISA and the presence of inhibitors in these complex biological materials that hamper detection. Here we use real-time quaking induced conversion (RT-QuIC to demonstrate CWD prions in both diluted and prion-enriched saliva samples from asymptomatic and symptomatic white-tailed deer. CWD prions were detected in 14 of 24 (58.3% diluted saliva samples from CWD-exposed white-tailed deer, including 9 of 14 asymptomatic animals (64.2%. In addition, a phosphotungstic acid enrichment enhanced the RT-QuIC assay sensitivity, enabling detection in 19 of 24 (79.1% of the above saliva samples. Bioassay in Tg[CerPrP] mice confirmed the presence of infectious prions in 2 of 2 RT-QuIC-positive saliva samples so examined. The modified RT-QuIC analysis described represents a non-invasive, rapid ante-mortem detection of prions in complex biologic fluids, excreta, or environmental samples as well as a tool for exploring prion trafficking, peripheralization, and dissemination.

The Neurobiology of Swallowing and Dysphagia

Science.gov (United States)

Miller, Arthur J.

2008-01-01

The neurobiological study of swallowing and its dysfunction, defined as dysphagia, has evolved over two centuries beginning with electrical stimulation applied directly to the central nervous system, and then followed by systematic investigations that have used lesioning, transmagnetic stimulation, magnetoencephalography, and functional magnetic…

Effects of Lactobacillus rhamnosus GG on saliva-derived microcosms

NARCIS (Netherlands)

Pham, L.C.; Hoogenkamp, M.A.; Exterkate, R.A.M.; Terefework, Z.; de Soet, J.J.; ten Cate, J.M.; Crielaard, W.; Zaura, E.

2011-01-01

Objective The probiotic strain Lactobacillus rhamnosus GG (LGG) is shown to hamper the presence of mutans streptococci in saliva and may have positive effects on oral health. We investigated the effects of LGG on the cariogenic potential and microbial composition of saliva-derived microcosms. Design

The role of electrostatics in saliva-induced emulsion flocculation

NARCIS (Netherlands)

Silletti, Erika; Vingerhoeds, Monique H.; Norde, Willem; Van Aken, George A.

Upon consumption food emulsions undergo different processes, including mixing with saliva. It has been shown that whole saliva induces emulsion flocculation [van Aken, G. A., Vingerhoeds, M. H., & de Hoog, E. H. A. (2005). Colloidal behaviour of food emulsions under oral conditions. In E. Dickinson

Assessing genetic polymorphisms using DNA extracted from cells present in saliva samples

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Nemoda Zsofia

2011-12-01

Full Text Available Abstract Background Technical advances following the Human Genome Project revealed that high-quality and -quantity DNA may be obtained from whole saliva samples. However, usability of previously collected samples and the effects of environmental conditions on the samples during collection have not been assessed in detail. In five studies we document the effects of sample volume, handling and storage conditions, type of collection device, and oral sampling location, on quantity, quality, and genetic assessment of DNA extracted from cells present in saliva. Methods Saliva samples were collected from ten adults in each study. Saliva volumes from .10-1.0 ml, different saliva collection devices, sampling locations in the mouth, room temperature storage, and multiple freeze-thaw cycles were tested. One representative single nucleotide polymorphism (SNP in the catechol-0-methyltransferase gene (COMT rs4680 and one representative variable number of tandem repeats (VNTR in the serotonin transporter gene (5-HTTLPR: serotonin transporter linked polymorphic region were selected for genetic analyses. Results The smallest tested whole saliva volume of .10 ml yielded, on average, 1.43 ± .77 μg DNA and gave accurate genotype calls in both genetic analyses. The usage of collection devices reduced the amount of DNA extracted from the saliva filtrates compared to the whole saliva sample, as 54-92% of the DNA was retained on the device. An "adhered cell" extraction enabled recovery of this DNA and provided good quality and quantity DNA. The DNA from both the saliva filtrates and the adhered cell recovery provided accurate genotype calls. The effects of storage at room temperature (up to 5 days, repeated freeze-thaw cycles (up to 6 cycles, and oral sampling location on DNA extraction and on genetic analysis from saliva were negligible. Conclusions Whole saliva samples with volumes of at least .10 ml were sufficient to extract good quality and quantity DNA. Using

Dysphagia in Lewy body dementia - a clinical observational study of swallowing function by videofluoroscopic examination.

Science.gov (United States)

Londos, Elisabet; Hanxsson, Oskar; Alm Hirsch, Ingrid; Janneskog, Anna; Bülow, Margareta; Palmqvist, Sebastian

2013-10-07

Dysphagia, which can result in aspiration pneumonia and death, is a well-known problem in patients with dementia and Parkinson's disease. There are few studies on dysphagia in patients with dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), especially studies objectively documenting the type of swallowing dysfunction. The aim of this study was therefore to investigate the prevalence, and define the actual swallowing dysfunction according to a videofluoroscopic swallowing examination (VFSE) in patients with DLB and PDD. Eighty-two consecutive patients with DLB or PDD in a clinical follow-up program were asked about symptoms of dysphagia. Those experiencing dysphagia were examined with VFSE. Prevalence and type of swallowing dysfunction was recorded. Twenty-six patients (32%) reported symptoms of dysphagia such as swallowing difficulties or coughing. Twenty-four (92%) of these had a documented swallowing dysfunction on VFSE. Eighty-eight percent suffered from pharyngeal dysfunction. Almost all DLB or PDD patients with subjective signs of dysphagia had pathologic results on VFSE, the majority of pharyngeal type. This type of dysphagia has not been reported in DLB before. The results have clinical implications and highlight the importance of asking for and examining swallowing function to prevent complications such as aspiration.

SU-E-J-193: Application of Surface Mapping in Detecting Swallowing for Head-&-Neck Cancer

Energy Technology Data Exchange (ETDEWEB)

Cao, D; Xie, X; Mehta, V; Shepard, D [Swedish Cancer Institute, Seattle, WA (United States)

2015-06-15

Purpose: Recent evidence is emerging that long term swallowing function may be improved after radiotherapy for head-&-neck cancer if doses are limited to certain swallowing structures. Immobilization of patients with head-&-neck cancer is typically done with a mask. This mask, however, doesn’t limit patient swallowing. Patient voluntary or involuntary swallowing may introduce significant tumor motion, which can lead to suboptimal delivery. In this study, we have examined the feasibility of using surface mapping technology to detect patient swallowing during treatment and evaluated its magnitude. Methods: The C-RAD Catalyst system was used to detect the patient surface map. A volunteer lying on the couch was used to simulate the patient under treatment. A virtual marker was placed near the throat and was used to monitor the swallowing action. The target motion calculated by the Catalyst system through deformable registration was also collected. Two treatment isocenters, one placed close to the throat and the other placed posterior to the base-of-tongue, were used to check the sensitivity of surface mapping technique. Results: When the patient’s throat is not in the shadow of the patient’s chest, the Catalyst system can clearly identify the swallowing motion. In our tests, the vertical motion of the skin can reach to about 5mm. The calculated target motion can reach up to 1 cm. The magnitude of this calculated target motion is more dramatic when the plan isocenter is closer to the skin surface, which suggests that the Catalyst motion tracking technique is more sensitive to the swallowing motion with a shallower isocenter. Conclusion: Surface mapping can clearly identify patient swallowing during radiation treatment. This information can be used to evaluate the dosimetric impact of the involuntary swallowing. It may also be used to potentially gate head-&-neck radiation treatments. A prospective IRB approved study is currently enrolling patients in our

Sensory and instrumental analysis for slipperiness and compliance of food during swallowing.

Science.gov (United States)

Seo, H-S; Hwang, I K; Han, T R; Kim, I S

2007-11-01

In spite of its importance, there have been few attempts to evaluate the sensory attributes of the food bolus during swallowing. In the current study, the slipperiness, the degree of slide for the food bolus through the mucosal surface of the oro-pharynx, and the compliance, how easily the shape of a food bolus can be transformed for automatic and comfortable swallowing, were derived among several sensory attributes related to the swallowing. Therefore, the study aims were twofold: (1) to develop the methods of sensory and instrumental analyses for determining the slipperiness and compliance of the food bolus during swallowing and (2) to examine the appropriateness of the newly designed devices by correlating the data between the sensory and instrumental analyses. Six commercial food products were evaluated by 10 trained panelists for each attribute. The devices for assessing each attribute were developed in consideration of the oro-pharyngeal movements. The sensory and instrumental analyses showed high correlation and regression coefficients as well as intensity differences of the 6 samples for each attribute. In conclusion, the slipperiness and the compliance were suitable for acquiring a better understanding of the sensory attributes of the food bolus during swallowing, and the newly developed devices showed a high potential for determining those attributes.

Swallowing disorders in nursing home residents: how can the problem be explained?

Directory of Open Access Journals (Sweden)

Nogueira D

2013-02-01

Full Text Available Dália Nogueira,1 Elizabeth Reis21Speech Therapy Department, Escola Superior de Saúde de Alcoitão, Estoril, Portugal; 2Department of Quantitative Methods, Lisbon University Institute ISCTE/IUL, Lisbon, PortugalBackground: The swallowing mechanism changes significantly as people age, even in the absence of chronic diseases. Presbyphagia, a term that refers to aging-related changes in the swallowing mechanism, may be linked to many health conditions and presents itself in distinct ways. Swallowing disorders are also identified as a major problem amongst the elderly population living in nursing homes.Methods: The study sought to determine the prevalence of swallowing disorders in nursing home residents, to identify the relationship between self-perceived swallowing disorders, cognitive functions, autonomy, and depression, and also to analyze which variables explain the score of the Dysphagia Self-Test (DST. For this purpose, the researchers chose to apply a survey conveying questions on demographic aspects, general health, eating and feeding, as well as instruments to assess functional performance and the 3 ounce Water Swallow Test.Results: The sample consisted of 272 elderly people living in eight nursing homes in Portugal. Six did not sign the informed consent form. Of the total, 29% were totally dependent, 33% were depressed, 45% had cognitive impairment, and 38% needed help with feeding. About 43% of the individuals reported having problems related to eating. Regarding the DST, 40% showed signs of dysphagia. With respect to the 3 ounce Water Swallow Test, 38% revealed at least one of the symptoms, wet voice being the most prevalent. Correlation measures showed that age had no linear association with the DST score although correlation with the Barthel Index and Mini Mental State Examination was found to be significant. A linear regression model was estimated with the DST score as the dependent variable and the MMSE and BI scores, gender, age

Parámetros inflamatorios en saliva y sangre en niños y adolescentes sanos Inflammatory parameters in saliva and blood from healthy children and adolescents

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Ninoska Tahis Viera Sirit

2011-09-01

Full Text Available En la actualidad se ha mostrado interés en el empleo de la saliva para ser utilizada como una alternativa de diagnóstico, predicción y progresión de diversas enfermedades con relación a otros fluidos corporales. Los objetivos trazados para la realización de este trabajo fueron: correlacionar las concentraciones en saliva y sangre de IL-1, IL-6, TNF-a, sustancias reactivas al ácido tiobarbitúrico y O2- de niños y adolescentes sistémicamente sanos. Se realizó un estudio de corte transversal en 23 niños y adolescentes sanos, entre 4 y 17 años de edad. Se les realizaron evaluaciones clínicas para determinar las condiciones bucales y estudios inmunológicos con el propósito de identificar los niveles de citosinas, a través del ensayo inmunoenzimático indirecto, el O2- por método citoquímico y las sustancias reactivas al ácido tiobarbitúrico, a través del ensayo colorimétrico. Hubo diferencia significativa entre las muestras de saliva y las de sangre periférica respecto a las citosinas y sustancias reactivas al ácido tiobarbitúrico estudiadas. Los resultados fueron: IL-1 en sangre= 1,646 ± 0,13 pg/mL y de IL-1 en saliva= 552,36 ± 75,7 pg/mL; IL-6 en sangre= 3,506 ± 1,85 pg/mL, e IL-6 en saliva= 26,89 ± 9,97 pg/mL. Al analizar el TNF-a en sangre fue de 12,91 ± 3,05 pg/mL y en saliva= 43,56 ± 6,44 pg/mL, las sustancias reactivas al ácido tiobarbitúrico en sangre= 9,46 ± 3,26 nmol/mL y en saliva= 1,26 ± 0,03 nmol/mL. No se observó correlación estadísticamente significativa entre las muestras de sangre y saliva para los valores de IL-1, IL-6 y sustancias reactivas al ácido tiobarbitúrico. En cuanto al TNF-a se evidenció una correlación significativa, r s= 0,78. No se evidenciaron células positivas para el O2- en las muestras estudiadas. Los resultados del análisis de correlación obtenido entre las muestras salivales y séricas, no aportaron evidencias suficientes para sugerir que la saliva pueda ser utilizada

Bacterial profiles of saliva in relation to diet, lifestyle factors, and socioeconomic status

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Belstrøm, Daniel; Holmstrup, Palle; Nielsen, Claus H

2014-01-01

BACKGROUND AND OBJECTIVE: The bacterial profile of saliva is composed of bacteria from different oral surfaces. The objective of this study was to determine whether different diet intake, lifestyle, or socioeconomic status is associated with characteristic bacterial saliva profiles. DESIGN: Stimu...... of saliva. CONCLUSIONS: The bacterial profile of saliva seems independent of diet intake, but influenced by smoking and maybe socioeconomic status.......BACKGROUND AND OBJECTIVE: The bacterial profile of saliva is composed of bacteria from different oral surfaces. The objective of this study was to determine whether different diet intake, lifestyle, or socioeconomic status is associated with characteristic bacterial saliva profiles. DESIGN...... presence and levels (mean HOMIM-value) of bacterial probes as endpoints, the influence of diet intake, lifestyle, and socioeconomic status on the bacterial saliva profile was analyzed by Mann-Whitney tests with Benjamini-Hochberg's correction for multiple comparisons and principal component analysis...

Cultural, behavioral, social, and psychological perceptions of saliva: relevance to clinical diagnostics.

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Nguyen, Sean; Wong, David T

2006-04-01

The search for a resource that can be used to detect a broad range of diseases easily and reliably is akin to a search for the diagnostic Holy Grail. Yet, each of us may have inside our mouths, a key to the pathological and disease biomarker library hidden inside our bodies. Saliva--the source of all this information--is the secretory product of glands located in or around the oral cavity. If one could read the stories of diagnostic information present within saliva, then the abundance of information waiting to be found could be comparable to a vast vault of information, such as the Internet. Upon dissection of this data, it would be seen that the source of this information is from saliva's origin as a filtrate of blood, and that the validity of both mediums should be equal. Although one day this may be the view, most people's hold of saliva, current and past cultures, have fared much more diverse meanings to the secretion. Ivan Pavlov's experiments has shown how closely tied salivation is with the thought of food, one of life's primary indulgences. The relationship between salivation and behaviors within our daily lives is undeniable. Yet most people never appreciate the uniqueness of saliva. Throughout the world, saliva carries definite positive and negative connotations, based upon its social, psychological, behavioral, and cultural settings. The thought of saliva may be viewed as grotesque in one population, yet may be the vehicle of blessing in other cultures. Saliva's double nature brings up some interesting cultural, social, behavioral, and psychological points about how saliva is perceived in the world, some of which are subsequently stated in order to present saliva as the spirited fluid it is.

Quantitative Measures of Swallowing Deficits in Patients With Parkinson's Disease.

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Ellerston, Julia K; Heller, Amanda C; Houtz, Daniel R; Kendall, Katherine A

2016-05-01

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. The purpose of this study was to investigate swallowing function in patients with PD using a norm-referenced, quantitative approach. This retrospective study includes 34 patients with a diagnosis of PD referred to a multidisciplinary voice and swallowing clinic. Modified barium swallow studies were performed using quantitative measures of pharyngeal transit time, hyoid displacement, CP sphincter opening, area of the pharynx at maximal constriction, and timing of laryngeal vestibule closure relative to bolus arrival at the CP sphincter. Reduced pharyngeal constriction was found in 30.4%, and a delay in airway closure relative to arrival of the bolus at the CP sphincter was the most common abnormality, present in 62% of patients. Previously reported findings of prolonged pharyngeal transit, poor hyoid elevation, and CP achalasia were not identified as prominent features. © The Author(s) 2015.

Differences in Swallowing between High and Low Concentration Taste Stimuli

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Ahmed Nagy

2014-01-01

Full Text Available Taste is a property that is thought to potentially modulate swallowing behavior. Whether such effects depend on taste, intensity remains unclear. This study explored differences in the amplitudes of tongue-palate pressures in swallowing as a function of taste stimulus concentration. Tongue-palate pressures were collected in 80 healthy women, in two age groups (under 40, over 60, stratified by genetic taste status (nontasters, supertasters. Liquids with different taste qualities (sweet, sour, salty, and bitter were presented in high and low concentrations. General labeled magnitude scale ratings captured perceived taste intensity and liking/disliking of the test liquids. Path analysis explored whether factors of taste, concentration, age group, and/or genetic taste status impacted: (1 perceived intensity; (2 palatability; and (3 swallowing pressures. Higher ratings of perceived intensity were found in supertasters and with higher concentrations, which were more liked/disliked than lower concentrations. Sweet stimuli were more palatable than sour, salty, or bitter stimuli. Higher concentrations elicited stronger tongue-palate pressures independently and in association with intensity ratings. The perceived intensity of a taste stimulus varies as a function of stimulus concentration, taste quality, participant age, and genetic taste status and influences swallowing pressure amplitudes. High-concentration salty and sour stimuli elicit the greatest tongue-palate pressures.

A Preliminary Videofluoroscopic Investigation of Swallowing Physiology and Function in Individuals with Oculopharyngeal Muscular Dystrophy (OPMD).

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Waito, Ashley A; Steele, Catriona M; Peladeau-Pigeon, Melanie; Genge, Angela; Argov, Zohar

2018-05-03

Dysphagia is one of the primary symptoms experienced by individuals with Oculopharyngeal Muscular Dystrophy (OPMD). However, we lack understanding of the discrete changes in swallowing physiology that are seen in OPMD, and the resulting relationship to impairments of swallowing safety and efficiency. This study sought to describe the pathophysiology of dysphagia in a small sample of patients with OPMD using a videofluoroscopy examination (VFSS) involving 3 × 5 mL boluses of thin liquid barium (22% w/v). The aim of this study is to extend what is known about the pathophysiology of dysphagia in OPMD, by quantifying changes in swallow timing, kinematics, safety, and efficiency, measured from VFSS. This study is a secondary analysis of baseline VFSS collected from 11 adults (4 male), aged 48-62 (mean 57) enrolled in an industry-sponsored phase 2 therapeutic drug trial. Blinded raters scored the VFSS recordings for safety [Penetration-Aspiration Scale (PAS)], efficiency [Normalized Residue Ratio Scale (NRRS)], timing [Pharyngeal Transit Time (PTT), Swallow Reaction Time (SRT), Laryngeal Vestibule Closure Reaction Time (LVCrt), Upper Esophageal Sphincter Opening Duration (UESD)], and kinematics (hyoid movement, pharyngeal constriction, UES opening width). Impairment thresholds from existing literature were defined to characterize swallowing physiology and function. Further, Fisher's Exact tests and Pearson's correlations were used to conduct a preliminary exploration of associations between swallowing physiology (e.g., kinematics, timing) and function (i.e., safety, efficiency). Compared to published norms, we identified significant differences in the degree of maximum pharyngeal constriction, hyoid movement distance and speed, as well as degree and timeliness of airway closure. Unsafe swallowing (PAS ≥ 3) was seen in only 3/11 patients. By contrast, clinically significant residue (i.e., NRRS scores ≥ 0.09 vallecular; ≥ 0.2 pyriform) was seen in

Experimental infection of cliff swallows (Petrochelidon pyrrhonota) with varying doses of West Nile virus

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Oesterle, P.T.; Nemeth, N.M.; VanDalen, Kaci K.; Sullivan, H.; Bentler, K.T.; Young, G.R.; McLean, R.G.; Clark, L.; Smeraski, C.; Hall, Jeffrey S.

2009-01-01

Cliff swallows (Petrochelidon pyrrhonota) were inoculated with differing doses of West Nile virus (WNV) to evaluate their potential role as reservoir hosts in nature. Swallows often nest in large colonies in habitats and months associated with high mosquito abundance and early WNV transmission in North America. Additionally, cliff swallow diet consists of insects, including mosquitoes, leading to an additional potential route of WNV infection. The average peak viremia titer among infected cliff swallows was 106.3 plaque-forming units (PFU)/mL serum and the reservoir competence index was 0.34. There was no correlation between dose and probability of becoming infected or viremia peak and duration. Oral shedding was detected from 2 to 14 days post-inoculation with an average peak titer of 1044 PFU/swab. These results suggest that cliff swallows are competent reservoir hosts of WNV and therefore, they may play a role in early seasonal amplification and maintenance of WNV. Copyright ?? 2009 by The American Society of Tropical Medicine and Hygiene.

SALIVA SEBAGAI UJI SARING OSTEOPOROSIS

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Niniarty Z. Djamal

2015-07-01

Full Text Available Osteoporosis is a metabolic bone disease, and is characterized by low bone mass and microstructure deterioration of the bone, which leads to increased risk of fracture. Biomarker of bone metabolism can be seen as beginning of bone loss and first detection before imbalanced bone turnover comes. Biomarker of bone formation as serum bone alkaline fosfatase, osteocalcin (OC, procollagen type I, and biomarker of bone resorption as urine pyridinoline (Pyd and deoxypyridinoline (Dpd crosslinks, hydroxyprolin. The simultaneous examination of serum OC and urine Pyd or Dpd as a very good screening test for determination of bone imbalanced at the moment of the menopausal or the beginning of the pasca menopausal. Saliva as a potential diagnostic fluid for the assessment of osteoporosis biomarker concentrations. The study found elevated three classic warning signs for osteopororsis os OC, Dpd and 116 in the saliva of sheep without ovaries, which were similar to the levels of signs found in their blood and urine. Expectations, that the test may become available within five years and one day the test may be able to be performed at home like pregnancy test. Osteoporosis biomarker in saliva suggested detected of bone mass density easier. Beside that can be used as a method of early diagnostic and as a monitor therapy that as salinity of the examinations of bone mass on radiology.

Prevalence of atypical swallowing: a kinesiographic study.

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Monaco, A; Cattaneo, R; Spadaro, A; Marchetti, E; Barone, A

2006-12-01

The aim of this study was to investigate the prevalence of kinesiographic coincidence between the most cranial position during deglutition of mandible and habitual occlusal position and to evaluate the distribution of clinical diagnosis according to the kinesiographic pattern of deglutition. 201 random patients in waiting list for dental treatment and classified as orthodontic patients, prosthetic patients, TMD patients and control patients, were evaluated. Kinesiographic records were acquired using K7I and positioning a magnetic sensor frame integral with the head and with the sensory field balanced on an artificial magnet adhering to the mucosa covering the roots of the lower mandibular incisors. The kinesiographic occlusal position was compared to the kinesiographic most cranial position of the mandible during swallowing. 99 patients displayed a discrepancy between the most cranial position during swallowing and the occlusal position. 102 patients did not show any discrepancy. In this group the kinesiographic most cranial position during swallowing coincided with the occlusal position. The finding suggests that computerised kinesiography could be useful to study deglutition, detecting in a reliable way the movement pattern. Atypical deglutition seems to be less atypical than previously though in dental patient population and, despite these data confirm its correlation with malocclusion, we noted an inverse correlation with necessity of prosthetic treatment and no higher prevalence in TMD patients.

Comparative evaluation of qigong on various parameters of saliva

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Bayat Movahed S.

2007-05-01

Full Text Available Background and Aim: Qigong is a type of Chinese psychosomatic exercise that integrates meditation, slow physical movements, and breathing. Numerous physical and mental benefits have been classically ascribed to qigong. On the other hand, unstimulated saliva is thought to play an important role in oral immunity, enamel stability and moisturizing the oral mucous membrane. Impaired salivary secretion leads to dental caries, mucosal deterioration and mouth dryness. The aim of the present study was to analyze the effect of a qigong program on various parameters of saliva such as quantity of unstimulated saliva, pH and SIgA. Materials and Methods: Twenty three subjects participated in this clinical trial study. The experimental subjects underwent a qigong training program, conducted by a qualified instructor. The program consisted of half an hour daily practice for 6 months (spring and winter. Saliva was collected in two periods: once during the spring before the experiment commencement and the second, in the following spring. During each period saliva collection was done on tuesday of each week. pH and quantity of salvia measurements were taken simultaneously. SIgA measurements were also taken based on the values obtained in the last phase of the experiment at the end of each spring. The results were analyzed using paired sample T test, one way repeated measure and Bon Ferroni multiple comparison. P<0.05 was the level of significance. Results: Based on our findings, the change in the amount of unstimulated salvia as well as SIgA was statistically significant (P<0.001; however, there was no significant difference in pH values before and after experiment. Conclusion: These findings demonstrate that after 6 months of practicing qigong, significant changes in amount of unstimulated saliva and SIgA occurred in participants. The authors suggest that qigong may be a beneficial adjunctive treatment that enhances amount of unstimulated saliva and SIgA.

Central inhibition of initiation of swallowing by systemic administration of diazepam and baclofen in anaesthetized rats.

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Tsujimura, Takanori; Sakai, Shogo; Suzuki, Taku; Ujihara, Izumi; Tsuji, Kojun; Magara, Jin; Canning, Brendan J; Inoue, Makoto

2017-05-01

Dysphagia is caused not only by neurological and/or structural damage but also by medication. We hypothesized memantine, dextromethorphan, diazepam, and baclofen, all commonly used drugs with central sites of action, may regulate swallowing function. Swallows were evoked by upper airway (UA)/pharyngeal distension, punctate mechanical stimulation using a von Frey filament, capsaicin or distilled water (DW) applied topically to the vocal folds, and electrical stimulation of a superior laryngeal nerve (SLN) in anesthetized rats and were documented by recording electromyographic activation of the suprahyoid and thyrohyoid muscles and by visualizing laryngeal elevation. The effects of intraperitoneal or topical administration of each drug on swallowing function were studied. Systemic administration of diazepam and baclofen, but not memantine or dextromethorphan, inhibited swallowing evoked by mechanical, chemical, and electrical stimulation. Both benzodiazepines and GABA A receptor antagonists diminished the inhibitory effects of diazepam, whereas a GABA B receptor antagonist diminished the effects of baclofen. Topically applied diazepam or baclofen had no effect on swallowing. These data indicate that diazepam and baclofen act centrally to inhibit swallowing in anesthetized rats. NEW & NOTEWORTHY Systemic administration of diazepam and baclofen, but not memantine or dextromethorphan, inhibited swallowing evoked by mechanical, chemical, and electrical stimulation. Both benzodiazepines and GABA A receptor antagonists diminished the inhibitory effects of diazepam, whereas a GABA B receptor antagonist diminished the effects of baclofen. Topical applied diazepam or baclofen was without effect on swallowing. Diazepam and baclofen act centrally to inhibit swallowing in anesthetized rats. Copyright © 2017 the American Physiological Society.

Voluntary Modulation of Hemodynamic Responses in Swallowing Related Motor Areas: A Near-Infrared Spectroscopy-Based Neurofeedback Study.

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Silvia Erika Kober

Full Text Available In the present study, we show for the first time that motor imagery of swallowing, which is defined as the mental imagination of a specific motor act without overt movements by muscular activity, can be successfully used as mental strategy in a neurofeedback training paradigm. Furthermore, we demonstrate its effects on cortical correlates of swallowing function. Therefore, N = 20 healthy young adults were trained to voluntarily increase their hemodynamic response in swallowing related brain areas as assessed with near-infrared spectroscopy (NIRS. During seven training sessions, participants received either feedback of concentration changes in oxygenated hemoglobin (oxy-Hb group, N = 10 or deoxygenated hemoglobin (deoxy-Hb group, N = 10 over the inferior frontal gyrus (IFG during motor imagery of swallowing. Before and after the training, we assessed cortical activation patterns during motor execution and imagery of swallowing. The deoxy-Hb group was able to voluntarily increase deoxy-Hb over the IFG during imagery of swallowing. Furthermore, swallowing related cortical activation patterns were more pronounced during motor execution and imagery after the training compared to the pre-test, indicating cortical reorganization due to neurofeedback training. The oxy-Hb group could neither control oxy-Hb during neurofeedback training nor showed any cortical changes. Hence, successful modulation of deoxy-Hb over swallowing related brain areas led to cortical reorganization and might be useful for future treatments of swallowing dysfunction.

Effects of isoflurane anesthesia and pilocarpine on rat parotid saliva flow

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Knudsen, Jacob Dronninglund; Nauntofte, Birgitte; Josipovic, M

2011-01-01

The purpose of this study was to investigate the effects of isoflurane on unstimulated and pilocarpine-stimulated parotid saliva secretion. Ten male Sprague-Dawley rats weighing 350-400 g were randomized into two groups, and the saliva flow rate and lag phase were measured at two doses of isoflur......The purpose of this study was to investigate the effects of isoflurane on unstimulated and pilocarpine-stimulated parotid saliva secretion. Ten male Sprague-Dawley rats weighing 350-400 g were randomized into two groups, and the saliva flow rate and lag phase were measured at two doses...... of isoflurane in a crossover study design. Increasing the isoflurane concentration from 1% to 2% was associated with a 19% decrease in saliva secretion rate, and the lag to saliva secretion was increased by 155%. To clarify whether the effect of isoflurane (1.5%) on the parotid flow varied with stimulus...... intensity, we measured the parotid flow induced by seven different doses of pilocarpine on sham-irradiated rats and rats irradiated with single doses of 15 Gy. A maximal pilocarpine response was obtained with 1.5 mg/kg in both irradiated and sham-irradiated rats; however, the parotid flow of the irradiated...

Radioimmunological determination of chloramphenicol in the saliva of lactating cows

International Nuclear Information System (INIS)

Dotter, A.; Kroker, R.; Arnold, D.; Somogyi, A.

1987-01-01

In an effort to search for noninvasive methods suitable to monitor compliance with the ban of chloramphenicol (CAP) in milkproducing animals, the pharmacokinetic behavior of this drug in bovine saliva was investigated. As revealed by studies using a radioimmunological assay, CAP appears following its intracisternal (i.c.) or subcutaneous (s.c.) administration in the saliva of lactating cows. The level of sensitivity of the method (1.5 ng CAP per g saliva) was reached 14 and 18 days after i.c. and s.c. administration, respectively. At present, the question must remain open as to whether the concentration of CAP in the saliva can serve as a reliable indicator for the enforcement of the highest permissible level set at 1 ng CAP per g of milk by German regulations. (orig.) [de

Radioimmunological determination of chloramphenicol in the saliva of lactating cows

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Dotter, A.; Kroker, R.; Arnold, D.; Somogyi, A.

1987-02-01

In an effort to search for noninvasive methods suitable to monitor compliance with the ban of chloramphenicol (CAP) in milk-producing animals, the pharmacokinetic behavior of this drug in bovine saliva was investigated. As revealed by studies using a radioimmunological assay, CAP appears following its intracisternal (i.c.) or subcutaneous (s.c.) administration in the saliva of lactating cows. The level of sensitivity of the method (1.5 ng CAP per g saliva) was reached 14 and 18 days after i.c. and s.c. administration, respectively. At present, the question must remain open as to whether the concentration of CAP in the saliva can serve as a reliable indicator for the enforcement of the highest permissible level set at 1 ng CAP per g of milk by German regulations.

Serum and saliva levels of cathepsin L in patients with acute coronary syndrome.

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Mirzaii-Dizgah, Iraj; Riahi, Esmail

2011-03-01

Coronary artery disease (CAD) is the major cause of death nearly all over the world, and accurate and rapid diagnosis of CAD is of major medical and economic importance. The aim of this study was to evaluate the serum and saliva levels of cathepsin L in patients with acute coronary syndrome (ACS). In a cross-sectional study, 39 patients with ACS and 28 with controls were recruited to the study, and cathepsin L levels were measured in serum, resting saliva, and stimulated saliva obtained 12 and 24 h after the onset of ACS by ELISA method. Statistical analyses of Fisher's exact test, the Student's t-test or Kruskal-Wallis test were performed. Stimulated saliva cathepsin L levels in patients with ACS 12 hours but not 24 hours after admission showed significant decrease compared with that in control subjects. However, there were no significant differences in serum and unstimulated saliva cathepsin L levels between groups. Serum and saliva levels of cathepsin L remain unchanged in patients with ACS and hence may not be a promising factor in CAD risk assessment. It seems that serum and saliva cathepsin L may not be a good biomarker for CHD. CAD: Coronary artery disease, ACS: Acute coronary syndrome, CHD: Coronary heart disease, EU: Emergency unit, MI: Myocardial infarction. Cathepsin L, Acute coronary syndrome, Resting saliva, Stimulated saliva. How to cite this article: Mirzaii-Dizgah I, Riahi E. Serum and Saliva Levels of Cathepsin L in Patients with Acute Coronary Syndrome. J Contemp Dent Pract 2011;12(2):114-119.

Autologous saliva transfusion: treatment for HIV?

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Arakeri, Gururaj

2010-05-01

The HIV-1 pandemic is a complex mix of diverse epidemics within and between countries and regions of the world, and is undoubtedly the defining public-health crisis of our time. Any therapeutic or prophylactic measure which holds promise or provides clues of eliminating or inhibiting the infection is worthy of investigation. As our body's own saliva is suspiciously escaping from the infection and providing clues regarding the resistance/inhibition of HIV; in this paper, a treatment approach is suggested with the rationale of in vitro effective antiviral action of autogenous saliva may also have a better therapeutic potential by its intravenous administration along with dextran.

Deglutitive inhibition, latency between swallow and esophageal contractions and primary esophageal motor disorders.

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Sifrim, Daniel; Jafari, Jafar

2012-01-01

Swallowing induces an inhibitory wave that is followed by a contractile wave along the esophageal body. Deglutitive inhibition in the skeletal muscle of the esophagus is controlled in the brain stem whilst in the smooth muscle, an intrinsic peripheral control mechanism is critical. The latency between swallow and contractions is determined by the pattern of activation of the inhibitory and excitatory vagal pathways, the regional gradients of inhibitory and excitatory myenteric nerves, and the intrinsic properties of the smooth muscle. A wave of inhibition precedes a swallow-induced peristaltic contraction in the smooth muscle part of the human oesophagus involving both circular and longitudinal muscles in a peristaltic fashion. Deglutitive inhibition is necessary for drinking liquids which requires multiple rapid swallows (MRS). During MRS the esophageal body remains inhibited until the last of the series of swallows and then a peristaltic contraction wave follows. A normal response to MRS requires indemnity of both inhibitory and excitatory mechanisms and esophageal muscle. MRS has recently been used to assess deglutitive inhibition in patients with esophageal motor disorders. Examples with impairment of deglutitive inhibition are achalasia of the LES and diffuse esophageal spasm.

Cannabinoids facilitate the swallowing reflex elicited by the superior laryngeal nerve stimulation in rats.

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Mostafeezur, Rahman Md; Zakir, Hossain Md; Takatsuji, Hanako; Yamada, Yoshiaki; Yamamura, Kensuke; Kitagawa, Junichi

2012-01-01

Cannabinoids have been reported to be involved in affecting various biological functions through binding with cannabinoid receptors type 1 (CB1) and 2 (CB2). The present study was designed to investigate whether swallowing, an essential component of feeding behavior, is modulated after the administration of cannabinoid. The swallowing reflex evoked by the repetitive electrical stimulation of the superior laryngeal nerve in rats was recorded before and after the administration of the cannabinoid receptor agonist, WIN 55-212-2 (WIN), with or without CB1 or CB2 antagonist. The onset latency of the first swallow and the time intervals between swallows were analyzed. The onset latency and the intervals between swallows were shorter after the intravenous administration of WIN, and the strength of effect of WIN was dose-dependent. Although the intravenous administration of CB1 antagonist prior to intravenous administration of WIN blocked the effect of WIN, the administration of CB2 antagonist did not block the effect of WIN. The microinjection of the CB1 receptor antagonist directly into the nucleus tractus solitarius (NTS) prior to intravenous administration of WIN also blocked the effect of WIN. Immunofluorescence histochemistry was conducted to assess the co-localization of CB1 receptor immunoreactivity to glutamic acid decarboxylase 67 (GAD67) or glutamate in the NTS. CB1 receptor was co-localized more with GAD67 than glutamate in the NTS. These findings suggest that cannabinoids facilitate the swallowing reflex via CB1 receptors. Cannabinoids may attenuate the tonic inhibitory effect of GABA (gamma-aminobuteric acid) neurons in the central pattern generator for swallowing.

Role of Basal Ganglia in Swallowing Process: A Systematic Review

OpenAIRE

Hamideh Ghaemi; Davood Sobhani-Rad; Ali Arabi; Sadegh Saifpanahi; Zahra Ghayoumi Anaraki

2016-01-01

Objectives: The basal ganglia (BG) controls different patterns of behavior by receiving inputs from sensory-motor and pre-motor cortex and projecting it to pre-frontal, pre-motor and supplementary motor areas. As the exact role of BG in swallowing process has not been fully determined, we aimed at reviewing the published data on neurological control in the swallowing technique to have a better understanding of BG’s role in this performance.  Methods: English-language articles, w...

Saliva in relation to dental erosion before and after radiotherapy

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Jensdottir, Thorbjorg; von Buchwald, Christian; Nauntofte, Birgitte

2013-01-01

Abstract Objective. Low saliva flow and abnormal saliva composition are common conditions after radiotherapy for oral cavity and pharyngeal cancer. Both conditions increase the susceptibility to dental caries and erosion, which may be further accelerated by changes in food preferences. The aim...... of this study was to determine changes in saliva flow and susceptibility to erosive challenges in pharyngeal cancer patients before and after radiotherapy to the head and neck. Materials and methods: The erosive potential of sucking acidic candies with and without calcium was determined in nine patients (50...

Swallowing function before and after concurrent chemoradiotherapy for pharyngeal cancer

International Nuclear Information System (INIS)

Kiyuna, Asanori; Hasegawa, Masahiro; Higa, Asano; Shinhama, Akihiko; Suzuki, Mikio

2010-01-01

Concurrent chemoradiotherapy (CCRT) for patients with advanced head or neck cancer has become popular as an effective treatment that can preserve their organs and functions after treatment. However, severe dysfunctions as the complications related to CCRT, e.g. dysphagia, sometimes appear in spite of preservation of the affected organs. The aim of the present study is to clarify swallowing function during and after CCRT. Medical records of subjects who received CCRT for treatment of oropharyngeal (21 cases) and hypopharyngeal (19 cases) cancer were retrospectively reviewed for mucositis and dysphagia before, during, and after CCRT using National Cancer Institute-Common Toxicity Criteria (NCI-CTC) version 2.0. Severity of mucositis and dysphagia kept deteriorating during CCRT and 27.5% of the subjects required tube feeding at the end of CCRT. The mucositis improved rapidly after treatment, but severe dysphagia still persisted in 7.5% of the subjects 6 months after CCRT. Planned neck dissections were carried out in 14 patients as additional treatment against lymph node involvement. Although severe dysphagia appeared immediately after surgery, swallowing function returned to preoperative condition within 1 month. The majority of patients who receive CCRT recover their swallowing function within 6 months after CCRT. However, since some patients demonstrate prolonged dysphagia after CCRT, we should receive informed consent from patients about their swallowing condition after CCRT. (author)

Isolation and Analytical Characterization of Local Malaysian Leech Saliva

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Mohamed Alaama

2011-12-01

Full Text Available Leech saliva contains biologically active compounds that are mainly proteins and peptides. In this study a modified and smooth extraction method of saliva was used without leeches' scarification. UV and Bradford Assay protein methods showed that the saliva extract contains high concentrations of proteins. RP-HPLC chromatogram revealed that more than 30 different peaks were observed in leech saliva extract. Gel electrophoresis revealed the existence of proteins and peptides with different molecular weights. The gel showed up to 25 different bands. Comparison of gel electrophoresis data with protein database revealed the closeness of four molecular weights to known proteins from Hirudinaria leech family. Other proteins detected by gel electrophoresis may be related to completely new biologically active proteins and peptides in the saliva extract or to a modification (isoforms of the existing ones or finally to a mixture of both.ABSTRAK: Air liur pacat secara biologinya mengandungi sebahagian besar campuran aktif protein dan peptida. Dalam kajian ini, kaedah pengestrakan air liur pacat yang telah diubah suai digunakan tanpa perlu membunuh pacat. Kaedah protein Cerakin UV dan Bradford menunjukkan air liur pacat yang diekstrak mengandungi konsentrasi protein yang tinggi. Kromatogram RP-HPLC memperlihatkan lebih daripada 30 puncak berbeza diperolehi semasa air liur pacat diekstrak. Gel elektroforesis memperlihatkan kewujudan protein dan peptida dengan berat molekul yang berbeza. Gel menunjukkan hingga 25 jalur yang berbeza. Perbandingan data menggunakan gel elektroforesis seiring dengan pangkalan data protein memperlihatkan persamaan empat berat molekul, dengan protein yang yang dikenali daripada keluarga pacat Hirudinaria. Jenis protein lain yang dikesan dengan menggunakan gel elektrofosis mungkin juga berkait secara biologinya dengan protein dan peptida aktif yang baru, dalam ekstrak air liur atau pengubahsuaian (beberapa jenis yang berbeza daripada

Effect of peripherally and cortically evoked swallows on jaw reflex responses in anesthetized rabbits.

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Suzuki, Taku; Yoshihara, Midori; Sakai, Shogo; Tsuji, Kojun; Nagoya, Kouta; Magara, Jin; Tsujimura, Takanori; Inoue, Makoto

2018-05-03

This study aimed to investigate whether the jaw-opening (JOR) and jaw-closing reflexes (JCR) are modulated during not only peripherally, but also centrally, evoked swallowing. Experiments were carried out on 24 adult male Japanese white rabbits. JORs were evoked by trigeminal stimulation at 1 Hz for 30 sec. In the middle 10 sec, either the superior laryngeal nerve (SLN) or cortical swallowing area (Cx) was simultaneously stimulated to evoke swallowing. The peak-to-peak JOR amplitude was reduced during the middle and late 10-sec periods (i.e., during and after SLN or Cx stimulation), and the reduction was dependent on the current intensity of SLN/Cx stimulation: greater SLN/Cx stimulus current resulted in greater JOR inhibition. The reduction rate was significantly greater during Cx stimulation than during SLN stimulation. The amplitude returned to baseline 2 min after 10-sec SLN/Cx stimulation. The effect of co-stimulation of SLN and Cx was significantly greater than that of SLN stimulation alone. There were no significant differences in any parameters of the JCR between conditions. These results clearly showed that JOR responses were significantly suppressed, not only during peripherally evoked swallowing but also during centrally evoked swallowing, and that the inhibitory effect is likely to be larger during centrally compared with peripherally evoked swallowing. The functional implications of these results are discussed. Copyright © 2018. Published by Elsevier B.V.

Cine-MRI swallowing evaluation after tongue reconstruction

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Hartl, Dana M. [Department of Otolaryngology-Head and Neck Surgery, Institute Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)], E-mail: dmhartl@aol.com; Kolb, Frederic; Bretagne, Evelyne [Department of Otolaryngology-Head and Neck Surgery, Institute Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France); Bidault, Francois; Sigal, Robert [Department of Radiology, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)

2010-01-15

Objective: To determine the feasibility of cine-MRI for non-invasive swallowing evaluation after surgery for lingual carcinoma with reconstruction using microvascular free flaps. Methods: Ten patients with stage IV carcinoma of the mobile tongue and/or tongue base treated by surgical resection and reconstruction with a free flap were evaluated after an average of 4.3 years (range: 1.5-11 years), using cine-MRI in 'single-shot fast spin echo' (SSFSE) mode. Fiberoptic laryngoscopy of swallowing was performed before MRI to detect aspiration. The tolerance and ability to complete the exam were noted. The mobilities of the oral and pharyngeal structures visualized were evaluated as normal, reduced or increased. Results: Cine-MRI was well tolerated in all cases; 'dry' swallow was performed for the 2 patients with clinical aspiration. Tongue base-pharyngeal wall contact was observed in 5 cases. An increased anterior tongue recoil, increased mandibular recoil, increased posterior oropharyngeal wall advancement and an increased laryngeal elevation were observed in 4 cases. One case of a passive 'slide' mechanism was observed. Conclusions: Cine-MRI is a safe, non-invasive technique for the evaluation of the mobility of oral and oropharyngeal structures after free-flap reconstruction of the tongue. For selected cases, it may be complementary to clinical examination for evaluation of dysphagia after surgery and free-flap reconstruction. Further technical advances will be necessary before cine-MRI can replace videofluoroscopy, however.

Cine-MRI swallowing evaluation after tongue reconstruction

International Nuclear Information System (INIS)

Hartl, Dana M.; Kolb, Frederic; Bretagne, Evelyne; Bidault, Francois; Sigal, Robert

2010-01-01

Objective: To determine the feasibility of cine-MRI for non-invasive swallowing evaluation after surgery for lingual carcinoma with reconstruction using microvascular free flaps. Methods: Ten patients with stage IV carcinoma of the mobile tongue and/or tongue base treated by surgical resection and reconstruction with a free flap were evaluated after an average of 4.3 years (range: 1.5-11 years), using cine-MRI in 'single-shot fast spin echo' (SSFSE) mode. Fiberoptic laryngoscopy of swallowing was performed before MRI to detect aspiration. The tolerance and ability to complete the exam were noted. The mobilities of the oral and pharyngeal structures visualized were evaluated as normal, reduced or increased. Results: Cine-MRI was well tolerated in all cases; 'dry' swallow was performed for the 2 patients with clinical aspiration. Tongue base-pharyngeal wall contact was observed in 5 cases. An increased anterior tongue recoil, increased mandibular recoil, increased posterior oropharyngeal wall advancement and an increased laryngeal elevation were observed in 4 cases. One case of a passive 'slide' mechanism was observed. Conclusions: Cine-MRI is a safe, non-invasive technique for the evaluation of the mobility of oral and oropharyngeal structures after free-flap reconstruction of the tongue. For selected cases, it may be complementary to clinical examination for evaluation of dysphagia after surgery and free-flap reconstruction. Further technical advances will be necessary before cine-MRI can replace videofluoroscopy, however.

Aphonia and dysphagia after gastrectomy.

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Ozawa, Hiroyuki; Satako, Kimura; Mizutari, Kunio; Fujimine, Takekatsu; Fujii, Masato; Syunji, Ikeuchi; Matunaga, Tatsuo; Tsunoda, Koichi

2005-11-01

A 67-year-old male was referred to our otolaryngological clinic because of aphonia and dysphagia. His voice was breathy and he could not even swallow saliva following a total gastrectomy for gastric carcinoma performed 2 weeks previously. Laryngeal fiberscopy revealed major glottal incompetence when he tried to phonate. However, both vocal folds abducted over the full range during inhalation. The patient could not swallow saliva because of a huge glottal chink, even during phonation. Based on these findings, he was diagnosed as having bilateral incomplete cricoarytenoid dislocation after intubation. The patient underwent speech therapy; within 1 min his vocal fold movement recovered dramatically and he was able to phonate and swallow. There have been few case reports of bilateral cricoarytenoid dislocation, and no effective rehabilitation has been reported. We believe that our method of vocal rehabilitation serves as a useful reference for physicians and surgeons worldwide.

Cannabinoids facilitate the swallowing reflex elicited by the superior laryngeal nerve stimulation in rats.

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Rahman Md Mostafeezur

Full Text Available Cannabinoids have been reported to be involved in affecting various biological functions through binding with cannabinoid receptors type 1 (CB1 and 2 (CB2. The present study was designed to investigate whether swallowing, an essential component of feeding behavior, is modulated after the administration of cannabinoid. The swallowing reflex evoked by the repetitive electrical stimulation of the superior laryngeal nerve in rats was recorded before and after the administration of the cannabinoid receptor agonist, WIN 55-212-2 (WIN, with or without CB1 or CB2 antagonist. The onset latency of the first swallow and the time intervals between swallows were analyzed. The onset latency and the intervals between swallows were shorter after the intravenous administration of WIN, and the strength of effect of WIN was dose-dependent. Although the intravenous administration of CB1 antagonist prior to intravenous administration of WIN blocked the effect of WIN, the administration of CB2 antagonist did not block the effect of WIN. The microinjection of the CB1 receptor antagonist directly into the nucleus tractus solitarius (NTS prior to intravenous administration of WIN also blocked the effect of WIN. Immunofluorescence histochemistry was conducted to assess the co-localization of CB1 receptor immunoreactivity to glutamic acid decarboxylase 67 (GAD67 or glutamate in the NTS. CB1 receptor was co-localized more with GAD67 than glutamate in the NTS. These findings suggest that cannabinoids facilitate the swallowing reflex via CB1 receptors. Cannabinoids may attenuate the tonic inhibitory effect of GABA (gamma-aminobuteric acid neurons in the central pattern generator for swallowing.

A population-based study of how children are exposed to saliva in KwaZulu-Natal Province, South Africa: implications for the spread of saliva-borne pathogens to children

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Butler, L. M.; Neilands, T. B.; Mosam, A.; Mzolo, S.; Martin, J. N.

2014-01-01

Summary Objectives In sub-Saharan Africa, many viral infections, including Epstein–Barr virus, cytomegalovirus, Kaposi’s sarcoma-associated herpesvirus and hepatitis B are acquired in childhood. While saliva is an important transmission conduit for these viruses, little is known about how saliva is passed to African children. We endeavoured to identify the range and determinants of acts by which African children are exposed to saliva. Methods To identify the range of acts by which African children are exposed to saliva, we conducted focus groups, semi-structured interviews and participant observations in an urban and a rural community in South Africa. To measure the prevalence and determinants of the identified acts, we administered a questionnaire to a population-based sample of caregivers. Results We identified 12 caregiving practices that expose a child’s oral–respiratory mucosa, cutaneous surfaces or anal–rectal mucosa to saliva. Several acts were heretofore not described in the contemporary literature (e.g., caregiver inserting finger lubricated with saliva into child’s rectum to relieve constipation). Among 896 participants in the population-based survey, many of the acts were commonly practised by all respondent types (mothers, fathers, grandmothers and siblings). The most common were premastication of food, sharing sweets and premastication of medicinal plants that are spit onto a child’s body. Conclusions African children are exposed to saliva through a variety of acts, practised by a variety of caregivers, with no single predominant practice. This diversity poses challenges for epidemiologic work seeking to identify specific saliva-passing practices that transmit viruses. Most acts could be replaced by other actions and are theoretically preventable. PMID:20149165

Auditory Verbal Cues Alter the Perceived Flavor of Beverages and Ease of Swallowing: A Psychometric and Electrophysiological Analysis

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Aya Nakamura

2013-01-01

Full Text Available We investigated the possible effects of auditory verbal cues on flavor perception and swallow physiology for younger and elder participants. Apple juice, aojiru (grass juice, and water were ingested with or without auditory verbal cues. Flavor perception and ease of swallowing were measured using a visual analog scale and swallow physiology by surface electromyography and cervical auscultation. The auditory verbal cues had significant positive effects on flavor and ease of swallowing as well as on swallow physiology. The taste score and the ease of swallowing score significantly increased when the participant’s anticipation was primed by accurate auditory verbal cues. There was no significant effect of auditory verbal cues on distaste score. Regardless of age, the maximum suprahyoid muscle activity significantly decreased when a beverage was ingested without auditory verbal cues. The interval between the onset of swallowing sounds and the peak timing point of the infrahyoid muscle activity significantly shortened when the anticipation induced by the cue was contradicted in the elderly participant group. These results suggest that auditory verbal cues can improve the perceived flavor of beverages and swallow physiology.

Patient-reported symptom questionnaires in laryngeal cancer: voice, speech and swallowing.

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Rinkel, R N P M; Verdonck-de Leeuw, I M; van den Brakel, N; de Bree, R; Eerenstein, S E J; Aaronson, N; Leemans, C R

2014-08-01

To validate questionnaires on voice, speech, and swallowing among laryngeal cancer patients, to assess the need for and use of rehabilitation services, and to determine the association between voice, speech, and swallowing problems, and quality of life and distress. Laryngeal cancer patients at least three months post-treatment completed the VHI (voice), SHI (speech), SWAL-QOL (swallowing), EORTC QLQ-C30, QLQ-HN35, HADS, and study-specific questions on rehabilitation. Eighty-eight patients and 110 healthy controls participated. Cut off scores of 15, 6, and 14 were defined for the VHI, SHI, and SWAL-QOL (sensitivity > 90%; specificity > 80%). Based on these scores, 56% of the patients reported voice, 63% speech, and 54% swallowing problems. VHI, SHI, and SWAL-QOL scores were associated significantly with quality of life (EORTC QLQ-C30 global quality of life scale) (r = .43 (VHI and SHI) and r = .46 (SWAL-QOL)) and distress (r = .50 (VHI and SHI) and r = .58 (SWAL-QOL)). In retrospect, 32% of the patients indicated the need for rehabilitation at time of treatment, and 81% of these patients availed themselves of such services. Post-treatment, 8% of the patients expressed a need for rehabilitation, and 20% of these patients actually made use of such services. Psychometric characteristics of the VHI, SHI, and SWAL-QOL in laryngeal cancer patients are good. The prevalence of voice, speech, and swallowing problems is high, and clearly related to quality of life and distress. Although higher during than after treatment, the perceived need for and use of rehabilitation services is limited. Copyright © 2014 Elsevier Ltd. All rights reserved.

CHROMOGRANIN A DETECTION IN SALIVA OF TYPE 2 DIABETES PATIENTS

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Martine Soell

2010-02-01

Full Text Available Chromogranin A is present in secretion granules of nerve, endocrine and immune cells and is a precursor of several peptides with antibacterial and antifungal properties at micromolar concentrations.Our aim in this prospective, double blind study, was to determine the expression of chromogranin A and its peptides at protein level in saliva of type 2 diabetic patients and thereby to obtain a new non-invasive diagnostic means for the future.Saliva was taken from 30 type 2 diabetic patients and 30 healthy individuals at the same time interval in the morning without any oral stimuli. Circadianic periodics in protein productions have been avoided. The presence of chromogranin A and its derived peptides was determined in whole saliva, after centrifugation at 40C for 12 min at 14 000 rpm, by SDS-PAGE electrophoresis and Immunoblotting (Western Blot. To ensure same protein concentrations Bradford protein quantification assay has been performed before.For the first time, we have determined an overexpression of chromogranin A in saliva of diabetic patients in 100% of the individuals.Chromogranin A, a circulating biomarker for epithelial tumours, is also overexpressed in saliva of type 2 diabetic patients. To confirm our results, more studies with a large amount of patients is necessary.

Chromogranin A Detection in Saliva of Type 2 Diabetes Patients

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Martine Soell

2010-02-01

Full Text Available Chromogranin A is present in secretion granules of nerve, endocrine and immune cells and is a precursor of several peptides with antibacterial and antifungal properties at micromolar concentrations.Our aim in this prospective, double blind study, was to determine the expression of chromogranin A and its peptides at protein level in saliva of type 2 diabetic patients and thereby to obtain a new non-invasive diagnostic means for the future.Saliva was taken from 30 type 2 diabetic patients and 30 healthy individuals at the same time interval in the morning without any oral stimuli. Circadianic periodics in protein productions have been avoided. The presence of chromogranin A and its derived peptides was determined in whole saliva, after centrifugation at 4°C for 12 min at 14 000 rpm, by SDS-PAGE electrophoresis and Immunoblotting (Western Blot. To ensure same protein concentrations Bradford protein quantification assay has been performed before.For the first time, we have determined an overexpression of chromogranin A in saliva of diabetic patients in 100% of the individuals.Chromogranin A, a circulating biomarker for epithelial tumours, is also overexpressed in saliva of type 2 diabetic patients. To confirm our results, more studies with a large amount of patients is necessary.

Dysphagia management: an analysis of patient outcomes using VitalStim therapy compared to traditional swallow therapy.

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Kiger, Mary; Brown, Catherine S; Watkins, Lynn

2006-10-01

This study compares the outcomes using VitalStim therapy to outcomes using traditional swallowing therapy for deglutition disorders. Twenty-two patients had an initial and a followup videofluoroscopic swallowing study or fiberoptic endoscopic evaluation of swallowing and were divided into an experimental group that received VitalStim treatments and a control group that received traditional swallowing therapy. Outcomes were analyzed for changes in oral and pharyngeal phase dysphagia severity, dietary consistency restrictions, and progression from nonoral to oral intake. Results of chi(2) analysis showed no statistically significant difference in outcomes between the experimental and control groups.

Some Biological Activities of Malaysian Leech Saliva Extract

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Abdualrahman M. Abdualkader; Ahmed Merzouk; Abbas Mohammed Ghawi; and Mohammed Alaama

2011-01-01

Leeches were fed on the phagostimulatory solution through parafilm membrane. The satiated leeches were forced to regurgitate the solution by soaking them in an ice-container. The anticoagulant activity was ascertained using thrombin time assay (TT). The result revealed that the saliva concentration which increases TT by 100% (IC100) is 43.205µg/ml plasma. The antimicrobial activity of the saliva was tested against several bacterial spp. (E.coli, P.aeruginosa, B.cereus, Sal.typhi and S...

Pengaruh Berkumur Air Kelapa Muda Terhadap Ph Saliva

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Mokoginta, Zuthra P

2017-01-01

PENGARUH BERKUMUR AIR KELAPA MUDA TERHADAP pH SALIVA Zuthra P. Mokoginta1) , Vonny N.S. Wowor1) , Juliatri1) 1)Program Studi Pendidikan Dokter Gigi, Fakultas Kedokteran UNSRAT Manado, 95115 ABSTRACT Saliva is one factor that contributes to the development of caries, particularly in the process of demineralization. The low pH in the oral cavity will facilitate the growth of acidogenic bacteria such as Streptococcus mutans and Lactobacillus which is the main cause microorganisms in th...

Speech and swallowing outcomes in buccal mucosa carcinoma

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Sunila John

2011-01-01

Full Text Available Buccal carcinoma is one of the most common malignant neoplasms among all oral cancers in India. Understanding the role of speech language pathologists (SLPs in the domains of evaluation and management strategies of this condition is limited, especially in the Indian context. This is a case report of a young adult with recurrent squamous cell carcinoma of the buccal mucosa with no deleterious habits usually associated with buccal mucosa carcinoma. Following composite resection, pectoralis major myocutaneous flap reconstruction, he developed severe oral dysphagia and demonstrated unintelligible speech. This case report focuses on the issues of swallowing and speech deficits in buccal mucosa carcinoma that need to be addressed by SLPs, and the outcomes of speech and swallowing rehabilitation and prognostic issues.

Electrochemical behavior and pH stability of artificial salivas for corrosion tests.

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Queiroz, Gláucia Maria Oliveira de; Silva, Leandro Freitas; Ferreira, José Tarcísio Lima; Gomes, José Antônio da Cunha P; Sathler, Lúcio

2007-01-01

It is assumed that the compositions of artificial salivas are similar to that of human saliva. However, the use of solutions with different compositions in in vitro corrosion studies can lead dissimilar electrolytes to exhibit dissimilar corrosivity and electrochemical stability. This study evaluated four artificial salivas as regards pH stability with time, redox potentials and the polarization response of an inert platinum electrode. The tested solutions were: SAGF medium, Mondelli artificial saliva, UFRJ artificial saliva (prepared at the School of Pharmacy, Federal University of Rio de Janeiro, RJ, Brazil) and USP-RP artificial saliva (prepared at the School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, SP, Brazil). It was observed that pH variations were less than 1 unit during a 50-hour test. The SAGF medium, and the UFRJ and USP-RP solutions exhibited more oxidizing characteristics, whereas the Mondelli solution presented reducing properties. Anodic polarization revealed oxidation of the evaluated electrolytes at potentials below +600 mV SCE. It was observed that the UFRJ and USP-RP solutions presented more intense oxidation and reduction processes as compared to the Mondelli and SAGF solutions.

Visualization of swallowing using real-time TrueFISP MR fluoroscopy

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Barkhausen, Joerg; Goyen, Mathias; Lauenstein, Thomas; Debatin, Joerg F. [Department of Diagnostic Radiology, University Hospital Essen (Germany); Winterfeld, F. von; Arweiler-Harbeck, Diana [Department of Otorhinolaryngology, University Hospital Essen (Germany)

2002-01-01

The aim of this study was to evaluate the ability of different real-time true fast imaging with steady precession (TrueFISP) sequences regarding their ability to depict the swallowing process and delineate oropharyngeal pathologies in patients with dysphagia. Real-time TrueFISP visualization of swallowing was performed in 8 volunteers and 6 patients with dysphagia using a 1.5 T scanner (Magnetom Sonata, Siemens, Erlangen Germany) equipped with high-performance gradients (amplitude 40 mT/m). Image quality of four different real-time TrueFISP sequences (TR 2.2-3.0 ms, TE 1.1-1.5 ms, matrix 63 x 128-135 x 256, field of view 250 mm{sup 2}, acquisition time per image 139-405 ms) was evaluated. Water, yoghurt, and semolina pudding were assessed as oral contrast agents. Functional exploration of the oropharyngeal apparatus was best possible using the fastest real-time TrueFISP sequence (TR 2.2 ms, TE 1.1 ms, matrix 63 x 128). Increased acquisition time resulted in blurring of anatomical structures. As the image contrast of TrueFISP sequences depends on T2/T1 properties, all tested foodstuff were well suited as oral contrast agents, but image quality was best using semolina pudding. Real-time visualization of swallowing is possible using real-time TrueFISP sequences in conjunction with oral contrast agents. For the functional exploration of swallowing high temporal resolution is more crucial than spatial resolution. (orig.)

Evaluation of swallowing disorders with videofluoroscopy in Austria: a survey

International Nuclear Information System (INIS)

Eisenhuber, Edith; Schima, Wolfgang; Stadler, Alfred; Schober, Ewald; Schibany, Nadja; Denk, Doris-Maria

2005-01-01

Aim: The aim of our study was to assess the availability of videofluoroscopy to examine patients with swallowing disorders in Austria. Materials and methods: A questionnaire was sent to the department heads of the radiology departments of all hospitals (n=143) and to all non-hospital-based radiologic practices (n=226) throughout Austria. The survey focused on the availability of videofluoroscopic swallowing studies and on the studies performed in patients with deglutition disorders. Results: The questionnaire was completed and returned by 134 of 143 radiology departments (94%) and 65 of 226 non-hospital-based radiologists (29%). Videofluoroscopic swallowing studies were performed in 38 of 134 radiology departments (28%) and in 21 of 65 practices (32%). The method is available in all nine Austrian states (100%) and 27 of 99 districts (27%). The number of examinations performed in different states ranged from 0.7 to 19 studies/10,000 population per year. The number of videofluoroscopic examinations per department or practice in the year 2001 ranged between 5 and 690 (median, 100 examinations). To 85% of videofluoroscopy units patients were referred from otorhinolaryngology/phoniatrics-logopedics, to 69% of videofluoroscopy units referrals were also from internal medicine, from neurology in 54%, and from pediatrics in 20%. Conclusion: Despite the widespread availability of videofluoroscopy throughout Austria, its use still varies largely between different states. The data show that in general there is a wide-spread demand for videofluoroscopic swallowing studies

Effect of acid swallowing on esophageal contraction in patients with heartburn related to hypersensitivity.

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Lee, Hyuk; Lee, Sang Kil; Park, Jun Chul; Shin, Sung Kwan; Lee, Yong Chan

2013-01-01

There are heterogeneous subgroups among those with heartburn, and data on these individuals are relatively scant. We aimed to evaluate the effect of acid challenge on the segmental contractions of esophageal smooth muscle in endoscopy-negative patients with normal esophageal acid exposure. High-resolution esophageal manometry (HRM) was performed on 30 endoscopy-negative patients with heartburn accompanied by normal esophageal acid exposure using 10 water swallows followed by 10 acidic pomegranate juice swallows. Patients were classified into functional heartburn (FH) and hypersensitive esophagus (HE) groups based on the results of 24-hr impedance pH testing. HRM topographic plots were analyzed and maximal wave amplitude and pressure volumes were measured for proximal and distal smooth muscle segments. The pressure volume of the distal smooth muscle segment in the HE group measured during acidic swallows was higher than during water swallows (2224.1 ± 68.2 mmHg/cm per s versus 2105.6 ± 66.4 mmHg/cm per s, P = 0.027). A prominent shift in the pressure volume to the distal smooth muscle segment was observed in the HE group compared with the FH group (segmental ratio: 2.72 ± 0.08 versus 2.39 ± 0.07, P = 0.005). Manometric measurements during acidic swallows revealed that this shift was augmented in the HE group. The optimal ratio of pomegranate juice swallowing for discrimination of FH from HE was 2.82, with a sensitivity of 88.9% and a specificity of 100%. Hypercontractile response of distal smooth muscle segment to acid swallowing was more prominent in the HE group than the FH group. © 2012 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Candida in saliva of Brazilian hemophilic patients Candida na saliva de pacientes hemofílicos brasileiros

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Claudio Maranhão Pereira

2004-12-01

Full Text Available Hemophilia is a common hereditary hemorrhagic disorder, however little is known about the oral microflora of hemophilic patients. The aim of this study was to quantify the Candida and identify its species in non-stimulated saliva of hemophilic patients, and consider its relationship with clinical factors influencing Candida carriage. This study comprised evaluation of 86 hemophilic patients of the Hematology Center/UNICAMP and 43 healthy subjects as controls. All patients were submitted to anamnesis, intraoral examination and unstimulated saliva collection. Candida counts and species identification were performed in salivary samples. Candida was present in 64% of the hemophilic patients and in 44% of the healthy controls. C. albicans represented 65% and 68% of the isolated species, in hemophiliacs and control group respectively, and C. tropicalis was the second most common species in both groups. These results indicate that hemophilic patients carry Candida more frequently and in higher counts than healthy controls, independently of oral clinical parameter considered, as viral infections, complete dentures, transfusions of hemoderivatives, and salivary flow.Hemofilia é uma alteração hemorrágica hereditária comum, entretanto pouco se sabe a respeito da microbiota oral destes indivíduos. O objetivo deste estudo foi quantificar a presença de Candida e identificar as suas espécies na saliva de hemofílicos, correlacionando os resultados com fatores clínicos que possam influenciar a presença deste fungo. Foram avaliados 86 hemofílicos do Hemocentro/UNICAMP e 43 indivíduos saudáveis. Todos os pacientes foram submetidos a anamnese, exame clínico intra-oral e coleta de saliva de forma não estimulada. A quantificação e identificação das espécies de Candida foram realizadas nas amostras de saliva. Candida estava presente em 64% dos hemofílicos e em 44% dos indivíduos saudáveis. C. albicans representou 65% e 68% das esp

Non-invasive monitoring of chewing and swallowing for objective quantification of ingestive behavior

International Nuclear Information System (INIS)

Sazonov, Edward; Schuckers, Stephanie; Lopez-Meyer, Paulo; Makeyev, Oleksandr; Sazonova, Nadezhda; Melanson, Edward L; Neuman, Michael

2008-01-01

A methodology of studying of ingestive behavior by non-invasive monitoring of swallowing (deglutition) and chewing (mastication) has been developed. The target application for the developed methodology is to study the behavioral patterns of food consumption and producing volumetric and weight estimates of energy intake. Monitoring is non-invasive based on detecting swallowing by a sound sensor located over laryngopharynx or by a bone-conduction microphone and detecting chewing through a below-the-ear strain sensor. Proposed sensors may be implemented in a wearable monitoring device, thus enabling monitoring of ingestive behavior in free-living individuals. In this paper, the goals in the development of this methodology are two-fold. First, a system comprising sensors, related hardware and software for multi-modal data capture is designed for data collection in a controlled environment. Second, a protocol is developed for manual scoring of chewing and swallowing for use as a gold standard. The multi-modal data capture was tested by measuring chewing and swallowing in 21 volunteers during periods of food intake and quiet sitting (no food intake). Video footage and sensor signals were manually scored by trained raters. Inter-rater reliability study for three raters conducted on the sample set of five subjects resulted in high average intra-class correlation coefficients of 0.996 for bites, 0.988 for chews and 0.98 for swallows. The collected sensor signals and the resulting manual scores will be used in future research as a gold standard for further assessment of sensor design, development of automatic pattern recognition routines and study of the relationship between swallowing/chewing and ingestive behavior

Non-invasive monitoring of chewing and swallowing for objective quantification of ingestive behavior.

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Sazonov, Edward; Schuckers, Stephanie; Lopez-Meyer, Paulo; Makeyev, Oleksandr; Sazonova, Nadezhda; Melanson, Edward L; Neuman, Michael

2008-05-01

A methodology of studying of ingestive behavior by non-invasive monitoring of swallowing (deglutition) and chewing (mastication) has been developed. The target application for the developed methodology is to study the behavioral patterns of food consumption and producing volumetric and weight estimates of energy intake. Monitoring is non-invasive based on detecting swallowing by a sound sensor located over laryngopharynx or by a bone-conduction microphone and detecting chewing through a below-the-ear strain sensor. Proposed sensors may be implemented in a wearable monitoring device, thus enabling monitoring of ingestive behavior in free-living individuals. In this paper, the goals in the development of this methodology are two-fold. First, a system comprising sensors, related hardware and software for multi-modal data capture is designed for data collection in a controlled environment. Second, a protocol is developed for manual scoring of chewing and swallowing for use as a gold standard. The multi-modal data capture was tested by measuring chewing and swallowing in 21 volunteers during periods of food intake and quiet sitting (no food intake). Video footage and sensor signals were manually scored by trained raters. Inter-rater reliability study for three raters conducted on the sample set of five subjects resulted in high average intra-class correlation coefficients of 0.996 for bites, 0.988 for chews and 0.98 for swallows. The collected sensor signals and the resulting manual scores will be used in future research as a gold standard for further assessment of sensor design, development of automatic pattern recognition routines and study of the relationship between swallowing/chewing and ingestive behavior.

Comparison of Masticatory and Swallowing Functional Outcomes in Surgically and Prosthetically Rehabilitated Maxillectomy Patients.

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Sreeraj, R; Krishnan, Vinod; V, Manju; Thankappan, Krishnakumar

This study compared masticatory and swallowing functional outcomes in maxillectomy patients who underwent surgical and prosthetic rehabilitation or prosthetic rehabilitation only following surgical resection. This comparative cross-sectional study involved 20 maxillectomy patients and compared their masticatory and swallowing functions following combined surgical and prosthodontic management vs an exclusively prosthodontic approach. Masticatory performance was measured by an originally modified sieve method using hydrocolloid material, and video fluoroscopic examination was employed for swallowing assessments. Masticatory performance was significantly better in the patient group treated with flaps and removable denture prostheses compared to patients treated with obturator prosthesis alone. Swallowing outcomes were comparable in both groups. Flap reconstruction followed by an obturator prosthesis seems to be a preferable option when planning for functional rehabilitation in maxillectomy patients. Further research is needed to substantiate the functional outcomes noted in this study.

Comparison of endoscopy and barium swallow with marshmallow in dysphagia.

Science.gov (United States)

Somers, S; Stevenson, G W; Thompson, G

1986-06-01

Forty-four patients with dysphagia were examined both by endoscopy and by barium swallow with a marshmallow bolus. In these patients 36 stenoses were found: 34 by radiology and 30 by endoscopy. The radiologic criteria for stenosis included arrest of the marshmallow in a manner to support a column of barium and reproduction of the patient's symptoms at the time this occurred. Radiologic false negative findings were partly due to an inability by patients to swallow an adequate marshmallow bolus; endoscopic failures were associated with small endoscopes and mild stenoses.

Speech, language and swallowing in Huntington’ Disease

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Maryluz Camargo-Mendoza

2017-04-01

Full Text Available Huntington’s disease (HD has been described as a genetic condition caused by a mutation in the CAG (cytosine-adenine-guanine nucleotide sequence. Depending on the stage of the disease, people may have difficulties in speech, language and swallowing. The purpose of this paper is to describe these difficulties in detail, as well as to provide an account on speech and language therapy approach to this condition. Regarding speech, it is worth noticing that characteristics typical of hyperkinetic dysarthria can be found due to underlying choreic movements. The speech of people with HD tends to show shorter sentences, with much simpler syntactic structures, and difficulties in tasks that require complex cognitive processing. Moreover, swallowing may present dysphagia that progresses as the disease develops. A timely, comprehensive and effective speech-language intervention is essential to improve the quality of life of people and contribute to their communicative welfare.

Effects of carbonated liquid on swallowing dysfunction in dementia with Lewy bodies and Parkinson’s disease dementia

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Larsson V

2017-08-01

Full Text Available Victoria Larsson,1 Gustav Torisson,1,2 Margareta Bülow,3 Elisabet Londos1 1Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, 2Department of Infectious Diseases, 3Diagnostic Centre of Imaging and Functional Medicine, Skåne University Hospital, Malmö, Sweden Background: Swallowing dysfunction is an increasingly recognized problem in patients with dementia with Lewy bodies (DLB and Parkinson’s disease dementia (PDD, which can result in aspiration pneumonia and death. Few studies have examined potential ways of improving swallowing function in this fragile patient group. The aim of this study was to evaluate swallowing dysfunction and carbonated liquid using videofluoroscopy in DLB and PDD patients. Methods: A total of 48 patients with DLB and PDD were referred for a clinical examination with videofluoroscopy. Descriptive overall assessments were provided at the time of the examination regarding swallowing function and the effects of different modifications, including carbonated thin liquid (CTL. Additionally, a repeated measures quantitative retrospective analysis has been performed comparing 1 thin liquids; 2 thickened liquids and 3 CTLs, with regard to the quantitative variables 1 pharyngeal transit time (PTT; 2 pharyngeal retention and 3 tracheal penetration. Results: In all, 40/48 (83% of the patients had a swallowing dysfunction, which was confirmed on videofluoroscopy, with 34/40 (85% patients having a pharyngeal-type dysfunction. A total of 14/40 (35% patients with an objective swallowing impairment did not have any subjective swallowing symptoms. Out of the patients with swallowing dysfunction, 87% had an overall improved swallowing function with carbonated liquid. PTT for carbonated liquid (median 633 ms, interquartile range [IQR] 516–786 ms was quicker than for thin liquid (760 ms, IQR 613–940 ms, P=0.014 and thickened liquid (880.0 ms, IQR 600–1,500 ms, P<0.001. No significant effect

Preliminary findings on the correlation of saliva pH, buffering ...

African Journals Online (AJOL)

The aim of the present comparative study was to compare some salivary characteristics between exclusive waterpipe smokers (EWPS) and non-smokers. 72 males (36 EWPS) were recruited. The volume of stimulated saliva was determined and divided by the duration of saliva collection. The pH was measured directly ...

Effects of different tastants on parotid saliva flow and composition

NARCIS (Netherlands)

Neyraud, E.; Heinzerling, C.I.; Bult, J.H.F.; Mesmin, C.; Dransfield, E.

2009-01-01

Saliva from parotid glands plays a role in taste perception. Parotid saliva is also stimulated by tastants. The aim of this work is to investigate the effects of different tastants on the parotid salivary response in six subjects. Five tastants were given in different concentrations in solution and

Therapeutic effect of acupuncture combining standard swallowing training for post-stroke dysphagia: A prospective cohort study.

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Mao, Li-Ya; Li, Li-Li; Mao, Zhong-Nan; Han, Yan-Ping; Zhang, Xiao-Ling; Yao, Jun-Xiao; Li, Ming

2016-07-01

To assess the therapeutic effect of acupuncture combining standard swallowing training for patients with dysphagia after stroke. A total of 105 consecutively admitted patients with post-stroke dysphagia in the Affiliated Hospital of Gansu University of Chinese Medicine were included: 50 patients from the Department of Neurology and Rehabilitation received standard swallowing training and acupuncture treatment (acupuncture group); 55 patients from the Department of Neurology received standard swallowing training only (control group). Participants in both groups received 5-day therapy per week for a 4-week period. The primary outcome measures included the scores of Videofluoroscopic Swallow Study (VFSS) and the Standardized Swallowing Assessment (SSA); the secondary outcome measure was the Royal Brisbane Hospital Outcome Measure for Swallowing (RBHOMS), all of which were assessed before and after the 4-week treatment. A total of 98 subjects completed the study (45 in the acupuncture group and 53 in the control group). Significant differences were seen in VFSS, SSA and RBHOMS scores in each group after 4-week treatment as compared with before treatment (Pdysphagia, and acupuncture therapy is worth further investigation in the treatment of post-stroke dysphagia.

INFLUENCE OF SYSTEMIC DISEASES AND REMOVABLE ORTHODONTIC APPLIANCES ON THE QUALITY OF SALIVA IN CHILDHOOD.

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Maya Rashkova

2012-03-01

Full Text Available During the last 10 years numerous investigations using saliva as a diagnostic tool have been carried out. The aim of present study is to evaluate saliva qualities for various general diseases and conditions that influence its qualities. (1 Evaluation of salivary flow and saliva consistency of children. (2 Evaluation of saliva pH and buffer capacity of children. Material and Methods. The investigation was carried out with 126 children (age 6 to 17 selected by their general diseases and conditions influencing the oral risk environment. The children were divided into 4 groups: 30 children with diabetes, 25 children with asthma treated with local corticosteroids, 27 healthy children with orthodontic treatment, 34 children as a control group (healthy children. The saliva of the children was tested with the help of “Saliva Check” of GC company. The instructions of the company producer were followed.Results. Stimulated saliva current is reliably lower for children with asthma treated with local corticosteroids, diabetes and children with orthodontic appliances. Saliva pH is with lower values for children with diabetes and asthma – diseases predisposing to acid oral environment. The decreased saliva buffer capacity for children with diabetes and asthma is an indicator for the difficult regulation of the dynamically changing oral electrolytic balance of those children.Conclusion. The saliva parameters studied can be used as biomarkers of the liquid oral environment with regard to the risks for caries and periodontal diseases in children. General health status influences saliva qualities increasing thus indirectly the caries risk.

Creatine metabolism: detection of creatine and guanidinoacetate in saliva of healthy subjects.

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Martínez, Lidia D; Bezard, Miriam; Brunotto, Mabel; Dodelson de Kremer, Raquel

2016-04-01

Creatine (Cr) plays an important role in storage and transmission of phosphate-bound energy. Cerebral creatine deficiency syndromes comprise three inherited defects in Cr biosynthesis and transport. The aim of this study was to investigate whether Cr and Guanidinoacetate (GAA) can be detected in saliva of healthy subjects and to establish the relationship between salivary and plasma levels of these molecules. An adapted gas chromatography (GC) method is described for the quantification of Cr and GAA biomarkers in saliva. Reference values were established for GAA and Cr in saliva. These values were age dependent (p= 0.001). No difference between genders was observed. We detected a difference between GAA and Cr concentrations in saliva and in plasma. The GC method for simultaneous determination of GAA and Cr in human saliva is fast, reliable, sensitive, non-invasive and precise to use as a biochemical approach in early detection of cerebral creatine deficiency syndromes. Sociedad Argentina de Investigación Odontológica.

Fiber-optic endoscopic evaluation of swallowing (FEES): predictor of swallowing-related complications in the head and neck cancer population.

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Deutschmann, Michael W; McDonough, Alanna; Dort, Joseph C; Dort, Erika; Nakoneshny, Steve; Matthews, T Wayne

2013-07-01

The treatment of head and neck cancer is associated with significant dysphagia and morbidity. Prescribing a safe oral diet in this population is challenging. Data from 116 consecutive patients having 189 fiber-optic endoscopic evaluation of swallowing (FEES) examinations over a 3-year period were analyzed. All patients had been treated for head and neck cancer and subsequently were assessed by FEES. The primary outcome was the incidence of swallowing-related adverse events resulting from the FEES-based dietary recommendations. There were 10 episodes of aspiration pneumonia, 4 episodes of airway obstruction, 3 unanticipated insertions of gastrostomy tubes, and 2 unexplained deaths within the study period. The overall rate of adverse events was 10.1%. The only statistically significant predictor of adverse events was the Rosenbek score (p = .03). Our experience is that FEES guides appropriate and safe diet recommendations in this population. Copyright © 2012 Wiley Periodicals, Inc.

Oropharyngeal and laryngeal sensory innervation in the pathophysiology of swallowing disorders and sensory stimulation treatments.

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Alvarez-Berdugo, Daniel; Rofes, Laia; Casamitjana, J Francesc; Padrón, Andreína; Quer, Miquel; Clavé, Pere

2016-09-01

Oropharyngeal dysphagia (OD) affects older and neurological patients, causing malnutrition and dehydration and increasing the risk for aspiration pneumonia. There is evidence that sensory deficits in those populations are closely related to swallowing disorders, and several research groups are developing new therapies based on sensory stimulation of this area. More information on the sensory innervation participating in the swallow response is needed to better understand the pathophysiology of OD and to develop new treatments. This review focuses on the sensory innervation of the human oropharynx and larynx in healthy people compared with patients with swallowing disorders in order to unravel the abnormalities that may lead to the loss of sensitivity in patients with OD. We also hypothesize the pathway through which active sensory-enhancement treatments may elicit their therapeutic effect on patients with swallowing dysfunctions. As far as we know, this is the first time a review covers the anatomy, histology, ultrastructure, and molecular biology of the sensory innervation of the swallowing function. © 2016 New York Academy of Sciences.

Influence of artificial saliva in biofilm formation of Candida albicans in vitro

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Michelle Peneluppi Silva

2012-02-01

Full Text Available Due to the increase in life expectancy, new treatments have emerged which, although palliative, provide individuals with a better quality of life. Artificial saliva is a solution that contains substances that moisten a dry mouth, thus mimicking the role of saliva in lubricating the oral cavity and controlling the existing normal oral microbiota. This study aimed to assess the influence of commercially available artificial saliva on biofilm formation by Candida albicans. Artificial saliva I consists of carboxymethylcellulose, while artificial saliva II is composed of glucose oxidase, lactoferrin, lysozyme and lactoperoxidase. A control group used sterile distilled water. Microorganisms from the oral cavity were transferred to Sabouraud Dextrose Agar and incubated at 37°C for 24 hours. Colonies of Candida albicans were suspended in a sterile solution of NaCl 0.9%, and standardisation of the suspension to 106 cells/mL was achieved. The acrylic discs, immersed in artificial saliva and sterile distilled water, were placed in a 24-well plate containing 2 mL of Sabouraud Dextrose Broth plus 5% sucrose and 0.1 mL aliquot of the Candida albicans suspension. The plates were incubated at 37°C for 5 days, the discs were washed in 2 mL of 0.9% NaCl and placed into a tube containing 10 mL of 0.9% NaCl. After decimal dilutions, aliquots of 0.1 mL were seeded on Sabouraud Dextrose Agar and incubated at 37°C for 48 hours. Counts were reported as CFU/mL (Log10. A statistically significant reduction of 29.89% (1.45 CFU/mL of Candida albicans was observed in saliva I when compared to saliva II (p = 0.002, considering p≤0.05.

Pengaruh (pH Saliva terhadap Terjadinya Karies Gigi pada Anak Usia Prasekolah

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Made Ayu Lely

2017-12-01

Full Text Available AbstractDental caries is a multifactorial process that occurs through the interaction between teeth and saliva as host, the bacteria in the oral cavity, as well as easily fermented foods. Saliva is one of the factors that have a major influence on the severity of dental caries. The aim of this study was to determine the relationship of salivary pH with dental caries among 564 preschool-age children in DIY Province and Banten Province. The results showed that pH levels of the preschool-age children’saliva are more than 75% basic ranging between 6.8 to 8.0 and the highest levels are in Serang District. Index def-t in Serang District is highest (8.83 and the lowest one is in Yogyakarta City (4.97. The mean number of cavities/ decay more than missing teeth or filling teeth. The study indicates that the acidity of saliva among preschool children in the two provinces is not associated with the occurrence of dental caries.It is more likely due to the habit of drinking sweet milk or eating sticky foods.Key words: thepH of saliva, dental caries,sweet food, sticky foods, preschool childrenageAbstrakKaries gigi merupakan proses multifaktor yang terjadi melalui interaksi antara gigi dan saliva sebagai pejamu, bakteri didalam rongga mulut, serta makanan yang mudah difermentasikan. Saliva merupakan salah satu faktor yang mempunyai pengaruh besar terhadap keparahan karies gigi. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh pH saliva terhadap terjadinya karies gigi pada anak usia prasekolah. Penelitian dilakukan secara potong lintang pada 564 orang anak usia prasekolah di Provinsi Daerah Istimewa Yogyakarta (Provinsi DIY dan Provinsi Banten. Hasil penelitian menunjukkan bahwa derajat keasaman (pH saliva pada anak-anak usia prasekolah lebih dari 75% bersifat basa berkisar antara 6,8-8,0 dan tertinggi di Kabupaten Serang. Indeks def-t tertinggi 8,83 di Kabupaten Serang dan yang terendah 4,97 di Kotamadya Yogyakarta. Rerata jumlah gigi berlubang

Altered Cortical Swallowing Processing in Patients with Functional Dysphagia: A Preliminary Study

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Wollbrink, Andreas; Warnecke, Tobias; Winkels, Martin; Pantev, Christo; Dziewas, Rainer

2014-01-01

Objective Current neuroimaging research on functional disturbances provides growing evidence for objective neuronal correlates of allegedly psychogenic symptoms, thereby shifting the disease concept from a psychological towards a neurobiological model. Functional dysphagia is such a rare condition, whose pathogenetic mechanism is largely unknown. In the absence of any organic reason for a patient's persistent swallowing complaints, sensorimotor processing abnormalities involving central neural pathways constitute a potential etiology. Methods In this pilot study we measured cortical swallow-related activation in 5 patients diagnosed with functional dysphagia and a matched group of healthy subjects applying magnetoencephalography. Source localization of cortical activation was done with synthetic aperture magnetometry. To test for significant differences in cortical swallowing processing between groups, a non-parametric permutation test was afterwards performed on individual source localization maps. Results Swallowing task performance was comparable between groups. In relation to control subjects, in whom activation was symmetrically distributed in rostro-medial parts of the sensorimotor cortices of both hemispheres, patients showed prominent activation of the right insula, dorsolateral prefrontal cortex and lateral premotor, motor as well as inferolateral parietal cortex. Furthermore, activation was markedly reduced in the left medial primary sensory cortex as well as right medial sensorimotor cortex and adjacent supplementary motor area (pdysphagia - a condition with assumed normal brain function - seems to be associated with distinctive changes of the swallow-related cortical activation pattern. Alterations may reflect exaggerated activation of a widely distributed vigilance, self-monitoring and salience rating network that interferes with down-stream deglutition sensorimotor control. PMID:24586948

Relationships between dysphagia and tongue pressure during swallowing in Parkinson's disease patients.

Science.gov (United States)

Minagi, Y; Ono, T; Hori, K; Fujiwara, S; Tokuda, Y; Murakami, K; Maeda, Y; Sakoda, S; Yokoe, M; Mihara, M; Mochizuki, H

2018-03-25

Although dysphagia is a life-threatening problem in patients with Parkinson's disease (PD), the pathophysiology of oropharyngeal dysphagia is yet to be understood. This study investigated the tongue motor function during swallowing in relation to dysphagia and the severity of PD. Thirty patients with PD (14 males and 16 females; average age, 69.4 years), Hoehn and Yahr stage II-IV, in Osaka University Hospital are participated in this study. During swallowing 5 ml of water, tongue pressure on the hard palate was measured using a sensor sheet with 5 measuring points. The maximal tongue pressure at each measuring point during swallowing was compared between patients with PD and healthy controls. Subjective assessment of oropharyngeal dysphagia was performed using Swallowing Disturbance Questionnaire-Japanese. The maximal tongue pressure at each measuring point was significantly lower in patients with PD than in healthy controls (8 males and 12 females; average age, 71.6 years). Furthermore, the maximal tongue pressure was significantly lower in dysphagic PD patients than non-dysphagic PD patients. Loss of tongue pressure production at the anterior part of the hard palate was strongly related to dysphagia in the oral phase as well as in the pharyngeal phase. An abnormal pattern of tongue pressure production was more frequently observed in dysphagic PD patients than in non-dysphagic PD patients. The results suggest that tongue pressure measurement might be useful for early and quantitative detection of tongue motor disability during swallowing in patients with PD. © 2018 John Wiley & Sons Ltd.

A predictive model for swallowing dysfunction after curative radiotherapy in head and neck cancer

International Nuclear Information System (INIS)

Langendijk, Johannes A.; Doornaert, Patricia; Rietveld, Derek H.F.; Verdonck-de Leeuw, Irma M.; Rene Leemans, C.; Slotman, Ben J.

2009-01-01

Introduction: Recently, we found that swallowing dysfunction after curative (chemo) radiation (CH) RT has a strong negative impact on health-related quality of life (HRQoL), even more than xerostomia. The purpose of this study was to design a predictive model for swallowing dysfunction after curative radiotherapy or chemoradiation. Materials and methods: A prospective study was performed including 529 patients with head and neck squamous cell carcinoma (HNSCC) treated with curative (CH) RT. In all patients, acute and late radiation-induced morbidity (RTOG Acute and Late Morbidity Scoring System) was scored prospectively. To design the model univariate and multivariate logistic regression analyses were carried out with grade 2 or higher RTOG swallowing dysfunction at 6 months as the primary (SWALL 6months ) endpoint. The model was validated by comparing the predicted and observed complication rates and by testing if the model also predicted acute dysphagia and late dysphagia at later time points (12, 18 and 24 months). Results: After univariate and multivariate logistic regression analyses, the following factors turned out to be independent prognostic factors for SWALL 6months : T3-T4, bilateral neck irradiation, weight loss prior to radiation, oropharyngeal and nasopharyngeal tumours, accelerated radiotherapy and concomitant chemoradiation. By summation of the regression coefficients derived from the multivariate model, the Total Dysphagia Risk Score (TDRS) could be calculated. In the logistic regression model, the TDRS was significantly associated with SWALL 6months ((p 6months was 5%, 24% and 46% in case of low-, intermediate- and high-risk patients, respectively. These observed percentages were within the 95% confidence intervals of the predicted values. The TDRS risk group classification was also significantly associated with acute dysphagia (P < 0.001 at all time points) and with late swallowing dysfunction at 12, 18 and 24 months (p < 0.001 at all time points

Radioimmunological analysis of circadian rhythms of cortisol and melatonin in saliva

International Nuclear Information System (INIS)

Demel, A.W.

1990-12-01

Since blood cortisol (F) and melatonin (MLT) display a circadian secretion pattern and since the saliva concentration of this hormones is an excellent indicator of its blood levels the measurement of salivary F and MLT may be used for examining circadian rhythmicity. In this study the relationship between salivary F and MLT was explored. For this purpose it was necessary first to establish and validate a radioimmunoassay for F in saliva: salivary F was determined by a direct radioimmunoassay using cortisol-3-(O-carboxymethyl) oximino-(2-( 125 I)iodohistamin) as tracer and cortisol-3-CMO-BSA antiserum. The parallel measurement of F levels in saliva and serum of adults gave an excellent correlation (r=0.87, p 0.00956x ). Serum F was assayed on the Abott TDX-System using a radioimmunofluorescence method. Secondly, using this assay the circadian saliva F pattern was determined as well as the pattern of salivary MLT in 9 young, healthy volunteers. For saliva MLT estimations a previously published method was applied (Schulz et al 1990). Using a computerized program (RHYTHM) written by Eve v. Cauter (1979), the hormone data of each individuum were examined for circadian rhythmicity and its acrophase (time of occurrence of the maximum of a sinusoid fitted to the data). The F acrophase occurred between 7:00 and 12:00 h (mean: 3:33 h, SD: 104.4 min). The easy stress-free non invasive nature of saliva collection makes saliva to one of the most accessible body fluids and of high value in studying the circadian system in healthy humans as well as in infants, children, pregnant women and anaemic patients. Measurements of salivary F and MLT may help to elucidate not only the circadian rhythms of these hormones under normal and pathological conditions but it may also provide insight in physiology and pathology of the circadian system in general. (author)

[The physicochemical and microbiological characteristics of saliva during and after pregnancy].

Science.gov (United States)

Martínez-Pabón, María C; Martínez Delgado, Cecilia M; López-Palacio, Ana M; Patiño-Gómez, Lina M; Arango-Pérez, Eduin A

2014-01-01

Identify the changes in some physiological and microbiological parameters in the saliva from a group of women during and after their pregnancies. Stimulated whole saliva was collected from a cohort of 35 women during their pregnancy and afterwards to determine each sample's physicochemical (secretion rate, pH and buffer capacity) and microbiological characteristics (acidogenic bacteria count). The pH and buffer capacity of saliva during pregnancy were lower than after pregnancy. There were no statistically significant changes regarding S. mutans and Lactobacillus spp. count, but a tendency towards increased values during pregnancy was noted. Changes occurring in the saliva of pregnant women can lead to an increase of risk of suffering disease affecting one's oral health, such as caries, gingivitis and periodontal disease; this could be prevented by appropriate diagnosis and dental follow-up, including education regarding pregnant women's oral health.

Clinical aspects of Candida species carriage in saliva of xerotomic subjects.

Science.gov (United States)

Torres, S R; Peixoto, C B; Caldas, D M; Silva, E B; Magalhães, F A C; Uzeda, M; Nucci, M

2003-10-01

In order to investigate the clinical factors that might influence the diversity and the degree of Candida species carriage in saliva, we conducted a cross-sectional study with 133 patients with complaints of xerostomia. Anamnesis, oral examination and collection of chewing-stimulated whole saliva were performed. The samples of saliva were kept refrigerated until they were plated onto CHROMagar Candida; cfu were counted and Candida species were identified by standard methods. There was a high prevalence of mixed Candida colonization. No relationship was found between total Candida cfu counts and variables like gender, age, place of origin, underlying diseases, exposure to medications (except antibiotics), daily habits and salivary flow rates. Oral candidiasis, antibiotic exposure and dental prosthesis wearing were associated with relatively high Candida counts in saliva. Low salivary flow rates predisposed to intense colonization by C. albicans and C. parapsilosis.

Between-group transmission dynamics of the swallow bug, Oeciacus vicarius.

Science.gov (United States)

Brown, Charles R; Brown, Mary Bomberger

2005-06-01

The parasitic cimicid swallow bug, Oeciacus vicarius, is the principal invertebrate vector for Buggy Creek virus (BCRV) and has also been associated with Venezuelan equine encephalitis virus. To help understand the spread of this vector, we experimentally measured the transmission of O. vicarius between groups (colonies) of its main host, the cliff swallow (Petrochelidonpyrrhonota), in the field. Transmission of bugs between colonies varied significantly with year, size of the colony, and week within the season. Bug immigration into sites tended to peak in mid-summer. Swallow nests in larger colonies had more consistent rates of bug introduction than did nests in small colonies, but within a colony a given nest's weekly immigrant-bug count varied widely across the season. Transmission of O. vicarius between host social groups follows broadly predictable seasonal patterns, but there is nevertheless temporal and spatial heterogeneity in bug transmission. By understanding how long-distance movement by this vector varies in time and space, we can better predict where and when BCRV epizootics may occur.

Electromyographic analysis of superior orbicularis oris muscle function in children surgically treated for unilateral complete cleft lip and palate.

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Szyszka-Sommerfeld, Liliana; Woźniak, Krzysztof; Matthews-Brzozowska, Teresa; Kawala, Beata; Mikulewicz, Marcin

2017-09-01

The aim of this study was to assess the electrical activity of the superior orbicularis oris muscle in children surgically treated for unilateral complete cleft lip and palate (UCCLP). The sample comprised 45 patients 6.38-12.68 years of age with UCCLP and 40 subjects 6.61-11.71 years of age with no clefts. Electromyographical (EMG) recordings were taken with a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) in the rest position and during saliva swallowing, lip protrusion and reciprocal compression of the lips, as well as while producing the phonemes /p/, /b/, and /m/ combined with the vowel /a/. The electrical activity of the upper lip during saliva swallowing and lip compression was significantly greater in the cleft group. Similar resting level activity was observed in both groups. During the production of the /p/, /b/, and /m/ phonemes combined with the vowel /a/ the results showed no significant differences in the EMG activity between children with UCCLP and noncleft subjects. Patients with UCCLP have abnormal upper lip function characterized by increased activity of the superior orbicularis oris muscle during saliva swallowing and lip compression, and this may affect facial morphology. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Sample Stability and Protein Composition of Saliva: Implications for Its Use as a Diagnostic Fluid

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Han Roelofsen

2008-01-01

Full Text Available Saliva is an easy accessible plasma ultra-filtrate. Therefore, saliva can be an attractive alternative to blood for measurement of diagnostic protein markers. Our aim was to determine stability and protein composition of saliva. Protein stability at room temperature was examined by incubating fresh whole saliva with and without inhibitors of proteases and bacterial metabolism followed by Surface Enhanced Laser Desorption/Ionization (SELDI analyses. Protein composition was determined by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE fractionation of saliva proteins followed by digestion of excised bands and identification by liquid chromatography tandem mass spectrometry (LC-MS/MS. Results show that rapid protein degradation occurs within 30 minutes after sample collection. Degradation starts already during collection. Protease inhibitors partly prevented degradation while inhibition of bacterial metabolism did not affect degradation. Three stable degradation products of 2937 Da, 3370 Da and 4132 Da were discovered which can be used as markers to monitor sample quality. Saliva proteome analyses revealed 218 proteins of which 84 can also be found in blood plasma. Based on a comparison with seven other proteomics studies on whole saliva we identified 83 new saliva proteins. We conclude that saliva is a promising diagnostic fl uid when precautions are taken towards protein breakdown.

Comparative analysis of bacterial profiles in unstimulated and stimulated saliva samples

DEFF Research Database (Denmark)

Belstrøm, Daniel; Holmstrup, Palle; Jensen, Allan Bardow

2016-01-01

BACKGROUND AND OBJECTIVE: The microbial profiles of stimulated saliva samples have been shown to differentiate between patients with periodontitis, patients with dental caries, and orally healthy individuals. Saliva was stimulated to allow for easy and rapid collection; however, microbial...

Can fluconazole concentrations in saliva be used for therapeutic drug monitoring?

NARCIS (Netherlands)

Koks, C. H.; Crommentuyn, K. M.; Hoetelmans, R. M.; Mathôt, R. A.; Beijnen, J. H.

2001-01-01

The saliva/plasma concentration ratio of fluconazole was investigated in 22 HIV-1-infected individuals with an oropharyngeal Candida infection to determine whether saliva fluconazole concentrations could provide useful information for therapeutic drug monitoring in this population. Steady-state

Increase of Substance P Concentration in Saliva after Pharyngeal Electrical Stimulation in Severely Dysphagic Stroke Patients – an Indicator of Decannulation Success?

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Paul Muhle

2017-10-01

Full Text Available Background/Aims: Substance P (SP is a neuropeptide, likely acting as a neurotransmitter in the pharyngeal mucosa enhancing the swallow and cough reflex. Pharyngeal Electrical Stimulation (PES induces a temporary increase of salivary SP levels in healthy adults. Previous evidence suggests that post-stroke dysphagia is related to reduced SP levels. Here, we investigated the effects of PES on SP levels in severely dysphagic stroke patients and a possible link between increase of SP and treatment success. Methods: 23 tracheotomized stroke patients who could not be decannulated due to severe and persisting dysphagia according to endoscopic evaluation received PES for 10 minutes a day over three consecutive days in this prospective single-center study. If initial treatment failed, repetitive stimulation cycles were provided. Saliva samples were collected before and directly after each PES. Results: 61% of participants were decannulated after the first treatment cycle. Increase of SP levels post-stimulation was closely related to treatment success, i.e. decannulation with 79% of successfully treated patients showing increase of SP, whereas 89% of unsuccessfully treated patients had stable or decreased SP levels. Applying logistic regression analysis, increase of SP level remained the only independent predictor of decannulation after PES. All 3 repetitively treated patients showed increased SP levels when progressing from the 1st to the 2nd cycle, two of whom were decannulated hereafter. Conclusions: The physiological mechanism of PES may consist in restoration of sensory feedback, which is known to be crucial for the execution of a safe swallow. SP possibly acts as a biomarker for indicating response to PES.

Feasibility and usefulness of using swallow contrast-enhanced ultrasound to diagnose Zenker's diverticulum: preliminary results.

Science.gov (United States)

Cui, Xin-Wu; Ignee, Andre; Baum, Ulrich; Dietrich, Christoph F

2015-04-01

Zenker's diverticulum (ZD) may be misdiagnosed on conventional ultrasound as a thyroid nodule or other lesion. A barium esophagram is usually used to confirm the diagnosis; however, this procedure exposes the patient to radiation. The aim of this study was to evaluate the feasibility of using swallow contrast-enhanced ultrasound (swallow-CEUS) to diagnose ZD. Ten consecutive patients with ZD (7 men and 3 women, aged 67 ± 11 y) were included in the study. In 4 patients, ZD was incidentally found on head and neck ultrasound, and in 6 patients, ZD was suspected because of dysphagia. All lesions could be detected on conventional ultrasound before swallow-CEUS. Ten healthy volunteers (8 men and 2 women, aged 60 ± 12 y) were chosen as a control group. Written informed consent was obtained. With the patient in the sitting or upright position, conventional ultrasound was performed first to image the lesion, then the patient was asked to swallow ultrasound contrast agent (UCA) (2-4 drops of SonoVue diluted with about 200 mL of tap water). Transity of the contrast agent in the esophagus was imaged with CEUS. Retention of the UCA in the diverticulum was monitored for at least 3 min. All patients underwent a barium esophagram as the gold standard. Swallow-CEUS revealed that in all patients (100%), the UCA was transported from the pharynx to the esophagus while the patient swallowed. ZD appeared as a pouch-shaped structure at the posterior pharyngo-esophageal junction that retained UCA longer than 3 min. The barium esophagram confirmed the diagnosis of ZD in all patients. For the 10 volunteers, no abnormal structure (retaining UCA) was detected during or after swallowing of UCA. With the advantages of no radiation and bedside availability, swallow-CEUS may become a method of choice in confirmation of the diagnosis of ZD, especially when ZD is suspected on conventional ultrasound. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier

Defining Swallowing-Related Quality of Life Profiles in Individuals with Amyotrophic Lateral Sclerosis

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Gaziano, Joy; Watts, Stephanie; Robison, Raele; Plowman, Emily K.

2016-01-01

Although it is known that dysphagia contributes to significant malnutrition, pneumonia, and mortality in amyotrophic lateral sclerosis (ALS), it remains unclear how swallowing impairment impacts quality of life in this vulnerable patient population. The aim of the current study was to (1) delineate swallow-related quality of life (SR-QOL) profiles in individuals with ALS and (2) evaluate relationships between SR-QOL, degree of swallowing impairment, and ALS global disease progression. Eighty-one ALS patients underwent a standardized videofluoroscopic swallow study and completed the swallowing quality of life (SWAL-QOL) instrument and ALS functional rating scale-revised (ALSFRS-R). Penetration Aspiration Scale (PAS) scores were derived by a blinded rater. Correlation analyses and a between groups ANOVA (safe vs. penetrators vs. aspirators) were performed. Mean SWAL-QOL score for this cohort was 75.94 indicating a moderate degree of SR-QOL impairment with fatigue, eating duration, and communication representing the most affected domains. Correlations were revealed between the SWAL-QOL and (1) PAS (r = −0.39, p < 0.001) and (2) ALSFRS-R (r = 0.23, p < 0.05). Mean (SD) SWAL-QOL scores for safe versus penetrator versus aspirator groups were 81.2 (2.3) versus 77 (3.4) versus 58.7 (5.9), respectively, with a main effect observed [F(2,78) = 9.71, p < 0.001]. Post hoc testing revealed lower SWAL-QOL scores for aspirators versus safe swallowers (p < 0.001) and aspirators versus penetrators (p < 0.001). Overall, SR-QOL was moderately reduced in this cohort of ALS patients and profoundly impacted in ALS aspirators and individuals with advanced disease. These findings highlight the importance of early multidisciplinary intervention to not only avoid malnutrition, weight loss, and pulmonary sequelae but also the associated reduced QOL seen in these individuals. PMID:26837611

A comparison of swallowing dysfunction in Becker muscular dystrophy and Duchenne muscular dystrophy.

Science.gov (United States)

Yamada, Yuka; Kawakami, Michiyuki; Wada, Ayako; Otsuka, Tomoyoshi; Muraoka, Kaori; Liu, Meigen

2018-06-01

Swallowing dysfunction has been reported in Duchenne muscular dystrophy (DMD), but has not been studied in Becker muscular dystrophy (BMD). The aims of this study were to report the characteristics of swallowing dysfunction in BMD compared with DMD. The study participants were 18 patients with BMD and 18 patients with DMD. All the patients were examined using videofluorography during swallowing of 5 mL of fluid. The penetration-aspiration scale (P-A scale) and the videofluorographic dysphagia scale (VDS) were used to evaluate dysphagia. Swinyard functional ability stage was not significantly different between the BMD and DMD groups. Rate of aspiration, P-A scale score, and total VDS score did not differ across groups, but the VDS item score for laryngeal elevation was lower in the BMD group than in the DMD group (median scores 4.5 and 9, respectively; p Becker muscular dystrophy (BMD) was not well known. Eighteen patients with BMD and 18 patients with Duchenne muscular dystrophy were examined with videofluorography. Patients with BMD have swallowing problems similar to those observed in patients with DMD.

The feasibility of magnetic resonance imaging of the dynamic swallowing

International Nuclear Information System (INIS)

Yang Jingquan; Gao Mingyong; Luo Suling; Lu Ruiliang; He Xiaohong

2012-01-01

Objective: To offer some visual and valuable clinical bases for the pharynx disease diagnosis and treatment by comparing the influence of different scanning sequences on the image quality and scanning time, and studying the application to the dynamic swallowing MRI scanning. Methods: The dynamic swallowing scanning of pharyngeal was performed on 20 nasopharyngeal carcinoma patients without deglutition disorders through GE 3.0 MRI system with fast imaging employing steady state acquisition (FIESTA) and fast gradient recalled echo (Fast GRE) sequences, and combined with the array spatial sensitivity encoding technique (ASSET), which accelerating factors was 2.0 ph, and sixty dynamic images were acquired sequentially. The image quality was graded into three classes:excellent, favorable and poor,which were visually assessed by three senior MRI physician using double-blinded method. The quantitative data were analyzed statistically with the SPSS13.0 software. Results: Under the same parameters,the scanning time with FIESTA, FIESTA+ASSET, Fast GRE and Fast GREA+ASSET sequences were 54 s, 28 s, 49 s and 25 s respectively. The number of excellent images with the four sequences were 44, 52, 52 and 56 respectively. The scanning time was the shortest and the image quality was the best with Fast GRE+ASSET sequence. Conclusions: The dynamic imaging of swallowing in sagittal view was achieved with Fast GRE+ASSET sequence on GE 3.0T MRI system. It could present status of the pharynx well, and the soft tissue of swallowing was showed clearly in the dynamic images. These will provide visual and effective evidence for clinical diagnosis and treatment. (authors)

The role of saliva in the process of oxidative stress – review of literature

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Anna Krysińska

2016-12-01

Full Text Available Background: Saliva constitutes a first line of defence against free radical-mediated oxidative stress, since the process of mastication and digestion promotes lipid peroxidation. During gingival inflammation, gingival crevicular fluid flow increases the change of saliva composition with products from the inflammatory response, modulating oxidative damages in the oral cavity. Authors review the current literature concerning the reactive oxygen species, oxidants, pro-oxidants and antioxidants in saliva, and methods for assessing the antioxidant capacity of saliva. Comparison of salivary antioxidant status in male and female subjects reveales a significant gender-related difference in saliva composition. The current data demonstrate a significant enhancement of the salivary antioxidant system in juvenile idiopathic arthritis patients. Also patients with chronic renal failure, diabetes and on hemodialysis show increase oxidative stress burden in both serum and saliva. The finding of reduced oral peroxidase levels in smoking subjects may represent a contributory mechanism for initiation and progression of cigarette smoke-related oral diseases such as oral cancer. The results of recent studies indicate that the total antioxidant capacity of saliva decreased in children with HIV infection. Conclusion: Whole saliva may contain simply measured indicators of oxidative processes. This may provide a tool for the development and monitoring of new treatment strategies. A non-invasive determination of the salivary concentrations of antioxidants such as superoxide dismutase (SOD and uric acid (UR allows the evaluation of the defensive capacity of the oral mucosa. Still, there is a need for standardization of methods for saliva sampling and testing protocol.

Effects of age and viscosity on food transport and breathing-swallowing coordination during eating of two-phase food in nursing home residents.

Science.gov (United States)

Yamada, Tsuyoshi; Matsuo, Koichiro; Izawa, Masayuki; Yamada, Shizuru; Masuda, Yuji; Ogasawara, Tadashi

2017-11-01

When eating food that contains both liquid and solid phases, the liquid component frequently enters the hypopharynx before swallowing and can increase the risk of aspiration. Thus, we examined whether the initial viscosity of mixed consistency food could alter pre-swallow food transport and breathing-swallowing coordination in older adults. Fiberoptic endoscopy was recorded while 18 healthy young adults and 19 older adults ate 5 g of steamed rice combined with 3 mL of blue-dye water. Liquid viscosity was set at three levels by the addition of a thickening agent (0 wt%, thin; 2 wt%, thicker; 4 wt%, higher-viscosity, respectively). We measured the timing of swallow initiation and its corresponding respiratory phase for each participant. For thin mixed consistency food, whereas the timing of swallow initiation was comparable between young and older participants, swallowing was initiated during inspiration significantly more often in older participants (31.6 %) than in young participants (5.6 %). In contrast, the timing of swallow initiation was delayed in older participants for thicker and higher-viscosity foods, although swallowing was commonly initiated during expiration in both groups. In older adults, we observed that swallow initiation function was preserved for thin mixed consistency samples, but breathing-swallowing coupling was diminished. For higher-viscosity foods, swallow initiation was delayed in this group, but breathing-swallowing coordination was not disturbed, probably as a result of the slow bolus flow into the hypopharynx. Thus, it appears the initial viscosity of mixed consistency food profoundly affects food transport before swallowing as well as breathing-swallowing coordination in nursing home residents. Geriatr Gerontol Int 2017; 17: 2171-2177. © 2017 Japan Geriatrics Society.

Bacterial composition in whole saliva from patients with severe hyposalivation

DEFF Research Database (Denmark)

Belstrøm, Daniel; Holmstrup, Palle; Fiehn, Nils-Erik

2016-01-01

OBJECTIVE: The purpose of this study was to compare the microbiota of stimulated whole saliva samples from patients with severe hyposalivation to samples from individuals with normal whole saliva flow rates. It was hypothesized that the two groups differ with regard to salivary bacterial profiles...... with severe hyposalivation do not differ from those of individuals with normal salivary secretion, when there are virtually no untreated active caries lesions present in the oral cavity. This article is protected by copyright. All rights reserved.......OBJECTIVE: The purpose of this study was to compare the microbiota of stimulated whole saliva samples from patients with severe hyposalivation to samples from individuals with normal whole saliva flow rates. It was hypothesized that the two groups differ with regard to salivary bacterial profiles....... METHODS: This cross-sectional study included 36 participants (24 females and 12 males, mean age 58.5 years) with severe hyposalivation and 36 gender-, age- and geographically-matched participants with normal salivary secretion from the Danish Health Examination Survey (DANHES). The microbiota...

Aspiration of barium contrast medium in an elderly man with disordered swallowing

OpenAIRE

Bağcı Ceyhan, B.; Çelikel, T.; Koç, M.; Ahıskalı, R.; Biren, T.; Ataizi Çelikel, Ç.

1995-01-01

The aspiration of contrast medium during the investigation of gastrointestinal diseases is a well recognized hazard, particularly in patients with swallowing disorders. A case is reported in which accidental aspiration of contrast barium occurred owing to disordered swallowing in an elderly man. The infiltration on chest x-ray persisted 2 years after barium contrast aspiration. Inflammatory reaction and retractile, granular material observed in lung biopsy specimens suggested barium-induced p...

Impacts and limitations of medialization thyroplasty on swallowing function of patients with unilateral vocal fold paralysis.

Science.gov (United States)

Tateya, Ichiro; Hirano, Shigeru; Kishimoto, Yo; Suehiro, Atsushi; Kojima, Tsuyohi; Ohno, Satoshi; Ito, Juichi

2010-11-01

Medialization thyroplasty was effective in improving swallowing function as well as vocal function in most cases with unilateral vocal fold paralysis. The impact of medialization thryoplasty was insufficient for the case with severe atrophy and that in which the vocal fold was fixed in the lateral position. To evaluate the impacts and limitations of medialization thyroplasty on swallowing function of the patients with unilateral vocal fold paralysis. Eight cases (mean age 68.5 years) with unilateral vocal fold paralysis chiefly complaining of swallowing disturbance were studied. All patients underwent thyroplasty type I. The causes of the paralysis were lung cancer in four cases, esophageal cancer in one case, aortic aneurysm in one case, subarachnoid hemorrhage in one case, and unknown in one case. Subjective swallowing function score, maximum phonation time (MPT), mean flow rate (MFR), amplitude perturbation quotient (APQ), and pitch perturbation quotient (PPQ) were examined pre- and postoperatively. The swallowing score improved in all except two cases. However, bilateral thryoplasty was necessary for the case with severe vocal fold atrophy and arytenoid adduction was needed for the case in which the vocal fold was fixed in the lateral position. The swallowing score, MPT, and MFR showed significant improvement after surgery.

Bond strength of self-etch adhesives after saliva contamination at different application steps.

Science.gov (United States)

Cobanoglu, N; Unlu, N; Ozer, F F; Blatz, M B

2013-01-01

This study evaluated and compared the effect of saliva contamination and possible decontamination methods on bond strengths of two self-etching adhesive systems (Clearfil SE Bond [CSE], Optibond Solo Plus SE [OSE]). Flat occlusal dentin surfaces were created on 180 extracted human molar teeth. The two bonding systems and corresponding composite resins (Clearfil AP-X, Kerr Point 4) were bonded to the dentin under six surface conditions (n=15/group): group 1 (control): primer/bonding/composite; group 2: saliva/drying/primer/bonding/composite; group 3: primer/saliva/rinsing/drying/primer/bonding/composite; group 4: primer/saliva/rinsing/drying/bonding/composite; group 5: primer/bonding (cured)/saliva/rinsing/drying/primer/bonding/composite; group 6: primer/bonding (cured)/saliva/removing contaminated layer with a bur/rinsing/drying/primer/bonding/composite. Shear bond strength was tested after specimens were stored in distilled water at 37°C for 24 hours. One-way analysis of variance and Tukey post hoc tests were used for statistical analyses. For CSE, groups 2, 3, and 4 and for OSE, groups 6, 2, and 4 showed significantly lower bond strengths than the control group (pcontamination occurred after light polymerization of the bonding agent, repeating the bonding procedure recovered the bonding capacity of both self-etch adhesives. However, saliva contamination before or after primer application negatively affected their bond strength.

Blood Contamination in Saliva: Impact on the Measurement of Salivary Oxidative Stress Markers

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Natália Kamodyová

2015-01-01

Full Text Available Salivary oxidative stress markers represent a promising tool for monitoring of oral diseases. Saliva can often be contaminated by blood, especially in patients with periodontitis. The aim of our study was to examine the impact of blood contamination on the measurement of salivary oxidative stress markers. Saliva samples were collected from 10 healthy volunteers and were artificially contaminated with blood (final concentration 0.001–10%. Next, saliva was collected from 12 gingivitis and 10 control patients before and after dental hygiene treatment. Markers of oxidative stress were measured in all collected saliva samples. Advanced oxidation protein products (AOPP, advanced glycation end products (AGEs, and antioxidant status were changed in 1% blood-contaminated saliva. Salivary AOPP were increased in control and patients after dental treatment (by 45.7% and 34.1%, p<0.01. Salivary AGEs were decreased in patients after microinjury (by 69.3%, p<0.001. Salivary antioxidant status markers were decreased in both control and patients after dental treatment (p<0.05 and p<0.01. One % blood contamination biased concentrations of salivary oxidative stress markers. Saliva samples with 1% blood contamination are visibly discolored and can be excluded from analyses without any specific biochemic detection of blood constituents. Salivary markers of oxidative stress were significantly altered in blood-contaminated saliva in control and patients with gingivitis after dental hygiene treatment.

The Test of Masticating and Swallowing Solids (TOMASS): Reliability, Validity and International Normative Data

Science.gov (United States)

Huckabee, Maggie-Lee; McIntosh, Theresa; Fuller, Laura; Curry, Morgan; Thomas, Paige; Walshe, Margaret; McCague, Ellen; Battel, Irene; Nogueira, Dalia; Frank, Ulrike; van den Engel-Hoek, Lenie; Sella-Weiss, Oshrat

2018-01-01

Background: Clinical swallowing assessment is largely limited to qualitative assessment of behavioural observations. There are limited quantitative data that can be compared with a healthy population for identification of impairment. The Test of Masticating and Swallowing Solids (TOMASS) was developed as a quantitative assessment of solid bolus…

Kinematic MRI using short TR single shot fast spin echo (SSFSE) in evaluating swallowing

Energy Technology Data Exchange (ETDEWEB)

Isogai, Satoshi; Takehara, Yasuo; Isoda, Haruo; Kodaira, Nami; Masunaga, Hatsuko; Ozawa, Fukujirou; Kaneko, Masao [Hamamatsu Univ. School of Medicine, Shizuoka (Japan); Nozaki, Atsushi; Kabasawa, Hiroyuki

1999-03-01

The utility of short TR single shot fast spin echo (SSFSE) MR imaging for evaluating swallowing was determined. Five healthy volunteers underwent kinematic MR imaging of swallowing with a 1.5 T MR scanner using the short TR (300 ms) SSFSE sequence. Twenty phases of sagittal sections were acquired within 6 sec, where the temporal resolution was 300 ms. For oral contrast medium, we used prune yogurt juice with Fe added. The image contrast of short TR SSFSE was found to be somewhere like that of T1-weighted images. In all cases, both the buccal and pharyngeal stages of swallowing were successfully depicted. The Fe-added prune yogurt juice performed as a positive contrast medium and helped determine anatomical structures in the buccal stage. Short TR (300 ms) SSFSE was useful in evaluating swallowing. The combined use of Fe-added prune yogurt juice was helpful in enhancing the surface of the oropharynx. (author)

Kinematic MRI using short TR single shot fast spin echo (SSFSE) in evaluating swallowing

International Nuclear Information System (INIS)

Isogai, Satoshi; Takehara, Yasuo; Isoda, Haruo; Kodaira, Nami; Masunaga, Hatsuko; Ozawa, Fukujirou; Kaneko, Masao; Nozaki, Atsushi; Kabasawa, Hiroyuki

1999-01-01

The utility of short TR single shot fast spin echo (SSFSE) MR imaging for evaluating swallowing was determined. Five healthy volunteers underwent kinematic MR imaging of swallowing with a 1.5 T MR scanner using the short TR (300 ms) SSFSE sequence. Twenty phases of sagittal sections were acquired within 6 sec, where the temporal resolution was 300 ms. For oral contrast medium, we used prune yogurt juice with Fe added. The image contrast of short TR SSFSE was found to be somewhere like that of T1-weighted images. In all cases, both the buccal and pharyngeal stages of swallowing were successfully depicted. The Fe-added prune yogurt juice performed as a positive contrast medium and helped determine anatomical structures in the buccal stage. Short TR (300 ms) SSFSE was useful in evaluating swallowing. The combined use of Fe-added prune yogurt juice was helpful in enhancing the surface of the oropharynx. (author)

Voice and Swallowing Outcomes after Hyoid Suspension Surgery in Patients with Obstructive Sleep Apnea.

Science.gov (United States)

Askar, Sherif M; Quriba, Amal S; Hassan, Elham M; Awad, Ali M; Bessar, Ahmad A

2018-05-15

The role of hyoidthyroidpexia (HTP) surgery in the management of patients with obstructive sleep apnea (OSA) is well described with good reported outcomes. The effect of HTP on other laryngeal functions is not well discussed. This study was designed to evaluate voice and swallowing outcomes after HTP. This study was applied on a selected group of OSA patients. HTP (as a sole procedure) was performed in 17 patients and 14 patients had simultaneous palatal procedures (e.g., anterior palatoplasty). Pre- and postoperative assessment of voice and swallowing were done. Comparison between pre- and postoperative results of voice and swallowing measures revealed a nonsignificant difference. HTP (as a sole technique or as part of a multilevel intervention) could help with airway collapse and might be considered a safe, simple, and effective technique in the management of selected patients experiencing OSA. In addition, it seems to have no hazardous effect on either the voice or swallowing function of patients. © 2018 S. Karger AG, Basel.

Electrochemical behavior and pH stability of artificial salivas for corrosion tests Comportamento eletroquímico e estabilidade de pH de salivas artificiais para testes de corrosão

Directory of Open Access Journals (Sweden)

Gláucia Maria Oliveira de Queiroz

2007-09-01

Full Text Available It is assumed that the compositions of artificial salivas are similar to that of human saliva. However, the use of solutions with different compositions in in vitro corrosion studies can lead dissimilar electrolytes to exhibit dissimilar corrosivity and electrochemical stability. This study evaluated four artificial salivas as regards pH stability with time, redox potentials and the polarization response of an inert platinum electrode. The tested solutions were: SAGF medium, Mondelli artificial saliva, UFRJ artificial saliva (prepared at the School of Pharmacy, Federal University of Rio de Janeiro, RJ, Brazil and USP-RP artificial saliva (prepared at the School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, SP, Brazil. It was observed that pH variations were less than 1 unit during a 50-hour test. The SAGF medium, and the UFRJ and USP-RP solutions exhibited more oxidizing characteristics, whereas the Mondelli solution presented reducing properties. Anodic polarization revealed oxidation of the evaluated electrolytes at potentials below +600 mV SCE. It was observed that the UFRJ and USP-RP solutions presented more intense oxidation and reduction processes as compared to the Mondelli and SAGF solutions.Admite-se que as composições das salivas artificiais são semelhantes àquela da saliva humana. A utilização de soluções de composições distintas em estudos de corrosão in vitro, entretanto, pode fazer com que eletrólitos diferentes exibam diferenças no processo corrosivo e na estabilidade eletroquímica. Este estudo avaliou quatro salivas artificiais em relação a estabilidade do pH em função do tempo, potencial redox e resposta à polarização de um eletrodo de platina inerte. As soluções testadas foram: meio SAGF, saliva artificial Mondelli, saliva artificial UFRJ (preparada pela Faculdade de Farmácia da Universidade Federal do Rio de Janeiro, RJ, Brasil e saliva artificial USP-RP (preparada pela

Xylitol concentrations in artificial saliva after application of different xylitol dental varnishes

OpenAIRE

Pereira,Agnes de Fátima Faustino; Silva,Thiago Cruvinel da; Silva,Thelma Lopes da; Caldana,Magali de Lourdes; Bastos,José Roberto Magalhães; Buzalaf,Marília Afonso Rabelo

2012-01-01

Objective: The present study analyzed xylitol concentrations in artificial saliva over time after application of varnishes containing 10% and 20% xylitol. Material and Methods: Fifteen bovine enamel specimens (8x4 mm) were randomly allocated to 3 groups (n=5/group), according to the type of varnish used: 10% xylitol, 20% xylitol and no xylitol (control). After varnish application (4 mg), specimens were immersed in vials containing 500 mu L of artificial saliva. Saliva samples were collected i...

Esophageal contractions, bolus transit and perception of transit after swallows of liquid and solid boluses in normal subjects

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Juciléia Dalmazo

2012-12-01

Full Text Available CONTEXT: Esophageal dysphagia is the sensation that the ingested material has a slow transit or blockage in its normal passage to the stomach. It is not always associated with motility or transit alterations. OBJECTIVES: To evaluate in normal volunteers the possibility of perception of bolus transit through the esophagus after swallows of liquid and solid boluses, the differences in esophageal contraction and transit with these boluses, and the association of transit perception with alteration of esophageal contraction and/or transit. METHODS: The investigation included 11 asymptomatic volunteers, 4 men and 7 women aged 19-58 years. The subjects were evaluated in the sitting position. They performed swallows of the same volume of liquid (isotonic drink and solid (macaroni boluses in a random order and in duplicate. After each swallow they were asked about the sensation of bolus passage through the esophagus. Contractions and transit were evaluated simultaneously by solid state manometry and impedance. RESULTS: Perception of bolus transit occurred only with the solid bolus. The amplitude and area under the curve of contractions were higher with swallows of the solid bolus than with swallows of the liquid bolus. The difference was more evident in swallows with no perception of transit (n = 12 than in swallows with perception (n = 10. The total bolus transit time was longer for the solid bolus than for the liquid bolus only with swallows followed by no perception of transit. CONCLUSION: The results suggest that the perception of esophageal transit may be the consequence of inadequate adaptation of esophageal transit and contraction to the characteristics of the swallowed bolus.

Esophageal Transit, Contraction and Perception of Transit After Swallows of Two Viscous Boluses.

Science.gov (United States)

Dalmazo, Jucileia; Aprile, Lilian Rose Otoboni; Dantas, Roberto Oliveira

2015-10-01

There have been results showing the influence of bolus viscosities and consistency on esophageal motility and transit. However, there is no description about the influence of two different viscous boluses on esophageal contractions, bolus transit and perception of transit. Our objective in this investigation was to evaluate the esophageal transit and contraction after swallows of two viscous boluses. By impedance and manometric methods, we measured the esophageal transit and contraction after swallows of two viscous boluses of 5 mL volume, 100% barium sulfate and yogurt, swallowed in duplicate in the supine and upright positions. The bolus transit, esophageal contractions and the perception of bolus transit through the esophagus were evaluated in both positions. Impedance and contraction were measured at 5, 10, 15 and 20 cm from the lower esophageal sphincter. After each swallow, the volunteers were asked about the sensation of bolus transit through the esophagus. In supine position, the yogurt had a less frequent complete bolus transit than barium. Also in the supine position, the esophageal transit was longer with yogurt than with barium. Esophageal contractions after swallows were similar between barium and yogurt boluses. There was no difference in perception of transit between the two boluses. Although both 100% barium sulfate and yogurt are viscous boluses and have similar viscosities, the transit through the esophagus is slower with yogurt bolus than with barium bolus, which suggests that viscosity may be not the sole factor to determine transit.

Characterization of swallow modulation in response to bolus volume in healthy subjects accounting for catheter diameter.

Science.gov (United States)

Ferris, Lara; Schar, Mistyka; McCall, Lisa; Doeltgen, Sebastian; Scholten, Ingrid; Rommel, Nathalie; Cock, Charles; Omari, Taher

2018-06-01

Characterization of the pharyngeal swallow response to volume challenges is important for swallowing function assessment. The diameter of the pressure-impedance recording catheter may influence these results. In this study, we captured key physiological swallow measures in response to bolus volume utilizing recordings acquired by two catheters of different diameter. Ten healthy adults underwent repeat investigations with 8- and 10-Fr catheters. Liquid bolus swallows of volumes 2.5, 5, 10, 20, and 30 mL were recorded. Measures indicative of distension, contractility, and flow timing were assessed. Pressure-impedance recordings with pressure-flow analysis were used to capture key distension, contractility, and pressure-flow timing parameters. Larger bolus volumes increased upper esophageal sphincter distension diameter (P < .001) and distension pressures within the hypopharynx and upper esophageal sphincter (P < .05). Bolus flow timing measures were longer, particularly latency of bolus propulsion ahead of the pharyngeal stripping wave (P < .001). Use of a larger-diameter catheter produced higher occlusive pressures, namely upper esophageal sphincter basal pressure (P < .005) and upper esophageal sphincter postdeglutitive pressure peak (P < .001). The bolus volume swallowed changed measurements indicative of distension pressure, luminal diameter, and pressure-flow timing; this is physiologically consistent with swallow modulation to accommodate larger, faster-flowing boluses. Additionally, catheter diameter predominantly affects lumen occlusive pressures. Appropriate physiological interpretation of the pressure-impedance recordings of pharyngeal swallowing requires consideration of the effects of volume and catheter diameter. NA. Laryngoscope, 128:1328-1334, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Frequency of enterococcus faecalis in saliva and root canals with treatment failure

International Nuclear Information System (INIS)

Khan, I.; Shan, T.; Manzoor, M.A.

2015-01-01

To compare the frequency of E. faecalis in the saliva and root canals of teeth associated with apical periodontitis due to endodontic treatment failure in the same patient. Study Design: Cross-sectional comparative study. Place and Duration of Study: Samples were collected from Operative Dentistry Department, AFID, while laboratory processing was done at AFIP, Rawalpindi. Study duration was one year. Patients and Methods: Fifty patients, both males and females with failed endodontic treatment were selected. Saliva and root canal samples were collected from each patient, inoculated on MacKonkey agar plate and incubated at 35-37 degree C for 48 hrs. E. faecalis colonies were identified by colony morphology, gramstain, catalase, bile asculin test, arabinose fermentation and growth in 6% NaCl nutrient broth. Results: The frequency of E. faecalis in saliva was 34% and in root canal it was 58%. Frequency between the presence of E. faecalis in root canals and saliva was found to be statistically different (p = 0.001). Conclusion: The presence of E. faecalis in root canal was not associated with their presence in saliva. (author)

Frequency of enterococcus faecalis in saliva and root canals with treatment failure

International Nuclear Information System (INIS)

Shan, T.; Manzoor, M.A.; Hussain, W.

2014-01-01

To compare the frequency of E.faecalis in the saliva and root canals of teeth associated with apical periodontitis due to endodontic treatment failure Study. Design: Cross-sectional comparative. Place and Duration of Study: Samples were collected from Operative Dentistry department, AFID, while laboratory processing was done at AFIP, Rawalpindi. Duration of this study was one year. Patients and Method: Fifty patients, both males and females with failed endodontic treatment were selected. Saliva and root canal samples were collected from each patient, inoculated on MacKonkey agar plate and incubated at 35-370 C for 48 hours. E.faecalis colonies were identified by colony morphology, Gram stain, catalase, bile asculin test, arabinose fermentation and growth in 6% NaCl nutrient broth. Results: The frequency of E.faecalis in saliva was 34% and 58% in root canal samples. Frequency of the presence of E.faecalis in root canals and saliva was found to be statistically different (p=0.000). Conclusion: The presence of E.faecalis in root canal was not associated with their presence in saliva. (author)

Diagnostic validity of methods for assessment of swallowing sounds: a systematic review.

Science.gov (United States)

Taveira, Karinna Veríssimo Meira; Santos, Rosane Sampaio; Leão, Bianca Lopes Cavalcante de; Neto, José Stechman; Pernambuco, Leandro; Silva, Letícia Korb da; De Luca Canto, Graziela; Porporatti, André Luís

2018-02-03

Oropharyngeal dysphagia is a highly prevalent comorbidity in neurological patients and presents a serious health threat, which may lead to outcomes of aspiration pneumonia, ranging from hospitalization to death. This assessment proposes a non-invasive, acoustic-based method to differentiate between individuals with and without signals of penetration and aspiration. This systematic review evaluated the diagnostic validity of different methods for assessment of swallowing sounds, when compared to Videofluroscopic of Swallowing Study (VFSS) to detect oropharyngeal dysphagia. Articles in which the primary objective was to evaluate the accuracy of swallowing sounds were searched in five electronic databases with no language or time limitations. Accuracy measurements described in the studies were transformed to construct receiver operating characteristic curves and forest plots with the aid of Review Manager v. 5.2 (The Nordic Cochrane Centre, Copenhagen, Denmark). The methodology of the selected studies was evaluated using the Quality Assessment Tool for Diagnostic Accuracy Studies-2. The final electronic search revealed 554 records, however only 3 studies met the inclusion criteria. The accuracy values (area under the curve) were 0.94 for microphone, 0.80 for Doppler, and 0.60 for stethoscope. Based on limited evidence and low methodological quality because few studies were included, with a small sample size, from all index testes found for this systematic review, Doppler showed excellent diagnostic accuracy for the discrimination of swallowing sounds, whereas microphone-reported good accuracy discrimination of swallowing sounds of dysphagic patients and stethoscope showed best screening test. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Antimicrobial defense systems in saliva

NARCIS (Netherlands)

van 't Hof, W.; Veerman, E.C.I.; Nieuw Amerongen, A.V.; Ligtenberg, A.J.M.; Ligtenberg, A.J.M.; Veerman, E.C.I.

2014-01-01

The oral cavity is one of the most heavily colonized parts of our body. The warm, nutrient-rich and moist environment promotes the growth of a diverse microflora. One of the factors responsible for the ecological equilibrium in the mouth is saliva, which in several ways affects the colonization and

Effect of endurance training on dental erosion, caries, and saliva.

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Frese, C; Frese, F; Kuhlmann, S; Saure, D; Reljic, D; Staehle, H J; Wolff, D

2015-06-01

The aim of this investigation was to give insights into the impact of endurance training on oral health, with regard to tooth erosion, caries, and salivary parameters. The study included 35 triathletes and 35 non-exercising controls. The clinical investigation comprised oral examination, assessment of oral status with special regard to caries and erosion, saliva testing during inactivity, and a self-administered questionnaire about eating, drinking, and oral hygiene behavior. In addition, athletes were asked about their training habits and intake of beverages and sports nutrition. For saliva assessment during exercise, a subsample of n = 15 athletes volunteered in an incremental running field test (IRFT). Athletes showed an increased risk for dental erosion (P = 0.001). No differences were observed with regard to caries prevalence and salivary parameters measured during inactivity between athletes and controls. Among athletes, a significant correlation was found between caries prevalence and the cumulative weekly training time (r = 0.347, P = 0.04). In athletes after IRFT and at maximum workload, saliva flow rates decreased (P = 0.001 stimulated; P = 0.01 unstimulated) and saliva pH increased significantly (P = 0.003). Higher risk for dental erosions, exercise-dependent caries risk, and load-dependent changes in saliva parameters point out the need for risk-adapted preventive dental concepts in the field of sports dentistry. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Antialarmin effect of tick saliva during the transmission of Lyme disease

NARCIS (Netherlands)

Marchal, Claire; Schramm, Frederic; Kern, Aurélie; Luft, Benjamin J.; Yang, Xiaohua; Schuijt, Tim J.; Hovius, Joppe W.; Jaulhac, Benoît; Boulanger, Nathalie

2011-01-01

Tick saliva has potent immunomodulatory properties. In arthropod-borne diseases, this effect is largely used by microorganisms to increase their pathogenicity and to evade host immune responses. We show that in Lyme borreliosis, tick salivary gland extract and a tick saliva protein, Salp15, inhibit

Evidence-Based Systematic Review: Effects of Neuromuscular Electrical Stimulation on Swallowing and Neural Activation

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Clark, Heather; Lazarus, Cathy; Arvedson, Joan; Schooling, Tracy; Frymark, Tobi

2009-01-01

Purpose: To systematically review the literature examining the effects of neuromuscular electrical stimulation (NMES) on swallowing and neural activation. The review was conducted as part of a series examining the effects of oral motor exercises (OMEs) on speech, swallowing, and neural activation. Method: A systematic search was conducted to…

“Pharyngocise”: Randomized Controlled Trial of Preventative Exercises to Maintain Muscle Structure and Swallowing Function During Head-and-Neck Chemoradiotherapy

International Nuclear Information System (INIS)

Carnaby-Mann, Giselle; Crary, Michael A.; Schmalfuss, Ilona; Amdur, Robert

2012-01-01

Purpose: Dysphagia after chemoradiotherapy is common. The present randomized clinical trial studied the effectiveness of preventative behavioral intervention for dysphagia compared with the “usual care.” Methods and Materials: A total of 58 head-and-neck cancer patients treated with chemoradiotherapy were randomly assigned to usual care, sham swallowing intervention, or active swallowing exercises (pharyngocise). The intervention arms were treated daily during chemoradiotherapy. The primary outcome measure was muscle size and composition (determined by T 2 -weighted magnetic resonance imaging). The secondary outcomes included functional swallowing ability, dietary intake, chemosensory function, salivation, nutritional status, and the occurrence of dysphagia-related complications. Results: The swallowing musculature (genioglossus, hyoglossuss, and mylohyoid) demonstrated less structural deterioration in the active treatment arm. The functional swallowing, mouth opening, chemosensory acuity, and salivation rate deteriorated less in the pharyngocise group. Conclusion: Patients completing a program of swallowing exercises during cancer treatment demonstrated superior muscle maintenance and functional swallowing ability.

Quantifying swallowing function for healthy adults in different age groups using acoustic analysis

Science.gov (United States)

Leung, Man-Yin

Dysphagia is a medical condition that can lead to devastating complications including weight loss, aspiration pneumonia, dehydration, and malnutrition; hence, timely identification is essential. Current dysphagia evaluation tools are either invasive, time consuming, or highly dependent on the experience of an individual clinician. The present study aims to develop a non-invasive, quantitative screening tool for dysphagia identification by capturing acoustic data from swallowing and mastication. The first part of this study explores the feasibility of using acoustic data to quantify swallowing and mastication. This study then further identifies mastication and swallowing trends in a neurotypical adult population. An acoustic capture protocol for dysphagia screening is proposed. Finally, the relationship among speaking, lingual and mastication rates are explored. Results and future directions are discussed.

Effects of isoflurane anesthesia and pilocarpine on rat parotid saliva flow

DEFF Research Database (Denmark)

Knudsen, Jacob Dronninglund; Nauntofte, Birgitte; Josipovic, M

2011-01-01

rats was 50% slower than that of the sham-irradiated rats. In conclusion, 1.5% isoflurane was found to be a good compromise between proper anesthesia and isoflurane-induced inhibition of saliva secretion. Pilocarpine induces saliva secretion in a dose-dependent matter, with supra-maximal stimulation...

Kinetics of Anti-Phlebotomus perniciosus Saliva Antibodies in Experimentally Bitten Mice and Rabbits.

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Inés Martín-Martín

Full Text Available Sand flies are hematophagous arthropods that act as vectors of Leishmania parasites. When hosts are bitten they develop cellular and humoral responses against sand fly saliva. A positive correlation has been observed between the number of bites and antibody levels indicating that anti-saliva antibody response can be used as marker of exposure to sand flies. Little is known about kinetics of antibodies against Phlebotomus perniciosus salivary gland homogenate (SGH or recombinant salivary proteins (rSP. This work focused on the study of anti-P. perniciosus saliva antibodies in sera of mice and rabbits that were experimentally exposed to the bites of uninfected sand flies.Anti-saliva antibodies were evaluated by ELISA and Western blot. In addition, antibody levels against two P. perniciosus rSP, apyrase rSP01B and D7 related protein rSP04 were determined in mice sera. Anti-saliva antibody levels increased along the immunizations and correlated with the number of sand fly bites. Anti-SGH antibody levels were detected in sera of mice five weeks after exposure, and persisted for at least three months. Anti-apyrase rSP01B antibodies followed similar kinetic responses than anti-SGH antibodies while rSP04 showed a delayed response and exhibited a greater variability among sera of immunized mice. In rabbits, anti-saliva antibodies appeared after the second week of exposure and IgG antibodies persisted at high levels, even 7 months post-exposure.Our results contributed to increase the knowledge on the type of immune response P. perniciosus saliva and individual proteins elicited highlighting the use of rSP01B as an epidemiological marker of exposure. Anti-saliva kinetics in sera of experimentally bitten rabbits were studied for the first time. Results with rabbit model provided useful information for a better understanding of the anti-saliva antibody levels found in wild leporids in the human leishmaniasis focus in the Madrid region, Spain.

The effect of dairy farm management regime on swallow (Hirundo rustica) abundance in the Netherlands

NARCIS (Netherlands)

Lubbe, S.K.; Snoo, de G.R.

2007-01-01

Aim To identify differences in Swallow abundance between organically and conventionally managed dairy farms, by examining three factors: farm buildings, food availability and farmer attitudes to Swallows. Methods Organic and conventional dairy farm holdings were compared in pairwise fashion. On

Radioimmunological analysis of circadian rhythms of cortisol and melatonin in saliva

International Nuclear Information System (INIS)

Demel, A.W.

1990-12-01

Since blood cortisol (F) and melatonin (MLT) display a circadian secretion pattern and since the saliva concentration of this hormones is an excellent indicator of its blood levels the measurement of salivary F and MLT may be user for examining circadian rhythmicity. In this study the relationship between salivary F and MLT was explored. For this purpose it was necessary first to establish and validate a radioimmunoassay for F in saliva: salivary F was determined by a direct radioimmunoassay using cortisol-3-(O-carb oxymethyl) oximino-(2-( 125 I)iodohistamin) as tracer and cortisol-3-CMO-BSA antiserum. The parallel measurement of F levels in saliva and serum of adults gave an excellent correlation (r=0.87, p 0.00956x ). Serum F was assayed on the Abott TDX-System using a radioimmunofluorescence method. Secondly, using this assay the circadian saliva F pattern was determined as well as the pattern of salivary MLT in 9 young, healthy volunteers. For saliva MLT estimations a previously published method was applied (SCHULZ et al 1990). Using a computerized program (RHYTHM) written by EVE v. CAUTER (1979), the hormone data of each individuum were examined for circadian rhythmicity and its acrophase (time of occurence of the maximum of a sinusoid fitted to the data). The F acrophase occured between 7:00 and 12:00 h (Mean: 3:33 h, SD: 104.4 min). The easy stress-free non invasive nature of saliva collection makes saliva to one of the most accessible body fluids and of high value in studying the circadian system in healthy humans as well as in infants, children, pregnant women and anaemic patients. Measurements of salivary F and MLT may help to elucidate not only the circadian rhythms of these hormones under normal and pathological conditions but it may also provide insight in physiology and pathology of the circadian system in general. (author)

Bacterial profiles of saliva in relation to diet, lifestyle factors, and socioeconomic status

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Daniel Belstrøm

2014-04-01

Full Text Available Background and objective: The bacterial profile of saliva is composed of bacteria from different oral surfaces. The objective of this study was to determine whether different diet intake, lifestyle, or socioeconomic status is associated with characteristic bacterial saliva profiles. Design: Stimulated saliva samples from 292 participants with low levels of dental caries and periodontitis, enrolled in the Danish Health Examination Survey (DANHES, were analyzed for the presence of approximately 300 bacterial species by means of the Human Oral Microbe Identification Microarray (HOMIM. Using presence and levels (mean HOMIM-value of bacterial probes as endpoints, the influence of diet intake, lifestyle, and socioeconomic status on the bacterial saliva profile was analyzed by Mann–Whitney tests with Benjamini–Hochberg's correction for multiple comparisons and principal component analysis. Results: Targets for 131 different probes were identified in 292 samples, with Streptococcus and Veillonella being the most predominant genera identified. Two bacterial taxa (Streptococcus sobrinus and Eubacterium [11][G-3] brachy were more associated with smokers than non-smokers (adjusted p-value<0.01. Stratification of the group based on extreme ends of the parameters age, gender, alcohol consumption, body mass index (BMI, and diet intake had no statistical influence on the composition of the bacterial profile of saliva. Conversely, differences in socioeconomic status were reflected by the bacterial profiles of saliva. Conclusions: The bacterial profile of saliva seems independent of diet intake, but influenced by smoking and maybe socioeconomic status.

Saliva secretion difference before and after rinsing with baking soda on menopause women

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Dewi Anggraeni

2007-03-01

Full Text Available Menopause women can experience a decrease in saliva secretion (decrease. To understand the clear picture about saliva secretion, the volume, flow rate, pH and viscosity were then measured. The aim of this research was to obtain a picture about the difference of saliva secretion before and after rinsing with baking soda on menopause women. The type of the research used was a laboratory quasi-experiment with comparative descriptive form. The technique used in this research is the survey method, and samples were taken using the multistage cluster random sampling method, and t-student statistical analysis. This research was conducted with the saliva collected with spitting method on 45 menopause women. The results show that the average volume, flow rate, pH and viscosity before rinsing with baking soda was 1.79 ml, 0.18 ml/minute, 7.40 and 0.81 mm2/second. The average volume, flow rate, pH and viscosity after rinsing with baking soda were 2.66 ml; 0.27 ml/minute; 8.67 and 0.78 mm2/second. Statistical analysis t-student on α = 0.05 shows volume changes, flow rate, pH and saliva viscosity before and after rinsing with baking soda was 0.873; 0.086; 1.273 and 0.037 respectively. The conclusion shows a significant difference between saliva secretion before and after rinsing with baking soda, and saliva secretion after rinsing with baking soda on menopause women.

Erosive potential of saliva stimulating tablets with and without fluoride in irradiated head and neck cancer patients

DEFF Research Database (Denmark)

Lajer, Christel; Buchwald, Christian; Nauntofte, Birgitte

2009-01-01

stimulated saliva without fluoride, and with fluoride. Saliva pH was determined without loss of CO(2) and in combination with inorganic measures used to calculate the degree of saturation of hydroxyapatite (HAp) and fluorapatite (FAp). EP was determined directly in all saliva samples by monitored dissolution......BACKGROUND: Patients irradiated in the head and neck region often suffer from severe dry mouth and use acidic saliva stimulating products, which may cause erosion of teeth. PURPOSE: To determine saliva stimulating effects and erosive potential (EP) of acidic saliva stimulating tablets (Xerodent...

Difficult to swallow: patient preferences for alternative valproate pharmaceutical formulations

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Monali Bhosle

2009-06-01

Full Text Available Monali Bhosle,1 Joshua S Benner,1 Mitch DeKoven,1 Jeff Shelton21Health Economics and Outcomes Research, IMS Health Inc, Falls Church, VA, USA; 2Answers and Insights Market Research, Inc, Indianapolis, IN, USAObjective: To determine the degree to which swallowing valproate (VP tablets is an issue, the proportion of patients who would prefer an alternative formulation, and the predictors of preference.Methods: A quantitative telephone survey of eligible adults (n = 400, ≥18 years old who currently take (n = 236 or previously took (n = 164 VP tablets within the past 6 months was conducted.Results: More than half of the patients indicated that VP tablets were ‘uncomfortable to swallow’ (68.5%, n = 274 and were ‘very interested’ (65.8%, n = 263 in medications that were easier to swallow. When choosing conceptually between taking VP tablet once/day or an equally safe and effective but significantly smaller soft gel capsule twice per day, the 82.8%, (n = 331 preferred the soft gel capsule. In the multivariate regression analysis, perceiving soft gel capsules to be easier to swallow (OR = 73.54; 95% CI = 15.01 to 360.40 and taking VP more frequently (OR = 2.02; 95% CI = 1.13 to 3.61 were significant predictors of soft gel capsule treatment preference.Conclusion: VP users would prefer a formulation that is easier to swallow, even if it is needed to be taken twice per day. When choosing between medications with similar efficacy and safety, physicians can consider patient preferences to optimize conditions for medication adherence.Keywords: patient preference, valproate formulations, tablet characteristics

Analysis of oropharyngeal dysphagia through fibroendoscopy evaluation of swallowing in patients with Parkinson's disease.

Science.gov (United States)

Correa-Flores, Melissa; Arch-Tirado, Emilio; Villeda-Miranda, Alicia; Rocha-Cacho, Karina Elizabeth; Verduzco-Mendoza, Antonio; Hernández-López, Xochiquetzal

2012-01-01

Parkinson's disease (PD) has a high incidence in Mexico and is estimated at approximately 500,000 patients. One of the main clinical manifestations of PD is dysphagia, which is the difficult passage of food from the mouth to the stomach. The aim of this study was to assess oropharyngeal dysphagia through fibroendoscopy evaluation of swallowing in patients with PD. We conducted a census sample of patients with PD: 17 males and 10 females, aged >49 years. Clinical history, physical examination and neurological evaluation of swallowing fibroendoscopy were carried out. Of the symptomatic patients, 16 patients (59.25%) reported dysphagia. Fibroendoscopic evaluation demonstrated swallowing disorders in 25 patients (92.59%). The main findings were poor bolus control in 19 patients (70.37%), deficits in bolus propulsion in 25 patients (92.59%), impaired swallowing in 14 patients (51.85%), fractional swallowing in 11 patients (40.74%), reduced epiglottic tilting in 11 patients (48.14%), food residue in vallecula in 24 patients (88.88%) and piriform sinus in 19 patients (70.37%). There was no correlation between duration of PD and degree of involvement of oropharyngeal dysphagia. Oropharyngeal dysphagia in patients with PD is a common symptom and can range from the oral cavity to the upper esophageal sphincter. Early onset of severe dysphagia is exceptional in this disease and should alert the clinician to the diagnostic possibility of parkinsonism.

Cigarette smoke-exposed saliva suppresses cellular and humoral immune responses in an animal model

International Nuclear Information System (INIS)

Jafarzadeh, A.; Bakhshi, H.; Rezayati, M.T.; Nemati, M.

2009-01-01

To evaluate the effects of cigarette smoke (CS)-exposed saliva on cellular and antibody responses in an animal model. The stimulatory and non-stimulatory saliva samples were collected from 10 healthy subjects and were then exposed to CS for 20 or 80 minutes. The CS-exposed saliva samples were administrated intraperitoneally (i.p) to male Balb/c mice. Then the delayed type hypersensitivity (DTH) and antibody responses to sheep red blood cell (SRBC) was assessed. Moreover, the total white blood cells (WBC) counts and the blood lymphocytes counts were determined. The mean of DTH responses of animal groups received 20 minutes or 80 minutes CS-exposed saliva samples was significantly lower than that observed in control group. Moreover, The mean titer of anti-SRBC antibody was significantly lower in animal groups who received 80 minutes CS-exposed stimulatory or non-stimulatory saliva as compared to control group (P<0.04 and P<0.002, respectively). The mean counts of blood lymphocytes in 80 minutes CS exposed-stimulatory saliva group was also significantly lower as compared to control group (P<0.05). These results show that the CS-exposed saliva samples have profound suppressive effects on both cellular and humoral immune response in a mouse animal model (JPMA 59:760; 2009). (author)

Total Protein of Whole Saliva as a Biomarker of Anaerobic Threshold

Science.gov (United States)

Bortolini, Miguel Junior Sordi; De Agostini, Guilherme Gularte; Reis, Ismair Teodoro; Lamounier, Romeu Paulo Martins Silva; Blumberg, Jeffrey B.; Espindola, Foued Salmen

2009-01-01

Saliva provides a convenient and noninvasive matrix for assessing specific physiological parameters, including some biomarkers of exercise. We investigated whether the total protein concentration of whole saliva (TPWS) would reflect the anaerobic threshold during an incremental exercise test. After a warm-up period, 13 nonsmoking men performed a…

The effect of saliva composition on texture perception of semi-solids

NARCIS (Netherlands)

Engelen, L.; Keybus, P.A.M. van den; Wijk, R.A. de; Veerman, E.C.I.; Amerongen, A.V.N.; Bosman, F.; Prinz, J.F.; Bilt, A. van der

2007-01-01

Saliva is expected to be of significance for the perception of food stimuli in the mouth. Mixing the food with saliva, including breakdown and dilution, is considered to be of large importance for semi-solids as these products are masticated without chewing. It is known that there are large

Swallowing assessment in early laryngeal cancer patients treated either with surgery or radiotherapy

International Nuclear Information System (INIS)

Celedon L, Carlos; Gambi A, Galo; Royer F, Michel; Esquivel C, Patricia; Arteaga J, Patricia; Valdes P, Constanza

2008-01-01

Swallowing is a complex neuromuscular process that requires anatomical indemnity and an adequate coordination of several organs. Laryngeal cancer treatment may cause swallowing disorders. Traditionally, a high frequency of this type of disorder after surgery has been reported, but no actual data concerning its incidence in patients undergoing radiotherapy for early laryngeal cancer has been published. Aim. To compare swallowing disorders frequency posterior to treatment in early laryngeal cancer patients. Material and Method. Two groups of early laryngeal cancer patients were transversally studied, one treated with vertical partial surgery (CP), and the other treated exclusively with radiotherapy. Each patient had otorhinolaryngological, nasofibroscopic and video fluoroscopic evaluations after treatment. Differences between groups were compared using the - square test. Results. Twenty patients per group were entered in this study, predominantly males of similar age. Both groups presented a high incidence of aspiration symptoms (55% in RT and 35% in CP). There were no significant differences between both groups. Discussion and Conclusion. A high incidence of swallowing disorders in patients treated for early laryngeal cancer was found. It should then be considered as a frequent alteration in this group of patients, either treated with RT or CP

Kontrasepsi Hormonal Meningkatkan Kadar α-Amylase Saliva

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Juni Handajani

2014-06-01

Full Text Available Salivary α-amylase atau α-amylase saliva (SAA adalah salah satu enzim dalam saliva yang berperan penting pada inisiasi digesti karbohidrat dan fungsi interaksi bakteri. Kontrasepsi hormonal sangat populer di Indonesia untuk mencegah kehamilan. Penelitian ini bertujuan untuk mengetahui kadar SAA wanita pemakai kontrasepsi pil dan suntik. Subjek penelitian sebanyak 30 perempuan usia 20-35 tahun. Prosedur penelitian telah mendapat persetujuan dari Komite Etik Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta. Subjek dibagi menjadi 3 kelompok (pemakai kontrasepsi pil, suntik, dan kontrol, masing-masing 10 perempuan. Kriteria subjek antara lain subjek sehat, tidak menggunakan alat ortodontik, protesa atau mahkota, serta menggunakan kontrasepsi hormonal lebih dari 3 bulan. Sampel saliva dikumpulkan pada sore hari (16.00-18.00 WIB selama 1 menit dengan metode tanpa stimulasi. Kadar tingkat SAA diukur menggunakan ELISA kit (Salimetrics LLC dengan Optical Density (OD pada 405 nm. Data dianalisis menggunakan ANOVA (p<0,05. Hasil penelitian menunjukkan kadar SAA tertinggi pada perempuan pemakai kontrasepsi  pil dan ada perbedaan yang signifikan diantara tiga kelompok. Disimpulkan bahwa kontrasepsi hormonal meningkatkan kadar SAA. Hormonal Contraceptive Increased The Level of Salivary Α-Amylase. Salivary α-amylase (SAA is one of the most important enzymes in saliva. This enzyme was mainly involved in the initiation of the digestion of starch in the oral cavity and has significant bacterial interactive function. Hormonal contraceptives are very popular in Indonesia to avoid pregnancy. This study aimed to evaluate the level of SAA in woman who taking pill and by injection contraceptives. Thirty women were in subjects, 20-35 years old, approval ethical clearance from Ethic Committee Medical Faculty of Gadjah Mada University, Yogyakarta Indonesia. Subjects were divided into three groups (taking pill contraceptive, by injection contraceptive and

Saliva/serum ghrelin, obestatin and homocysteine levels in patients with ischaemic heart disease

Science.gov (United States)

Kilic, Nermin; Dagli, Necati; Aydin, Suleyman; Erman, Fazilet; Bek, Yuksel; Akin, Okhan; Kilic, SS; Erdemli, Haci Kemal; Alacam, Hasan

2017-01-01

Summary Background: We aimed to compare ghrelin, obestatin, homocysteine (Hcy), vitamin B12 and folate levels in the serum and saliva of ischaemic heart disease patients. Methods: Serum and saliva were collected from 33 ischaemic heart disease (IHD) patients and 28 age- and body mass index-matched healthy individuals. Levels of acylated and desacylated ghrelin, obestatin and Hcy were determined using the ELISA method. Results: Acylated ghrelin, desacylated ghrelin and obestatin levels in the saliva were found to be higher than those in the serum of the control group, while acylated and desacylated ghrelin levels in the saliva were significantly lower than those in the serum. Obestatin levels were higher in IHD patients (p = 0.001). Saliva and serum vitamin B12 and folate levels in IHD patients were significantly lower than in the control group (p = 0.001). Conclusions: It was determined that serum ghrelin levels increased in ischaemic heart disease patients, while serum levels of obestatin decreased. PMID:28759087

Hubungan Body Mass Index dengan Laju Aliran Saliva (Studi pada Mahasiswa Fakultas Kedokteran Gigi Universitas Andalas

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Fildzah Nurul Fajrin

2015-12-01

Relationship between Body Mass Index and Saliva Flow Rate (A Study in Faculty of Dentistry, Andalas University. Saliva flow rate is an affecting factor of caries formation. Adequate saliva flow rate can prevent cariess formation process and progression of periodontal disease and oral infection. Nutritional status is known as an influencing factor of saliva flow rate. The parameter of nutritional status is Body Mass Index (BMI. The purpose of this study is to discover the relation between BMI and saliva flow rate in College Students of the Dentistry Faculty Andalas University. This observational study with cross sectional design was conducted to 24 college students of the Dentistry Faculty Andalas University whose ages were 18-25 years old who complied with inclussion and exclussion criteria. BMI was calculated with BMI formula. The saliva flow rate was determined with Sialometry Method of Navazesh 2008 with ”ml/minute” unit. The univariat data analysis was caried out to describe each variable. Normality test Kolmogorov Smirnoff was done to see the normal distribution (p > 0,05. After the distribution was proven to be normal, corelation and regression test was executed to discover the relation between BMI and saliva flow rate. Based on the correlation test result, BMI of college students of the Dentistry Faculty Andalas University is χχ ± SD = 24,6 ± 6,02 kg/m2 and saliva flow rate is χχ ± SD = 0,29 ± 0,1 ml/minute. The relation between BMI and saliva flow rate expresses medium correlation with negative direction ( r = - 0,451. The result of linear regression shows that Saliva Flow Rate = 0,404 - 0,008*(BMI. The coefficient of regression BMI 0.008 shows that increasing 1 unit of BMI will decrease saliva flow rate 0,008 ml/minute. This study concludes that there is correlation between Body Mass Index and saliva flow rate. Obesity group has the lowest saliva flow rate, while the saliva flow rate does not decrease in underweight group.

Use of fiberoptic endoscopic evaluation of swallowing (FEES) in the management of psychogenic dysphagia in children.

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Thottam, Prasad John; Silva, Rodrigo C; McLevy, Jennifer D; Simons, Jeffrey P; Mehta, Deepak K

2015-02-01

To describe the use of fiberoptic endoscopic evaluation of swallowing (FEES) as an adjunct in the management of children presenting with psychogenic dysphagia, defined as food avoidance and excessive fear of eating without identifiable anatomic or functional swallowing abnormalities. Case series of patients presenting to the otolaryngology clinic of a tertiary pediatric teaching hospital between 2007 and 2008 that were evaluated and managed with the utilization of FEES. The outcomes measured were age, gender, duration of symptoms, findings of FEES, additional work-up and resolution of symptoms at follow-up. Five patients (4 males, 1 female) with ages ranging from 5 to 13 years old (mean=8.6). The median duration of symptoms before presentation was 3 weeks. Four families described refusal of solids starting after choking episode and variable estimated weight loss (mean 2.8kg). One child presented with vague complaints of intermittent odynophagia and food refusal. Fiberoptic endoscopic evaluation of swallowing was performed on all patients. No abnormalities of the oropharyngeal swallow were appreciated. Additional management included different combinations of modified barium swallow study, esophagastroduodenoscopy (EGD), upper GI series, antibiotics, and psychotherapy. Mean follow-up with clinic visit was 4.2 months. Three of the five children reported complete resolution of symptoms after FEES at follow-up visit. Fiberoptic endoscopic evaluation of swallowing can be a useful management tool in children with psychogenic dysphagia as it provides direct visualization of the oropharyngeal swallowing mechanism. This can be used to provide visual reassure and biofeedback to patients and parents. Additional workup should be decided on an individual basis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Non-Coding RNAs in Saliva: Emerging Biomarkers for Molecular Diagnostics

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Blanca Majem

2015-04-01

Full Text Available Saliva is a complex body fluid that comprises secretions from the major and minor salivary glands, which are extensively supplied by blood. Therefore, molecules such as proteins, DNA, RNA, etc., present in plasma could be also present in saliva. Many studies have reported that saliva body fluid can be useful for discriminating several oral diseases, but also systemic diseases including cancer. Most of these studies revealed messenger RNA (mRNA and proteomic biomarker signatures rather than specific non-coding RNA (ncRNA profiles. NcRNAs are emerging as new regulators of diverse biological functions, playing an important role in oncogenesis and tumor progression. Indeed, the small size of these molecules makes them very stable in different body fluids and not as susceptible as mRNAs to degradation by ribonucleases (RNases. Therefore, the development of a non-invasive salivary test, based on ncRNAs profiles, could have a significant applicability to clinical practice, not only by reducing the cost of the health system, but also by benefitting the patient. Here, we summarize the current status and clinical implications of the ncRNAs present in human saliva as a source of biological information.

Erosive potential of saliva stimulating tablets with and without fluoride in irradiated head and neck cancer patients

International Nuclear Information System (INIS)

Lajer, Christel; Buchwald, Christian; Nauntofte, Birgitte; Specht, Lena; Bardow, Allan; Jensdottir, Thorbjoerg

2009-01-01

Background: Patients irradiated in the head and neck region often suffer from severe dry mouth and use acidic saliva stimulating products, which may cause erosion of teeth. Purpose: To determine saliva stimulating effects and erosive potential (EP) of acidic saliva stimulating tablets (Xerodent TM ) with and without fluoride in irradiated head and neck cancer patients. Materials and method: Nineteen irradiated patients (median age 57 years) sucked Xerodent TM tablets with and without fluoride. Saliva collections were divided into three 10-min sessions in the sequence: unstimulated whole saliva, Xerodent TM stimulated saliva without fluoride, and with fluoride. Saliva pH was determined without loss of CO 2 and in combination with inorganic measures used to calculate the degree of saturation of hydroxyapatite (HAp) and fluorapatite (FAp). EP was determined directly in all saliva samples by monitored dissolution of HAp crystals. Results: Saliva flow rates increased significantly (15-fold) when sucking both tablets (p TM with and without fluoride were evaluated as non-erosive, however, for additional caries protection the fluoride variant is preferable.

DNA extraction from human saliva deposited on skin and its use in forensic identification procedures Extração de DNA de saliva humana depositada sobre a pele e sua aplicabilidade aos processos de identificação forense

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Evelyn Anzai-Kanto

2005-09-01

Full Text Available Saliva is usually deposited in bite marks found in many homicides, assault and other criminal cases. In the present study, saliva obtained from volunteers was deposited on skin and recovered for DNA extraction and typing in order to evaluate its usefulness for practical case investigation and discuss the contribution of forensic dentistry to saliva DNA typing. Twenty saliva samples were colleted from different donors and used as suspects' samples. Five of these samples were randomly selected and deposited (250 µl on arm skin. Saliva was collected from skin using the double swab technique. DNA from saliva and skin-deposited saliva samples was extracted by the phenol-chloroform method. DNA samples were amplified by PCR for DNA typing using a set of 15 STRs. The recovery of DNA from saliva deposited in the skin was 14 to 10 times lower than DNA quantity from saliva samples. DNA typing was demonstrated in 4 of 5 deposited saliva samples, the likelihood ratios estimated for these samples based on data of the Brazilian population were 1:11, 1:500, 1:159.140 and 1:153.700.123. Our results indicate that standardized procedures used for DNA collection and extraction from skin-deposited saliva can be used as a method to recover salivary DNA in criminal cases. However, it is important to observe that DNA recovery in forensic samples can be difficult. This study suggests that the analysis of saliva deposited on skin be incorporated into a criminal investigation since it may have great discriminatory power.A saliva é usualmente depositada em marcas de mordida encontradas em homicídios, agressões e outros crimes. Neste estudo, a saliva obtida de voluntários foi depositada na pele, recuperada para extração e tipagem do DNA, para avaliação de sua utilização e sua contribuição na odontologia legal. Vinte amostras de saliva foram coletadas de diferentes doadores e utilizadas como amostras de suspeitos. Cinco dessas amostras foram sorteadas e

Effects of neuromuscular electrical stimulation combined with effortful swallowing on post-stroke oropharyngeal dysphagia: a randomised controlled trial.

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Park, J-S; Oh, D-H; Hwang, N-K; Lee, J-H

2016-06-01

Neuromuscular electrical stimulation (NMES) has been used as a therapeutic intervention for dysphagia. However, the therapeutic effects of NMES lack supporting evidence. In recent years, NMES combined with traditional swallowing therapy has been used to improve functional recovery in patients with post-stroke dysphagia. This study aimed to investigate the effects of effortful swallowing combined with neuromuscular electrical stimulation on hyoid bone movement and swallowing function in stroke patients. Fifty stroke patients with mild dysphagia who were able to swallow against the resistance applied by using NMES and cooperate actively in training were included. This study was designed as a 6-week single-blind, randomised, controlled study. In the experimental group, two pairs of electrodes were placed horizontally in the infrahyoid region to depress the hyoid bone. The NMES intensity was increased gradually until the participants felt a grabbing sensation in their neck and performed an effortful swallow during the stimulation. In the placebo group, the same procedure was followed except for the intensity, which was increased gradually until the participants felt an electrical sensation. All participants underwent this intervention for 30 min per session, 5 sessions per week, for 6 weeks. Videofluoroscopic swallowing studies (VFSS) were carried out before and after the intervention and kinematics of the hyoid bone and swallowing function were analysed based on the VFSS. The experimental group revealed a significant increase in anterior and superior hyoid bone movement and the pharyngeal phase of the swallowing function. This intervention can be used as a novel remedial approach in dysphagic stroke patients. © 2016 John Wiley & Sons Ltd.

Comprehensive swallowing exercises to treat complicated dysphagia caused by esophageal replacement with colon: A case report.

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Jiang, Li; Wang, Yujue; Li, Na; Qiu, Weihong; Wu, Huixiang; Huo, Jianshan; Dai, Meng; Yu, Yong; Wan, Guifang; Dou, Zulin; Guo, Weiping

2017-02-01

Surgical procedures for colonic replacement of the esophagus are most commonly associated with anastomotic stricture which cause dysphagia. In this report, we describe a rare case of a patient who demonstrated dysphagia resulting from an anastomotic stricture following esophageal replacement with the colon. All the treatments to dilate the anastomotic stricture were ineffective. To investigate the new treatment strategy for a case with complicated dysphagia, clinical dysphagia evaluations, functional oral intake scale (FOIS), videofluoroscopic swallowing study as well as high-resolution manometry were used to evaluate the swallowing function of the patient before and after treatments. Comprehensive swallowing exercises included the protective airway maneuver, tongue pressure resistance feedback exercise, Masako Maneuver swallowing exercise, and the effortful swallowing exercise. Comprehensive swallowing exercises showed good effect in the patient. The FOIS score increased from level 1 to level 7. The videofluoroscopy digital analysis showed that the pharynx constriction rate was 23% and 50%, before and after treatment, respectively. The data from the high-resolution manometry displayed that: the value of the velopharyngeal pressure peak was 82.8 mmHg before treatment and 156.9 mmHg after treatment; the velopharyngeal contraction duration time was 310 milliseconds before treatment and 525 milliseconds after treatment; the value of the hypopharynx pressure peak was 53.7 mmHg before treatment and 103.2 mmHg after treatment; and the hypopharynx contraction duration time was 390 milliseconds before treatment and 1030 milliseconds after treatment. The swallowing visualization illustrated that a bolus could normally pass through the anastomotic stoma, and the bolus leakage was no longer present. The patient was able to eat various consistencies of food independently, and we were able to remove the jejunum nutrient catheter before discharging the patient. For

Reflex Cough and Disease Duration as Predictors of Swallowing Dysfunction in Parkinson's Disease.

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Troche, Michelle S; Schumann, Beate; Brandimore, Alexandra E; Okun, Michael S; Hegland, Karen W

2016-12-01

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. ROC and Chi-square analyses identified predictors of swallowing safety (penetration-aspiration score) in PD. Disease duration significantly discriminated between patients with normal and abnormal swallowing safety (p = 0.027, sensitivity: 71 %, specificity: 55.4 %). Cough reflex sensitivity significantly discriminated between patients who penetrated above the level of the vocal folds and those with more severe penetration/aspiration (p = 0.021, sensitivity: 71.0 %, specificity 57.6 %). Urge-to-cough sensitivity (log-log linear slope) was the only variable which significantly discriminated between patients with penetration versus aspiration (p = 0.017, sensitivity: 85.7 %, specificity 73.2 %). It is important to identify the factors which influence airway protective outcomes in PD especially given that aspiration pneumonia is a leading cause of death. Results from this study highlight the ecological validity of reflex cough in the study of airway protection and this study further identifies important factors to consider in the screening of airway protective deficits in PD.

Objective clinical assessment of change in swallowing ability of maxillectomy patients when wearing obturator prostheses.

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Matsuyama, Miwa; Tsukiyama, Yoshihiro; Koyano, Kiyoshi

2005-01-01

Evaluation of treatment outcome is important in maxillofacial rehabilitation. Although eating is one of the oral functions that most strongly influences patients' quality of life, only a few reports exist on the objective assessment of swallowing for maxillectomy patients. The purpose of this study was to identify changes in the swallowing ability of maxillectomy patients when wearing obturator prostheses through the use of an objective clinical assessment. The swallowing ability of 38 postmaxillectomy patients consecutively treated with obturator prostheses was objectively evaluated with the "water-drinking test" that was developed for the assessment of dysphagia patients after cerebrovascular disease. In this test, the subjects were instructed to drink 30 mL of water in one swallow. The profile was evaluated with the combination of the time required for drinking the water and the incidence of cough reflex. Statistical analysis was performed using the Wilcoxon signed-rank test, the paired t test, and the Chi-square test with StatView 5.0 for the Macintosh. Performance improved significantly when the patients wore prostheses (P = .0026, Wilcoxon signed-rank test). The mean drinking times without and with prostheses were 8.2 +/- 6.3 s and 5.0 +/- 3.5 s, respectively. Drinking time was shortened significantly when the prosthesis was worn (P = .0002, paired t test). The assessment of behavior and episodes revealed that the swallowing ability of the maxillectomy patients was significantly improved when a prosthesis was worn (P = .0002, Chi-square test). The swallowing ability of maxillectomy patients was quantitatively and qualitatively improved with obturator prostheses.

Identifikasi epitop dari Streptococcus mutans terhadap sekretori Imunoglobulin A saliva (The identification of Streptococcus mutans epitopes to secretory Immunoglobulin A saliva

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Anita Yuliati

2005-09-01

Full Text Available S. mutans is one of the etiology agent of dental caries, these bacteria have a surface protein of about 185 kDa named Ag I/II. The secretory of sIgA saliva to Ag I/II of S.mutans has shown to be able to prevent colonization in human oral cavity. Peptides derived from the 824 to 853 residues of the P region of antigen I/II S. mutans related to the pathogenesis of dental caries. The aim of this study was to identify the overlapping sequence of amino acids (epitope derived from the 624 to 853 residues of P of antigen I/II S. mutans to sIgA saliva on caries and caries-free subject in a observational cross sectional study. The P region of antigen I/II S.mutans was cut into 22 peptides of 9 mer sequences with an overlapping of 8 mer and an offset of 1 mer, synthesized on polyethylene pins and tested for the reactivity with an ELISA indirect method to sIgA saliva on caries and caries-free subject. The results of this study showed that amino acid sequences with TPPVKP (832–837 and TAPTKPTY (838–845 were reactive to sIgA saliva on caries and caries-free subject. The conclusion of this study was that the overlapping common sequence of amino acid (epitopes corresponding to TPPVKP (832–837 and TAPTKPTY (838–845 was identified as caries marker epitopes in human.

The study on development of easily chewable and swallowable foods for elderly.

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Kim, Soojeong; Joo, Nami

2015-08-01

When the functions involved in the ingestion of food occurs failure, not only loss of enjoyment of eating, it will be faced with protein-energy malnutrition. Dysmasesis and difficulty of swallowing occurs in various diseases, but it may be a major cause of aging, and elderly people with authoring and dysmasesis and difficulty of swallowing in the aging society is expected to increase rapidly. In this study, we carried out a survey targeting nutritionists who work in elderly care facilities, and examined characteristics of offering of foods for elderly and the degree of demand of development of easily chewable and swallowable foods for the elderly who can crush foods and take that by their own tongues, and sometimes have difficulty in drinking water and tea. In elderly care facilities, it was found to provide a finely chopped food or ground food that was ground with water in a blender for elderly with dysmasesis. Elderly satisfaction of provided foods is appeared overall low. Results of investigating the applicability of foods for elderly and the reflection will of menus, were showed the highest response rate in a gelification method in molecular gastronomic science technics, and results of investigating the frequent food of the elderly; representative menu of beef, pork, white fish, anchovies and spinach, were showed Korean barbecue beef, hot pepper paste stir fried pork, pan fried white fish, stir fried anchovy, seasoned spinach were the highest offer frequency. This study will provide the fundamentals of the development of easily chewable and swallowable foods, gelification, for the elderly. The study will also illustrate that, in the elderly, food undergone gelification will reduce the risk of swallowing down to the wrong pipe and improve overall food preference.

Protein buffering in model systems and in whole human saliva.

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Andreas Lamanda

Full Text Available The aim of this study was to quantify the buffer attributes (value, power, range and optimum of two model systems for whole human resting saliva, the purified proteins from whole human resting saliva and single proteins. Two model systems, the first containing amyloglucosidase and lysozyme, and the second containing amyloglucosidase and alpha-amylase, were shown to provide, in combination with hydrogencarbonate and di-hydrogenphosphate, almost identical buffer attributes as whole human resting saliva. It was further demonstrated that changes in the protein concentration as small as 0.1% may change the buffer value of a buffer solution up to 15 times. Additionally, it was shown that there was a protein concentration change in the same range (0.16% between saliva samples collected at the time periods of 13:00 and others collected at 9:00 am and 17:00. The mode of the protein expression changed between these samples corresponded to the change in basic buffer power and the change of the buffer value at pH 6.7. Finally, SDS Page and Ruthenium II tris (bathophenantroline disulfonate staining unveiled a constant protein expression in all samples except for one 50 kDa protein band. As the change in the expression pattern of that 50 kDa protein band corresponded to the change in basic buffer power and the buffer value at pH 6.7, it was reasonable to conclude that this 50 kDa protein band may contain the protein(s belonging to the protein buffer system of human saliva.

Observations on saliva osmolality during progressive dehydration and partial rehydration.

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Taylor, Nigel A S; van den Heuvel, Anne M J; Kerry, Pete; McGhee, Sheena; Peoples, Gregory E; Brown, Marc A; Patterson, Mark J