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Sample records for swallow riparia riparia

  1. Population Trends and Management of the Bank Swallow (Riparia riparia) on the Sacramento River, California

    Science.gov (United States)

    Barrett A. Garrison; Ronald W. Schlorff; Joan M. Humphrey; Stephen A. Laymon; Frank J. Michny

    1989-01-01

    Annual monitoring of Bank Swallows (Riparia riparia) along the Sacramento River, California has been conducted since 1986 to determine population trends, evaluate impacts from bank protection and flood control projects, and implement and monitor mitigation efforts. The population of Bank Swallows in a 50-mile river reach remained static over 3...

  2. Aerial Hunting Techniques and Predation Success of Hobbies Falco subbuteo on Sand Martin Riparia riparia at Breeding Colonies

    National Research Council Canada - National Science Library

    R. Probst; H.L. Nemeschkal; M. McGrady; M. Tucakov; T. Szép

    2011-01-01

    Probst R., Nemeschkal H.L., McGrady M., Tucakov M. & Szép T. 2011. Aerial hunting techniques and predation success of Hobbies Falco subbuteo on Sand Martin Riparia riparia at breeding colonies. Ardea 99: 9–16...

  3. Effect of food shortage on the physiology and competitive abilities of sand martin (Riparia riparia) nestlings.

    Science.gov (United States)

    Brzek, P; Konarzewski, M

    2001-09-01

    We examined developmental and behavioural plasticity of sand martin (Riparia riparia) nestlings hand-reared under laboratory conditions. We created six broods of six 4-day-old nestlings and randomly assigned them to one of the two following feeding regimens, each lasting for 3 days: (1) all nestmates fed a similar, limited amount of food (FR nestlings). This simulated synchronous hatching under conditions of food restriction. (2) Half the brood were food-restricted (FR/AL nestlings), and half were fed ad libitum (AL nestlings), as in asynchronously hatched broods with differential food allocation. Under both regimens, food restriction resulted in a reduction in body mass, intestinal mass, pectoral muscle mass, fat reserves, body temperature and resting metabolic rate (RMR). However, it simultaneously triggered a significant increase in intestinal uptake rates of L-proline and locomotor activity, quantified as frequency of crawling into the artificial nest tunnel by individual nestlings. Locomotor activity and intestinal uptake rates of L-proline by FR nestlings were higher than those of FR/AL young, while body temperature and RMR of FR nestlings were lower. We conclude that food-restricted nestlings responded actively to food shortages by upregulating their gut function, reducing the energy costs of maintenance and increasing locomotor activity. These behavioural and physiological responses were strongest in broods of similar-sized FR nestlings, which can be interpreted as an escalation of sibling competition. Thus, developmental and behavioural plasticity may be an important factor in the evolution of sibling rivalry.

  4. Systematic notes on Asian birds. 61. New data on taxonomy and nomenclature of the Common Sand Martin Riparia riparia (Linnaeus, 1758) and the Pale Sand Martin R. diluta (Sharpe & Wyatt, 1893)

    NARCIS (Netherlands)

    Loskot, V.M.

    2006-01-01

    The main diagnostic characters of Riparia riparia and R. diluta are discussed based on fresh examinations of extensive material. The opinion of Zarudny that his subspecies innominata belongs to R. riparia is validated, but the series of syntypes of R. riparia innominata includes birds of both these

  5. Morpho-sédimentologie des sites naturels littoraux colonisés par l’Hirondelle de rivage (Riparia riparia)

    OpenAIRE

    Fournier, Jerome; Corbeau, Alexandre; Le Mao, Patrick

    2016-01-01

    L’Hirondelle de rivage Riparia riparia revient annuellement sur un même site pour y établir une colonie. Ces sites sont naturels ou d’origine anthropique mais toujours soumis à des changements permanents. L’espèce se caractérise par sa capacité à creuser des tunnels dans lesquels elle mène à bien son cycle de reproduction. Plusieurs auteurs ont tenté d’identifier les critères utilisés par les hirondelles pour choisir un site favorable à l’installation d’une colonie Parmi les nombreux paramètr...

  6. Antidermatophytic activity of hydroalcoholic extracts from Rosmarinus officinalis and Tetradenia riparia.

    Science.gov (United States)

    Endo, E H; Costa, G M; Nakamura, T U; Nakamura, C V; Dias Filho, B P

    2015-12-01

    Rosmarinus officinalis and Tetradenia riparia are used in folk medicine for the treatment of disease, including infectious diseases and skin disorders. The purpose of this study was to investigate the antifungal activity of hydroalcoholic extracts from R. officinalis and T. riparia against strains of Trichophyton rubrum, T. mentagrophytes and Microsporum gypseum. Hydroalcoholic extracts prepared with dried leaves from R. officinalis, Psidium guajava and T. riparia were assayed against dermatophyte species by the microdilution technique and by microscopy. R. officinalis and T. riparia were the most active against dermatophytes, as determined from the minimal inhibitory concentration (MIC) and minimal fungicidal concentration (MFC), and were investigated further. Fluorescence microscopy and scanning electron microscopy were used to investigate inhibition of hyphal growth by the two extracts, and showed a strong inhibition and an irregular growth pattern. Both extracts showed good action against dermatophytes, inhibiting fungal growth and causing alterations in their hyphae. Therefore, R. officinalis and T. riparia are potential sources of new compounds for the development of antifungal drugs. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  7. A novel emulsion-forming arabinogalactan gum from the stems of Frost grape (Vitis riparia Michx.)

    Science.gov (United States)

    A novel arabinogalactan polysaccharide (FGP) is described that is produced in large quantities from the cut stems of Frost grape (Vitis riparia Michx.). The sugar composition consists of L-arabinofuranose (L-Araf, 55.2 %) and D-galactopyranose (D-Galp 30.1%), with smaller components of D-xylose (11....

  8. Physical, rheological, functional and film properties of a novel emulsifier: Frost grape polysaccharide (FGP) from Vitis riparia Michx

    Science.gov (United States)

    A novel emulsifier, Frost grape polysaccharide (FGP), isolated from natural exudate of the species Vitis riparia Michx, was physically and rheologically characterized. The determination of the physical, structural, thermodynamic, emulsification, film, and rheological properties of FGP provide essent...

  9. Antimicrobial activity of the essential oil of Tetradenia riparia (Hochst.) Codd. (Lamiaceae) against cariogenic bacteria

    Science.gov (United States)

    de Melo, Nathalya Isabel; de Carvalho, Carlos Eduardo; Fracarolli, Letícia; Cunha, Wilson Roberto; Veneziani, Rodrigo Cassio Sola; Martins, Carlos Henrique Gomes; Crotti, Antônio Eduardo Miller

    2015-01-01

    In Brazilian folk medicine, Tetradenia riparia (Hochst.) Codd. (Lamiaceae) is used to treat toothaches and dental abscesses and diseases induced by worms, bacteria, or fungi. This paper aims to investigate the chemical composition and the antibacterial effects of the essential oil obtained from Tetradenia riparia leaves (TR-EO) grown in Southeastern Brazil against a representative panel of oral pathogens. We evaluated the antibacterial activity of TR-EO in terms of the minimal inhibitory concentration (MIC). We identified aromadendrene oxide (14.0%), (E,E)-farnesol (13.6%), dronabinol (12.5%), and fenchone (6.2%) as the major constituents of TR-EO. TR-EO displayed MIC values between 31.2 and 500 μg/mL, with the lowest MIC value being obtained against Streptococcus mitis (31.2 μg/mL), S. mutans (62.5 μg/mL), S. sobrinus (31.2 μg/mL), and Lactobacillus casei (62.5 μg/mL). In time-kill experiments, TR-EO demonstrated bactericidal activity against S. mutans within the first 12 h, resulting in a curve profile similar to that of chlorhexidine. These results revealed that the essential oil of Tetradenia riparia displays promising activity against most of the selected cariogenic bacteria, including Streptococcus mutans. PMID:26273268

  10. Antimicrobial activity of the essential oil of Tetradenia riparia (Hochst. Codd. (Lamiaceae against cariogenic bacteria

    Directory of Open Access Journals (Sweden)

    Nathalya Isabel de Melo

    2015-06-01

    Full Text Available In Brazilian folk medicine, Tetradenia riparia (Hochst. Codd. (Lamiaceae is used to treat toothaches and dental abscesses and diseases induced by worms, bacteria, or fungi. This paper aims to investigate the chemical composition and the antibacterial effects of the essential oil obtained from Tetradenia riparia leaves (TR-EO grown in Southeastern Brazil against a representative panel of oral pathogens. We evaluated the antibacterial activity of TR-EO in terms of the minimal inhibitory concentration (MIC. We identified aromadendrene oxide (14.0%, (E,E-farnesol (13.6%, dronabinol (12.5%, and fenchone (6.2% as the major constituents of TR-EO. TR-EO displayed MIC values between 31.2 and 500 μg/mL, with the lowest MIC value being obtained against Streptococcus mitis (31.2 μg/mL, S. mutans (62.5 μg/mL, S. sobrinus (31.2 μg/mL, and Lactobacillus casei (62.5 μg/mL. In time-kill experiments, TR-EO demonstrated bactericidal activity against S. mutans within the first 12 h, resulting in a curve profile similar to that of chlorhexidine. These results revealed that the essential oil of Tetradenia riparia displays promising activity against most of the selected cariogenic bacteria, including Streptococcus mutans.

  11. Antimicrobial activity of the essential oil of Tetradenia riparia (Hochst.) Codd. (Lamiaceae) against cariogenic bacteria.

    Science.gov (United States)

    de Melo, Nathalya Isabel; de Carvalho, Carlos Eduardo; Fracarolli, Letícia; Cunha, Wilson Roberto; Veneziani, Rodrigo Cassio Sola; Martins, Carlos Henrique Gomes; Crotti, Antônio Eduardo Miller

    2015-06-01

    In Brazilian folk medicine, Tetradenia riparia (Hochst.) Codd. (Lamiaceae) is used to treat toothaches and dental abscesses and diseases induced by worms, bacteria, or fungi. This paper aims to investigate the chemical composition and the antibacterial effects of the essential oil obtained from Tetradenia riparia leaves (TR-EO) grown in Southeastern Brazil against a representative panel of oral pathogens. We evaluated the antibacterial activity of TR-EO in terms of the minimal inhibitory concentration (MIC). We identified aromadendrene oxide (14.0%), (E,E)-farnesol (13.6%), dronabinol (12.5%), and fenchone (6.2%) as the major constituents of TR-EO. TR-EO displayed MIC values between 31.2 and 500 μg/mL, with the lowest MIC value being obtained against Streptococcus mitis (31.2 μg/mL), S. mutans (62.5 μg/mL), S. sobrinus (31.2 μg/mL), and Lactobacillus casei (62.5 μg/mL). In time-kill experiments, TR-EO demonstrated bactericidal activity against S. mutans within the first 12 h, resulting in a curve profile similar to that of chlorhexidine. These results revealed that the essential oil of Tetradenia riparia displays promising activity against most of the selected cariogenic bacteria, including Streptococcus mutans.

  12. Proteomic analysis of shoot tissue during photoperiod induced growth cessation in V. riparia Michx. grapevines

    Directory of Open Access Journals (Sweden)

    Victor Kim J

    2010-08-01

    Full Text Available Abstract Background Growth cessation, cold acclimation and dormancy induction in grapevines and other woody perennial plants native to temperate continental climates is frequently triggered by short photoperiods. The early induction of these processes by photoperiod promotes winter survival of grapevines in cold temperate zones. Examining the molecular processes, in particular the proteomic changes in the shoot, will provide greater insight into the signaling cascade that initiates growth cessation and dormancy induction. To begin understanding transduction of the photoperiod signal, Vitis riparia Michx. grapevines that had grown for 35 days in long photoperiod (long day, LD, 15 h were subjected to either a continued LD or a short photoperiod (short day, SD, 13 h treatment. Shoot tips (4-node shoot terminals were collected from each treatment at 7 and 28 days of LD and SD for proteomic analysis via two-dimensional (2D gel electrophoresis. Results Protein profiles were characterized in V. riparia shoot tips during active growth or SD induced growth cessation to examine physiological alterations in response to differential photoperiod treatments. A total of 1054 protein spots were present on the 2D gels. Among the 1054 proteins, 216 showed differential abundance between LD and SD (≥ two-fold ratio, p-value ≤ 0.05. After 7 days, 39 protein spots were more abundant in LD and 30 were more abundant in SD. After 28 days, 93 protein spots were more abundant in LD and 54 were more abundant in SD. MS/MS spectrometry was performed to determine the functions of the differentially abundant proteins. Conclusions The proteomics analysis uncovered a portion of the signal transduction involved in V. riparia grapevine growth cessation and dormancy induction. Different enzymes of the Calvin-Benson cycle and glutamate synthetase isoforms were more abundant either in LD or SD treatments. In LD tissues the significantly differentially more abundant proteins

  13. Pro-coagulant activity of phenolic acids isolated from Blumea riparia.

    Science.gov (United States)

    Huang, Li; Lin, Cuiwu; Li, Aiyuan; Wei, Baoyao; Teng, Jianwen; Li, Lue

    2010-08-01

    The effects of extracts of the aerial part of Blumea riparia DC. and their phenolic acids on hemostasis were evaluated. The EtOAc fraction showed significantly reduced blood clotting time (CT) and tail bleeding time of transection (BT) of mice in vivo. This fraction contained vanillic acid (1), syringic acid (2), p-coumaric acid (3), caffeic acid (4), and protocatechuic acid (5). Compound 1 reduced prothrombin time (PT), and strengthened mice uterine contractions. Compound 3 reduced CT and the activated partial thromboplastin time (APTT). Compound 5 reduced CT and increased the frequency of mice uterine contraction in a dose-dependent manner. Compound 2 reduced APTT. Compound 4 remarkably strengthened uterine contraction. Taken together, these data suggest that compounds 1, 3, and 5 possess procoagulant activity which jointly synergize blood coagulation via different mechanisms.

  14. Antischistosomal and Cytotoxic Effects of the Essential Oil of Tetradenia riparia (Lamiaceae).

    Science.gov (United States)

    de Melo, Nathalya I; Mantovani, André L L; de Oliveira, Pollyanna F; Groppo, Milton; Filho, Ademar A Da Silva; Rodrigues, Vanderlei; Cunha, Wilson R; Tavares, Denise C; Magalhães, Lizandra G; Crottii, Antônio E M

    2015-09-01

    This paper reports on the antischistosomal and cytotoxic effects of the essential oil obtained from Tetradenia riparia leaves (TR-EO). At concentrations of 50 and 100 µg/mL, TR-EO killed all the worms after 120 and 24 h of incubation, respectively. At a concentration equal to or higher than 50 µg/mL, this oil also separated the coupled pairs and decreased the adult worm motor activity after incubation periods higher than 72 h. In addition, at 120 h of incubation, TR-EO slightly decreased the number of eggs produced by Schistosoma mansoni adult worms and significantly reduced the percentage of developed eggs, in a dose-dependent manner. XTT-colorimetric assays showed that the tested TR-EO concentrations were not considerably cytotoxic to V79 cells (IC50 = 253.5 µg/mL). The effects of TR-EO on egg development were noteworthy; therefore, this essential oil deserves further investigation to identify the chemical constituents that elicit activity against S. mansoni.

  15. Acaricidal activity of the essential oil from Tetradenia riparia (Lamiaceae) on the cattle tick Rhipicephalus (Boophilus) microplus (Acari; Ixodidae).

    Science.gov (United States)

    Gazim, Zilda Cristiani; Demarchi, Izabel Galhardo; Lonardoni, Maria Valdrinez Campana; Amorim, Ana Carolina L; Hovell, Ana Maria C; Rezende, Claudia Moraes; Ferreira, Gilberto Alves; de Lima, Edson Luiz; de Cosmo, Fábio Antunes; Cortez, Diogenes Aparício Garcia

    2011-10-01

    Tetradenia riparia (Lamiaceae) is a well-known herbal medicine with a variety of useful properties, including its acaricidal effect. This experiment was carried out to study the bioacaricidal activity of T. riparia essential oil (EO) against engorged females of Rhipicephalus (Boophilus) microplus (Acari; Ixodidae). For this purpose, nine serial concentrations (12.50%, 6.25%, 3.75%, 1.80%, 0.90%, 0.45%, 0.22%, 0.11%, and 0.056% w/v) of T. riparia were used for the adult immersion test (AIT). For the larval packet test (LPT), we used 14 serial concentrations (100.00%, 50.00%, 25.00%, 12.50%, 6.25%, 3.65%, 1.82%, 0.91%, 0.45%, 0.228%, 0.114%, 0.057%, 0.028%, and 0.014% w/v). The results for AIT showed 100.00% and 2.05% mortality, 19.00 and 90.20% for the total number of eggs, egg-laying inhibition of 0.00% and 90.20%, hatchability inhibition of 0.00% and 70.23%, and product effectiveness of 100.00% and 2.89%, respectively. The AIT indicated that the LC(50) and LC(99.9), calculated using the Probit test, were for mortality (%) 0.534g/mL (0.436-0.632) and 1.552g/mL (1.183-1.92); for total number of eggs were 0.449g/mL (0.339-0.558) and 1.76g/mL (1.27-2.248); and for hatchability inhibition were 0.114g/mL (0.0-0.31) and 2.462g/mL (1.501-3.422), respectively. Larvae between 14 and 21days old were fasted and placed in each envelope. Bioassays were performed at 27°±1°C, RH⩾80%. Larval mortality was observed 24h after treatment and showed 10.60-100% mortality in the LPT bioassay. The LPT showed that the LC(50) and LC(99.9) were 1.222g/mL (0.655-1.788) and 11.382g/mL (7.84-14.91), respectively. A positive correlation between T. riparia EO concentration and tick control, was observed by the strong acaricidal effects against R. (B.) microplus, and the mortality rate of ticks was dose-dependent. Our results showed that T. riparia is a promising candidate as an acaricide against resistant strains of R. (B.) microplus. Crown Copyright © 2011. Published by Elsevier Inc. All

  16. Frost Grape Polysaccharide (FGP), an emulsion-forming arabinogalactan gum from the stems of native North American grape species Vitis riparia Michx

    Science.gov (United States)

    A new arabinogalactan is described that is produced in large quantity from the cut stems of the North American grape species Vitis riparia (Frost grape). The sugar composition consists of L-arabinofuranose (L-Araf, 55.2 %) and D-galactopyranose (D-Galp 30.1%), with smaller components of D-xylose (11...

  17. General and species-specific transcriptional responses to downy mildew infection in a susceptible (Vitis vinifera) and a resistant (V. riparia) grapevine species

    Science.gov (United States)

    2010-01-01

    Background Downy mildew is a destructive grapevine disease caused by Plasmopara viticola (Berk. and Curt.) Berl. and de Toni, which can only be controlled by intensive fungicide treatments. Natural sources of resistance from wild grapevine (Vitis) species are used in conventional breeding approaches, but the signals and effectors involved in resistance in this important crop species are not well understood. Results Early transcriptional changes associated with P. viticola infection in susceptible V. vinifera and resistant V. riparia plants were analyzed using the Combimatrix microarray platform. Transcript levels were measured 12 and 24 h post-inoculation, reflecting the time points immediately preceding the onset of resistance in V. riparia, as determined by microscopic analysis. Our data indicate that resistance in V. riparia is induced after infection, and is not based on differences in basal gene expression between the two species. The strong and rapid transcriptional reprogramming involves the induction of pathogenesis-related proteins and enzymes required for the synthesis of phenylpropanoid-derived compounds, many of which are also induced, albeit to a lesser extent, in V. vinifera. More interestingly, resistance in V. riparia also involves the specific modulation of numerous transcripts encoding components of signal transduction cascades, hypersensitive reaction markers and genes involved in jasmonate biosynthesis. The limited transcriptional modulation in V. vinifera represents a weak attempted defense response rather than the activation of compatibility-specific pathways. Conclusions Several candidate resistance genes were identified that could be exploited in future biotechnological approaches to increase disease resistance in susceptible grapevine species. Measurements of jasmonic acid and methyl jasmonate in infected leaves suggest that this hormone may also be involved in V. riparia resistance to P. viticola. PMID:20167053

  18. Подвиды береговой ласточки riparia riparia (Linnaeus, 1758) фауны России и сопредельных территорий

    OpenAIRE

    Евтихова, Анастасия; Редькин, Ярослав

    2012-01-01

    Longstanding consideration the forms of diluta group as a subspecies of Collared Sand Martin was strongly distorted the notion of distribution of R. riparia and the scale (scope) of geographic variation of this species. At present taxonomical boundaries of the Pale Sand Martin R. diluta as self-polytypic species were finally determined (Goroshko 1993; Dickinson et al. 2001; Loskot 2001). The purpose of our study was to trace the distribution details of R. riparia (in its present meaning) in b...

  19. Enraizamento de estacas herbáceas do porta-enxerto de videira 'Riparia de Traviú' tratadas com auxinas Rooting of herbaceous cuttings of the grape rootstock 'Riparia de Traviú' treated with auxinas

    Directory of Open Access Journals (Sweden)

    Fabíola Villa

    2003-12-01

    Full Text Available Estudou-se o efeito do ácido indol-butírico (AIB e ácido naftalenoacético (ANA no enraizamento de estacas do porta-enxerto de videira 'Riparia de Traviú', resultantes da desbrota realizada em plantas situadas no local definitivo, antes de serem enxertadas, visando à obtenção antecipada de novos porta-enxertos. O experimento foi conduzido em casa-de-vegetação com 50% de sombrite, temperatura e nebulização controladas, no pomar didático da Universidade Federal de Lavras - UFLA. As estacas herbáceas desprovidas de folhas e com comprimento de 15 cm e 8 mm de diâmetro foram imersas em soluções AIB e ANA (0, 1000, 2000, 3000 e 4000 mg.L-1 por 15 segundos e, em seguida, colocadas em bandejas de isopor preenchidas com substrato vermiculita. Após 60 dias, coletaram-se os seguintes dados biométricos: porcentagem de estacas enraizadas e brotadas, número de folhas e brotos, comprimento médio das raízes e biomassa seca das brotações. Não houve efeito significativo das concentrações AIB e ANA para todas as características analisadas. Para a característica porcentagem de estacas enraizadas, obtiveram-se 56,73% de enraizamento sem aplicação de auxinas, podendo esse método resultar na antecipação da obtenção de novos porta-enxertos, utilizando-se material resultante da desbrota.The effect of the indol butiric acid (IBA and the naftalenoacetic acid (NAA in the rooting of 'Riparia de Traviú' cuttings obtained from the sproutings of the plants, before being grafted, in order to obtain new rootstocks. The experiment was conduted under green house conditions, at the orchard of the Lavras Federal University (UFLA. The herbaceous cuttings, measuring 15 cm of lengh 8 mm of diameter and without leaves, were treated with IBA and NAA (0, 1000, 2000, 3000 and 4000 mg.L-1 for 15 seconds and taken to polystyrene trays filled with vermiculita. After 60 days, the percentage of rooting and sprouted cuttings, the number of leaves and sprouts

  20. Impacto del uso de plaguicidas asociados al cultivo de soja transgénica sobre especies no blanco de la flora riparia y acuática

    OpenAIRE

    Martin, María Laura

    2011-01-01

    La Argentina ha incrementado en la última década ampliamente la superficie de cultivos transgénicos resistentes al glifosato. La gran expansión de este tipo de producción influye en los ambientes acuáticos vecinos a los agroecosistemas. La flora riparia y acuática funciona como sistema amortiguador entre los cultivo y los cursos de agua. Las comunidades desarrolladas en estas franjas se ven afectadas tanto por la restricción de espacio, como por la deriva de plaguicidas sobre las mismas. El o...

  1. Two psammophilic noctuids newly associated with beach plum, Prunus maritima (Rosaceae): The Dune Noctuid (Sympistis riparia) and Coastal Heathland Cutworm (Abagrotis benjamini) in Northeastern North America (Lepidoptera, Noctuidae).

    Science.gov (United States)

    Goldstein, Paul Z; Nelson, Michael W

    2017-01-01

    Beach plum, Prunus maritima Marshall, 1785 not Wangenh., 1787 (Rosaceae), currently under development as a potential crop, represents an under-acknowledged host plant for several Lepidoptera that have undergone declines in the northeastern USA. The Coastal Heathland Cutworm, Abagrotis nefascia (Smith, 1908), and the Dune Noctuid, Sympistis riparia (Morrison, 1875), are unrelated species of psammophilic noctuines (Lepidoptera: Noctuidae) regularly encountered on a localized basis in coastal southern New England and New York, and whose precise life history requirements are undocumented. We inferred and, based on field observation and rearing, corroborated beach plum as a larval host for these species in Massachusetts; the plant's role in sustaining other moths with limited or contracting regional distributions is discussed. Sympistis riparia, belonging to a widely distributed complex of closely related species, has been associated specifically with both maritime and freshwater dunes. The eastern populations of Abagrotis nefascia represent a conspicuous range disjunction, separated from the nearest western populations by more than 2000 miles, and originally described by Franclemont as race benjamini of Abagrotis crumbi, both later synonymized with Abagrotis nefascia. Following examination of types and other material, an evaluation of putatively diagnostic features from both the original description and our own observations, genitalic characters, and the results of provisional barcode analyses, Abagrotis benjamini Franclemont, stat. rev., is elevated to the rank of a valid species rather than representing eastern populations of Abagrotis nefascia (=crumbi) to which it originally referred.

  2. Seasonal Variation, Chemical Composition, and Analgesic and Antimicrobial Activities of the Essential Oil from Leaves of Tetradenia riparia (Hochst. Codd in Southern Brazil

    Directory of Open Access Journals (Sweden)

    Gilberto Alves Ferreira

    2010-08-01

    Full Text Available The seasonal variation of the chemical composition of the essential oil from fresh leaves of Tetradenia riparia (Hochst. Codd grown in southern Brazil was analyzed by GC-MS, and the analgesic and antimicrobial activities of this oil were assayed. The yield of essential oil ranged from 0.17% to 0.26%, with the maximum amount in winter and the minimum in spring. The results obtained from principal components analysis (PCA revealed the existence of high chemical variability in the different seasons. The samples were clearly discriminated into three groups: winter, autumn, and spring-summer. Samples collected during winter contained the highest percentages of calyculone (24.70%, abietadiene (13.54%, and viridiflorol (4.20%. In autumn, the major constituents were ledol (8.74% and cis-muurolol-5-en-4-α-ol (13.78%. Samples collected in spring-summer contained the highest percentages of fenchone (12.67%, 14-hydroxy-9-epi-caryophyllene (24.36%, and α-cadinol (8.33%. Oxygenated sesquiterpenes were predominant in all the samples analyzed. The observed chemovariation might be environmentally determined by a seasonal influence. The essential oil, when given orally at a dose of 200 mg/kg, exhibited good analgesic activity on acetic acid-induced writhing in mice, inhibiting the constrictions by 38.94% to 46.13%, and this effect was not affected by seasonal variation. The antimicrobial activity of the essential oil against the bacterial strains: Staphylococcus aureus, Bacillus subtilis, Enterococcus faecalis, Escherichia coli, Salmonella enterica, Pseudomonas aeruginosa, Klebsiella pneumonia, Proteus mirabilis, Morganella morganii, and Enterobacter cloacae, and the pathogenic fungus Candida albicans was assessed by the disc diffusion method and determination of the minimum inhibitory concentration. The results obtained, followed by measurement of the minimum inhibitory concentration (MIC, indicated that S. aureus, B. subtilis, and Candida albicans were the

  3. Listeria floridensis sp. nov., Listeria aquatica sp. nov., Listeria cornellensis sp. nov., Listeria riparia sp. nov. and Listeria grandensis sp. nov., from agricultural and natural environments.

    Science.gov (United States)

    den Bakker, Henk C; Warchocki, Steven; Wright, Emily M; Allred, Adam F; Ahlstrom, Christina; Manuel, Clyde S; Stasiewicz, Matthew J; Burrell, Angela; Roof, Sherry; Strawn, Laura K; Fortes, Esther; Nightingale, Kendra K; Kephart, Daniel; Wiedmann, Martin

    2014-06-01

    Sampling of agricultural and natural environments in two US states (Colorado and Florida) yielded 18 Listeria-like isolates that could not be assigned to previously described species using traditional methods. Using whole-genome sequencing and traditional phenotypic methods, we identified five novel species, each with a genome-wide average BLAST nucleotide identity (ANIb) of less than 85% to currently described species. Phylogenetic analysis based on 16S rRNA gene sequences and amino acid sequences of 31 conserved loci showed the existence of four well-supported clades within the genus Listeria; (i) a clade representing Listeria monocytogenes, L. marthii, L. innocua, L. welshimeri, L. seeligeri and L. ivanovii, which we refer to as Listeria sensu stricto, (ii) a clade consisting of Listeria fleischmannii and two newly described species, Listeria aquatica sp. nov. (type strain FSL S10-1188(T) = DSM 26686(T) = LMG 28120(T) = BEI NR-42633(T)) and Listeria floridensis sp. nov. (type strain FSL S10-1187(T) = DSM 26687(T) = LMG 28121(T) = BEI NR-42632(T)), (iii) a clade consisting of Listeria rocourtiae, L. weihenstephanensis and three novel species, Listeria cornellensis sp. nov. (type strain TTU A1-0210(T) = FSL F6-0969(T) = DSM 26689(T) = LMG 28123(T) = BEI NR-42630(T)), Listeria grandensis sp. nov. (type strain TTU A1-0212(T) = FSL F6-0971(T) = DSM 26688(T) = LMG 28122(T) = BEI NR-42631(T)) and Listeria riparia sp. nov. (type strain FSL S10-1204(T) = DSM 26685(T) = LMG 28119(T) = BEI NR- 42634(T)) and (iv) a clade containing Listeria grayi. Genomic and phenotypic data suggest that the novel species are non-pathogenic. © 2014 IUMS.

  4. Análise florística e estrutural de florestas riparias do alto Rio Paraná, Taquaruçu, MS Floristic and structural analyses of riparian forest of the "Alto Rio Paraná", Taquaruçu, MS

    Directory of Open Access Journals (Sweden)

    Mariza Barion Romagnolo

    2000-08-01

    Full Text Available Utilizando-se de método fitossociológico, foi realizado estudo comparativo entre três remanescentes de floresta riparia da margem direita do alto rio Paraná (22º43'-45'S; 53º15'-18'W. Em cada um deles foi demarcada uma área de 3.150m subdividida em 21 parcelas contínuas de 150m², tendo como critério mínimo de amostragem o perímetro à altura do peito igual ou superior a 15cm. Foram levantados, na amostragem total, 58 espécies, 46 gêneros e 30 famílias, sendo duas indeterminadas. As famílias de maior riqueza específica foram Myrtaceae e Lauraceae com cinco espécies cada, Mimosaceae com quatro, Annonaceae e Rubiaceae com três cada uma, enquanto que os gêneros foram, Nectandra com quatro, Eugenia, Inga, Pouteria, Psidium e Sloanea com dois cada um. Os índices de diversidade (H' específicos foram de 2,94, 2,52 e 2,88 para, respectivamente, os remanescentes jusante, intermediário e montante. O índice de similaridade de Sorensen entre os três remanescentes variou de 54% a 65%. Do total de 58 espécies amostradas, somente 16 (26,7% ocorreram nos três remanescentes. Dentre as 10 espécies de maior valor de importância, apenas Cecropia pachystachya e Inga uruguensis foram comuns aos remanescentes. Os resultados da análise fitossociológica, principalmente, permitiram concluir que o remanescente intermediário encontra-se em fase mais imatura de sucessão. A homogeneidade da topografia e do solo indicam que as diferenças estruturais entre os três remanescentes devem-se a fatores relacionados à antropização.In this study, the structure of the vegetation and the species diversity of three remnants of riparian forest of the right bank of the upper Paraná river (22º43'-45'S; 53º15'-18'W were analysed and compared. In each forest remnant, 3,150m² were marked and subdivided into 21 continuous plots of 150m² each. Only trees with a perimeter at breast height > 15cm were measured. Fifity eigth species belonging to 46 genera

  5. BUDDLEJA DAVIDII (BUTTERFLY BUSH): A GROWING THREAT TO RIPARIA?

    Science.gov (United States)

    Buddleja davidii, an Asian shrub or small tree (family Buddlejaceae; commonly referred to as Butterfly bush) is found in the United States, New Zealand, Australia, and Europe as a popular ornamental and an aggressive invasive that has become widespread in floodplains, riverbeds, ...

  6. Energetics of free existence in swallows and martins (hirundinidae) during breeding: a comparative study using doubly labeled water.

    Science.gov (United States)

    Westerterp, Klaas R; Bryant, David M

    1984-06-01

    Energy metabolism of three sympatric swallows (Hirundinidae) was investigated during the breeding season using doubly labeled water ((2)H2(18)O). Interspecific and intraspecific differences in energy metabolism were examined in relation to the habits, size and environment of the birds. To facilitate comparisons we expressed energy metabolism (M) as the ratio of average daily metabolic rate (ADMR, cm(3)CO2g(-1)h(-1)) to basal metabolic rate (BMR). We observed adults during incubation and when feeding nestlings. Then, both sexes of Sand Martins Riparia riparia and House Martins Delinchon urbica were either at the nest or on the wing. Incubation reduced activity levels during the day resulting in M (incubation) being 17-26% lower than during rearing. Differences in energy costs for rearing chicks depended mainly on flight behaviour, the smaller Sand Martin doing nearly twice as much flapping during flight as the House Martin, giving higher values for M. In Swallows Hirundo rustica the female incubates alone, alternating between short feeding trips and incubating in daytime. This pattern was linked with a relatively high value for M in the only individual behaving like our controls. Both sexes of Swallows feed the chicks, and they showed similar values of M. They also closely resembled House Martins, despite contrasts in the time spent flying and their behaviour during flight. Feeding conditions affected activity, and thereby M, in a species specific way. The House Martin did more gliding in poor weather, taking less mobile prey, reducing M. Swallows reduced foraging costs further by using body reserves, as in the House Martin. The smaller Sand Martin, in contrast, showed a high expenditure in poor weather. Over two breeding seasons ADMR reached values around 5 BMR for all three species.

  7. Brood parasitism in the sand martin, Riparia riparia: evidence for two parasitic strategies in a colonial passerine.

    Science.gov (United States)

    Alves; Bryant

    1998-12-01

    Sand martin parentage was studied at a large breeding colony in central Scotland. Multilocus DNA fingerprinting was used during the 3-year study to exclude some social parents as true parents, and thereby determine the frequency of monogamy, quasiparasitism (QP), intraspecific brood parasitism (ISBP) and extrapair fertilization (EPF) amongst 45 broods and 167 nestlings. Monogamous parentage characterized the majority of broods (60%), so most chicks were the offspring of their social parents (81%). QP (involving a male's extrapair mate laying in his nest) was found in 9% of broods and 2.4% of chicks and ISBP (or 'egg dumping') in 4% of broods and 1.8% of chicks. A substantial proportion of offspring arose from EPFs, affecting 36% of broods and 14% of chicks. On present evidence, the relatively high frequency of QP found in sand martins is unusual. We propose that its observed frequency is unlikely to be due to chance events and may represent a female-driven strategy. (c)1998 The Association for the Study of Animal Behaviour.

  8. Final Record of Decision/Remedial Action Plan, Nine Sites, Sierra Army Depot, Lassen County, California.

    Science.gov (United States)

    1996-10-01

    space and most of the land in this category is covered with native vegetation . A vast majority of this land is in public ownership, with some private...dominant vegetative cover in poorly drained, highly alkaline soil where the water table is near ground surface. Big sagebrush [Artemisia tridentata) and...Honey Lake Valley. The state-listed threatened bank swallow [ Riparia riparia ) is included on the list of SIAD wildlife (Colberg, 1992). Bank swallows

  9. Supplemental Environmental Assessment (EA) for the Vernal Pool Restoration Project in Wing Infrastructure Development Outlook (WINDO) Implementation Plan EA, Volume 2 Beale Air Force Base, California

    Science.gov (United States)

    2010-09-01

    jamaicensis coturniculus)  Greater sandhill crane (Grus canadensis tabida)  Bank swallow ( Riparia riparia ) The Swainson’s hawk prefers to nest in...found in riparian forest vegetation . The project does not involve any work near riparian areas; this species would not be impacted by the Proposed...woodlands or in trees along marsh edges, it forages in grassland or other open vegetative communities. Peak nesting season for this species occurs

  10. LEAF LITTER BREAKDOWN RATES AND ASSOCIATED FAUNA OF NATIVE AND EXOTIC TREES USED IN NEOTROPICAL RIPARIA REFORESTATION

    Directory of Open Access Journals (Sweden)

    Nataly Gutiérrez Isaza

    2013-09-01

    Full Text Available ABSTRACT A signature of globalization is the prevalence of exotic trees along reforested urban and rural riparian zones in the Neotropics, but little is known about the instream processing of its leaf litter. In this study, leaf litter breakdown rates were measured during 35 days using mesh bags within a reference headwater stream for seven exotic and three native tree species commonly used in urban and rural reforestation. Artocarpus altilis, Schefflera actinophylla and Terminalia catappa scored the highest mass loss rates (>85 %; mean life: t50 85 %; vida media: t50 <15 d, mientras que las menores tasas las obtuvieron Cecropia sp. y Cespedesia macrophylla (pérdida de masa =36 y 15 %; t50 =58 y 153 d, respectivamente. Sin embargo, se observó una amplia gama de tasas de pérdida de masa entre las diez especies estudiadas. La proporción carbono:fósforo (C:P y la dureza de la hojarasca fueron los mejores predictores de las tasas de pérdida de masa. Sin embargo, estas características no se correlacionaron con los muy bajos valores de abundancia y diversidad de macroinvertebrados, y la escasez de morfotipos de insectos clasificados como fragmentadores. Por lo tanto, los controles físicos parecen ser más importantes que los biológicos para explicar la variabilidad de las tasas de pérdida de masa; y, las especies con tasas más bajas podrían estar proveyendo hábitat, más que alimento para las especies de insectos acuáticos, principalmente los recolectores. Este estudio sugiere que la reforestación ribereña propagará efectos específicos sobre los procesos dentro del cauce dependiendo de las especies de árbol plantadas mediados por la calidad de la hojarasca, los cuales deberían ser considerados para mejorar las estrategias de reforestación. Estudios futuros deben someter a prueba si existen diferencias en las tasas de fragmentación y colonización de macroinvertebrados entre especies de hojarasca de diferente origen (nativa vs. exótica.

  11. Archaeological Test Excavations of the Historic Component of 45-WT-1 Texas City/Riparia, Whitman County, Washington, 1983.

    Science.gov (United States)

    1984-01-01

    kitchen and dining room served large numbers of railroad employees and passengers of the steamboats and trains (Torgeson 1983:personal communication...serve as a front fence in Hay. The kitchen cook stove is now in a basement and various parts of doors, windows, floors, and ceilings have been carted...F4.7.348, 83.2.4) were also recovered. Additional utensils from the site are a fragmented handle to a spatula or similar utensil (F1.6.347) and a bottle

  12. LEAF LITTER BREAKDOWN RATES AND ASSOCIATED FAUNA OF NATIVE AND EXOTIC TREES USED IN NEOTROPICAL RIPARIA REFORESTATION

    Directory of Open Access Journals (Sweden)

    Nataly Gutiérrez Isaza

    2014-01-01

    Full Text Available ABSTRACT A signature of globalization is the prevalence of exotic trees along reforested urban and rural riparian zones in the Neotropics, but little is known about the instream processing of its leaf litter. In this study, leaf litter breakdown rates were measured during 35 days using mesh bags within a reference headwater stream for seven exotic and three native tree species commonly used in urban and rural reforestation. Artocarpus altilis, Schefflera actinophylla and Terminalia catappa scored the highest mass loss rates (>85 %; mean life: t50 85 %; vida media: t50

  13. Swallowing Trouble

    Science.gov (United States)

    ... it is important to seek treatment to avoid malnutrition and dehydration. How are swallowing disorders treated? Many ... causing discomfort. Other causes may include: hypertension; diabetes; thyroid disease; stroke; progressive neurologic disorder; the presence of ...

  14. Swallowing difficulty

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007543.htm Swallowing difficulty To use the sharing features on this page, ... Duplication for commercial use must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map ...

  15. Cultural Resources Investigations of Larose to Golden Meadow Hurricane Protection Project Levee Section D, Lafourche Parish, Louisiana

    Science.gov (United States)

    1991-03-01

    freshwater marsh). Nonwetlands and the hardwood interarea support a greater variety of vegetation and animal species than the wetlands environment...river crawfish (Procambarus blandingii) (Harper and Row 1981). Backswamp vegetation includes more water-adaptive plants. Tupelogum (Nyssa aquatica...Charadrius vociferus), bank swallow ( Riparia ), belted kingfisher (Meaceryle alcyon), and sandpiper (Bartramia Iongicauda). Reptiles and amphibians

  16. Relación entre comunidad íctica y cobertura vegetal riparia en dos períodos hidrológicos (Eje Cafetero, Colombia

    Directory of Open Access Journals (Sweden)

    María Angélica Pérez-Mayorga

    2011-08-01

    Full Text Available Relationship between fish community and riparian vegetation cover in two hydrological periods (Coffee-growing region, ColombiaObjective. To assess the relationship between structure and diet of the fish community and the riparian vegetation cover (RVC, in twohydrological periods (HYPE in streams of the La Vieja river basin. Materials and methods. Collections were done with electrofishingand rapiché in March and May 2010. Efficiency of sampling effort was assessed with the estimator Chao2. Structure was analyzedusing the indices of richness, dominance, diversity and evenness which were compared with an ANOVA. Gastrointestinal contents wereanalysed with the indices of vacuity coefficient, frequency, volume and food importance. We examined the relationship among diet,HYPE and RVC using the multiple correlation coefficient (r, the coefficient of determination (r2 and a Canonical CorrespondenceAnalysis (CCA. Results. According to the Chao2 estimator, in most streams the fish species richness values are representative. Therewere no significant differences (P>0.05 among the structural variables, the HYPE and the RVC. According to r and r2 the diet of most fish species did not vary as a function of RVC and HYPE; however, according to the CCA diet varies as a function of HYPE but not of RVC. Conclusions. The fish community structure did not show changes according to RVC and HYPE. Although most species showedno changes in their diet, the community did show changes in diet according to HYPE, due to a change in composition; however dietchanges were not detected by RVC.

  17. Speech and Swallowing

    Science.gov (United States)

    ... You are here Home › Speech and Swallowing Problems Speech and Swallowing Problems People with Parkinson’s may notice ... How do I know if I have a speech or voice problem? My voice makes it difficult ...

  18. Swallowed toothbrush: Case series

    Directory of Open Access Journals (Sweden)

    S Kiran

    2016-01-01

    Full Text Available Toothbrush swallowing is rare, and most cases are seen in young women with anorexia nervosa or bulimia or associated with mental retardation or schizophrenia. Prompt removal is recommended because no cases of spontaneous passage have been reported. There is no previously reported case series on swallowed toothbrush in mentally normal young men. Here, we report three cases of swallowed toothbrush found in the esophagus and stomach on endoscopy. In our case series, successful removal of the toothbrush was done without endotracheal intubation or over tube, without any complications. To our knowledge, this is the first documented case series of swallowed toothbrush managed successfully endoscopically.

  19. Speech and Swallowing

    Science.gov (United States)

    ... of Smell Cognitive Changes Depression Fatigue Constipation & Nausea Hallucinations/Delusions Pain Skeletal & Bone Health Skin Changes Sleep Disorders Speech & Swallowing Problems Urinary Incontinence Vision Changes Weight Management Help Us Make a Difference ...

  20. 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 ...

  1. Atypical swallowing: a review.

    Science.gov (United States)

    Maspero, C; Prevedello, C; Giannini, L; Galbiati, G; Farronato, G

    2014-06-01

    Atypical swallowing is a myofunctional problem consisting of an altered tongue position during the act of swallowing. High incidence in population, multifactorial etiology and the recurring connection with the presence of malocclusions made it a topic of strong interest and discussion in science. The purpose of this review is to illustrate the current orientation on the topic of atypical swallowing, trying in particular to answer two questions: 1) what kind of connection is there between atypical swallowing and malocclusion; 2) what kind of therapy should be used to solve it. This review was conducted on the Medline database [www.ncbi.nim.nih.gov/pubmed] searching for the keywords "atypical swallowing" and "tongue thrust". We examined all the documents from the year 1990 onwards, excluding the ones about syndromic cases of the central motor system. The causal relation between the two problems seems to be biunique: some authors affirm that this oral habit starts as a compensation mechanism for a preexisting malocclusion (especially in case of open-bite); other texts show that it has a tendency to exacerbate cases of malocclusion; it is also proven that a non-physiological tongue thrust can negatively influence the progress of an ongoing orthodontic therapy. Thereby, the best therapeutic approach seems to be a multidisciplinary one: beside orthodontics, which is necessary to correct the malocclusion, it is essential to set up a myofunctional rehabilitation procedure to correct the oral habit, therefore granting long time permanent results. There is also proof of a substantial difference between the results obtained from early (deciduous or primary mixed dentition) or later treatments. The biunique causal relation between atypical swallowing and malocclusion suggests a multidisciplinary therapeutic approach, orthodontic and myofunctional, to temporarily solve both problems. An early diagnosis and a prompt intervention have a significantly positive influence on the

  2. A new genus Globulidrilus and three new enchytraeid species (Oligochaeta: Enchytraeidae) from Seoraksan National Park (Korea)

    DEFF Research Database (Denmark)

    Christensen, Bent; Dózsa-Farkas, Klára

    2012-01-01

    From the Seoraksan National Park, Korea, a new enchytraeid genus, Globulidrilus gen. nov., is defined and three new species, Globulidrilus helgei sp. nov., Fridericia seoraksani sp. nov. and Mesenchytraeus longiductus sp. nov., are described. Globulidrilus also includes Marionina riparia Bretscher......, 1899 augm. Cernosvitov 1928, a globally distributed species with a complicated taxonomic history. Pending a revision of Marionina riparia sensu latu (auct.), we retain the species name riparia for a variant of common occurrence in Europe....

  3. INFLUENCE THE STOCKS ON YIELD AND QUALITY OF GRAPES AND ALIGOTE WINE

    OpenAIRE

    Chausov V. M.

    2016-01-01

    The article presents results of the six-year study of the effect of stocks Riparia × Rupestris 101-14 and Berlandieri × Riparia Kober 5BB on yield, quality of grapes and Aligote wine in the central zone of the Krasnodar region. Effect of stock on scion strongly depends on the annual weather conditions. In a given year, there is a stock better adapted to the weather conditions. Stocks of Riparia × Rupestris 101-14 increase winter hardiness, and the stock Berlandieri × Riparia Kober 5BB - droug...

  4. Utility of a Clinical Swallowing Exam for Understanding Swallowing Physiology.

    Science.gov (United States)

    Rangarathnam, Balaji; McCullough, Gary H

    2016-08-01

    A clinical swallowing examination (CSE) is generally believed to be inadequate for making judgments regarding swallowing physiology compared to objective assessments. A large volume of studies has heavily focused on identifying aspiration using a CSE and research addressing physiologic information gathered from a CSE is sparse. The purpose of this study was to examine the utility of the CSE for assessing physiology compared to videofluoroscopic swallowing studies (VFSS). Data were derived from a prior investigation of sixty adult patients post-stroke tested with CSE and VFSS. The CSE included an examination of historical measures, oral motor/speech/voice, and trial swallows. The VFSS consisted of swallows of controlled portions of thin, thick, puree, and solid boluses. Previous results from these patients demonstrated significant accuracy in making binary estimates of aspiration and the presence of dysphagia. This analysis of data focused on physiologic measures, as well as overall dysphagia severity and diet recommendations. Significant associations between CSE and VFSS ratings were observed for hyolaryngeal elevation, overall swallowing severity, and diet recommendations. These findings were specific for certain bolus consistencies. These data suggest that the CSE may not provide significant physiological information other than hyolaryngeal excursion. This does not preclude the fact that the CSE is important in providing substantial information about overall dysphagia severity. It appears that the CSE is more powerful than simply a "screening" tool. More prospective research designs are warranted to substantiate the strengths of the CSE.

  5. Bank Swallow - Monitoring [ds6

    Data.gov (United States)

    California Department of Resources — 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...

  6. Effect of posture on swallowing.

    African Journals Online (AJOL)

    neck flexed, head/neck extend- ed and lying supine. There are individual differences in swallowing and dys- phagia limit depending on individual condition, prefer- ences and habits. However, different head and neck posi- tions can facilitate ...

  7. Sword swallowing and its side effects.

    Science.gov (United States)

    Witcombe, Brian; Meyer, Dan

    2006-12-23

    To evaluate information on the practice and associated ill effects of sword swallowing. Letters sent to sword swallowers requesting information on technique and complications. Membership lists of the Sword Swallowers' Association International. 110 sword swallowers from 16 countries. We had information from 46 sword swallowers. Major complications are more likely when the swallower is distracted or swallows multiple or unusual swords or when previous injury is present. Perforations mainly involve the oesophagus and usually have a good prognosis. Sore throats are common, particularly while the skill is being learnt or when performances are too frequent. Major gastrointestinal bleeding sometimes occurs, and occasional chest pains tend to be treated without medical advice. Sword swallowers without healthcare coverage expose themselves to financial as well as physical risk. Sword swallowers run a higher risk of injury when they are distracted or adding embellishments to their performance, but injured performers have a better prognosis than patients who suffer iatrogenic perforation.

  8. Swallowing disorders after ischemic stroke

    Directory of Open Access Journals (Sweden)

    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.

  9. Review. Reproductive ecology of riparian elms

    National Research Council Canada - National Science Library

    López-Almansa, Juan Carlos

    2004-01-01

    ... de la ecología reproductiva en el género Ulmus, del que hay poca información disponible. Las especies del género Ulmus se reproducen, al igual que ocurre en otras especies riparias o sub-riparias, tanto sexual coma vegetativamente...

  10. A contrasting study: cliff and bank swallows

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of the project was to contrast as population of Cliff Swallows and a population of Bank Swallows. Both populations had nests located in a gravel pit near...

  11. 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.

  12. 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…

  13. Pharyngeal Swallowing Mechanics Secondary to Hemispheric Stroke.

    Science.gov (United States)

    May, Nelson H; Pisegna, Jessica M; Marchina, Sarah; Langmore, Susan E; Kumar, Sandeep; Pearson, William G

    2017-05-01

    Computational analysis of swallowing mechanics (CASM) is a method that utilizes multivariate shape change analysis to uncover covariant elements of pharyngeal swallowing mechanics associated with impairment using videofluoroscopic swallowing studies. The goals of this preliminary study were to (1) characterize swallowing mechanics underlying stroke-related dysphagia, (2) decipher the impact of left and right hemispheric strokes on pharyngeal swallowing mechanics, and (3) determine pharyngeal swallowing mechanics associated with penetration-aspiration status. Videofluoroscopic swallowing studies of 18 dysphagic patients with hemispheric infarcts and age- and gender-matched controls were selected from well-controlled data sets. Patient data including laterality and penetration-aspiration status were collected. Coordinates mapping muscle group action during swallowing were collected from videos. Multivariate morphometric analyses of coordinates associated with stroke, affected hemisphere, and penetration-aspiration status were performed. Pharyngeal swallowing mechanics differed significantly in the following comparisons: stroke versus controls (D = 2.19, P mechanics associated with each comparison were visualized using eigenvectors. Whereas current literature focuses on timing changes in stroke-related dysphagia, these data suggest that mechanical changes are also functionally important. Pharyngeal swallowing mechanics differed by the affected hemisphere and the penetration-aspiration status. CASM can be used to identify patient-specific swallowing impairment associated with stroke injury that could help guide rehabilitation strategies to improve swallowing outcomes. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  14. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, J.E.; Brennan, M.T.; Verdonck- de Leeuw, I.M.; Gibson, R.J.; Eilers, J.G.; Waltimo, T.; Bots, C.P.; Michelet, M.; Sollecito, T.P.; Rouleau, T.S.; Sewnaik, A.; Bensadoun, R.J.; Fliedner, M.C.; Silverman, S.; Spijkervet, F.K.L.

    2012-01-01

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  15. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, Judith E.; Brennan, Mike T.; Leeuw, Irma M. Verdonck-de; Gibson, Rachel J.; Eilers, June G.; Waltimo, Tuomas; Bots, Casper P.; Michelet, Marisol; Sollecito, Thomas P.; Rouleau, Tanya S.; Sewnaik, Aniel; Bensadoun, Rene-Jean; Fliedner, Monica C.; Silverman, Sol; Spijkervet, Fred K. L.

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  16. Effect of posture on swallowing.

    African Journals Online (AJOL)

    lowing stroke, motor neuron disease, Parkinson's disease, cerebral palsy, etc.3,4 It can further lead to aspiration pneu- ... umes of water, healthy adults didn't experience piecemeal deglutition or aspiration; however while ... help in treatment of dysphagia by affecting bolus flow to improve speed and safety of swallowing by ...

  17. Coordination of Mastication, Swallowing and Breathing

    Science.gov (United States)

    Matsuo, Koichiro; Palmer, Jeffrey B.

    2009-01-01

    Summary The pathways for air and food cross in the pharynx. In breathing, air may flow through either the nose or the mouth, it always flows through the pharynx. During swallowing, the pharynx changes from an airway to a food channel. The pharynx is isolated from the nasal cavity and lower airway by velopharyngeal and laryngeal closure during the pharyngeal swallow. During mastication, the food bolus accumulates in the pharynx prior to swallow initiation. The structures in the oral cavity, pharynx and larynx serve multiple functions in breathing, speaking, mastication and swallowing. Thus, the fine temporal coordination of feeding among breathing, mastication and swallowing is essential to provide proper food nutrition and to prevent pulmonary aspiration. This review paper will review the temporo-spatial coordination of the movements of oral, pharyngeal, and laryngeal structures during mastication and swallowing, and temporal coordination between breathing, mastication, and swallowing. PMID:20161022

  18. Neonatal swallowing assessment using fiberoptic endoscopic evaluation of swallowing (FEES).

    Science.gov (United States)

    Vetter-Laracy, Susanne; Osona, Borja; Roca, Antonia; Peña-Zarza, Jose A; Gil, Jose A; Figuerola, Joan

    2018-01-22

    Swallowing disorders which lead to aspiration are common in premature infants with a postmenstrual age (PMA) of >36 weeks. Aspiration is often silent and the unique symptom is desaturation during feeding. The aim of this study was 1) to determine the number of prematures with desaturations during feeding due to aspiration, using Fiberoptic Endoscopic Evaluation of Swallowing (FEES); 2) to relate clinical factors and FEES findings to aspiration; and 3) to describe type and efficacy of suggested treatments. A retrospective review of 62 ex-premature babies with a median PMA of 40 weeks which underwent FEES due to persistent feeding desaturations. Aspiration was related to other FEES findings and to clinical and demographic data. The efficacy of the treatment was evaluated during the FEES and by comparing recorded desaturations during feeding 7 days before and after FEES. A total of 44 (71%) infants were diagnosed with aspiration and/or penetration. No relation was found to demographic or clinical data. The accumulation of saliva and residues post-swallowing were related to aspiration (P thickener seemed to reduce aspiration during FEES and was suggested as a treatment. 13.6% of infants received anti-reflux treatment after FEES and 9.1% required gastrostomy. Aspiration is very frequent in premature infants who present desaturations during feeding and FEES is a useful method for diagnosing and suggesting treatments. © 2018 Wiley Periodicals, Inc.

  19. Surface electromyography pattern of human swallowing

    Directory of Open Access Journals (Sweden)

    Spadaro Alessandro

    2008-03-01

    Full Text Available Abstract Background The physiology of swallowing is characterized by a complex and coordinated activation of many stomatognathic, pharyngeal, and laryngeal muscles. Kinetics and electromyographic studies have widely investigated the pharyngeal and laryngeal pattern of deglutition in order to point out the differences between normal and dysphagic people. In the dental field, muscular activation during swallowing is believed to be the cause of malocclusion. Despite the clinical importance given to spontaneous swallowing, few physiologic works have studied stomatognathic muscular activation and mandibular movement during spontaneous saliva swallowing. The aim of our study was to investigate the activity patterns of the mandibular elevator muscles (masseter and anterior temporalis muscles, the submental muscles, and the neck muscles (sternocleidomastoid muscles in healthy people during spontaneous swallowing of saliva and to relate the muscular activities to mandibular movement. Methods The spontaneous swallowing of saliva of 111 healthy individuals was analyzed using surface electromyography (SEMG and a computerized kinesiography of mandibular movement. Results Fifty-seven of 111 patients swallowed without occlusal contact (SNOC and 54 individuals had occlusal contact (SOC. The sternocleidomastoid muscles showed a slight, but constant activation during swallowing. The SEMG of the submental and sternocleidomastoid muscles showed no differences between the two groups. The SEMG of the anterior temporalis and masseter muscles showed significant differences (p Conclusion The data suggest that there is not a single "normal" or "typical" pattern for spontaneous saliva swallowing. The polygraph seemed a valuable, simple, non-invasive and reliable tool to study the physiology of swallowing.

  20. Oral Health and Swallowing Problems

    OpenAIRE

    Furuta, Michiko; Yamashita, Yoshihisa

    2013-01-01

    Oral health impacts systemic health. Therefore, oral care is an important consideration in maintaining quality of life (QOL). Previously, maintenance and improvement of oral hygiene was considered essential for achieving oral health. In addition to oral hygiene, oral care in terms of oral function is now considered to maintain QOL. Ingestion of exogenous nutrients via the oral cavity is fundamental to the function of all higher animals, not only human beings. Chewing and swallowing processes ...

  1. Surface Electromyographic Assessment of Swallowing Function

    Directory of Open Access Journals (Sweden)

    Marziyeh Poorjavad

    2017-03-01

    Full Text Available The reliability of surface electromyographic (sEMG variables during swallowing determines the potential usefulness of these measures in swallowing assessment and treatment. This study aimed to establish the reliability of the sEMG measures of the swallowing function of muscles during different swallowing conditions in healthy young and old volunteers. Two groups of volunteers (24 older adults, 10 younger adults participated in this cross-sectional study during 2014. The activity of masseter, submental, and infrahyoid groups were measured using sEMG during three repetitions of different swallowing tasks. Both the relative and absolute reliability (characterized respectively by ICC, SEM%, and SRD% were calculated for the sEMG indices of muscle activity during swallowing events. Statistical analyses were performed by the SPSS 19.0 and Microsoft Excel 2007 software packages. Statistical significance was set at P≤0.05. The relative reliability calculations showed significant agreements between repetitions for the mean and peak amplitude and the average of median frequency (MDF of the studied muscles function during most swallowing types in both groups. However, the duration and particularly the time to peak of muscle activity showed significant agreements during fewer swallowing conditions. Excluding MDF, we found high SEM% and SRD% for the studied measures (particularly timing measures of muscles function during most swallowing types in both groups. The reliability of sEMG measures was influenced by the age and swallowing types. Our findings suggest that the MDF of muscle function during almost all studied swallowing types can be a reliable measure for the sEMG assessment of swallowing function in both younger and older adults.

  2. The Effects of Removable Denture on Swallowing

    OpenAIRE

    Son, Dae-Sik; Seong, Jin Wan; Kim, Younghoon; Chee, Youngjoon; Hwang, Chang Ho

    2013-01-01

    Objective To investigate the relationship between removable dentures and swallowing and describe risks. Methods Twenty-four patients with removable dentures who were referred for videofluoroscopic swallowing study (VFSS) were enrolled. We evaluated the change of swallowing function using VFSS before and after the removal of the removable denture. The masticatory performance by Kazunori's method, sensation of oral cavity by Christian's method, underlying disease, and National Institutes of Hea...

  3. Lung Volume during Swallowing: Single Bolus Swallows in Healthy Young Adults

    Science.gov (United States)

    Hegland, Karen M. Wheeler; Huber, Jessica E.; Pitts, Teresa; Sapienza, Christine M.

    2009-01-01

    Purpose: This study examined the relationship between swallowing and lung volume initiation in healthy adults during single swallows of boluses differing in volume and consistency. Differences in lung volume according to respiratory phase surrounding the swallow were also assessed. Method: Nine men and 11 women between the ages of 19 and 28 years…

  4. Swallowing dysfunction in cancer patients.

    Science.gov (United States)

    Raber-Durlacher, Judith E; Brennan, Mike T; Verdonck-de Leeuw, Irma M; Gibson, Rachel J; Eilers, June G; Waltimo, Tuomas; Bots, Casper P; Michelet, Marisol; Sollecito, Thomas P; Rouleau, Tanya S; Sewnaik, Aniel; Bensadoun, Rene-Jean; Fliedner, Monica C; Silverman, Sol; Spijkervet, Fred K L

    2012-03-01

    Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools, prevalence, complications, and impact on quality of life in patients with a variety of different cancers, particularly in those treated with curative chemoradiation for head and neck cancer. The literature search was limited to the English language and included both MEDLINE/PubMed and EMBASE. The search focused on papers reporting dysphagia as a side effect of cancer and cancer therapy. We identified relevant literature through the primary literature search and by articles identified in references. A wide range of assessment tools for dysphagia was identified. Dysphagia is related to a number of factors such as direct impact of the tumor, cancer resection, chemotherapy, and radiotherapy and to newer therapies such as epidermal growth factor receptor inhibitors. Concomitant oral complications such as xerostomia may exacerbate subjective dysphagia. Most literature focuses on head and neck cancer, but dysphagia is also common in other types of cancer. Swallowing impairment is a clinically relevant acute and long-term complication in patients with a wide variety of cancers. More prospective studies on the course of dysphagia and impact on quality of life from baseline to long-term follow-up after various treatment modalities, including targeted therapies, are needed.

  5. Quantitative classification of pediatric swallowing through accelerometry

    Directory of Open Access Journals (Sweden)

    Celeste Merey

    2012-06-01

    Full Text Available Abstract Background Dysphagia or swallowing disorder negatively impacts a child’s health and development. The gold standard of dysphagia detection is videofluoroscopy which exposes the child to ionizing radiation, and requires specialized clinical expertise and expensive institutionally-based equipment, precluding day-to-day and repeated assessment of fluctuating swallowing function. Swallowing accelerometry is the non-invasive measurement of cervical vibrations during swallowing and may provide a portable and cost-effective bedside alternative. In particular, dual-axis swallowing accelerometry has demonstrated screening potential in older persons with neurogenic dysphagia, but the technique has not been evaluated in the pediatric population. Methods In this study, dual-axis accelerometric signals were collected simultaneous to videofluoroscopic records from 29 pediatric participants (age 6.8 ± 4.8 years; 20 males previously diagnosed with neurogenic dysphagia. Participants swallowed 3-5 sips of barium-coated boluses of different consistencies (normally, from thick puree to thin liquid by spoon or bottle. Videofluoroscopic records were reviewed retrospectively by a clinical expert to extract swallow timings and ratings. The dual-axis acceleration signals corresponding to each identified swallow were pre-processed, segmented and trimmed prior to feature extraction from time, frequency, time-frequency and information theoretic domains. Feature space dimensionality was reduced via principal components. Results Using 8-fold cross-validation, 16-17 dimensions and a support vector machine classifier with an RBF kernel, an adjusted accuracy of 89.6% ± 0.9 was achieved for the discrimination between swallows with and with out airway entry. Conclusions Our results suggest that dual-axis accelerometry has merit in the non-invasive detection of unsafe swallows in children and deserves further consideration as a pediatric medical device.

  6. Movements of temporomandibular condyles during swallowing.

    Science.gov (United States)

    Čimić, Samir; Šimunković, Sonja Kraljević; Gospić, Renata Kevilj; Badel, Tomislav; Dulčić, Nikša; Ćatić, Amir

    2015-03-01

    There have been studies that investigated mandibular movements and positioning during swallowing, but the results were inconsistent, and still the exact position of the condyles during swallowing is unknown. The purpose of this investigation was to study the kinematics of the mandible and the condyles, and to determine the actual movement paths and position of mandible and condyles during the process of swallowing. The study was performed on a sample of 44 dental students. Measurements were done with an electronic axiograph. After non-occlusing attachment was fixed in the mouth, every subject swallowed for five times from the rest position. The final swallowing position of the left and the right condyles was measured in the sagittal plane. The final swallowing position of the sagittal incisal point was measured in sagittal, frontal and horizontal plane, and data was statistically analyzed. The condyles showed average movement toward posterior (left 0.17 mm, SD 0.28, right 0.16 mm, SD 0.25) and superior (left 0.14 mm, SD 0.20, right 0.14 mm, SD 0.23). Anterior and/or inferior position had 20% of participants. The average sagittal incisal point movement during swallowing was toward anterior (0.30 mm, SD 0.53) and superior (0.81 mm, SD 0.84). The mean mandibular lateral movement was 0.1 mm (SD 0.1). The results of the study suggest that retrusion during swallowing is not the rule, although on average there is a slight tendency of condylar movement toward posterior. Swallowing can be used as auxiliary method for determining vertical dimension of occlusion.

  7. Lung Volume Measured during Sequential Swallowing in Healthy Young Adults

    Science.gov (United States)

    Hegland, Karen Wheeler; Huber, Jessica E.; Pitts, Teresa; Davenport, Paul W.; Sapienza, Christine M.

    2011-01-01

    Purpose: Outcomes from studying the coordinative relationship between respiratory and swallow subsystems are inconsistent for sequential swallows, and the lung volume at the initiation of sequential swallowing remains undefined. The first goal of this study was to quantify the lung volume at initiation of sequential swallowing ingestion cycles and…

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

    Science.gov (United States)

    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…

  9. Management of sword-swallower injuries.

    Science.gov (United States)

    Moberly, A C; Fritsch, M H; Mosier, K M

    2011-02-01

    To report an unusual case of hypopharyngeal perforation in a sword-swallower, with emphasis on management options. Case report and review of the English language literature concerning sword-swallowing injuries to the hypopharynx and oesophagus. A 29-year-old male sword-swallower suffered hypopharyngeal perforation during a performance. The patient received conservative management, with intensive care unit admission, infectious disease consultation, intravenous antibiotics, discontinuation of oral intake and close observation. He progressed well, resumed oral intake on hospital day six, and was discharged home on hospital day eight. Sword-swallowing is an unusual vocation which may lead to potentially devastating injuries. This case report and review of the literature illustrates the management options for such hypopharyngeal and oesophageal injuries.

  10. [The physiologic and the pathologic swallowing process].

    Science.gov (United States)

    Cantemir, S; Laubert, A

    2017-03-01

    It is estimated that 5 million people in Germany currently suffer from swallowing disorders. Due to increasing life expectancy and the good outcome of very premature infants, this number is expected to increase. Swallowing normally occurs in four phases, and for each phase there are diagnostic tools to assess whether the problem is anatomic-organic or functional. A detailed case history is followed by clinical examination of the cranial nerves, the orofacial region, the swallowing reflex, and pharyngeal and esophageal transit. Attention is also paid to age-related changes in the swallowing process, nasal regurgitation, retention at the base of the tongue or in the hypopharynx, and signs of aspiration.

  11. 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 ...

  12. Instrumentation for bedside analysis of swallowing disorders.

    Science.gov (United States)

    Greco, Catiuscia S S; Nunes, Luiz G Q; Melo, Pedro L

    2010-01-01

    Disordered swallowing, or dysphagia, is a common problem seen in patients undergoing treatment for cancer, stroke and neurodegenerative illnesses. This disease is associated with aspiration-induced chest infections. The methods currently used for diagnosis, however, are qualitative or based on expensive equipment. Swallowing accelerometry is a promising low-cost, quantitative and noninvasive tool for the evaluation of swallowing. This work describes the design and application of a bedside instrument able to evaluate swallowing mechanisms and to identify patients at risk of aspiration. Three-axis swallowing accelerometry was used to measure the neck vibrations associated with deglutition, providing analog signals to a virtual instrument developed in LabVIEW environment. In vivo tests in normal subjects as well as tests with disphagic patients showed that the system was able to easily and non-invasively detect changes in the swallowing acceleration pattern associated with increasing values of water volume (p disphagia. We concluded that the developed system could be a useful tool for the objective bedside evaluation of patients at risk of aspiration.

  13. 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.

  14. The interaction between breathing and swallowing in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Erdem, Nazan Simsek; Karaali, Kamil; Ünal, Ali; Kızılay, Ferah; Öğüş, Candan; Uysal, Hilmi

    2016-12-01

    The aim of the study is to determine the association between respiratory swallow patterns in amyotrophic lateral sclerosis (ALS) patients. Furthermore, it aims to clarify the role of the dysphagia limit in defining the relationship between swallowing disorders and respiratory disorders. Functional rating scales were used to describe swallowing and respiratory function. Swallowing was observed using the dysphagia limit. Dysphagia limit is the volume at which a second or more swallows are required to swallow the whole bolus. Laryngeal and chest movement sensors, pulmonary function tests, submental, and diaphragm electromyography activity were used to evaluate the relationship between swallowing and respiratory phase. Of the 27 patients included in the study, 14 were dysphagic and 13 were non-dysphagic. Tests showed normal respiratory function in 11 of the non-dysphagic patients and 3 of the dysphagic patients. There was a high correlation between the dysphagia limit and Amyotrophic Lateral Sclerosis Functional Rating Scale swallowing parameters. Non-dysphagic patients were able to swallow during inspiration but only six patients in the dysphagic group were able to swallow during inspiration. The occurrence of dysphagia in ALS is related to piecemeal deglutition and respiration consistency during swallowing. Detecting the timing of disturbances in the relationship between swallowing and respiration may be a way of identifying dysphagia. Dysphagia limit may be a useful, complementary test for assessing swallowing disturbances in amyotrophic lateral sclerosis.

  15. Registros adicionales de aves para Hidalgo, Mexico

    National Research Council Canada - National Science Library

    Valencia-Herverth, J; Valencia-Herverth, R; Mendoza-Quijano, F

    2008-01-01

    .... Ademas, se indica la ampliacion del area de distribucion de Tigrisoma mexicanum. Los sitios de muestreo corresponden a parches de selva mediana subperennifolia, bosque mesofilo de montana, vegetacion riparia y areas perturbadas...

  16. EFFECT OF GUM CHEWING ON AIR SWALLOWING, SALIVA SWALLOWING AND BELCHING

    Directory of Open Access Journals (Sweden)

    Ana Cristina Viana da SILVA

    2015-09-01

    Full Text Available BackgroundEructation is a physiologic event which allows gastric venting of swallowed air and most of the time is not perceived as a symptom. This is called gastric belching. Supragastric belching occurs when swallowed air does not reach the stomach and returns by mouth a short time after swallowing. This situation may cause discomfort, life limitations and problems in daily life.ObjectiveOur objective in this investigation was to evaluate if gum chewing increases the frequency of gastric and/or supragastric belches.MethodsEsophageal transit of liquid and gas was evaluated by impedance measurement in 16 patients with complaint of troublesome belching and in 15 controls. The Rome III criteria were used in the diagnosis of troublesome belching. The esophageal transit of liquid and gas was measured at 5 cm, 10 cm, 15 cm and 20 cm from the lower esophageal sphincter. The subjects were evaluated for 1 hour which was divided into three 20-minute periods: (1 while sitting for a 20-minute base period; (2 after the ingestion of yogurt (200 mL, 190 kcal, in which the subjects were evaluated while chewing or not chewing gum; (3 final 20-minute period in which the subjects then inverted the task of chewing or not chewing gum. In gastric belch, the air flowed from the stomach through the esophagus in oral direction and in supragastric belch the air entered the esophagus rapidly from proximal and was expulsed almost immediately in oral direction. Air swallows were characterized by an increase of at least 50% of basal impedance and saliva swallow by a decrease of at least 50% of basal impedance, that progress from proximal to distal esophagus.ResultsIn base period, air swallowing was more frequent in patients than in controls and saliva swallowing was more frequent in controls than in patients. There was no difference between the medians of controls and patients in the number of gastric belches and supragastric belches. In six patients, supragastric belches

  17. Remote management of voice and swallowing disorders.

    Science.gov (United States)

    Mashima, Pauline A; Brown, Janet E

    2011-12-01

    Telehealth or telepractice can alleviate shortages of speech-language pathologists, particularly in rural and underserved areas, where specialists in voice and swallowing disorders may not be available. In addition to improving access to services, telehealth offers the opportunity for patients to receive care in their natural environment, as in the case of home health care where treatment can include family members and caregivers. This article presents an overview of telehealth applications in the remote management of voice and swallowing disorders including historical background, current issues, and a brief review of clinical effectiveness studies. Published by Elsevier Inc.

  18. Bird ringing in Slovenia in 2014 and results of the first telemetry study of an African migrant

    Directory of Open Access Journals (Sweden)

    Vrezec Al

    2015-12-01

    Full Text Available In 2014, 162 bird species were recorded during the bird ringing activities in Slovenia. Of 155 species, 62,275 birds were ringed, and 107 recoveries of birds ringed in Slovenia and found abroad, 148 foreign recoveries in Slovenia and 1395 local recoveries were recorded. The most frequently ringed species were Blackcap Sylvia atricapilla and Great Tit Parus major. As far as ringed nestlings are concerned, Great Tits and Barn Swalllows Hirundo rustica predominated. Considering the recoveries ringed of found birds abroad, the commonest were Black-headed Gulls Chroicocephalus ridibundus and Mute Swans Cygnus olor. The farthest recovery was a Barn Swallow Hirundo rustica found in the Democratic Republic of Congo (5171 km away. Among the more interesting finds was also the so far southernmost recovery of a Sand Martin Riparia riparia found in Israel. Let us also mention the first recovery of a Corncrake Crex crex, which bred and was ringed in 2013 at Planinsko polje (central Slovenia and was found in the 2014 breeding season in the Czech Republic. Among rare species, two Little Buntings Emberiza pusilla were caught and ringed. After nine years, the Roller Coracias garrulus bred again in Slovenia in 2014 and its nestlings were ringed. The paper also brings the description of the migration route of the first African migrant, the Black Stork Ciconia nigra, marked with a GPS/GSM telemetric device, which migrated across the Adriatic Sea, Sicily and Sahara to Nigeria.

  19. Nonspecific effects of gap paradigm on swallowing.

    Science.gov (United States)

    Yoneda, Masaki; Saitoh, Kazuya

    2017-02-01

    Analogous to the gap paradigm in experiments for saccadic eye movements with very short reaction times, we hypothesized that the initiation of oropharyngeal swallowing movements guided by visual cues are encouraged under experimental conditions using a similar gap paradigm. A red visual cue indicating to hold a bolus in the mouth and a blue one indicating to swallow the bolus were sequentially provided on a computer display to 11 healthy participants. The gap period between these cues varied from 0 to 800ms. Swallowing kinetics and kinematics were recorded using surface electromyography and a laser displacement sensor, respectively. In comparison with the no-gap paradigm, the delay from the onset of muscle activities to initiation of movement significantly decreased with a 100- (pparadigm of 100-200ms. Wrist flexion was boosted in a similar manner. Thus, the gap effect may be a generalized warning effect. Our findings might provide insights into the contribution of the basal ganglia to volitional swallowing. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Senescent Swallowing: Impact, Strategies and Interventions

    Science.gov (United States)

    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

  1. The effects of removable denture on swallowing.

    Science.gov (United States)

    Son, Dae-Sik; Seong, Jin Wan; Kim, Younghoon; Chee, Youngjoon; Hwang, Chang Ho

    2013-04-01

    To investigate the relationship between removable dentures and swallowing and describe risks. Twenty-four patients with removable dentures who were referred for videofluoroscopic swallowing study (VFSS) were enrolled. We evaluated the change of swallowing function using VFSS before and after the removal of the removable denture. The masticatory performance by Kazunori's method, sensation of oral cavity by Christian's method, underlying disease, and National Institutes of Health Stroke Scale for level of consciousness were collected. Functional dysphagia scales, including the oral transit time (OTT), pharyngeal transit time (PTT), percentage of oral residue, percentage of pharyngeal residue, oropharyngeal swallow efficiency (OPSE), and presence of aspiration were measured. Four patients dropped out and 20 patients were analyzed (stroke, 13 patients; pneumonia, 3 patients; and others, 4 patients). The mean age was 73.3±11.4 years. There were significant differences before and after the removal of the denture for the OTT. OTT was significantly less after the removal of the denture (8.87 vs. 4.38 seconds, p=0.01). OPSE increased remarkably after the removal of the denture, but without significance (18.24%/sec vs. 25.26%/sec, p=0.05). The OTT and OPSE, while donning a removable denture, were correlated with the masticatory performance (OTT, p=0.04; OPSE, p=0.003) and sensation of oral cavity (OTT, p=0.006; OPSE, p=0.007). A removable denture may have negative effects on swallowing, especially OTT and OPSE. These affects may be caused by impaired sensation of the oral cavity or masticatory performance induced by the removable denture.

  2. Swallowing Disorders in Severe Brain Injury in the Arousal Phase.

    Science.gov (United States)

    Bremare, A; Rapin, A; Veber, B; Beuret-Blanquart, F; Verin, E

    2016-08-01

    The objective of this study was to determine the clinical characteristics of swallowing disorders in severe brain injury in the arousal phase after coma. Between December 1, 2013 and June 30, 2014, eleven patients with severe acquired brain injury who were admitted to rehabilitation center (Male 81.8 %; 40.7 ± 14.6 years) were included in the study. Evaluation of swallowing included a functional examination, clinical functional swallowing test, and naso-endoscopic swallowing test. All patients had swallowing disorders at admission. The first functional swallowing test showed oral (77.8 %) and pharyngeal (66.7 %) food bolus transport disorders; and alterations in airway protection mechanisms (80 %). Swallowing test under endoscopic control showed a disorder in swallowing coordination in 55.6 % of patients tested. Seven (63.6 %) patients resumed oral feeding within an average of 6 weeks after admission to rehabilitation center and 14 weeks after acquired brain injury. Six (85.7 %) of these seven patients continued to require modified solid and liquid textures. Swallowing disorders are a major concern in severe brain injury in the arousal phase. Early bedside assessment of swallowing is essential for detection of swallowing disorders to propose appropriate medical rehabilitation care to these patients in a state of altered consciousness.

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

    Science.gov (United States)

    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.

  4. Speech, language and swallowing in Huntington’ Disease

    Directory of Open Access Journals (Sweden)

    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.

  5. Assessing children's swallowing: Parent and professional perceptions

    OpenAIRE

    Cockerill, H.; Van Den Engel-Hoek, L.; Harding, C.

    2016-01-01

    Purpose-For infants and children who have difficulties with eating, drinking and swallowing (dysphagia), there are significant health risks that include aspiration (food and fluid entering the lungs) and poor growth. Videofluoroscopy is often the instrumental method of assessment used to exclude or confirm aspiration. The purpose of this paper is to investigate parental and referrer perceptions of the reasons for and the outcomes of videofluoroscopy. \\ud \\ud Design/methodology/approach-Data w...

  6. Functional connectivity patterns of normal human swallowing: difference among various viscosity swallows in normal and chin-tuck head positions.

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L; Perera, Subashan; Sejdić, Ervin

    2016-12-01

    Consuming thicker fluids and swallowing in the chin-tuck position has been shown to be advantageous for some patients with neurogenic dysphagia who aspirate due to various causes. The anatomical changes caused by these therapeutic techniques are well known, but it is unclear whether these changes alter the cerebral processing of swallow-related sensorimotor activity. We sought to investigate the effect of increased fluid viscosity and chin-down posture during swallowing on brain networks. 55 healthy adults performed water, nectar-thick, and honey thick liquid swallows in the neutral and chin-tuck positions while EEG signals were recorded. After pre-processing of the EEG timeseries, the time-frequency based synchrony measure was used for forming the brain networks to investigate whether there were differences among the brain networks between the swallowing of different fluid viscosities and swallowing in different head positions. We also investigated whether swallowing under various conditions exhibit small-world properties. Results showed that fluid viscosity affects the brain network in the Delta, Theta, Alpha, Beta, and Gamma frequency bands and that swallowing in the chin-tuck head position affects brain networks in the Alpha, Beta, and Gamma frequency bands. In addition, we showed that swallowing in all tested conditions exhibited small-world properties. Therefore, fluid viscosity and head positions should be considered in future swallowing EEG investigations. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Functional connectivity patterns of normal human swallowing: difference among various viscosity swallows in normal and chin-tuck head positions

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L.; Perera, Subashan

    2016-01-01

    Consuming thicker fluids and swallowing in the chin-tuck position has been shown to be advantageous for some patients with neurogenic dysphagia who aspirate due to various causes. The anatomical changes caused by these therapeutic techniques are well known, but it is unclear whether these changes alter the cerebral processing of swallow-related sensorimotor activity. We sought to investigate the effect of increased fluid viscosity and chin-down posture during swallowing on brain networks. 55 healthy adults performed water, nectar-thick, and honey thick liquid swallows in the neutral and chin-tuck positions while EEG signals were recorded. After pre-processing of the EEG timeseries, the time-frequency based synchrony measure was used for forming the brain networks to investigate whether there were differences among the brain networks between the swallowing of different fluid viscosities and swallowing in different head positions. We also investigated whether swallowing under various conditions exhibit small-world properties. Results showed that fluid viscosity affects the brain network in the Delta, Theta, Alpha, Beta, and Gamma frequency bands and that swallowing in the chin-tuck head position affects brain networks in the Alpha, Beta, and Gamma frequency bands. In addition, we showed that swallowing in all tested conditions exhibited small-world properties. Therefore, fluid viscosity and head positions should be considered in future swallowing EEG investigations. PMID:27693396

  8. Anatomical Directional Dissimilarities in Tri-axial Swallowing Accelerometry Signals.

    Science.gov (United States)

    Movahedi, Faezeh; Kurosu, Atsuko; Coyle, James L; Perera, Subashan; Sejdic, Ervin

    2017-05-01

    Swallowing accelerometry is a noninvasive approach currently under consideration as an instrumental screening test for swallowing difficulties, with most current studies focusing on the swallowing vibrations in the anterior-posterior (A-P) and superior-inferior (S-I) directions. However, the displacement of the hyolaryngeal structure during the act of swallowing in patients with dysphagia involves declination of the medial-lateral (M-L), which suggests that the swallowing vibrations in the M-L direction have the ability to reveal additional details about the swallowing function. With this motivation, we performed a broad comparison of the swallowing vibrations in all three anatomical directions. Tri-axial swallowing accelerometry signals were concurrently collected from 72 dysphagic patients undergoing videofluoroscopic evaluation of swallowing (mean age: 63.94 ± 12.58 years period). Participants swallowed one or more thickened liquids with different consistencies including thin-thick liquids, nectar-thick liquids, and pudding-thick liquids with either a comfortable self-selected volume from a cup or a controlled volume by the examiner from a 5-ml spoon. Swallows were grouped based on the viscosity of swallows and the participant's stroke history. Then, a comprehensive set of features was extracted in multiple signal domains from 881 swallows. The results highlighted inter-axis dissimilarities among tri-axial swallowing vibrations including the extent of variability in the amplitude of signals, the degree of predictability of signals, and the extent of disordered behavior of signals in time-frequency domain. First, the upward movement of the hyolaryngeal structure, representing the S-I signals, were actually more variable in amplitude and showed less predictable behavior than the sideways and forward movements, representing the A-P and M-L signals, during swallowing. Second, the S-I signals, which represent the upward movement of the hyolaryngeal structure

  9. Gas swallow during meals in patients with excessive belching.

    Science.gov (United States)

    Caballero, N; Serra, J

    2017-09-01

    Swallowed gas is an important source of abdominal gas, and aerophagia is often believed as a putative cause of gas-related abdominal symptoms. However, altered gas-swallow during meals has not been demonstrated. Our aim was to characterize the number of gas swallows during meals in patients complaining of excessive belching and gaseousness and a control group without abdominal symptoms during a 24-h period. A 24-h pH-impedance monitoring was performed in 10 patients with excessive belching, and 11 patients without digestive symptoms or reflux in the pH-impedance study. During the study, patients followed their daily routine and customary meals, without any specific limitation. In each patient the number and content of swallows and belches were analyzed. Total meal periods were similar in controls (75±26 min) and patients (79±21 min; P=.339), but the number of gaseous swallows was greater in patients (114±13 swallows) than controls (71±8 swallows; P=.007), due to a greater frequency of gaseous swallows during meals (15±2 swallows/10 min vs 10±1 swallows/10 min, respectively; P=.008). During the 24-h study period, 66±13 belches were recorded in patients, but only 13±3 belches in controls (PGas is frequently swallowed during meals. Patients complaining of excessive belching have a different swallow pattern during meals, with an increased ingestion of gas that correlates with increased gastric belching events. © 2017 John Wiley & Sons Ltd.

  10. Importance of the swallowing atypical in them malocclusions

    OpenAIRE

    Jiménez Jiménez, Jonatan; Universidad Nacional Mayor de San Marcos, Facultad de Odontología.

    2017-01-01

    This review aims to determine the atypical swallowing malocclusions. When there are inadequate move-ments of the tongue and / or other structures during oral and pharyngolaryngeal phase of swallowing, talking about atypical swallowing, as a non-physiological habit. Its objectives may be multiple, simul-taneously acting alone or cumulatively. The size of a large tongue has been found as an impediment to correct such alternations, though this is a cause of causing malocclusion. the importance o...

  11. Assessment of swallowing sounds by digital cervical auscultation in children.

    Science.gov (United States)

    Almeida, Sheila T; Ferlin, Elton L; Parente, Maria Alice M P; Goldani, Helena A S

    2008-04-01

    There is a lack of studies regarding swallowing sounds in children 3 to 11 years of age. This study aimed to assess swallowing sounds by digital cervical auscultation in children of this age group without symptoms of oropharyngeal dysphagia. Digital cervical auscultation was performed in 118 subjects by use of a piezoelectric microphone. The children swallowed 5 mL of liquid and yogurt. The components of perceptual acoustic analysis were discrete initial signal (DIS), main signal of swallowing sound (MS), discrete final signal (DFS), and expiratory return (ER). Duration in seconds was the objective parameter of the swallowing sound signal analyzed. Fifty-six boys and 62 girls were evaluated at a mean (+/- SD) age of 6.9 +/- 2.03 years. A complete DIS-MS-DFS-ER swallowing sequence was found in 60% of the children. There was no significant difference in swallowing sound duration between both food consistencies (p = .189) or between genders either for liquid (p = .327) or yogurt (p = .792). There was no correlation between age and duration of the swallowing sound for liquid or yogurt. We concluded that digital cervical auscultation was able to provide objective information about the swallowing process that could contribute to methodological standardization in children.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. 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

    Feeding difficulties are known to occur with advancing age in Duchenne muscular dystrophy (DMD). We evaluated the role of videofluoroscopy swallow study (VFSS) in a group of 30 DMD patients with feeding difficulties. Indications for feeding assessment were: respiratory infections potentially...

  14. The surgical management and speech and swallowing rehabilitation ...

    African Journals Online (AJOL)

    Advanced tongue cancer may have a devastating effect on a person's ability to speak and to swallow. Very little is known about the surgical management and speech and swallowing rehabilitation of persons with advanced tongue cancer in South Africa. The aim of this study was to obtain information regarding clinical ...

  15. Breeding biology and taxonomy of the Red-breasted Swallow ...

    African Journals Online (AJOL)

    Nocturnal trapping and ringing of swallows around Harare, Zimbabwe, showed that at least five species have adapted their breeding behaviour to manmade road culverts, none more so than the Red-breasted Swallow, Hirundo semirufa, which may be found nesting in the smallest (46cm diameter) of pipe culverts.

  16. Vocalizations of the South African cliff swallow Hirundo spilodera

    African Journals Online (AJOL)

    the impression that all chicks had these facial markings but never actually stated the number that really had these markings. In the South African swallow less than 250/0 of all chicks examined had any white markings, probably too few for facial recognition of chicks to be universal in a South. African cliff swallow colony.

  17. Swallow Characteristics in Patients with Oculopharyngeal Muscular Dystrophy

    Science.gov (United States)

    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…

  18. Emetic stimulation inhibits the swallowing reflex in decerebrate rats.

    Science.gov (United States)

    Kurozumi, Chiharu; Yamagata, Ryuzo; Himi, Naoyuki; Koga, Tomoshige

    2008-06-01

    The effects of emetic stimulation on the swallowing reflex were investigated in decerebrated rats. Hypoxia, gastric distension and LiCl administration were used as emetic stimulations. The swallowing reflex was elicited by electrical stimulation of the superior laryngeal nerve (SLN, 20 Hz, 3-5 V, 0.3 ms duration) for 20 s. To examine the effect of hypoxia, nitrogen gas was inhaled under artificial ventilation. There were significantly fewer swallows during a decrease in PO(2) than under air ventilation (p<0.05). The number of swallows during 3-ml stomach distension was significantly lower than that before distension (p<0.05). Intravenous administration of LiCl (100 mg/kg) also significantly reduced the number of swallows (p<0.05). The combination of SLN stimulation and emetic stimuli occasionally produced burst activity of abdominal muscles, which might be associated with the gag reflex. Both the gag and swallowing reflexes are well known to be mediated by the nucleus of the solitary tract. The physiological roles of the gag reflex and the swallowing reflex are considered to be reciprocal. Taken together, these results suggest that emetic stimulation inhibits the swallowing pattern generator via the nucleus of the solitary tract, which in turn facilitates the gag reflex.

  19. Prophylactic Swallowing Exercises in Head and Neck Cancer Radiotherapy

    DEFF Research Database (Denmark)

    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 curativ...

  20. Swallow-wort (Vincetoxicum spp.) biological control update

    Science.gov (United States)

    Pale swallow-wort (Vincetoxicum rossicum = Cynanchum rossicum) and black swallow-wort (V. nigrum = C. louiseae) are herbaceous, perennial, viney milkweeds introduced from Europe (Apocynaceae-subfamily Asclepiadoideae). Both species are becoming increasingly invasive in a variety of natural and manag...

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

    African Journals Online (AJOL)

    Two surveys of Blue Swallows were conducted in the southern Tanzanian highland grasslands in order to determine the habitat preferences and estimate the size of this subpopulation. During the 2008/09 and 2012 surveys, a total distance of 3 635 km was travelled in search of Blue Swallows (at an altitude of above 1 400 ...

  2. Ginger Orally Disintegrating Tablets to Improve Swallowing in Older People.

    Science.gov (United States)

    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.

  3. 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.

  4. Tactile thermal oral stimulation increases the cortical representation of swallowing

    Directory of Open Access Journals (Sweden)

    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.

  5. Tactile thermal oral stimulation increases the cortical representation of swallowing

    Science.gov (United States)

    Teismann, Inga K; Steinsträter, Olaf; Warnecke, Tobias; Suntrup, Sonja; Ringelstein, Erich B; Pantev, Christo; Dziewas, Rainer

    2009-01-01

    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. PMID:19566955

  6. Fabrication of Artificial Food Bolus for Evaluation of Swallowing.

    Directory of Open Access Journals (Sweden)

    Miyu Hosotsubo

    Full Text Available Simple and easy methods to evaluate swallowing are required because of the recently increased need of rehabilitation for dysphagia. "Artificial food bolus", but not "artificial food", would be a valuable tool for swallowing evaluation without considering the mastication effect which is altered according to the individual's oral condition. Thus, this study was carried out to fabricate artificial bolus resembling natural food bolus. The mechanical property and the volume change of food bolus in normal people were firstly investigated. Thirty healthy adults without dysphagia were selected and asked to chew four sample foods (rice cake, peanut, burdock, and gummy candy. The results indicated that Young's modulus of bolus before swallowing was below 150 kPa. The bolus volume before swallowing was below 400 mm3. In addition, the saliva component ratio of each bolus was approximately 30wt%, and the average saliva viscosity of research participants was approximately 10 mPa•s. Based on the obtained data, artificial food bolus was designed and fabricated by using alginate hydrogel as a visco-elastic material and gelatin solution as a viscotic material with a ratio of 7:3 based on weight. Consequently, the swallowing time of fabricated artificial food bolus was measured among the same participants. The results indicated the participants swallowed fabricated food bolus with similar manner reflecting their mechanical property and volume. Thus, this artificial food bolus would be a promising tool for evaluation of swallowing.

  7. Oral medication delivery in impaired swallowing: thickening liquid medications for safe swallowing alters dissolution characteristics.

    Science.gov (United States)

    Manrique, Yady J; Sparkes, Arron M; Cichero, Julie A Y; Stokes, Jason R; Nissen, Lisa M; Steadman, Kathryn J

    2016-09-01

    Acetaminophen (paracetamol) is available in a wide range of oral formulations designed to meet the needs of the population across the age-spectrum, but for people with impaired swallowing, i.e. dysphagia, both solid and liquid medications can be difficult to swallow without modification. The effect of a commercial polysaccharide thickener, designed to be added to fluids to promote safe swallowing by dysphagic patients, on rheology and acetaminophen dissolution was tested using crushed immediate-release tablets in water, effervescent tablets in water, elixir and suspension. The inclusion of the thickener, comprised of xanthan gum and maltodextrin, had a considerable impact on dissolution; acetaminophen release from modified medications reached 12-50% in 30 min, which did not reflect the pharmacopeia specification for immediate release preparations. Flow curves reflect the high zero-shear viscosity and the apparent yield stress of the thickened products. The weak gel nature, in combination with high G' values compared to G'' (viscoelasticity) and high apparent yield stress, impact drug release. The restriction on drug release from these formulations is not influenced by the theoretical state of the drug (dissolved or dispersed), and the approach typically used in clinical practice (mixing crushed tablets into pre-prepared thickened fluid) cannot be improved by altering the order of incorporation or mixing method.

  8. Tachyarrhythmias triggered by swallowing and belching

    Science.gov (United States)

    Wilmshurst, P

    1999-01-01

    Three cases with supraventricular tachyarrhythmias related to oesophageal transit are reported. A 61 year old man had episodes of atrial tachycardia on each swallow of food but not liquid; this has been reported only rarely. A 55 year old man had atrial fibrillation initiated by drinking ice cold beverages; this has not been described previously although atrial tachycardia triggered by drinking ice cold beverages has been described once. A 68 year old man had supraventricular tachycardia initiated by belching; this has not been described previously. These cases illustrate the diversity of atrial tachyarrhythmias that can be precipitated by oesophageal stimulation and suggest that what is regarded as a very rare phenomenon may be found more commonly when sought.

 Keywords: atrial tachycardia; atrial fibrillation; deglutition; eructation; arrhythmias PMID:10026360

  9. Using devices to upregulate nonnutritive swallowing in typically developing infants.

    Science.gov (United States)

    Hegyi Szynkiewicz, Sarah; Mulheren, Rachel W; Palmore, Kathryn W; O'Donoghue, Cynthia R; Ludlow, Christy L

    2016-10-01

    The role of various sensory stimuli for stimulating swallowing in infants may be of importance for assisting infants to develop oral feeding. We evaluated the swallowing mechanism response to two devices for increasing the rate of nonnutritive swallowing in two typically developing infant age groups, ages 2-4 mo and 7-9 mo. One device was a pacifier familiar to the infant; the other was a small vibrator placed on the skin overlying the thyroid cartilage. The rate of nonnutritive swallowing while infants were awake was compared in three 10-min conditions: at rest without stimulation (spontaneous); during nonnutritive sucking with a pacifier; and over 10 min containing 18 epochs of vibratory stimulation for 10 s each. To assess whether vibration on the throat over the laryngeal area altered respiration, the mean cycle length was compared between 10-min intervals either containing vibratory stimulation or without stimulation at rest. Both the pacifier and laryngeal vibration stimulation doubled the rate of swallowing in the infants with a mean age of 3 mo 16 days and infants with a mean age of 8 mo 8 days. No differences occurred in the mean respiratory cycle length between intervals with and without vibration in either age group. Results suggest that nonnutritive sucking, vibration, or both might be beneficial in enhancing swallowing in young infants. Because vibration on the neck would not interfere with oral transfer of liquid, it might provide additional stimulation for swallowing during oral feeding. Both stimulation types should be evaluated for enhancing swallowing in infants with immature swallowing skills. Copyright © 2016 the American Physiological Society.

  10. Functional Connectivity of the Cortical Swallowing Network in Humans

    Science.gov (United States)

    Babaei, Arash; Ward, B. Douglas; Siwiec, Robert; Ahmad, Shahryar; Kern, Mark; Nencka, Andrew; Li, Shi-Jiang; Shaker, Reza

    2014-01-01

    Introduction Coherent fluctuations of blood oxygenation level dependent (BOLD) signal have been referred as “functional connectivity” (FC). Our aim was to systematically characterize FC of underlying neural network involved in swallowing, and to evaluate its reproducibility and modulation during rest or task performance. Methods Activated seed regions within known areas of the cortical swallowing network (CSN) were independently identified in 16 healthy volunteers. Subjects swallowed using a paradigm driven protocol, and the data analyzed using an event-related technique. Then, in the same 16 volunteers, resting and active state data were obtained for 540 seconds in three conditions: 1) swallowing task; 2) control visual task; and 3) resting state; all scans were performed twice. Data was preprocessed according to standard FC pipeline. We determined the correlation coefficient values of member regions of the CSN across the three aforementioned conditions and compared between two sessions using linear regression. Average FC matrices across conditions were then compared. Results Swallow activated twenty-two positive BOLD and eighteen negative BOLD regions distributed bilaterally within cingulate, insula, sensorimotor cortex, prefrontal and parietal cortices. We found that: 1) Positive BOLD regions were highly connected to each other during all test conditions while negative BOLD regions were tightly connected amongst themselves; 2) Positive and negative BOLD regions were anti-correlated at rest and during task performance; 3) Across all three test conditions, FC among the regions was reproducible (r > 0.96, p<10-5); and 4) The FC of sensorimotor region to other regions of the CSN increased during swallowing scan. Conclusions 1) Swallow activated cortical substrates maintain a consistent pattern of functional connectivity; 2) FC of sensorimotor region is significantly higher during swallow scan than that observed during a non-swallow visual task or at rest. PMID

  11. Decoding human swallowing via electroencephalography: a state-of-the-art review.

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L; Sejdić, Ervin

    2015-10-01

    Swallowing and swallowing disorders have garnered continuing interest over the past several decades. Electroencephalography (EEG) is an inexpensive and non-invasive procedure with very high temporal resolution which enables analysis of short and fast swallowing events, as well as an analysis of the organizational and behavioral aspects of cortical motor preparation, swallowing execution and swallowing regulation. EEG is a powerful technique which can be used alone or in combination with other techniques for monitoring swallowing, detection of swallowing motor imagery for diagnostic or biofeedback purposes, or to modulate and measure the effects of swallowing rehabilitation. This paper provides a review of the existing literature which has deployed EEG in the investigation of oropharyngeal swallowing, smell, taste and texture related to swallowing, cortical pre-motor activation in swallowing, and swallowing motor imagery detection. Furthermore, this paper provides a brief review of the different modalities of brain imaging techniques used to study swallowing brain activities, as well as the EEG components of interest for studies on swallowing and on swallowing motor imagery. Lastly, this paper provides directions for future swallowing investigations using EEG.

  12. Decoding human swallowing via electroencephalography: a state-of-the-art review

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L.; Sejdić, Ervin

    2015-10-01

    Swallowing and swallowing disorders have garnered continuing interest over the past several decades. Electroencephalography (EEG) is an inexpensive and non-invasive procedure with very high temporal resolution which enables analysis of short and fast swallowing events, as well as an analysis of the organizational and behavioral aspects of cortical motor preparation, swallowing execution and swallowing regulation. EEG is a powerful technique which can be used alone or in combination with other techniques for monitoring swallowing, detection of swallowing motor imagery for diagnostic or biofeedback purposes, or to modulate and measure the effects of swallowing rehabilitation. This paper provides a review of the existing literature which has deployed EEG in the investigation of oropharyngeal swallowing, smell, taste and texture related to swallowing, cortical pre-motor activation in swallowing, and swallowing motor imagery detection. Furthermore, this paper provides a brief review of the different modalities of brain imaging techniques used to study swallowing brain activities, as well as the EEG components of interest for studies on swallowing and on swallowing motor imagery. Lastly, this paper provides directions for future swallowing investigations using EEG.

  13. Clock gene variation in Tachycineta swallows

    Science.gov (United States)

    Dor, Roi; Cooper, Caren B; Lovette, Irby J; Massoni, Viviana; Bulit, Flor; Liljesthrom, Marcela; Winkler, David W

    2012-01-01

    Many animals use photoperiod cues to synchronize reproduction with environmental conditions and thereby improve their reproductive success. The circadian clock, which creates endogenous behavioral and physiological rhythms typically entrained to photoperiod, is well characterized at the molecular level. Recent work provided evidence for an association between Clock poly-Q length polymorphism and latitude and, within a population, an association with the date of laying and the length of the incubation period. Despite relatively high overall breeding synchrony, the timing of clutch initiation has a large impact on the fitness of swallows in the genus Tachycineta. We compared length polymorphism in the Clock poly-Q region among five populations from five different Tachycineta species that breed across a hemisphere-wide latitudinal gradient (Fig. 1). Clock poly-Q variation was not associated with latitude; however, there was an association between Clock poly-Q allele diversity and the degree of clutch size decline within breeding seasons. We did not find evidence for an association between Clock poly-Q variation and date of clutch initiation in for any of the five Tachycineta species, nor did we found a relationship between incubation duration and Clock genotype. Thus, there is no general association between latitude, breeding phenology, and Clock polymorphism in this clade of closely related birds. Figure 1 Photos of Tachycineta swallows that were used in this study: A) T. bicolor from Ithaca, New York, B) T. leucorrhoa from Chascomús, Argentina, C) T. albilinea from Hill Bank, Belize, D) T. meyeni from Puerto Varas, Chile, and E) T. thalassina from Mono Lake, California, Photographers: B: Valentina Ferretti; A, C-E: David Winkler. PMID:22408729

  14. Swallowed dentures: Two cases and a review

    Science.gov (United States)

    Gachabayov, Mahir; Isaev, Mubariz; Orujova, Lala; Isaev, Emin; Yaskin, Evgeniy; Neronov, Dmitriy

    2015-01-01

    Introduction Denture ingestion or aspiration is a problem requiring awareness of different specialists including dentists, surgeons, otolaryngologists, anesthesiologists etc. in terms of prevention, early diagnosis and adequate treatment. Complications of swallowed dentures include hollow viscus necrosis, perforation, penetration to neighbor organs leading to fistulae, bleeding and obstruction. Presentation of cases First case is a 54-year-old female who accidentally swallowed retractable one-tooth denture during fall about 22 h before admission and clinical manifestation of acute small bowel obstruction developed. The patient underwent laparotomy, enterotomy with retrieval of the foreign body. The second case is a 31-year-old male who accidentally ingested fixed one-tooth prosthesis while eating which impacted in the ileocaecal valve. During the preparation to colonoscopy the denture spontaneously passed out with stools. Discussion Denture ingestion is more common among patients with psychoneurologic deficit, alcohol and drug abusers. Among healthy and younger population denture ingestion is rare. Both reported patients are not elder. Thus dislodgement of removable or fixed dentures is another risk factor of denture ingestion. Most common site of denture impaction is esophagus; small bowel impaction is rare. Moreover, in most reported cases, small bowel impaction of ingested dentures leads to small bowel perforation. In our first case the complication of denture ingestion appeared to be bowel obstruction what is even rarer. Conclusion Fixed dentures can be accidentally ingested as well as removable dentures. Denture loosening leads to accidental denture ingestion. Patients with denture loosening should be recommended to visit dentist as soon as possible. PMID:26635957

  15. Mis-swallowing of cleaning naphtha: report of three cases.

    Science.gov (United States)

    Kuo, C Y; Lee, C Y

    1990-01-01

    Cleaning naphtha, a product of Chinese Petroleum Corporation, is a complex hydrocarbon mixture which contains mainly aliphatic hydrocarbons. It is used as a cleaning fluid and solvent. Three toddlers mis-swallowed a mouth of cleaning naphtha accidentally. One developed multiple organ failure before death, another completely recovered without sequelae, and the other died very soon after mis-swallowing. Two fatal cases were both induced vomiting with aspiration immediately after mis-swallowing by their parents. Therefore, inducing vomiting should not be encouraged especially at home, and prevention of aspiration is very important in the management of such cases.

  16. Promoting safe swallowing when puree is swallowed without aspiration but thin liquid is aspirated: nectar is enough.

    Science.gov (United States)

    Leder, Steven B; Judson, Benjamin L; Sliwinski, Edward; Madson, Lindsay

    2013-03-01

    The use of thickened liquids is a common compensatory strategy to improve swallow safety. The purpose of this study was to determine the optimal liquid viscosity to use to promote successful swallowing in a specific subset of dysphagic patients who swallow puree without aspiration but thin liquid with aspiration. A referral-based sample of 84 consecutive inpatients from a large, urban, tertiary-care teaching hospital who met the study criteria was analyzed prospectively. Inclusion criteria were no preexisting dysphagia, a successful pharyngeal swallow without aspiration with puree consistency but pharyngeal dysphagia with aspiration of thin liquid consistency, and stable medical, surgical, and neurological status at the time of transnasal fiberoptic swallow testing and up to 24 h after recommendations for oral alimentation with a modified diet consisting of nectar-like and honey-like thickened liquids. Success with ingesting both nectar-like and honey-like thickened liquids and clinically evident aspiration events were recorded. Care providers were blinded to the study's purpose. All 84 patients were successfully ingesting nectar-like and honey-like thickened liquids at the time of swallow testing and up to 24 h after testing. A specific subset of dysphagic patients who swallowed puree without aspiration but aspirated thin liquid demonstrated 100 % successful swallowing of both nectar-like and honey-like thickened liquids. Therefore, a nectar-like thickened liquid appears to be adequate to promote safe swallowing in these patients and, because of patient preference for the least thick liquid, may enhance compliance and potentially contribute to maintenance of adequate hydration requirements.

  17. Cliff swallow populations in the southern Askinuk Mountains, Alaska

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — During breeding season, cliff swallows are widely distributed throughout Alaska and North America south to Mexico, and they are locally common in western and...

  18. Role of Basal Ganglia in Swallowing Process: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Hamideh Ghaemi

    2016-12-01

    Discussion: Swallowing is a multifaceted performance that needs contribution of the tongue, larynx, pharynx, and esophagus as well as the neurological structures such as neocortex and subcortical regions - BG and brainstem.

  19. Weather-related Tree Swallow Mortality and Reduced Nesting Effort

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report documents the spring 2007 die-off of 216 Tree Swallows in western New York due to a period of unseasonably warm temperatures followed immediately by a...

  20. Automated Detection and Evaluation of Swallowing Using a Combined EMG/Bioimpedance Measurement System

    Directory of Open Access Journals (Sweden)

    Corinna Schultheiss

    2014-01-01

    Full Text Available Introduction. Developing an automated diagnostic and therapeutic instrument for treating swallowing disorders requires procedures able to reliably detect and evaluate a swallow. We tested a two-stage detection procedure based on a combined electromyography/bioimpedance (EMBI measurement system. EMBI is able to detect swallows and distinguish them from similar movements in healthy test subjects. Study Design. The study was planned and conducted as a case-control study (EA 1/019/10, and EA1/160/09, EA1/161/09. Method. The study looked at differences in swallowing parameters in general and in the event of penetration during swallows in healthy subjects and in patients with an oropharyngeal swallowing disorder. A two-stage automated swallow detection procedure which used electromyography (EMG and bioimpedance (BI to reliably detect swallows was developed. Results. Statistically significant differences between healthy subjects and patients with a swallowing disorder were found in swallowing parameters previously used to distinguish between swallowing and head movements. Our two-stage algorithm was able to reliably detect swallows (sensitivity = 96.1%, specificity = 97.1% on the basis of these differences. Discussion. Using a two-stage detection procedure, the EMBI measurement procedure is able to detect and evaluate swallows automatically and reliably. The two procedures (EMBI + swallow detection could in future form the basis for automated diagnosis and treatment (stimulation of swallowing disorders.

  1. Automated detection and evaluation of swallowing using a combined EMG/bioimpedance measurement system.

    Science.gov (United States)

    Schultheiss, Corinna; Schauer, Thomas; Nahrstaedt, Holger; Seidl, Rainer O

    2014-01-01

    Developing an automated diagnostic and therapeutic instrument for treating swallowing disorders requires procedures able to reliably detect and evaluate a swallow. We tested a two-stage detection procedure based on a combined electromyography/bioimpedance (EMBI) measurement system. EMBI is able to detect swallows and distinguish them from similar movements in healthy test subjects. The study was planned and conducted as a case-control study (EA 1/019/10, and EA1/160/09, EA1/161/09). The study looked at differences in swallowing parameters in general and in the event of penetration during swallows in healthy subjects and in patients with an oropharyngeal swallowing disorder. A two-stage automated swallow detection procedure which used electromyography (EMG) and bioimpedance (BI) to reliably detect swallows was developed. Statistically significant differences between healthy subjects and patients with a swallowing disorder were found in swallowing parameters previously used to distinguish between swallowing and head movements. Our two-stage algorithm was able to reliably detect swallows (sensitivity = 96.1%, specificity = 97.1%) on the basis of these differences. Using a two-stage detection procedure, the EMBI measurement procedure is able to detect and evaluate swallows automatically and reliably. The two procedures (EMBI + swallow detection) could in future form the basis for automated diagnosis and treatment (stimulation) of swallowing disorders.

  2. 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....

  3. 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 )....

  4. Observation the swallowing mechanism in elderly patients with pharyngeal dysphagia

    Directory of Open Access Journals (Sweden)

    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.

  5. Functional magnetic resonance and swallowing: critical literature review,

    Directory of Open Access Journals (Sweden)

    Maíra Santilli de Lima

    2015-12-01

    Full Text Available ABSTRACT INTRODUCTION: Aspects of the neuroanatomical representation of swallowing have been investigated in humans through brain mapping techniques, such as functional magnetic resonance imaging (fMRI. OBJECTIVE: This critical qualitative review of the literature analyzed international scientific publications in the PubMed database that investigated the activation of the central nervous system in humans during the act of swallowing. METHODS: This investigation was limited to articles that investigated adults older than 18 years, published in English or Portuguese, between January 2002 and December 2013. Publications that did not have access to the full text, that were repeated by overlapping keywords, case studies, literature reviews, letters to the editor, and those not directly related to the topic of the investigation were excluded. RESULTS: A total of 649 articles were identified, of which 21 matched the inclusion criteria. CONCLUSION: The main purpose of the manuscripts that investigate the swallowing process through fMRI were: to characterize swallowing in different pathologies; to compare swallowing in different age groups; to describe brain activation in different stimulation conditions. These studies indicate multiple cortical regions involved in swallowing control. Overall, the studies indicate that fMRI is a non-invasive and quantitative method that allows the investigation of characteristics that are quite often not clinically visible.

  6. Normal erect swallowing. Normal function and incidence of variations.

    Science.gov (United States)

    Curtis, D J; Cruess, D F; Dachman, A H

    1985-10-01

    Of 871 candidates presenting for upper gastrointestinal examinations, 16 met the rigorous criteria established for selecting asymptomatic normal volunteers. Frame-by-frame evaluation of their videorecorded pharyngeal swallow confirmed many observations made previously utilizing cine recording at much higher radiation dosages. In addition, new observations were made: the nasopharynx may not occlude until the bolus is entirely within the pharynx; air mixes with the bolus if the swallow is an "open" type; the epiglottis always inverts in normal individuals regardless of the type of swallow ("open," air filled oro-and hypopharynx into which the swallowed bolus is dropped; "closed," airless oropharynx into which the swallowed bolus is pushed by a continuous peristaltic drive of the tongue and palate, thus reconstituting the pharyngeal space); laryngeal descent may aid in stripping the bolus from the pharynx; the vestibule may not completely close during the swallow and the larynx can still be impervious to the bolus; the peristaltic wave does not begin until the bolus has breeched the cricopharyngeus; the cricopharyngeus may be seen frequently in normal individuals, but does not delay the passage of the bolus; asymmetric flow of the bolus around the larynx is common and may not be the result of epiglottic tilt or head positioning.

  7. Effects of strengthening exercises on swallowing musculature and function in senior healthy subjects; a prospective effectiveness and feasibility study

    NARCIS (Netherlands)

    Kraaijenga, S.A.C.; van der Molen, L.; Stuiver, M.M.; Teertstra, H.J.; Hilgers, F.J.M.; van den Brekel, M.

    2015-01-01

    Head and neck cancer (HNC) patients may develop dysphagia due to muscle atrophy and fibrosis following chemoradiotherapy. Strengthening of the swallowing muscles through therapeutic exercise is potentially effective for improving swallowing function. We hypothesize that a customized Swallow Exercise

  8. Effects of Strengthening Exercises on Swallowing Musculature and Function in Senior Healthy Subjects: a Prospective Effectiveness and Feasibility Study

    NARCIS (Netherlands)

    Kraaijenga, S. A. C.; van der Molen, L.; Stuiver, M. M.; Teertstra, H. J.; Hilgers, F. J. M.; van den Brekel, M. W. M.

    2015-01-01

    Head and neck cancer (HNC) patients may develop dysphagia due to muscle atrophy and fibrosis following chemoradiotherapy. Strengthening of the swallowing muscles through therapeutic exercise is potentially effective for improving swallowing function. We hypothesize that a customized Swallow Exercise

  9. Gamma radiation effects on nestling Tree Swallows

    Energy Technology Data Exchange (ETDEWEB)

    Zach, R.; Mayoh, K.R.

    1984-10-01

    The sensitivity of Tree Swallows (Tachycineta bicolor) to the stress of ionizing radiation was investigated with growth analysis. Freshly hatched nestlings were temporarily removed from nests, taken to the laboratory and acutely exposed to 0.9, 2.7, or 4.5 Gy gamma radiation. Some of the unirradiated control nestlings were also taken to the laboratory whereas others were left in the nests. Growth of all the nestlings was measured daily and analyzed by fitting growth models. There was no detectable radiation-induced mortality up to fledgling, approx. = 20 d after irradiation. Radiation exposure did not affect the basic growth pattern; the logistic growth model was most suitable for body mass and foot length, and the von Bertalanffy model for primary-feather length, irrespective of treatment. Parameter values from these models indicated pronounced growth depression in the 2.7-Gy and 4.5-Gy groups, particularly for body mass. Radiation also affected the timing of development. The growth depression of the 2.7-Gy group was similar to that caused by hatching asynchrony in unirradiated nestlings. The 4.5-Cy nestlings grew as well as unexposed nestlings that died from natural causes. Chronic irradiation at approx. = 1.0 Cy/d caused more severe growth effects than acute exposure to 4.5 Gy and may have caused permanent stunting. Growth analysis is a potent tool for assessing man-made environmental stresses. Observed body-mass statistics and model parameters seem to be most sensitive to environmental stresses, but coefficients of variation are not necessarily correlated with sensitivity. 34 references, 2 figures, 4 tables.

  10. Effect of wearing a palatal plate on swallowing function.

    Science.gov (United States)

    Toyoshita, Yoshifumi; Koshino, Hisashi; Hirai, Toshihiro; Matsumi, Tamachi

    2009-10-01

    The purpose of this study was to determine the effect of wearing a palatal plate on swallowing function. The subject group consisted of 10 healthy, fully dentate males. Two experimental palatal plates (EPP) were used in this study: one was 1.4mm thick (EPP1), and the other was 2.8mm thick (EPP2). Tongue movements and swallowing sounds were simultaneously recorded. The position of the surface of the tongue was recorded by using ultrasound diagnostic equipment in the sagittal plane. Swallowing tests were performed under three conditions: without EPP (WOE), with EPP1 (WP1), and with EPP2 (WP2). Swallowing index (SI) and tongue contact time (TCT) was calculated. The value of SI was lowest under WOE, and highest under WP2, with a statistically significant difference. There was no statistical significance, however, between SI under WOE and that under WP1. The value of TCT was longest under WOE, and shortest under WP2, with a statistically significant difference. This investigation suggests that the thickness of a palatal plate influences SI and TCT, which correlate with swallowing function.

  11. Hard to Swallow: Developmental Biological Insights into Pediatric Dysphagia

    Science.gov (United States)

    LaMantia, Anthony-Samuel; Moody, Sally A.; Maynard, Thomas M.; Karpinski, Beverly A.; Zohn, Irene E.; Mendelowitz, David; Lee, Norman H.; Popratiloff, Anastas

    2015-01-01

    Pediatric dysphagia—feeding and swallowing difficulties that begin at birth, last throughout childhood, and continue into maturity—is one of the most common, least understood complications in children with developmental disorders. We argue that a major cause of pediatric dysphagia is altered hindbrain patterning during pre-natal development. Such changes can compromise craniofacial structures including oropharyngeal muscles and skeletal elements as well as motor and sensory circuits necessary for normal feeding and swallowing. Animal models of developmental disorders that include pediatric dysphagia in their phenotypic spectrum can provide mechanistic insight into pathogenesis of feeding and swallowing difficulties. A fairly common human genetic developmental disorder, DiGeorge/22q11.2 Deletion Syndrome (22q11DS) includes a substantial incidence of pediatric dysphagia in its phenotypic spectrum. Infant mice carrying a parallel deletion to 22q11DS patients have feeding and swallowing difficulties. Altered hindbrain patterning, neural crest migration, craniofacial malformations, and changes in cranial nerve growth prefigure these difficulties. Thus, in addition to craniofacial and pharyngeal anomalies that arise independently of altered neural development, pediatric dysphagia may reflect disrupted hindbrain patterning and its impact on neural circuit development critical for feeding and swallowing. The mechanisms that disrupt hindbrain patterning and circuitry may provide a foundation to develop novel therapeutic approaches for improved clinical management of pediatric dysphagia. PMID:26554723

  12. 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.

  13. Prevalence of swallowing dysfunction screened in Swedish cohort of COPD patients.

    Science.gov (United States)

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

    2017-01-01

    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). 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). 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. 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.

  14. Recent Advances in Sensing Oropharyngeal Swallowing Function in Japan

    Directory of Open Access Journals (Sweden)

    Takahiro Ono

    2009-12-01

    Full Text Available Dysphagia (difficulty in swallowing is an important issue in the elderly because it causes aspiration pneumonia, which is the second largest cause of death in this group. It also causes decline in activities of daily living and quality of life. The oral phase of swallowing has been neglected, despite its importance in the evaluation of dysphagia, because adequate protocols and measuring devices are unavailable. However, recent advances in sensor technology have enabled straightforward, non-invasive measurement of the movement of important swallowing-related organs such as the lips and tongue, as well as the larynx. In this article, we report the present state and possibility of clinical application of such systems developed in Japan.

  15. 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

  16. VIDEOFLUOROSCOPIC SWALLOWING STUDY: esophageal alterations in patients with dysphagia

    Directory of Open Access Journals (Sweden)

    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.

  17. Tracking the hyoid bone in videofluoroscopic swallowing studies

    Science.gov (United States)

    Kellen, Patrick M.; Becker, Darci; Reinhardt, Joseph M.; van Daele, Douglas

    2008-03-01

    Difficulty swallowing, or dysphagia, has become a growing problem. Swallowing complications can lead to malnutrition, dehydration, respiratory infection, and even death. The current gold standard for analyzing and diagnosing dysphagia is the videofluoroscopic barium swallow study. In these studies, a fluoroscope is used to image the patient ingesting barium solutions of different volumes and viscosities. The hyoid bone anchors many key muscles involved in swallowing and plays a key role in the process. Abnormal hyoid bone motion during a swallow can indicate swallowing dysfunction. Currently in clinical settings, hyoid bone motion is assessed qualitatively, which can be subject to intra-rater and inter-rater bias. This paper presents a semi-automatic method for tracking the hyoid bone that makes quantitative analysis feasible. The user defines a template of the hyoid on one frame, and this template is tracked across subsequent frames. The matching phase is optimized by predicting the position of the template based on kinematics. An expert speech pathologist marked the position of the hyoid on each frame of ten studies to serve as the gold standard. Results from performing Bland-Altman analysis at a 95% confidence interval showed a bias of 0.0+/-0.08 pixels in x and -0.08+/-0.09 pixels in y between the manually-defined gold standard and the proposed method. The average Pearson's correlation between the gold standard and the proposed method was 0.987 in x and 0.980 in y. This paper also presents a method for automatically establishing a patient-centric coordinate system for the interpretation of hyoid motion. This coordinate system corrects for upper body patient motion during the study and identifies superior-inferior and anterior-posterior motion components. These tools make the use of quantitative hyoid motion analysis feasible in clinical and research settings.

  18. Respiratory phase resetting and airflow changes induced by swallowing in humans.

    Science.gov (United States)

    Paydarfar, D; Gilbert, R J; Poppel, C S; Nassab, P F

    1995-01-01

    1. Relationships between the timing of respiration and deglutition were studied in thirty awake healthy subjects at rest. Deglutition was monitored by submental electromyography, pharyngeal manometry and videofluoroscopy. Respiration was recorded by measurement of oronasal airflow and chest wall movement. Three types of deglutition were studied: injected bolus swallows, spontaneous swallows, and visually cued swallows of boluses previously placed in the mouth. 2. The effect of each swallow on respiratory rhythm was characterized by measurement of cophase, defined as the interval between the onset of deglutitive submental EMG activity to the onset of subsequent rescheduled inspirations. Cophase was determined for swallows initiated at different phases of the respiratory cycle. In all subjects deglutition caused phase resetting of respiratory rhythm. Cophase was largest for swallows initiated near the the inspiratory-expiratory (E-I) transition and smallest for swallows initiated near the expiratory-inspiratory (E-I) transition. The pattern of respiratory resetting by deglutition was topologically classified as type 0. This pattern was shown for swallows induced by bolus injection or visual cue, and for spontaneous swallows. 3. The incidence of spontaneous deglutition was influenced by the position of the swallow in the respiratory cycle. Few spontaneous swallows were initiated near the E-I transition whereas most occurred from late inspiration to mid-expiration. 4. Deglutition caused an abrupt decrease in airflow leading to an interval of apnoea, followed by a period of expiration. The duration of deglutition apnoea for spontaneous swallows was shorter than that for 5 ml bolus swallows, and was unaffected by the respiratory phase of swallow initiation. The period of expiration after swallowing was longest for swallows initiated at the I-E transition, and shortest for E-I swallows. 5. The intervals between bolus injection and the onset of deglutition apnoea, and the

  19. Examining user perceptions of SwallowIT: A pilot study of a new telepractice application for delivering intensive swallowing therapy to head and neck cancer patients.

    Science.gov (United States)

    Wall, Laurelie R; Ward, Elizabeth C; Cartmill, Bena; Hill, Anne J; Porceddu, Sandro V

    2017-01-01

    Consumer feedback and end-user perceptions provide important information regarding the clinical acceptability of new telepractice systems. This pilot investigation aimed to evaluate end-user perceptions of a new asynchronous telepractice application, ' SwallowIT', designed to support patients to remotely complete intensive swallowing therapy during curative chemoradiotherapy (CRT) treatment for head and neck cancer (HNC). Insights were sought from 15 patients with oropharyngeal cancer who used SwallowIT to complete supported home swallowing therapy. Perceptions were evaluated via structured questionnaires, completed following initial orientation to SwallowIT and on completion of CRT. Semi-structured phone interviews were conducted ≥3 months post-treatment. The majority of patients reported positive initial perceptions towards SwallowIT for comfort (87%), confidence (87%), motivation (73%) and support (87%). No statistically significant change in perceptions was observed from baseline to end of CRT ( p > 0.05). Thematic analysis of interviews revealed four main themes: the ease of use of SwallowIT, motivating factors, circumstances which made therapy difficult, and personal preferences for service-delivery models. These preliminary findings demonstrate that SwallowIT was well-perceived by the current group of HNC consumers and suggest that SwallowIT may be well-accepted as an alternate service-delivery model for delivering intensive swallowing therapy during CRT.

  20. Ultrasound of oral and masticatory muscles: Why every neuromuscular swallow team should have an ultrasound machine

    NARCIS (Netherlands)

    Engel-Hoek, L. van den; Lagarde, M.L.J.; Alfen, N. van

    2017-01-01

    Patients with neuromuscular disorders often present with swallowing difficulties due to oral phase problems and pharyngeal residue after swallow. It is important to assess the underlying pathology and cause of the swallowing disturbance in this patient group, such as dystrophic changes in oral and

  1. A Pilot Study of the Head Extension Swallowing Exercise: New Method for Strengthening Swallowing-Related Muscle Activity.

    Science.gov (United States)

    Oh, Jong-Chi

    2016-10-01

    This pilot study examined the effect of a new head extension swallowing exercise (HESE) on submental muscle activity and tongue strength in healthy volunteers. Fifteen young adults (10 females and 5 males) were instructed to extend their head backwards as much as possible, and while watching the ceiling, swallowed their saliva every 10 s for a duration of 20 min. Twenty-four treatments were performed over 8 weeks. The outcome variables evaluated at baseline, 4 and 8 weeks of training, and 12-week follow-up included mean and peak submental muscle activation amplitudes during normal and effortful swallowing measured via surface electromyography, and anterior and posterior isometric tongue pressures were measured with the Iowa Oral Performance Instrument. Results indicated that the muscle activation amplitudes during effortful swallowing increased significantly at 4 and 8 weeks compared to baseline (p < 0.025). However, the increases in amplitudes during normal swallowing were minor (nonsignificant) after 8 weeks compared to baseline. The isometric pressures of the tongue tip and the posterior part of the oral tongue were significantly higher at 8 weeks compared to baseline (p < 0.025). Thus, the 8-week HESE protocol significantly improved suprahyoid muscle activity during effortful swallowing as well as the isometric tongue pressures. The HESE appears effective in exercising and strengthening the suprahyoid muscles and tongue muscles in healthy participants. Although encouraging, these results need to be replicated in clinical trials for testing the therapeutic effects of the HESE in older adults and patients with dysphagia who present with decreased hyolaryngeal elevation.

  2. Differences in Swallowing between High and Low Concentration Taste Stimuli

    Directory of Open Access Journals (Sweden)

    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.

  3. Swallowing Disorders in Parkinson's Disease: Impact of Lingual Pumping

    Science.gov (United States)

    Argolo, Natalie; Sampaio, Marília; Pinho, Patrícia; Melo, Ailton; Nóbrega, Ana Caline

    2015-01-01

    Background: Lingual pumping (LP) is a repetitive, involuntary, anteroposterior movement of the tongue on the soft palate that is executed prior to transferring the food bolus to the pharynx, but we also observed LP when multiple swallows were taken. LP may be associated with rigidity and bradykinesia in patients with Parkinson's disease (PD). This…

  4. Time budget of South African cliff swallows during breeding

    African Journals Online (AJOL)

    for predicting standard metabolic rate and the cost of flight. The highest daily energy expenditur.e was ... predict standard metabolic rate (SMR) of the South African cliff swallow and the cost of flight was estimated from ... estimation of the time spent in social activities was made. To calculate the cost of building a nest the time ...

  5. Evaluation of swallowing in infants with congenital heart defect.

    Science.gov (United States)

    Pereira, Karine da Rosa; Firpo, Cora; Gasparin, Marisa; Teixeira, Adriane Ribeiro; Dornelles, Silvia; Bacaltchuk, Tzvi; Levy, Deborah Salle

    2015-01-01

    Introduction Surgical repair of congenital heart disease in the first years of life compromises the coordination of the suction, breathing, and swallowing functions. Objective To describe the alterations in swallowing found in infants with congenital heart defect during their hospitalization. Methods Prospective, cross-sectional study in a reference hospital for heart disease. The sample consisted of 19 postsurgical patients who underwent an evaluation of swallowing. The infants included were younger than 7 months and had a diagnosis of congenital heart defect and suspected swallowing difficulties. Results Of the 19 infants with congenital heart defect, the median age was 3.2 months. A significant association was found between suction rhythm and dysphagia (p = 0.036) and between oral-motor oral feeding readiness and dysphagia (p = 0.014). Conclusions The data suggest that dysphagia often occurs after surgery in infants with congenital heart defect. Infants with congenital heart defect had very similar behavior to preterm infants in terms of oral feeding readiness.

  6. Evaluation of Swallowing in Infants with Congenital Heart Defect

    Directory of Open Access Journals (Sweden)

    Pereira, Karine da Rosa

    2014-11-01

    Full Text Available Introduction Surgical repair of congenital heart disease in the first years of life compromises the coordination of the suction, breathing, and swallowing functions. Objective To describe the alterations in swallowing found in infants with congenital heart defect during their hospitalization. Methods Prospective, cross-sectional study in a reference hospital for heart disease. The sample consisted of 19 postsurgical patients who underwent an evaluation of swallowing. The infants included were younger than 7 months and had a diagnosis of congenital heart defect and suspected swallowing difficulties. Results Of the 19 infants with congenital heart defect, the median age was 3.2 months. A significant association was found between suction rhythm and dysphagia (p = 0.036 and between oral-motor oral feeding readiness and dysphagia (p = 0.014. Conclusions The data suggest that dysphagia often occurs after surgery in infants with congenital heart defect. Infants with congenital heart defect had very similar behavior to preterm infants in terms of oral feeding readiness.

  7. Swallow syncope caused by third-degree atrioventricular block.

    Science.gov (United States)

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

    2015-10-27

    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. 2015 BMJ Publishing Group Ltd.

  8. Short communications: White-throated Swallow Hirundo albigularis ...

    African Journals Online (AJOL)

    Short communications: White-throated Swallow Hirundo albigularis in Tanzania. NE Baker, EM Baker. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for ...

  9. Effect of posture on swallowing | Alghadir | African Health Sciences

    African Journals Online (AJOL)

    Background: Swallowing is a systematic process. Any structural, physiological or neurological disturbance in this process may cause dysphagia. Although there are studies that report head/neck movements during mastication, there are fewer studies that show the effect of different head/neck postures on difficulty while ...

  10. [Specialties in dentistry. Salivary flow and swallowing in Parkinson's disease

    NARCIS (Netherlands)

    Wierink, C.D.; Spijker, P.C.; Baat, C. de

    2006-01-01

    Parkinson's disease is a slowly progressive and irreversible disorder of the nervous system. Drooling is listed as a secondary symptom of Parkinson's disease. Its cause is insufficiently clear. In the literature 2 possible causes are described: hypersalivation and swallowing abnormalities. These

  11. Time budget of South African cliff swallows during breeding

    African Journals Online (AJOL)

    1973) (see Appendix). The South African cliff swallow spent most of the 24-h day in the nest (Table 1). This included about 9 h spent sleeping in the nest at night. Nest building was a minor component of total activity during the incubation and ...

  12. \\'The snake will swallow you': supernatural snakes and the creation ...

    African Journals Online (AJOL)

    \\'The snake will swallow you': supernatural snakes and the creation of the Khotso legend. Felicity Wood. Abstract. No Abstract. Indilinga: African Journal of Indigenous Knowledge Systems (IAJIKS) Vol. 4(1) 2005: 347-359. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  13. Predictable swallowing function after open horizontal supraglottic partial laryngectomy.

    Science.gov (United States)

    Breunig, Christine; Benter, Philipp; Seidl, Rainer O; Coordes, Annekatrin

    2016-12-01

    After horizontal supraglottic partial laryngectomy, patients have an increased risk of dysphagia as they are not able to close the laryngeal entrance during swallowing, especially if the surgical defect of the tongue base has increased. There is no investigation that studies risk factors for impaired swallow function, or that predicts postoperative swallow outcomes based on radiologically determined tumor dimensions. The present study investigated the impact of the tongue base tumor extension (determined by CT scan in patients undergoing partial laryngectomy) on the recovery rate of swallow function. The retrospective study in a tertiary hospital between 2000 and 2015 included all patients who underwent open horizontal supraglottic partial laryngectomy due to oropharyngeal cancer of the tongue base, or supraglottic laryngeal cancer with tongue base infiltration. All clinicopathological data were collected. The dimension of tongue base infiltration was measured using CT scan. Swallow function was recorded by Fiberoptic Endoscopic Evaluation of Swallowing and determined by evaluating both the duration until nasogastric tube removal and changing of the cuffed tracheostomy tube for an uncuffed speech cannula. The study included 26 patients (44-76 years, median 59 years). The clinical tumor (cT) classification included cT2 and cT3, while the pathologic tumor (pT) classification included pT2 and pT3 in 90% and pT1 and pT4 in 10% respectively. The duration until using the speech cannula was not associated with clinicopathological data, including the investigated radiologic tumor dimensions (biggest tumor diameter, tongue base infiltration depth, width, height, area and volume). The duration until nasogastric tube removal was significantly associated with the tongue base infiltration width (p=0.012), height (p=0.026) and area (pfunction after open horizontal supraglottic partial laryngectomy depends on the tumor extension of the tongue base. The tongue base infiltration

  14. Physiology and Pathophysiology of the Swallowing Area of Human Motor Cortex

    Directory of Open Access Journals (Sweden)

    S. Hamdy

    2001-01-01

    Full Text Available Swallowing problems can affect as many as one in three patients in the period immediately after stroke. Despite this, in the majority of cases, recovery usually occurs to a safe level after a month or two. In this review, we show. how the organization of the cortical projections to swallowing nuscles can account for many of the clinical observations on swallowing after stroke and explain why recovery is common in the long term. In addition, we examine approaches that may be useful in speeding up recovery of swallowing. Swallowing may be a useful model in which to study central nervous reorganization after injury.

  15. Radiation doses to children during modified barium swallow studies

    Energy Technology Data Exchange (ETDEWEB)

    Weir, Kelly A. [University of Queensland, Discipline of Paediatrics and Child Health, School of Medicine, Herston, Queensland (Australia); McMahon, Sandra M. [SpeechNet Speech Pathology Services, Brisbane (Australia); Long, Gillian; Bunch, Judith A. [Royal Children' s Hospital, Department of Medical Imaging, Herston (Australia); Pandeya, Nirmala [Queensland Institute of Medical Research, Herston (Australia); Coakley, Kerry S. [Biomedical Technology Services, Royal Brisbane and Women' s Hospital, Herston (Australia); Chang, Anne B. [Royal Children' s Hospital, Department of Respiratory Medicine, Herston (Australia)

    2007-03-15

    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{sup 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.)

  16. A comparison between swallowing sounds and vibrations in patients with dysphagia.

    Science.gov (United States)

    Movahedi, Faezeh; Kurosu, Atsuko; Coyle, James L; Perera, Subashan; Sejdić, Ervin

    2017-06-01

    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. This study aims to compare 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 had 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 5 ml spoon was given to the participants. A broad feature set 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. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Differences in brain networks during consecutive swallows detected using an optimized vertex-frequency algorithm.

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L; Sejdić, Ervin

    2017-03-06

    Patients with dysphagia can have higher risks of aspiration after repetitive swallowing activity due to the "fatigue effect". However, it is still unknown how consecutive swallows affect brain activity. Therefore, we sought to investigate differences in swallowing brain networks formed during consecutive swallows using a signal processing on graph approach. Data were collected from 55 healthy people using electroencephalography (EEG) signals. Participants performed dry swallows (i.e., saliva swallows) and wet swallows (i.e., water, nectar-thick, and honey thick swallows). After standard pre-processing of the EEG time series, brain networks were formed using the time-frequency-based synchrony measure, while signals on graphs were formed as a line graph of the brain networks. For calculating the vertex frequency information from the signals on graphs, the proposed algorithm was based on the optimized window size for calculating the windowed graph Fourier transform and the graph S-transform. The proposed algorithms were tested using synthetic signals and showed improved energy concentration in comparison to the original algorithm. When applied to EEG swallowing data, the optimized windowed graph Fourier transform and the optimized graph S-transform showed that differences exist in brain activity between consecutive swallows. In addition, the results showed higher differences between consecutive swallows for thicker liquids. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Dirven, Steven; Allen, Jacqueline; (Peter Xu, Weiliang; Cheng, Leo K.

    2017-03-01

    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.

  19. Submental sEMG and Hyoid Movement during Mendelsohn Maneuver, Effortful Swallow, and Expiratory Muscle Strength Training

    Science.gov (United States)

    Wheeler-Hegland, Karen M.; Rosenbek, John C.; Sapienza, Christine M.

    2008-01-01

    Purpose: This study investigated the concurrent biomechanical and electromyographic properties of 2 swallow-specific tasks (effortful swallow and Mendelsohn maneuver) and 1 swallow-nonspecific (expiratory muscle strength training [EMST]) swallow therapy task in order to examine the differential effects of each on hyoid motion and associated…

  20. Human swallowing simulation based on videofluorography images using Hamiltonian MPS method

    Science.gov (United States)

    Kikuchi, Takahiro; Michiwaki, Yukihiro; Kamiya, Tetsu; Toyama, Yoshio; Tamai, Tasuku; Koshizuka, Seiichi

    2015-09-01

    In developed nations, swallowing disorders and aspiration pneumonia have become serious problems. We developed a method to simulate the behavior of the organs involved in swallowing to clarify the mechanisms of swallowing and aspiration. The shape model is based on anatomically realistic geometry, and the motion model utilizes forced displacements based on realistic dynamic images to reflect the mechanisms of human swallowing. The soft tissue organs are modeled as nonlinear elastic material using the Hamiltonian MPS method. This method allows for stable simulation of the complex swallowing movement. A penalty method using metaballs is employed to simulate contact between organ walls and smooth sliding along the walls. We performed four numerical simulations under different analysis conditions to represent four cases of swallowing, including a healthy volunteer and a patient with a swallowing disorder. The simulation results were compared to examine the epiglottic downfolding mechanism, which strongly influences the risk of aspiration.

  1. The swallowing reflex and its significance as an airway defensive reflex

    Directory of Open Access Journals (Sweden)

    Takashi eNishino

    2013-01-01

    Full Text Available Swallowing function, in humans, is very complex. Swallowing plays, not only an important role in food digestion, but also a major role in preventing the entrance of food and/or other materials into the lower respiratory tract. To achieve this, precise coordination is necessary between breathing and swallowing since the pharynx serves as a common pathway for both respiration and digestion. The swallowing reflex consists of afferent pathways, central integration, and efferent pathways. Any defect or disorder along reflex arc can cause a potential delay or impairment in swallow function. The swallowing reflex can be modulated not only by pathological factors but also by physiological factors. Among these, timing of swallows in relation to the phase of respiration may be the most important factor that determines the occurrence of pulmonary aspiration, since phases of inspiration and the expiration-inspiration transition are the most vulnerable for pulmonary aspiration.

  2. Aging-related changes in swallowing, and in the coordination of swallowing and respiration determined by novel non-invasive measurement techniques.

    Science.gov (United States)

    Wang, Chin-Man; Chen, Ji-Yih; Chuang, Chiung-Cheng; Tseng, Wen-Chun; Wong, Alice M K; Pei, Yu-Cheng

    2015-06-01

    Previous studies have shown that the process of swallowing changes with aging, a phenomenon known as presbyphagia. These subtle and subclinical age-related changes make older adults more vulnerable to dysphagia during disease insults. However, there are limited studies of the swallowing process in older adults, because measurements are typically invasive or require exposure to X-rays. In the present study, we used integrated non-invasive measurements to determine aging-related changes of swallowing, and in the coordination of swallowing and respiration for a population of healthy participants. The non-invasive system provided measurements of larynx movement with piezoelectric sensors, submental muscle activity with surface electromyography and respiration-swallowing coordination by measurement of nasal airflow. We recruited 112 healthy participants from the community, 35 in a young-age group (age 20-30 years), 38 in a middle-age group (age 31-50 years) and 39 in an old-age group (age 51-70 years). The oropharyngeal swallowing parameters of the old-age group had delayed onset latency and longer swallowing apnea duration relative to the other groups, and these differences were greater for larger boluses. The middle- and old-age groups had less expiratory-expiratory respiratory phase pattern than the young-age group. The probability of piecemeal deglutition was highest in the old-age group and lowest in the young-age group. These results show that the phases of oropharyngeal swallowing and the coordination of swallowing with respiration gradually change with aging. We used integrated non-invasive measurements to document age-related changes in swallowing, and in the coordination of swallowing and respiration in healthy adults. © 2014 The Authors. Geriatrics & Gerontology International published by Wiley Publishing Asia Pty Ltd on behalf of Japan Geriatrics Society.

  3. Fetal swallowing as a protective mechanism against oligohydramnios and polyhydramnios in late gestation sheep.

    Science.gov (United States)

    Brace, Robert A; Anderson, Debra F; Cheung, Cecilia Y

    2013-03-01

    Our objectives were to (1) quantify the relationship between daily swallowed volume and amniotic fluid volume (AF volume) in late gestation ovine fetuses and (2) use the resulting regression equation to explore the role of swallowing in regulating AF volume. Daily swallowed volume ranged from 36 to 1963 mL/d while experimental AF volume ranged from 160 to 6150 mL (n = 115). Swallowed volume was near zero when AF volume was far below normal, a maximum of 635 ± 41 (standard error) mL/d when AF volume was 1682 ± 31 mL and did not increase further with higher AF volumes. Computer simulations predicted that fetal swallowing would (1) return AF volume to normal in 5 to 6 days following an acute volume change in the absence of changes in other amniotic inflows or outflows and (2) stabilize AF volume in 4 to 8 days following sustained alterations in amniotic inflows or outflows other than swallowing. The volume of AF swallowed each day by the fetus is a strong function of AF volume and reaches a maximum when mild polyhydramnios develops. With deviations in AF volume from normal, changes in fetal swallowing protect against oligohydramnios and polyhydramnios because the changes in swallowing over time reduce the extent of the AF volume change. However, with experimental changes in AF volume stabilizing in 1 to 2 days, it appears that swallowing is not the major regulator of AF volume.

  4. Enhancing effects of flavored nutritive stimuli on cortical swallowing network activity

    Science.gov (United States)

    Babaei, Arash; Kern, Mark; Antonik, Stephen; Mepani, Rachel; Ward, B. Douglas; Li, Shi-Jiang; Hyde, James

    2010-01-01

    A better understanding of the central control of the physiology of deglutition is necessary for devising interventions aimed at correcting pathophysiological conditions of swallowing. Positive modulation of the cortical swallowing network can have clinical ramifications in dysphagia due to central nervous system deficits. Our aim was to determine the effect of nutritive sensory input on the cortical swallowing network. In 14 healthy right-handed volunteers, we utilized a paradigm-driven protocol to quantify the number of activated voxels and their signal intensity within the left hemispheric cortical swallowing network by high-resolution functional MRI (fMRI) during five different swallowing conditions. Swallowing conditions included a dry swallow (saliva) and natural water-, lemon-, popcorn-, and chocolate-flavored liquid swallows. Each flavored liquid was presented simultaneously by its image, scent, and taste in random order and tested over three runs. fMRIs were analyzed in a blinded fashion. Average fMRI blood oxygenation level-dependent signal intensity and number of activated voxels during swallowing concurrent with nutritive gustatory, olfactory, and visual stimulations were significantly increased compared with dry/natural water swallows throughout the cortical swallowing network (P < 0.001 and P < 0.05, respectively). Subregion analysis showed the increased activity for flavored liquids in prefrontal, cingulate gyrus, and sensory/motor cortex, but not in precuneus and insula. Concurrent gustatory, olfactory, and visual nutritive stimulation enhances the activity of the cortical swallowing network. This finding may have clinical implications in management of swallowing disorders due to cortical lesions. PMID:20508154

  5. Clinical Characteristics and Lesions Responsible for Swallowing Hesitation After Acute Cerebral Infarction.

    Science.gov (United States)

    Saito, Tsukasa; Hayashi, Keisuke; Nakazawa, Hajime; Ota, Tetsuo

    2016-08-01

    Some stroke patients with a unilateral lesion demonstrate acute dysphagia characterized by a markedly prolonged swallowing time, making us think they are reluctant to swallow. In order to clarify the clinical characteristics and causative lesions of delayed swallowing, we conducted a retrospective analysis of 20 right-handed patients without a history of swallowing dysfunction who underwent videofluorography on suspicion of dysphagia after a first ischemic stroke. The oral processing time plus the postfaucial aggregation time required to swallow jelly for patients classified as having delayed swallowing was over 10 s. The time required for swallowing jelly was significantly longer than that without the hesitation (median value, 24.1 vs. 8.9 s, P oral processing time plus the postfaucial aggregation time required for patients with delayed swallowing to swallow thickened water was largely over 5 s and significantly longer than that of patients without swallowing hesitation (median value, 10.2 vs. 3.3 s, P acute unilateral infarction could be separated into two different patterns. Because four of the five patients with a rippling tongue movement in the swallowing hesitation pattern had a lesion in the left primary motor cortex, which induces some kinds of apraxia, swallowing hesitation with a rippling tongue movement seems to be a representative characteristic of apraxia. The patients with swallowing hesitation with a temporary stasis of the tongue in this study tended to have broad lesions in the frontal lobe, especially in the middle frontal gyrus, which is thought to be involved in higher cognition.

  6. Speech and swallowing outcomes in buccal mucosa carcinoma

    Directory of Open Access Journals (Sweden)

    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.

  7. Innate immune response development in nestling tree swallows

    Science.gov (United States)

    Stambaugh, T.; Houdek, B.J.; Lombardo, M.P.; Thorpe, P.A.; Caldwell, Hahn D.

    2011-01-01

    We tracked the development of innate immunity in nestling Tree Swallows (Tachycineta bicolor) and compared it to that of adults using blood drawn from nestlings during days 6, 12, and 18 of the ???20-day nestling period and from adults. Innate immunity was characterized using an in vitro assay of the ability of whole blood to kill Escherichia coli. The ability of whole blood to kill E. coli increased as nestlings matured. Neither this component of innate immunity nor right wing chord length on day18 were as developed as in adults indicating that development of the innate immune system and growth both continued after fledging. Narrow sense heritability analyses suggest that females with strong immune responses produced nestlings with strong immune responses. These data suggest nestling Tree Swallows allocated sufficient energy to support rapid growth to enable fledging by day 18, but that further development of innate immunity occurred post-fledging. ?? 2011 by the Wilson Ornithological Society.

  8. Pain, masticatory performance and swallowing threshold in orthodontic patients

    Directory of Open Access Journals (Sweden)

    Marcos Porto Trein

    2013-12-01

    Full Text Available OBJECTIVE: The aim of this study was to assess pain, masticatory performance and swallowing threshold of patients undergoing orthodontic treatment. METHODS: Ten patients of both genders (mean age of 17.25 ± 5.21 years, with complete permanent dentition, who underwent orthodontic treatment with fixed appliances were evaluated. The masticatory performance and the swallowing threshold were assessed by patient's individual capacity of fragmenting an artificial test food (Optocal which was chewed and had the resulting particles processed by a standardized sieving method, presenting the median particle size (MPS of crushed units. The intensity of pain / discomfort during chewing was evaluated by means of a visual analog scale. All tests were performed at the following times: T0 - before activating the orthodontic appliance; T1 - 24 hours after activation, and T2 - 30 days after activation. RESULTS: The results showed a significant increase in pain at T1 (T0 - 0.60 ± 0.70 mm; T1 - 66.2 ± 34.5 mm, returning to baseline values at T2 (3.20 ± 3.82 mm. Masticatory performance was also reduced in T1 (MPS 10.15 ± 1.1 mm² in comparison to T0 (MPS 7.01 ± 2.9 mm² and T2 (MPS 6.76 ± 1.3 mm². However, particle size was not affected in the swallowing threshold test (T0 - 5.47 ± 2.37 mm²; T1 - 6.19 ± 2.05 mm²; T2 - 5.94 ± 2.36 mm². CONCLUSION: The orthodontic appliances did not interfere in the size of the particles that would be swallowed, even in the presence of pain.

  9. Difficult to swallow: patient preferences for alternative valproate pharmaceutical formulations

    Directory of Open Access Journals (Sweden)

    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

  10. Epidermal electronics for electromyography: An application to swallowing therapy.

    Science.gov (United States)

    Constantinescu, Gabriela; Jeong, Jae-Woong; Li, Xinda; Scott, Dylan K; Jang, Kyung-In; Chung, Hyun-Joong; Rogers, John A; Rieger, Jana

    2016-08-01

    Head and neck cancer treatment alters the anatomy and physiology of patients. Resulting swallowing difficulties can lead to serious health concerns. Surface electromyography (sEMG) is used as an adjuvant to swallowing therapy exercises. sEMG signal collected from the area under the chin provides visual biofeedback from muscle contractions and is used to help patients perform exercises correctly. However, conventional sEMG adhesive pads are relatively thick and difficult to effectively adhere to a patient's altered chin anatomy, potentially leading to poor signal acquisition in this population. Here, the emerging technology of epidermal electronics is introduced, where ultra-thin geometry allows for close contouring of the chin. The two objectives of this study were to (1) assess the potential of epidermal electronics technology for use with swallowing therapy and (2) assess the significance of the reference electrode placement. This study showed comparative signals between the new epidermal sEMG patch and the conventional adhesive patches used by clinicians. Furthermore, an integrated reference yielded optimal signal for clinical use; this configuration was more robust to head movements than when an external reference was used. Improvements for future iterations of epidermal sEMG patches specific to day-to-day clinical use are suggested. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  11. Effect of age on proximal esophageal response to swallowing

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    Roberto Oliveira Dantas

    2010-12-01

    Full Text Available CONTEXT: It has been demonstrated that the ageing process affects esophageal motility. OBJECTIVES: To evaluate the effect of the age on the proximal esophageal response to wet swallows. METHOD: We measured the proximal esophageal response to swallows of a 5 mL bolus of water in 69 healthy volunteers, 20 of them aged 18-30 years (group I, 27 aged 31-50 years (group II, and 22 aged 51-74 years (group III. We used the manometric method with continuous perfusion. The proximal esophageal contractions were recorded 5 cm from a pharyngeal recording site located 1 cm above the upper esophageal sphincter. The time between the onset of the pharyngeal and of the proximal esophageal recording (pharyngeal-esophageal time and the amplitude, duration and area under the curve of the proximal esophageal contraction were measured. RESULTS: The pharyngeal-esophageal time was shorter in group I subjects than in group II and III subjects (P<0.05. The duration of proximal esophageal contractions was longer in group I than in groups II and III (P<0.001. There was no differences between groups in the amplitude or area under the curve of contractions. There were no differences between groups II and III for any of the measurements. CONCLUSION: We conclude that the age may affects the response of the proximal esophagus to wet swallows.

  12. Pattern of tongue pressure on hard palate during swallowing.

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    Ono, Takahiro; Hori, Kazuhiro; Nokubi, Takashi

    2004-01-01

    Contact of the tongue against the hard palate plays an important role in swallowing. This study aimed to clarify the pattern of contact between the tongue and hard palate by analyzing tongue pressure produced in swallowing 15 ml of water by healthy subjects wearing an experimental palatal plate with seven pressure sensors. Tongue pressure was generated initially by close contact with the anteriomedian part of the hard palate, then with the circumferential part, and finally softly with the posteriomedian part. Tongue pressure reached a peak quickly, then decreased gradually before disappearing almost simultaneously at each measured part of the hard palate. Magnitude and duration were significantly larger in the anteriomedian part compared to the other six parts measured, and was significantly smaller in the posteriomedian part. No laterality was found in tongue pressure produced at the circumferential parts of the hard palate. Our findings indicate that the order of tongue contact against each part of the hard palate as well as duration and magnitude of tongue pressure are coordinated precisely during swallowing. These findings could aid assessment of the tongue movement of dysphagic patients during rehabilitation.

  13. An electrophysiological study of the sequential water swallowing.

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    Gürgör, N; Arıcı, Ş; Kurt Incesu, Tülay; Seçil, Y; Tokuçoğlu, F; Ertekin, C

    2013-06-01

    Sequential water swallowing (SWS) was mostly investigated by the videofluoroscopic and endoscopic methods. However some physiological features of SWS was rarely evaluated by neurophysiological techniques. Our aim was to investigate some neural and muscular changes on sequences of SWS using electromyography (EMG) methods. Fifty-eight normal adults were investigated. SWS was initiated voluntarily with 50ml and 100ml water volumes from a cup. Submental EMG, respiratory signals, heart rate, and sympathetic skin responses (SSR) were measured during SWS. All parameters were increased significantly during the 100ml SWS. During swallowing apnea period, compensatory respiration cycles occurred in 24% and 48% of participants in the 50ml and 100ml SWS, respectively. Heart rate increased during swallowing apnea. SSR were evoked just before and just after the SWS in more than halves of participants. A foreburst EMG in SM muscles at the initiation of SWS was recorded in 86% of normal participants. Older age was associated with a prolonged duration of the apnea period. All parameters of the SWS could be recorded numerically and objectively using electrphysiological methods. These are similar to those obtained by videofluoroscopic and similar methods. The foreburst activity of the initiation of SWS may represents preparatory activity from the activation of the fast cortical descending motor pathway. Increasing heart rate and the prolonged apnea urged that older people and patients could be carefully tested for respiratory and cardiac rhythm disorders. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Thirty years of blackouts: a case report of swallow syncope

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    Irene Lambiris

    2013-04-01

    Full Text Available Deglutition syncope has been demonstrated in isolated case reports, the first being described over 50 years ago. It is thought to be caused by a hypersensitive vagotonic reflex in response to esophageal dilation after swallowing. It can cause syncope due to complete atrioventricular (AV block and acute reduction of cardiac output. Although rare, its lethality is worthy of discussion, as early recognition can offer complete treatment with placement of a pacemaker. A 54-year-old man presented with 30 years of lightheadedness and syncope, followed by disorientation and tremors, after eating sandwiches or drinking carbonated beverages. He initially was evaluated by a neurologist. Work-up included cardiac 2D transthoracic echocardiogram, electroencephalogram, swallow stud, pulmonary function tests, electrocardiogram, and cardiac stress testing. All tests were within normal limits, and it was determined that he was suffering from convulsive syncope and deglutition syncope. Referral to the cardiac electrophysiology department with tilt-table testing accompanied by swallow evaluation was then recommended. The tests demonstrated marked vagal response resulting in sinus bradycardia with second-degree AV block and pauses up to 3.5 seconds. Patient experienced near syncope. A rate-responsive, dual-chamber Boston Scientific pacemaker with DDDR programming was implanted. Patient has remained asymptomatic at follow-up.

  15. Mastication and swallowing: influence of fluid addition to foods

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    Luciano José Pereira

    2007-02-01

    Full Text Available 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 chewing physiology. Materials and METHODS: Twenty subjects chewed on melba toast, cake, carrot, peanut and Gouda cheese. They also chewed on these foods after addition of different volumes of water or alpha-amylase solution. Jaw muscle activity, number of chewing cycles until swallowing and chewing cycle duration were measured. Repeated measures analysis of variance was applied to test the null hypothesis that there would be no statistically significant difference among the results obtained for the various food types and fluids. Subsequently, contrasts were determined to study the levels of intra-subjects factors (food type and fluid volume. Linear regression was used to determine the changes in muscle activity and cycle duration as a function of the chewing cycles. RESULTS: Fluid addition significantly decreased muscle activity and swallowing threshold for melba, cake and peanut (p0.05. Doubling the volume of tap water had a greater effect. CONCLUSIONS: Fluid addition facilitated chewing of dry foods (melba, cake, but did not influence the chewing of fatty (cheese and wet products (carrot. This study is relevant to improve patients' life quality and the management of chewing and feeding disorders caused by hyposalivation.

  16. Suck, swallow and breathing coordination in infants with infantile colic

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    Hanlie Degenaar

    2015-12-01

    Objective: The objective of the study was to explore the suck, swallow and breathing coordination in infants with infantile colic and compare it with infants without the condition. Method: An assessment protocol for suck, swallow and breathing coordination was compiled from literature. This protocol was performed on a research group of 50 infants, independently diagnosed with infantile colic, and a control group of 28 infants without the condition. All participants were from two rural towns in the North–West province, South Africa, selected with a snowball selection method and strict selection criteria. The study followed a static comparison group design. Results: A significant difference in the key components of feeding and the presence of colic in participants of four age categories were found. The correlation between postural control and the presence of infantile colic were sustained in participants from 2–19 weeks old. Conclusion: Suck, swallow and breathing were found to be significantly associated with infantile colic. The findings should be investigated further. It appears that speech-language therapists may play an expanding role in infantile colic. [pdf to follow

  17. 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.

  18. Anesthesia and increased hypercarbic drive impair the coordination between breathing and swallowing

    Science.gov (United States)

    D'Angelo, Olivia M.; Diaz-Gil, Daniel; Nunn, Danuza; Simons, Jeroen C.P.; Gianatasio, Chloe; Mueller, Noomi; Meyer, Matthew J.; Pierce, Eric; Rosow, Carl; Eikermann, Matthias

    2017-01-01

    Background Coordination between breathing and swallowing helps prevent aspiration of foreign material into the respiratory tract. We examined the effects of anesthesia, and hypercapnia on swallowing-breathing coordination. Methods In a randomized controlled cross-over study, general anesthesia with propofol or sevoflurane was titrated using an up-down method to identify the threshold for suppression of the motor response to electrical stimulation of the forearm. Additional measurements included bispectral index, genioglossus electromyogram, ventilation (pneumotachometer), and hypopharyngeal pressure. During wakefulness and at each level of anesthetic, carbon dioxide was added to increase its end tidal pressure by 4 and 8 mmHg. A swallow was defined as increased genioglossus activity with deglutition apnea and an increase in hypopharyngeal pressure. Spontaneous swallows were categorized as physiological (during expiration or followed by expiration), or pathological (during inspiration or followed by an inspiration). Results A total of 224 swallows were analyzed. Anesthesia increased the proportion of pathological swallows (25.9% versus 4.9%), and decreased the number of swallows per hour (1.7 ± 3.3 versus 28.0 ± 22.3) compared to wakefulness. During anesthesia, hypercapnia decreased hypopharyngeal pressure during inspiration (-14.1±3.7 versus -8.7±2 mmHg), and increased minute ventilation the proportion of pathological swallows (19.1% versus 12.3%), and the number of swallows per hour (5.5 ±17.0. versus 1.3 ± 5.5). Conclusions Anesthesia impaired the coordination between swallowing and respiration. Mild hypercapnia increased the frequency of swallowing during anesthesia and the likelihood of pathological swallowing. During anesthesia, the risk for aspiration may be further increased when ventilatory drive is stimulated. PMID:25275368

  19. Effects of liquid stimuli on dual-axis swallowing accelerometry signals in a healthy population

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    Sejdić Ervin

    2010-02-01

    Full Text Available Abstract Background Dual-axis swallowing accelerometry has recently been proposed as a tool for non-invasive analysis of swallowing function. Although swallowing is known to be physiologically modifiable by the type of food or liquid (i.e., stimuli, the effects of stimuli on dual-axis accelerometry signals have never been thoroughly investigated. Thus, the objective of this study was to investigate stimulus effects on dual-axis accelerometry signal characteristics. Signals were acquired from 17 healthy participants while swallowing 4 different stimuli: water, nectar-thick and honey-thick apple juices, and a thin-liquid barium suspension. Two swallowing tasks were examined: discrete and sequential. A variety of features were extracted in the time and time-frequency domains after swallow segmentation and pre-processing. A separate Friedman test was conducted for each feature and for each swallowing task. Results Significant main stimulus effects were found on 6 out of 30 features for the discrete task and on 5 out of 30 features for the sequential task. Analysis of the features with significant stimulus effects suggested that the changes in the signals revealed slower and more pronounced swallowing patterns with increasing bolus viscosity. Conclusions We conclude that stimulus type does affect specific characteristics of dual-axis swallowing accelerometry signals, suggesting that associated clinical screening protocols may need to be stimulus specific.

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

    Science.gov (United States)

    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.

  1. Spontaneous swallowing frequency has potential to identify dysphagia in acute stroke.

    Science.gov (United States)

    Crary, Michael A; Carnaby, Giselle D; Sia, Isaac; Khanna, Anna; Waters, Michael F

    2013-12-01

    Spontaneous swallowing frequency has been described as an index of dysphagia in various health conditions. This study evaluated the potential of spontaneous swallow frequency analysis as a screening protocol for dysphagia in acute stroke. In a cohort of 63 acute stroke cases, swallow frequency rates (swallows per minute [SPM]) were compared with stroke and swallow severity indices, age, time from stroke to assessment, and consciousness level. Mean differences in SPM were compared between patients with versus without clinically significant dysphagia. Receiver operating characteristic curve analysis was used to identify the optimal threshold in SPM, which was compared with a validated clinical dysphagia examination for identification of dysphagia cases. Time series analysis was used to identify the minimally adequate time period to complete spontaneous swallow frequency analysis. SPM correlated significantly with stroke and swallow severity indices but not with age, time from stroke onset, or consciousness level. Patients with dysphagia demonstrated significantly lower SPM rates. SPM differed by dysphagia severity. Receiver operating characteristic curve analysis yielded a threshold of SPM≤0.40 that identified dysphagia (per the criterion referent) with 0.96 sensitivity, 0.68 specificity, and 0.96 negative predictive value. Time series analysis indicated that a 5- to 10-minute sampling window was sufficient to calculate spontaneous swallow frequency to identify dysphagia cases in acute stroke. Spontaneous swallowing frequency presents high potential to screen for dysphagia in acute stroke without the need for trained, available personnel.

  2. Spontaneous Swallowing Frequency [Has Potential to] Identify Dysphagia in Acute Stroke

    Science.gov (United States)

    Carnaby, Giselle D; Sia, Isaac; Khanna, Anna; Waters, Michael

    2014-01-01

    Background and Purpose Spontaneous swallowing frequency has been described as an index of dysphagia in various health conditions. This study evaluated the potential of spontaneous swallow frequency analysis as a screening protocol for dysphagia in acute stroke. Methods In a cohort of 63 acute stroke cases swallow frequency rates (swallows per minute: SPM) were compared to stroke and swallow severity indices, age, time from stroke to assessment, and consciousness level. Mean differences in SPM were compared between patients with vs. without clinically significant dysphagia. ROC analysis was used to identify the optimal threshold in SPM which was compared to a validated clinical dysphagia examination for identification of dysphagia cases. Time series analysis was employed to identify the minimally adequate time period to complete spontaneous swallow frequency analysis. Results SPM correlated significantly with stroke and swallow severity indices but not with age, time from stroke onset, or consciousness level. Patients with dysphagia demonstrated significantly lower SPM rates. SPM differed by dysphagia severity. ROC analysis yielded a threshold of SPM ≤ 0.40 which identified dysphagia (per the criterion referent) with 0.96 sensitivity, 0.68 specificity, and 0.96 negative predictive value. Time series analysis indicated that a 5 to 10 minute sampling window was sufficient to calculate spontaneous swallow frequency to identify dysphagia cases in acute stroke. Conclusions Spontaneous swallowing frequency presents high potential to screen for dysphagia in acute stroke without the need for trained, available personnel. PMID:24149008

  3. 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.

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

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    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 < 0.001) and central neurologic insult. In general, 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.

  5. The importance of the reproducibility of oropharyngeal swallowing in amyotrophic lateral sclerosis. An electrophysiological study.

    Science.gov (United States)

    Cosentino, G; Alfonsi, E; Mainardi, L; Alvisi, E; Brighina, F; Valentino, F; Fierro, B; Sandrini, G; Bertino, G; Berlangieri, M; De Icco, R; Fresia, M; Moglia, A

    2017-05-01

    To investigate electrophysiologically the reproducibility of oropharyngeal swallowing in patients with ALS. We enrolled 26 ALS patients, both with and without clinical signs of dysphagia, and 30 age-matched controls. The reproducibility of the electrophysiological signals related to the oral phase (electromyographic activity of the submental/suprahyoid muscles) and the pharyngeal phase (laryngeal-pharyngeal mechanogram) of swallowing across repeated swallows was assessed. To do this we computed two similarity indexes (SI) by using previously described mathematical algorithms. The reproducibility of oropharyngeal swallowing was significantly reduced both in patients with and in those without clinical signs of dysphagia, with more marked alterations being detected in the dysphagic group. The SI of both phases of swallowing, oral and pharyngeal, correlated significantly with dysphagia severity and disease severity. In ALS different pathophysiological mechanisms can alter the stereotyped motor behaviors underlying normal swallowing, thus reducing the reproducibility of the swallowing act. A decrease in swallowing reproducibility could be a preclinical sign of dysphagia and, beyond a certain threshold, a pathological hallmark of oropharyngeal dysphagia. Electrophysiological assessment is a simple and useful tool for the early detection of swallowing abnormalities, and for the management of overt dysphagia in ALS. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

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

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

    2017-10-20

    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.

  7. Pharyngeal electrical stimulation can modulate swallowing in cortical processing and behavior - magnetoencephalographic evidence.

    Science.gov (United States)

    Suntrup, Sonja; Teismann, Inga; Wollbrink, Andreas; Winkels, Martin; Warnecke, Tobias; Pantev, Christo; Dziewas, Rainer

    2015-01-01

    The act of swallowing is a complex neuromuscular function that is processed in a distributed network involving cortical, subcortical and brainstem structures. Difficulty in swallowing arises from a variety of neurologic diseases for which therapeutic options are currently limited. Pharyngeal electrical stimulation (PES) is a novel intervention designed to promote plastic changes in the pharyngeal motor cortex to aid dysphagia rehabilitation. In the present study we evaluate the effect of PES on cortical swallowing network activity and associated changes in swallowing performance. In a randomized, crossover study design 10min of real (0.2-ms pulses, 5Hz, 280V, stimulation intensity at 75% of maximum tolerated threshold) or sham PES were delivered to 14 healthy volunteers in two separate sessions. Stimulation was delivered via a pair of bipolar ring electrodes mounted on an intraluminal catheter positioned in the pharynx. Before and after each intervention swallowing capacity (ml/s) was tested using a 150ml-water swallowing stress test. Event-related desynchronization (ERD) of cortical oscillatory activity during volitional swallowing was recorded applying whole-head magnetoencephalography before, immediately after and 45min past the intervention. A prominent reduction of ERD in sensorimotor brain areas occurred in the alpha and beta frequency ranges immediately after real PES but not after sham stimulation (pefficiency, which is associated with subtle changes in swallowing function in healthy subjects. Our data contribute evidence that swallowing network organization and behavior can effectively be modulated by PES. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. 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.

  9. 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

  10. 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.

  11. Influence of attention and bolus volume on brain organization during swallowing.

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L; Perera, Subashan; Sejdić, Ervin

    2017-10-20

    It has been shown that swallowing involves certain attentional and cognitive resources which, when disrupted can influence swallowing function with in dysphagic patient. However, there are still open questions regarding the influence of attention and cognitive demands on brain activity during swallowing. In order to understand how brain regions responsible for attention influence brain activity during swallowing, we compared brain organization during no-distraction swallowing and swallowing with distraction. Fifteen healthy male adults participated in the data collection process. Participants performed ten 1 ml, ten 5 ml, and ten 10 ml water swallows under both no-distraction conditions and during distraction while EEG signals were recorded. After standard pre-processing of the EEG signals, brain networks were formed using the time-frequency based synchrony measure. The brain networks formed were then compared between the two sets of conditions. Results showed that there are differences in the Delta, Theta, Alpha, Beta, and Gamma frequency bands between no-distraction swallowing and swallowing with distraction. Differences in the Delta and Theta frequency bands can be attributed to changes in subliminal processes, while changes in the Alpha and Beta frequency bands are directly associated with the various levels of attention and cognitive demands during swallowing process, and changes in the Gamma frequency band are due to changes in motor activity. Furthermore, we showed that variations in bolus volume influenced the swallowing brain networks in the Delta, Theta, Alpha, Beta, and Gamma frequency bands. Changes in the Delta, Theta, and Alpha frequency bands are due to sensory perturbations evoked by the various bolus volumes. Changes in the Beta frequency band are due to reallocation of cognitive demands, while changes in the Gamma frequency band are due to changes in motor activity produced by variations in bolus volume. These findings could potentially lead to

  12. 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

  13. Fluid mechanics of eating, swallowing and digestion - overview and perspectives.

    Science.gov (United States)

    Engmann, Jan; Burbidge, Adam S

    2013-02-26

    From a very simplistic viewpoint, the human digestive system can be regarded as a long tube (with dramatic variations in diameter, cross-section, wall properties, pumping mechanisms, regulating valves and in-line sensors). We single out a few fluid mechanical phenomena along the trajectory of a food bolus from the mouth to the small intestine and discuss how they influence sensorial perception, safe transport, and nutrient absorption from a bolus. The focus is on lubrication flows between the tongue and palate, the oropharyngeal stage of swallowing and effects of flow on absorption in the small intestine. Specific challenges and opportunities in this research area are highlighted.

  14. Graphic representation of pharyngeal wall motion during swallow: technical note.

    Science.gov (United States)

    Ekberg, O; Borgstrom, P S

    1989-01-01

    Movements of the pharyngeal wall were measured at 12 transverse levels, on consecutive cineradiograms obtained during swallowing of thin, liquid barium, in a single nondysphagic volunteer. By graphic representation of these measurements on the IBM personal computer, it was possible to analyze in detail pharyngeal motor activity in terms of displacement of the pharyngeal wall. The contraction created a fairly steep narrowing of the lumen. The peristaltic wave was more difficult to analyze. Movements of the pharyngeal wall in posteroanterior projection gave good information about the constrictors. Although this technique has several inherent methodologic difficulties, its use may expand our knowledge of pharyngeal peristalsis.

  15. Name changes for Malesian species of Chionanthus (Oleaceae)

    NARCIS (Netherlands)

    Kiew, Ruth

    1998-01-01

    New combinations under Chionanthus L. are made for Linociera beccarii, L. brassii, L. gigas, L. clementis, L. hahlii, L. kajewskii, L. nitida, L. remotinervia, L. riparia, L. rupicola, L. sessiliflora L. salicifolia, and L. stenura. Linociera cumingiana is synonymous with C. ramiflorus, L.

  16. Reduced-molecular-weight derivatives of frost grape polysaccharide

    Science.gov (United States)

    A new Type II arabinogalactan was recently described as an abundant gum exudate from stems of wildfrost grape (Vitus riparia Michx.). The purpose of the current study is to more thoroughly characterize the physical properties of this frost grape polysaccharide (FGP), and develop methods to modify th...

  17. 2045-IJBCS-Article-Bagalwa Jacques

    African Journals Online (AJOL)

    hp

    the natural processes, i.e. precipitation inputs, erosion, weathering, and .... washing. The substratum is composed of mud and small stones. The vegetation consists of a mixture of emergent macrophytes, Commelina diffusa, Pennisetum purpureum and Riparia sp. ..... the United Nations), (1993) classification of surface water ...

  18. Walla Walla District History: Part II: 1970-1975

    Science.gov (United States)

    1976-01-01

    voir area on Snake River that the Northern Pacific Rai lroad would in t he future operate over the Union Pacific tracks from Riparia to the 6 mouth...limnological, vegetation , aesthetics, and direct impact on physical properti~s. One report submitted in draft form in 1972 on the authorized

  19. Natural Areas Inventory 1981 (GREAT III)

    Science.gov (United States)

    1982-01-01

    area 104 Ü (18) Vegetation types 1 I I *NC# Plant community name LEGAL STATUS & USE (19) Ownership type: (T) Pv (?) Pc 3. Uk (20) Number...rufidulum Vitis aestivalis 3 Vitis cinerea Z Vitis riparia Vitis vulpina Xanthoxylum americanum _2^Glgdi-Kir». aauaiica. 2_Sm’ilax ^p f 2 IZc

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

    NARCIS (Netherlands)

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

    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

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

    NARCIS (Netherlands)

    Langendijk, J.A.; Doornaert, P.A.H.; Rietveld, D.H.F.; de Leeuw, I.M.; Leemans, C.R.; Slotman, B.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

  2. Tongue Pressure and Submental Surface Electromyography Measures during Noneffortful and Effortful Saliva Swallows in Healthy Women

    Science.gov (United States)

    Yeates, Erin M.; Steele, Catriona M.; Pelletier, Cathy A.

    2010-01-01

    Purpose: The effortful swallow, a compensatory technique frequently employed by speech-language pathologists for their patients with dysphagia, is still not fully understood in terms of how it modifies the swallow. In particular, although age-related changes are known to reduce maximum isometric tongue pressure, it is not known whether age affects…

  3. Effect of aging on oral and swallowing function after meal consumption.

    Science.gov (United States)

    Hiramatsu, Tetsuya; Kataoka, Hideyuki; Osaki, Mari; Hagino, Hiroshi

    2015-01-01

    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). 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. 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. 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 efforts in mastication and swallowing.

  4. 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

  5. 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

  6. Normal swallowing acoustics across age, gender, bolus viscosity, and bolus volume.

    Science.gov (United States)

    Youmans, Scott R; Stierwalt, Julie A G

    2011-12-01

    Cervical auscultation has been proposed as an augmentative procedure for the subjective clinical swallowing examination due to the tangible differences between normal and dysphagic swallowing sounds. However, the research is incomplete regarding cervical auscultation and swallowing acoustics in that the differences between the sounds of normal versus dysphagic swallowing have yet to be fully understood or quantified. The swallows of 96 reportedly healthy adults, balanced for gender and divided into younger, middle, and older age groups, were audio-recorded while ingesting several boluses of varying viscosity and volume. The audio signals were then analyzed to determine their temporal and acoustic characteristics. Results indicated increasing pharyngeal swallowing duration with increasing age, bolus viscosity, and bolus volume. In addition, an increased duration to peak intensity with increasing age was found in one of our two analyses, as well as with some of the more viscous versus less viscous boluses. Men and older persons produced higher peak intensities and peak frequencies than women and younger persons. Thin liquids were produced with more intensity than honey or more viscous boluses, and with greater frequency than mechanical soft solids. Larger volumes resulted in greater peak frequency values. Some of the acoustic measurements appear to be more useful than others, including the duration of the acoustic swallowing signal and the within-subjects peak intensity variable. We noted that differences in swallowing acoustics were more related to changes in viscosity rather than volume. Finally, within-participant observations were more useful than between-participant observations.

  7. 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…

  8. The interactions between different tastes on initiation of reflex swallow elicited by electrical stimulation in humans.

    Science.gov (United States)

    Otake, Masanori; Kurose, Masayuki; Uchida, Yoshiaki; Hasegawa, Mana; Yamada, Yoshiaki; Saito, Isao; Yamamura, Kensuke

    2016-09-01

    The act of eating is a source of pleasure for people and is a major factor in maintaining a good quality of life. Several types of products for dysphagia patients are available to decrease aspiration of food that often accompanies daily food intake. The final goal of these products is to improve the ease of forming a food bolus and/or the safety of the swallowing process; however, tastes of products are not a major concern with initiation of swallowing. In the present study, we investigated the effect of bitter taste stimuli (quinine) and the combination of quinine and umami (monosodium glutamate: MSG) applied to the oropharynx on reflex swallows evoked by electrical stimulation to the oropharyngeal mucosa. Each of the distilled water (DW), quinine and quinine-MSG mixture solution (volume of each solutions, 100 µl) was applied 1 s prior to electrical stimulation. No swallow was evoked when each of the solutions was applied without electrical stimulation. The application of DW and lower concentration of quinine (<100 µM) did not affect the latency of reflex swallow, but 100 µM quinine application increased the latency of the reflex swallow. In addition, application of quinine-MSG mixture solution counteracted the increase in latency induced by quinine application alone. These findings suggest that MSG enhances the initiation of swallowing along with its well-known increase in appetite stimulation. Adding MSG might be effective when creating food to promote swallowing.

  9. Prevalence of Auditory Problems in Children with Feeding and Swallowing Disorders

    Science.gov (United States)

    Rawool, Vishakha Waman

    2017-01-01

    Purpose: Although an interdisciplinary approach is recommended for assessment and management of feeding or swallowing difficulties, audiologists are not always included in the interdisciplinary team. The purpose of this study is to report the prevalence of middle ear and hearing problems in children with feeding and swallowing disorders and to…

  10. Prevalence and Severity of Voice and Swallowing Difficulties in Mitochondrial Disease

    Science.gov (United States)

    Read, Jennifer L.; Whittaker, Roger G.; Miller, Nick; Clark, Sue; Taylor, Robert; McFarland, Robert; Turnbull, Douglass

    2012-01-01

    Background: Mutations of mitochondrial DNA (mtDNA) cause a broad spectrum of clinical phenotypes. Anecdotal evidence suggests that voice and swallow problems are a common feature of these diseases. Aims: To characterize accurately the prevalence and severity of voice and swallow problems in a large cohort of patients with mitochondrial disease.…

  11. Extraction of average neck flexion angle during swallowing in neutral and chin-tuck positions

    Directory of Open Access Journals (Sweden)

    Sejdić Ervin

    2009-10-01

    Full Text Available Abstract Background A common but debated technique in the management of swallowing difficulties is the chin tuck swallow, where the neck is flexed forward prior to swallowing. Natural variations in chin tuck angles across individuals may contribute to the differential effectiveness of the technique. Methodology To facilitate the study of chin tuck angle variations, we present a template tracking algorithm that automatically extracts neck angles from sagittal videos of individuals performing chin tuck swallows. Three yellow markers geometrically arranged on a pair of dark visors were used as tracking cues. Results The algorithm was applied to data collected from 178 healthy participants during neutral and chin tuck position swallows. Our analyses revealed no major influences of body mass index and age on neck flexion angles during swallowing, while gender influenced the average neck angle only during wet swallows in the neutral position. Chin tuck angles seem to be independent of anthropometry and gender in healthy adults, but deserve further study in pathological populations. Conclusion The proposed neck flexion angle extraction algorithm may be useful in future studies where strict participant compliance to swallowing task protocol can be assured.

  12. Extraction of average neck flexion angle during swallowing in neutral and chin-tuck positions.

    Science.gov (United States)

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

    2009-10-07

    A common but debated technique in the management of swallowing difficulties is the chin tuck swallow, where the neck is flexed forward prior to swallowing. Natural variations in chin tuck angles across individuals may contribute to the differential effectiveness of the technique. To facilitate the study of chin tuck angle variations, we present a template tracking algorithm that automatically extracts neck angles from sagittal videos of individuals performing chin tuck swallows. Three yellow markers geometrically arranged on a pair of dark visors were used as tracking cues. The algorithm was applied to data collected from 178 healthy participants during neutral and chin tuck position swallows. Our analyses revealed no major influences of body mass index and age on neck flexion angles during swallowing, while gender influenced the average neck angle only during wet swallows in the neutral position. Chin tuck angles seem to be independent of anthropometry and gender in healthy adults, but deserve further study in pathological populations. The proposed neck flexion angle extraction algorithm may be useful in future studies where strict participant compliance to swallowing task protocol can be assured.

  13. [Swallowing after non-surgical treatment (radiation therapy / radiochemotherapy protocol) of laryngeal cancer].

    Science.gov (United States)

    Portas, Juliana; Socci, Claudia Pereira; Scian, Eliana Perissato; Queija, Débora Dos Santos; Ferreira, Alessandra Sampaio; Dedivitis, Rogério Aparecido; Barros, Ana Paula Brandão

    2011-01-01

    Radiation therapy and radiochemotherapy protocols can cause swallowing difficulties. To evaluate swallowing in patients undergoing radiation therapy and radiochemotherapy protocol only for the treatment of laryngeal tumors. A prospective study of 20 patients, with a mean age of 62 years, at the end of oncological therapy. Six patients (30%) underwent radiation therapy, and 14 patients (70%) underwent combined therapy. The mean time between treatment and an evaluation of swallowing was 8.5 months. Videofluoroscopy was done to assess the preparatory, oral and pharyngeal phases of swallowing. All patients had only an oral diet. Normal swallowing was present in only 25% of patients. The swallowing videofluoroscopic examination identified the following changes: bolus formation (85%), bolus ejection (60%), oral cavity stasis (55%), changes in the onset of the pharyngeal phase (100%), decreased laryngeal elevation (65%), and hypopharyngeal stasis (80%). Laryngeal penetration was observed in 25% of the cases; 40% presented tracheal aspiration. The grade of penetration/aspiration was mild in 60% of cases. Aspiration was silent in 35% of patients. Although 75% of patients had dysphagia, only 25% complained of swallowing difficulties. Patients with laryngeal cancer that underwent radiation therapy/combined treatment can present changes in all swallowing phases, or may be asymptomatic.

  14. Evidence-Based Systematic Review: Effects of Neuromuscular Electrical Stimulation on Swallowing and Neural Activation

    Science.gov (United States)

    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…

  15. Mechanism of Sequential Swallowing during Straw Drinking in Healthy Young and Older Adults

    Science.gov (United States)

    Daniels, Stephanie K.; Corey, David M.; Hadskey, Leslie D.; Legendre, Calli; Priestly, Daniel H.; Rosenbek, John C.; Foundas, Anne L.

    2004-01-01

    Recent research has revealed differences between isolated and sequential swallowing in healthy young adults; however, the influence of normal aging on sequential swallowing has not been studied. Thus, the purpose of this investigation was to examine the effects of normal aging on deglutition during sequential straw drinking. Videofluoroscopic…

  16. Effects of Pacifier and Taste on Swallowing, Esophageal Motility, Transit and Respiratory Rhythm in Human Neonates

    Science.gov (United States)

    Shubert, Theresa R.; Sitaram, Swetha; Jadcherla, Sudarshan R.

    2015-01-01

    Background Pacifier use is widely prevalent globally despite hygienic concerns and uncertain mechanistic effects on swallowing or airway safety. Aims The effects of pacifier and taste interventions on pharyngo-esophageal motility, bolus transit and respiratory rhythms were investigated by determining the upper esophageal sphincter (UES), esophageal body, esophagogastric junction (EGJ) motor patterns as well as deglutition apnea, respiratory rhythm disturbances and esophageal bolus clearance. Methods Fifteen infants (6 males; median gestation 31 wks and birth weight 1.4 kg) underwent high resolution impedance manometry at 43 (41-44) weeks post-menstrual age. Manometric, respiratory, and impedance characteristics of spontaneous swallows, pacifier associated dry swallowing and taste (pacifier dipped in 3% sucrose) associated swallowing were analyzed. Linear mixed and generalized estimating equation models were used. Data are presented as mean ± SEM, %, or median (IQR). Key Results Pharyngo-esophageal motility, respiratory, and impedance characteristics of 209 swallows were analyzed (85 spontaneous swallows, 63 pacifier associated dry swallows, 61 taste associated swallows). Basal UES and EGJ pressures decreased upon pacifier (P<0.05) and taste interventions (P<0.05); however, esophageal motility, respiratory rhythm, and impedance transit characteristics were similar with both interventions. Conclusions and Inferences Oral stimulus with pacifier or taste interventions decreases UES and EGJ basal pressure, but has no effects on pharyngo-esophageal motility, airway interactions, or esophageal bolus transit. A decrease in central parasympathetic-cholinergic excitatory drive is likely responsible for the basal effects. PMID:26727930

  17. Relationship between ease of swallowing and deglutition-related muscle activity in various postures.

    Science.gov (United States)

    Sakuma, T; Kida, I

    2010-08-01

    The purpose of this study was to investigate the relationship between the ease of swallowing and the deglutition-related muscle activity in various body and head postures by surface electromyography (EMG). Bipolar surface electrodes were placed on the right suprahyoid and infrahyoid muscles of nine healthy adults (19-28 years) while swallowing jelly. Ten postures per subject were examined: five body angulations (0 degrees [supine], 30 degrees, 60 degrees, 90 degrees [upright] and 120 degrees from the horizontal) and two head positions (chin-up and chin-down). The duration and amplitude of suprahyoid and infrahyoid muscle activity were measured by an electromyograph, and the ease of swallowing was subjectively determined by using a rating scale (0 = difficult to swallow, 10 = easy to swallow). The group-average duration and amplitude of muscle activity and the group-average rating scales mostly showed insignificant changes with the body angulations independent of the head positions. Interestingly, the duration and amplitude of muscle activity during swallowing were negatively correlated with the rating scales, indicating that a shorter duration and smaller activity of muscle activity corresponds to easier swallowing. Consequently, the duration and amplitude of suprahyoid and infrahyoid muscle activity measured by surface EMG would be a useful indicator of the easy-to-swallow performance.

  18. Respiratory-swallow training in patients with head and neck cancer.

    Science.gov (United States)

    Martin-Harris, Bonnie; McFarland, David; Hill, Elizabeth G; Strange, Charlton B; Focht, Kendrea L; Wan, Zhuang; Blair, Julie; McGrattan, Katlyn

    2015-05-01

    To test a novel intervention to train swallowing to occur in the midexpiratory to low expiratory phase of quiet breathing to improve swallowing safety and efficiency. Safety and efficacy nonrandomized controlled trial with 1-month follow-up. Ambulatory clinics. Patients (N=30) with head and neck cancer (HNC) and chronic dysphagia completed the intervention. Fifteen of these patients participated in a 1-month follow-up visit. Training protocol based on hierarchy of motor skill acquisition to encourage autonomous and optimal respiratory-swallowing coordination. Visual feedback of respiratory phase and volume for swallowing initiation was provided by nasal airflow and rib cage/abdomen signals. Respiratory-swallow phase pattern, Modified Barium Swallow Impairment Profile (MBSImP) scores, Penetration-Aspiration Scale (PAS) scores, and MD Anderson Dysphagia Inventory scores. Using visual feedback, patients were trained to initiate swallows during the midexpiratory phase of quiet breathing and continue to expire after swallowing. This optimal phase patterning increased significantly after treatment (Pdysphagia, with favorable effects on airway protection and bolus clearance. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Leaf anthracnose, a new disease of swallow-worts from Russia

    Science.gov (United States)

    Black swallow-wort Vincetoxicum nigrum (L.) Moench (synonym=Cynanchum louiseae Kartesz & Gandhi) and pale swallow-wort Vincetoxicum rossicum (Kleopow) Borhidi (synonym=Cynanchum rossicum (Kleopow) Borhidi) are invasive plants belonging to the family Apocynaceae and are the targets of biological cont...

  20. New biological information on the invasive swallow-worts (Vincetoxicum spp.)

    Science.gov (United States)

    Vincetoxicum nigrum (L.) Moench [Cynanchum louiseae Kartesz & Gandhi] (black swallow-wort) and V. rossicum (Kleopow) Barbar. [Cynanchum rossicum (Kleopow) Borhidi] (pale swallow-wort) are herbaceous perennial vines in the Apocynaceae native to Europe. Both species are considered invasive in their in...

  1. Leaf anthracnose, a new disease of swallow-worts caused by Colletotrichum lineola from Russia

    Science.gov (United States)

    Black swallow-wort Vincetoxicum nigrum (L.) Moench and pale swallow-wort Vincetoxicum rossicum (Kleopow) Borhidi (family Apocynaceae subfamily Asclepiadoideae) are invasive plants and are the targets of biological control efforts to control their spread in the USA. In 2010, diseased leaves of a rela...

  2. Soft Electronics Enabled Ergonomic Human-Computer Interaction for Swallowing Training

    Science.gov (United States)

    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.

  3. Intrarater and interrater reliability for measurements in videofluoroscopy of swallowing

    Energy Technology Data Exchange (ETDEWEB)

    Baijens, Laura, E-mail: laura.baijens@mumc.nl [Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht (Netherlands); Barikroo, Ali, E-mail: a.Barikroo@ufl.edu [Swallowing Research Laboratory, Department of Speech, Language and Hearing Sciences, College of Public Health and Health Professions, University of Florida, Gainesville, FL (United States); Pilz, Walmari, E-mail: walmari.pilz@mumc.nl [Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht (Netherlands)

    2013-10-01

    Objective: Intrarater and interrater reliability is crucial to the quality of diagnostic and therapy-effect studies. This paper reports on a systematic review of studies on intrarater and interrater reliability for measurements in videofluoroscopy of swallowing. The aim of this review was to summarize and qualitatively analyze published studies on that topic. Materials and methods: Those published up to March 2013 were found through a comprehensive electronic database search using PubMed, Embase, and The Cochrane Library. Two reviewers independently assessed the studies using strict inclusion criteria. Results: Nineteen studies were included and then qualitatively analyzed. In several of these, methodological problems were found. Moreover, intrarater and interrater reliability varied with the measure applied. A meta-analysis was not carried out as studies were not of sufficient quality to warrant doing so. Conclusion: In order to achieve reliable measurements in videofluoroscopy of swallowing, it is recommended that raters use well-defined guidelines for the levels of ordinal visuoperceptual variables. Furthermore, in order to make the measurements reliable (intrarater and interrater) it is recommended that, following protocolled pre-experimental training, the raters should have maximum consensus about the definition of the measured variables.

  4. A Mathematical Model for Swallowing of Concentrated Fluids in Oesophagus

    Directory of Open Access Journals (Sweden)

    S. K. Pandey

    2011-01-01

    Full Text Available This model investigates particularly the impact of an integral and a non-integral number of waves on the swallowing of food stuff such as jelly, tomato puree, soup, concentrated fruits juices and honey transported peristaltically through the oesophagus. The fluid is considered as a Casson fluid. Emphasis is on the study of the dependence of local pressure distribution on space and time. Mechanical efficiency, reflux limit and trapping are also discussed. The effect of Casson fluid vis-à-vis Newtonian fluid is investigated analytically and numerically too. The result is physically interpreted as that the oesophagus makes more efforts to swallow fluids with higher concentration. It is observed that the pressure is uniformly distributed when an integral number of waves is there in the oesophagus; but it is non-uniform when a non-integral number of waves is present therein. It is further observed that as the plug flow region widens, the pressure difference increases, which indicates that the averaged flow rate will reduce for a Casson fluid. It is also concluded that Casson fluids are more prone to reflux.

  5. Neural activation of swallowing and swallowing-related tasks in healthy young adults: an attempt to separate the components of deglutition.

    Science.gov (United States)

    Malandraki, Georgia A; Sutton, Bradley P; Perlman, Adrienne L; Karampinos, Dimitrios C; Conway, Charles

    2009-10-01

    Understanding the underlying neural pathways that govern the highly complex neuromuscular action of swallowing is considered crucial in the process of correctly identifying and treating swallowing disorders. The aim of the present investigation was to identify the neural activations of the different components of deglutition in healthy young adults using functional magnetic resonance imaging (fMRI). Ten right-handed young healthy individuals were scanned in a 3-Tesla Siemens Allegra MRI scanner. Participants were visually cued for both a "Swallow" task and for component/control tasks ("Prepare to swallow", "Tap your tongue", and "Clear your throat") in a randomized order (event-related design). Behavioral interleaved gradient (BIG) methodology was used to address movement-related artifacts. Areas activated during each of the three component tasks enabled a partial differentiation of the neural localization for various components of the swallow. Areas that were more activated during throat clearing than other components included the posterior insula and small portions of the post- and pre-central gyri bilaterally. Tongue tapping showed higher activation in portions of the primary sensorimotor and premotor cortices and the parietal lobules. Planning did not show any areas that were more activated than in the other component tasks. When swallowing was compared with all other tasks, there was significantly more activation in the cerebellum, thalamus, cingulate gyrus, and all areas of the primary sensorimotor cortex bilaterally.

  6. Evaluation of an EMG bioimpedance measurement system for recording and analysing the pharyngeal phase of swallowing.

    Science.gov (United States)

    Schultheiss, Corinna; Schauer, Thomas; Nahrstaedt, Holger; Seidl, Rainer O

    2013-07-01

    A neuroprosthetic device for treating swallowing disorders requires an implantable measurement system capable to analysing the timing and quality of the swallowing process in real time. A combined EMG bioimpedance (EMBI) measurement system was developed and is evaluated here. The study was planned and performed as a case-control study. The studies were approved by the Charité Berlin ethics committee in votes EA1/160/09 and EA1/161/09. Investigations were carried out on healthy volunteers in order to examine the usefulness and reproducibility of measurements, the ability to distinguish between swallowing and head movements and the effect of different food consistencies. The correlation between bioimpedance and anatomical and functional changes occurring during the pharyngeal phase of swallowing in non-healthy patients was examined using videofluoroscopy (VFSS). 31 healthy subjects (15♂, 16♀) were tested over the course of 1350 swallows and 19 (17♂, 2♀) non-healthy patients over the course of 54 swallows. The signal curves obtained from both transcutaneous and subcutaneous measurement were similar, characteristic and reproducible (r > 0.5) and correlated with anatomical and functional changes during the pharyngeal phase of swallowing observed using VFSS. Statistically significant differences between head movements and swallowing movements, food volumes and consistencies were found. Neither the conductivity of the food, the sex of the test subject nor the position of the measurement electrodes exerted a statistically significant effect on the measured signal. EMBI is able to reproducibly map the pharyngeal phase of swallowing and changes associated with it both transcutaneously and subcutaneously. The procedure therefore appears to be suitable for use in performing automated evaluation of the swallowing process and for use as a component of an implant.

  7. 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

  8. Factors associated with swallowing assessment after oral endotracheal intubation and mechanical ventilation for acute lung injury.

    Science.gov (United States)

    Brodsky, Martin B; González-Fernández, Marlís; Mendez-Tellez, Pedro A; Shanholtz, Carl; Palmer, Jeffrey B; Needham, Dale M

    2014-12-01

    Endotracheal intubation is associated with postextubation swallowing dysfunction, but no guidelines exist for postextubation swallowing assessments. We evaluated the prevalence, patient demographic and clinical factors, and intensive care unit (ICU) and hospital organizational factors associated with swallowing assessment after oral endotracheal intubation and mechanical ventilation in patients with acute lung injury (ALI). We performed a secondary analysis of a prospective cohort study in which investigators evaluated 178 eligible patients with ALI who were mechanically ventilated via oral endotracheal tube. The patients were recruited from 13 ICUs at four teaching hospitals in Baltimore, Maryland. Patient demographic and clinical factors, types of ICU, and hospital study sites were evaluated for their association with completion of a swallowing assessment both in the ICU and after the ICU stay before hospital discharge. Factors significantly associated with a swallow assessment were evaluated in a multivariable logistic regression model. Before hospital discharge, 79 (44%) patients completed a swallowing assessment, among whom 59 (75%) had their assessments initiated in ICU and 20 (25%) had their assessments initiated on the hospital ward. Female sex (odds ratio [OR] = 2.01; 95% confidence interval [95% CI] = 1.03-3.97), orotracheal intubation duration (OR = 1.13 per day; 95% CI = 1.05-1.22), and hospital study site (Site 3: OR = 2.41; 95% CI = 1.00-5.78) were independently associated with swallowing assessment. Although Site 3 had a twofold increase in swallowing assessments in the ICU, there was no significant difference between hospitals in the frequency of swallowing assessments completed after ICU discharge (P = 0.287) or in the proportion of patients who failed a swallowing assessment conducted in the ICU (P = 0.468) or on the ward (P = 0.746). In this multisite prospective study, female sex, intubation duration, and

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

    Directory of Open Access Journals (Sweden)

    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

  10. Swallowing of bolus types by postsurgical head and neck cancer patients.

    Science.gov (United States)

    Stachler, R J; Hamlet, S L; Mathog, R H; Jones, L; Heilbrun, L K; Manov, L J; O'Campo, J M

    1994-01-01

    Clinically, head and neck cancer patients with anterior resections have better postoperative outcomes than do patients with posterior resections. Videofluoroscopy was used to study the swallowing characteristics in postsurgery head and neck cancer patients and normal controls. Most patients received post-operative radiotherapy and chemotherapy, and no cancer recurrence was noted at the time of study, 4-8 months posttreatment. Bolus types included: 3 mL and 10 mL liquid barium, barium paste, and barium-coated cookie. Temporal measurements and a count of the number of swallows required to ingest each material were made from the videotaped data. Statistical analysis using an unbalanced univariate repeated measures ANOVA was performed. The major differences were found between bolus types, with few differences noted between surgical groups (anterior vs posterior resections) and normal controls. Patients took longer to ingest viscous material, accomplishing this by multiple piecemeal and clearing swallows. Coordination of mastication and swallowing of the cookie was different between normal and patient groups. Patients who are able to swallow reasonably well postoperatively maintain normal coordination and timing of swallowing activity and do not vary these parameters to compensate for structural inadequacy. Instead, repeated swallows are used.

  11. Natural capsaicinoids improve swallow response in older patients with oropharyngeal dysphagia.

    Science.gov (United States)

    Rofes, Laia; Arreola, Viridiana; Martin, Alberto; Clavé, Pere

    2013-09-01

    There is no pharmacological treatment for oropharyngeal dysphagia (OD). The aim of this study was to compare the therapeutic effect of stimulation of oropharyngeal transient receptor potential vanilloid type 1 (TRPV1) with that of thickeners in older patients with OD. A clinical videofluoroscopic non-randomised study was performed to assess the signs of safety and efficacy of swallow and the swallow response in (1) 33 patients with OD (75.94 ± 1.88 years) while swallowing 5, 10 and 20 ml of liquid (20.4 mPa.s), nectar (274.4 mPa.s), and pudding (3930 mPa.s) boluses; (2) 33 patients with OD (73.94 ± 2.23 years) while swallowing 5, 10 and 20 ml nectar boluses, and two series of nectar boluses with 150 μM capsaicinoids and (3) 8 older controls (76.88 ± 1.51 years) while swallowing 5, 10 and 20 ml nectar boluses. Increasing bolus viscosity reduced the prevalence of laryngeal penetrations by 72.03% (p capsaicinoids reduced both, penetrations by 50.% (p capsaicinoids strongly improved safety and efficacy of swallow and shortened the swallow response in older patients with OD. Stimulation of TRPV1 might become a pharmacologic strategy to treat OD.

  12. Effect of oral piperine on the swallow response of patients with oropharyngeal dysphagia.

    Science.gov (United States)

    Rofes, Laia; Arreola, Viridiana; Martin, Alberto; Clavé, Pere

    2014-12-01

    Oropharyngeal dysphagia (OD) is a major gastrointestinal motility disorder that causes severe nutritional and respiratory complications in elderly and neurological patients. In an earlier study, we found that stimulation of pharyngeal sensory neurons by capsaicinoids acting on transient receptor potential vanilloid 1 (TRPV1) improved the swallow response of dysphagic patients. The aim of this study was to explore the effect of piperine, a dual TRPV1/TRPA1 agonist, on the swallow response of dysphagic patients. A videofluoroscopic study was performed to assess the signs of impaired safety and efficacy of swallow and the swallow response of 40 dysphagic patients while swallowing one series of nectar control boluses and two series of nectar boluses supplemented with piperine. Patients were randomized into two groups: one group received 150 μM piperine and the other group received 1 mM. Piperine improved the safety of swallow by: (a) reducing the prevalence of unsafe swallows by -34.48% (P = 0.004) at 150 μM and -57.19% (P sensory neurons is a very promising neurostimulation strategy for dysphagic patients.

  13. Characterizing Dysphagia and Swallowing Intervention in the Traumatic Spinal Injury Population

    Science.gov (United States)

    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

  14. Evaluation of Swallow Function in Patients with Craniofacial Microsomia: A Retrospective Study.

    Science.gov (United States)

    van de Lande, Lara S; Caron, Cornelia J J M; Pluijmers, Britt I; Joosten, Koen F M; Streppel, Marloes; Dunaway, David J; Koudstaal, Maarten J; Padwa, Bonnie L

    2017-11-04

    Craniofacial microsomia (CFM) is characterized by underdevelopment of the structures derived from the first and second pharyngeal arches resulting in aesthetic, psychological, and functional problems including feeding and swallowing difficulties. The aim of this study is to gain more insight into swallowing difficulties in patients with CFM. A retrospective study was conducted in the population of patients diagnosed with CFM at three major craniofacial units. Patients with feeding difficulties and those who underwent video fluoroscopic swallow (VFS) studies were included for further analyses. The outcome of the VFS-studies was reviewed with regard to the four phases of swallowing. In our cohort, 13.5% of the 755 patients were diagnosed with swallowing difficulties. The outcome of the VFS-studies of 42 patients showed difficulties in the oral and pharyngeal phases with both thin and thick liquids. Patients with more severe mandibular hypoplasia showed more difficulties to form an appropriate bolus compared to patients who were less severely affected. This is the first study to document swallowing problems in patients with CFM. Difficulties were seen in both the oral and pharyngeal phases. We recommend routine screening for swallowing issues by a speech and language therapist in all patients with CFM and to obtain a VFS-study in patients with a type III mandible.

  15. 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.

  16. Assessment of swallowing and its disorders—A dynamic MRI study

    Energy Technology Data Exchange (ETDEWEB)

    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.

  17. Influence of the cuff pressure on the swallowing reflex in tracheostomized intensive care unit patients.

    Science.gov (United States)

    Amathieu, R; Sauvat, S; Reynaud, P; Slavov, V; Luis, D; Dinca, A; Tual, L; Bloc, S; Dhonneur, G

    2012-10-01

    Because recovery of an efficient swallowing reflex is a determining factor for the recovery of airway protective reflexes, we have studied the influence of the tracheostomy tube cuff pressure (CP) on the swallowing reflex in tracheotomized patients. Twelve conscious adult intensive care unit (ICU) patients who had been weaned from mechanical ventilation were studied. Simultaneous EMG of the submental muscles with measurement of peak activity (EMGp) and amplitude of laryngeal acceleration (ALA) were performed during reflex swallows elicited by pharyngeal injection of distilled water boluses during end expiration. After cuff deflation, characteristics of the swallowing reflex (latency time: LaT, EMGp, and ALA) were measured at CPs of 5, 10, 15, 20, 25, 30, 40, 50, and 60 cm H(2)O. LaT and CP were linearly related (P<0.01). CP was inversely correlated (P<0.01) to both ALA and EMGp. We demonstrated that LaT, EMGp, and ALA of the swallowing reflex were influenced by tracheostomy tube CP. The swallowing reflex was progressively more difficult to elicit with increasing CP and when activated, the resulting motor swallowing activity and efficiency at elevating the larynx were depressed.

  18. Pre-emptive swallowing stimulation in long-term intubated patients.

    Science.gov (United States)

    Hwang, Chang Ho; Choi, Kyoung Hyo; Ko, Yoon Suk; Leem, Chae Man

    2007-01-01

    To evaluate the effect of pre-emptive swallowing stimulation on the recovery of swallowing function in long-term intubated patients. Patients in the intensive care unit intubated for at least 48 hours due to respiratory distress from March to August 2004 were randomly divided into two groups. Fifteen patients of mean age 55.39+/-17.9 years were stimulated (experimental group) and 18 patients of mean age 61.39+/-13.5 years were not stimulated (control group). The duration of intubation was 15.59+/-6.7 days in the experimental group and 15.79+/-6.5 days in the control group. Duration of stimulation in the experimental group was 7.39+/-3.6 days. After extubation, we compared the severity of dysphagia via video-fluoroscopic swallow study. There were no statistically significant differences in the percentage of aspiration and the swallowed volume between the two groups. However, oral transit time in the experimental group (0.379+/-0.07 seconds) was significantly shorter than that of the control group (0.839+/-0.10 seconds), and the oropharyngeal swallowing efficiency of the experimental group (73.39+/-17.4%/s) was significantly higher than that of the control group (50.19+/-13.0%/s). Pre-emptive swallowing stimulation during intubation assists in the recovery of swallowing function in long-term intubated patients.

  19. Effect of carrot puree in vegetable juice on linguapalatal swallowing pressure.

    Science.gov (United States)

    Moritaka, Hatsue; Mineki, Machiko; Kobayashi, Makoto; Ono, Takahiro; Hori, Kazuhiro

    2017-12-11

    This study aimed to ascertain the influence of various amounts (0-30%) of carrot puree (CP) in vegetable juice on linguapalatal swallowing pressure in healthy volunteers. Twenty healthy women (age range: 20-22 years) swallowed a 17-ml drink in a natural state, and linguapalatal swallowing pressure was measured using a special sensor sheet. Peak magnitude (maximum pressure of the tongue pushing on the hard palate), integrated values of linguapalatal swallowing pressure on the waveform, and duration of linguapalatal swallowing pressure were increased with increases in CP concentrations. The total integrated value for 30% CP vegetable juice was larger than that of vegetable juice with no CP. The apparent viscosity of the vegetable juice with a low CP concentration was smaller than that with a high CP concentration at the same shear rate. These results suggest that vegetable juice containing CP affects mechanoreceptor activity in the mouth and generates a neuromotor response. This study aimed to ascertain the influence of various amounts of carrot puree (CP) in vegetable juice on linguapalatal swallowing pressure measured by using a special sensor sheet in healthy volunteers. Obtained results of this study clearly showed that vegetable juice containing CP affects the movement of the tongue in maneuvering the bolus. Moreover, the results demonstrated that this effect depended on the concentration of CP in the vegetable juice. These findings are expected to provide clinically valuable data on the effect of mechanical stimulation during the oral stage of swallowing. © 2017 Wiley Periodicals, Inc.

  20. Noninvasive Mechanical Ventilation Improves Breathing-Swallowing Interaction of Ventilator Dependent Neuromuscular Patients: A Prospective Crossover Study.

    Science.gov (United States)

    Garguilo, Marine; Lejaille, Michèle; Vaugier, Isabelle; Orlikowski, David; Terzi, Nicolas; Lofaso, Frédéric; Prigent, Hélène

    2016-01-01

    Respiratory involvement in neuromuscular disorders may contribute to impaired breathing-swallowing interactions, swallowing disorders and malnutrition. We investigated whether the use of non-invasive ventilation (NIV) controlled by the patient could improve swallowing performances in a population of neuromuscular patients requiring daytime NIV. Ten neuromuscular patients with severe respiratory failure requiring extensive NIV use were studied while swallowing without and with NIV (while ventilated with a modified ventilator allowing the patient to withhold ventilation as desired). Breathing-swallowing interactions were investigated by chin electromyography, cervical piezoelectric sensor, nasal flow recording and inductive plethysmography. Two water-bolus sizes (5 and 10ml) and a textured yogurt bolus were tested in a random order. NIV use significantly improved swallowing fragmentation (defined as the number of respiratory interruption of the swallowing of a single bolus) (p = 0.003) and breathing-swallowing synchronization (with a significant increase of swallows followed by an expiration) (p controlled NIV improves swallowing parameters in patients with severe neuromuscular respiratory failure requiring daytime NIV, without impairing swallowing comfort. ClinicalTrials.gov NCT01519388.

  1. Evaluation of normal swallowing functions by using dynamic high-density surface electromyography maps.

    Science.gov (United States)

    Zhu, Mingxing; Yu, Bin; Yang, Wanzhang; Jiang, Yanbing; Lu, Lin; Huang, Zhen; Chen, Shixiong; Li, Guanglin

    2017-11-21

    Swallowing is a continuous process with substantive interdependencies among different muscles, and it plays a significant role in our daily life. The aim of this study was to propose a novel technique based on high-density surface electromyography (HD sEMG) for the evaluation of normal swallowing functions. A total of 96 electrodes were placed on the front neck to acquire myoelectric signals from 12 healthy subjects while they were performing different swallowing tasks. HD sEMG energy maps were constructed based on the root mean square values to visualize muscular activities during swallowing. The effects of different volumes, viscosities, and head postures on the normal swallowing process were systemically investigated by using the energy maps. The results showed that the HD sEMG energy maps could provide detailed spatial and temporal properties of the muscle electrical activity, and visualize the muscle contractions that closely related to the swallowing function. The energy maps also showed that the swallowing time and effort was also explicitly affected by the volume and viscosity of the bolus. The concentration of the muscular activities shifted to the opposite side when the subjects turned their head to either side. The proposed method could provide an alternative method to physiologically evaluate the dynamic characteristics of normal swallowing and had the advantage of providing a full picture of how different muscle activities cooperate in time and location. The findings from this study suggested that the HD sEMG technique might be a useful tool for fast screening and objective assessment of swallowing disorders or dysphagia.

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

    Science.gov (United States)

    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.

  3. The prevalence of pediatric voice and swallowing problems in the United States.

    Science.gov (United States)

    Bhattacharyya, Neil

    2015-03-01

    Determine the prevalence of pediatric voice and swallowing problems in the United States. The 2012 National Health Interview Survey pediatric voice and language module was analyzed, identifying children reporting a voice or swallowing problem in the preceding 12 months. In addition to demographic data, specific data regarding visits to health care professionals for voice or swallowing problems, diagnoses given, and severity of voice or swallowing problem were analyzed. An estimated 839 ± 89 thousand children (1.4% ± 0.1%) reported a voice problem. Overall, 53.5% ± 1.9% were given a diagnosis for the voice problem and 22.8% ± 4.6% received voice services. Laryngitis (16.6% ± 5.5%) and allergies (10.4% ± 4.0%) were the most common diagnoses. A total of 16.4% graded the voice problem as a "big" or "very big" problem. An estimated 569 ± 63 thousand children (0.9% ± 0.1%) reported a swallowing problem. A total of 12.7% ± 3.8% received swallowing services and 13.4% ± 1.6% were given a diagnosis for their swallowing problem. Neurological problems were the most common diagnoses (11.1% ± 4.5%). A total of 17.9% graded the swallowing problem as a "big" or "very big" problem. These data provide the first insight into the prevalence of childhood voice and swallowing problems, which affect approximately 1% of children annually. A relative minority seek care for their problem, despite the disease impact. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  4. Swallowing transit times and valleculae residue in stable chronic obstructive pulmonary disease

    Science.gov (United States)

    2014-01-01

    Background Breathing and swallowing are physiologically linked to ensure effortless gas exchange during oronasal breathing and to prevent aspiration during swallowing. Studies have indicated consistent aspiration in chronic obstructive pulmonary disease, mainly related to delayed swallowing reflex and problems with lingual propulsion and pharyngeal peristalsis as a result of bilateral weakness and incoordination of the related muscles. The purpose of the present study was to evaluate swallowing transit times and valleculae residue characteristics of stable COPD patients who have no swallowing complaints. Methods Our study population included 20 stable patients with COPD and no swallowing complaints and 20 healthy controls. Swallowing was assessed through videofluoroscopic examination and involved the analysis of the following parameters: (1) pharyngeal stages of deglutition; (2) the duration of bolus movement through the oral cavity and pharynx (i.e. transit times); (3) valleculae residue ratio; (4) penetration/aspiration. Results Participants of the study did not present any signs of penetration-aspiration for any of the tested consistencies. Patients with COPD presented longer pharyngeal transit times during the ingestion of the liquid consistency and during the ingestion of the paste consistency. Regarding the duration of tongue base contact with the posterior pharyngeal wall, COPD patients also presented longer durations for the liquid and paste consistencies. No significant difference was observed for the distribution of individuals among the different valleculae residue severity levels. Conclusions Our study suggests that stable COPD patients may present physiological adaptations as a protective swallowing maneuver to avoid aspiration/penetration of pharyngeal contents. Moreover, valleculae residue cannot be seen as an isolated factor when trying to explain swallowing alterations in this population. PMID:24739506

  5. [Clinical characterisation and course following therapeutic intervention for swallowing disorders in hospitalised paediatric patients].

    Science.gov (United States)

    Salinas-Valdebenito, Luis; Núñez-Farias, Alicia C; Milagros, Angeli; Escobar-Henríquez, Raúl G

    Swallowing disorders are common in hospitalised patients and are an added difficulty when it comes to discharging them from hospital. Suitable characterisation performed by means of assessments conducted by a neurologist and a speech and language therapist allows for more accurate therapeutic decision-making. To describe swallowing disorders from the speech and language therapy evaluation performed on admission until discharge in paediatric patients and their relation with the therapeutic intervention that was implemented. We performed a retrospective analysis consisting in the examination of the medical records of 38 paediatric patients hospitalised between May 2007 and June 2008. Functional clinical evaluation was carried out in 100% of patients, and a video swallow study was conducted in 34%. Swallowing disorders were characterised as mild, moderate and severe, according to the stage that was altered and aspiratory risk to the airway. A speech therapist provided therapeutic intervention, and parents and caregivers were given special training. Swallowing disorders were chiefly associated to prematurity. The most frequently used therapeutic techniques were: tactile stimulation, providing patterns and training of parents. In the speech and language therapy evaluation performed on admission, 37% of disorders were severe, 21% were moderate and 42% were mild disorders. In most of the newborn infants, progress was favourable, as shown by a shift to normal swallowing in 48% and to mild in 8%. In the 17 preterm newborn infants, there was a change to normal swallowing in 65% and to mild in 12%. Swallowing disorders in this group of patients is mainly associated to prematurity. Systematic therapeutic intervention would help in the recovery from swallowing disorders, especially in preterm newborn infants.

  6. Implication of the vagus nerve in breathing pattern during sequential swallowing in rats.

    Science.gov (United States)

    Ouahchi, Yacine; Duclos, Celia; Marie, Jean Paul; Verin, Eric

    2017-10-01

    The ventilatory pattern during sequential swallowing is influenced by the vagal activity. As the vagus nerve is paired and mixed, we aimed (1) to determine if vagal implication in swallowing and breathing coordination is symmetric. (2) to study the importance of vagal afferences in swallowing and breathing coordination. Sixty two Wistar rats (7-11weeks, 260-400g) were studied by barometric plethysmography. In the first part of the study, we determined the effects of a right cervical vagotomy and the effects of a left cervical vagotomy on ventilatory pattern at rest and during sequential swallowing (14 rats with right vagotomy, 14 rats with left vagotomy and 14 rats with sham surgery). Comparisons of ventilatory variables were made between right and left vagotomized animals. Thereafter, we determined the effects of electrical vagus nerve stimulation (VNS) on ventilatory pattern at rest and during sequential swallowing (10 rats with electrical VNS and 10 rats with sham VNS). We showed that a right or a left cervical vagotomy does not alter ventilation at rest, but induces during sequential swallowing a decrease in respiratory rate (RR) (p0.05). Electrical VNS had no effect on ventilation at rest, but it minimized during sequential swallowing a decrease in RR related to a local alteration of the vagus nerve after placement of the electrodes as shown following sham VNS. In conclusion, the implication of vagus nerve in breathing pattern during sequential swallowing seems symmetric and influenced by activation of the vagal afferent pathway. These data can be useful when testing electrical VNS in swallowing disorders. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Fiberoptic endoscopic evaluation of swallowing in swallowing disorders – fees-. Case report at Popayán, Colombia.

    Directory of Open Access Journals (Sweden)

    Rodrigo Molina-García

    2011-09-01

    Full Text Available Dysphagia is a frequently pathological condition in pa­tients with stroke and carries a substantial risk of dehy­dration, malnutrition and aspiration pneumonia. So far there are two methods for diagnosis; Videofluoroscopy (VFC and Fiberoptic Endoscopic Evaluation of Swa­llowing (FEES. The first is considered the gold standard method, with a high cost, radiation exposure that requires the transfer of the patient to radiology, the patient’s abili­ty to follow simple commands and time required to com­plete. VFC does not replicate physiological conditions in which the patient is routinely, so it is considered that its representation is limited, the second test is an alternative procedure to be more economical, safe, well tolerated, wi­dely available, lasting approximately 20 minutes and with the possibility of doing it in the patient’s bed. Unlike FVC, to evaluate the presence of pharyngeal, this correlates with the risk of aspiration. Clinical report: The objective of this report is to present a male patient, 33 years old, who admitted to a health institution because it presents a clini­ cal picture compatible with stroke, as findings found right hemiplegia and swallowing disorder, as required gastros­tomy tubes. We performed Fiberoptic Endoscopic Evalua­tion of Swallowing (FEES as a diagnostic method, which allowed visualization of the anatomic and functional en­vironment, the type of food consistency could be secure in their feeding process, thus avoiding silent aspirations and insights that could lead an aspiration pneumonia. It also allowed the group to make recommendations for nutritio­nal support, physiotherapy and speech therapy for ambu­latory management of the patient.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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.

  12. Randomized trial of two swallowing assessment approaches in patients with acquired brain injury

    DEFF Research Database (Denmark)

    Kjaersgaard, Annette; Nielsen, Lars Hedemann; Sjölund, Bengt H.

    2014-01-01

    OBJECTIVE: To examine whether patients assessed for initiation of oral intake only by Facial-Oral Tract Therapy had a greater risk of developing aspiration pneumonia during neurorehabilitation than patients assessed by Fibreoptic Endoscopic Evaluation of Swallowing. DESIGN: Randomized controlled ...

  13. Contribution of the lateral lemniscus to the control of swallowing in decerebrate cats.

    Science.gov (United States)

    Ota, R; Takakusaki, K; Katada, A; Harada, H; Nonaka, S; Harabuchi, Y

    2013-12-19

    Lateral lemniscus, a relay nucleus of auditory sensation, is involved in the control of phonatory movements such as human speech and vocalization of animals. The present study was designed to test whether neurons in the lateral lemniscus contributed to the control of swallowing, one of non-phonic oro-pharyngolaryngeal movements. In acutely decerebrated cats (n=15), swallowing was induced by electrical stimulation (20-80μA at 10Hz for 20s with rectangular pulses of 0.2ms duration) delivered to the superior laryngeal nerve (SLN). Repetitive electrical stimulation (30-50μA at 50Hz for 10-20s) applied to the dorsal nucleus of the lateral lemniscus (LLD) increased the number and reduced the latency to the onset of the SLN-induced swallowing. On the other hand, stimulation of the ventral nucleus of the lateral lemniscus and the paralemniscal area, corresponding to the ventrolateral part of the parabrachial nucleus and the Kölliker-Fuse nucleus, often suppressed the SLN-induced swallowing. Microinjection of NMDA (0.1-0.15μl, 5.0-10mM) into the LLD through a stereotaxically placed glass micropipette facilitated the SLN-induced swallowing, i.e., the number was increased and the latency of swallowing was reduced. We also injected muscimol (a gamma amino-butyric acid (GABA)A receptor agonist), bicuculline (a GABAA receptor antagonist) and baclofen (a GABAB receptor agonist) into the LLD (0.1-0.15μl and 5.0mM for each substance). It was observed that an injection of muscimol suppressed the SLN-induced swallowing. However, an injection of bicuculline facilitated the swallowing. An injection of baclofen did not alter the swallowing. These results suggest the presence of functional topography in the lateral lemniscus and the paralemniscal area in relation to the control of swallowing. The facilitatory LLD-effects on swallowing are modulated by glutamatergic and GABAergic receptors on neurons in the LLD. Copyright © 2013 IBRO. Published by Elsevier Ltd. All rights reserved.

  14. Accumulation of PCB congeners in nestling tree swallows (Tachycineta bicolor) on the Hudson River, New York

    Science.gov (United States)

    Echols, Kathy R.; Tillitt, Donald E.; Nichols, John W.; Secord, Anne L.; McCarty, John P.

    2004-01-01

    Tree swallows (Tachycineta bicolor) were used as a sentinel species to monitor the contamination and bioavailability of polychlorinated biphenyls (PCBs) in the Hudson River watershed. Several tree swallow nest box colonies around and downstream from Hudson Falls, NY, were studied. Tree swallow eggs, adults, and 5-, 10-, and 15-day-old nestlings were collected and analyzed for 103 PCB congeners. Emergent insects collected by net (primarily Odonata) or as a food bolus (primarily Diptera) taken from the mouths of adult tree swallows returning to the nest were analyzed in the same manner. Total PCB concentrations (wet weight) in eggs from two contaminated sites ranged from 9000 to 25 000 ng/g and accumulated to 32 000 and 96 000 ng/g in 15-day-old nestling at two contaminated sites. The congener patterns of PCBs in eggs, nestlings, and adults were compared to those found in emergent insects (Odonata and Diptera) using principal components analysis. The PCB patterns of the biota differed from that of Aroclor technical mixtures. PCB patterns in adult tree swallows were similar to those in eggs, while the patterns in dietary insects were similar to nestling tree swallows. Uptake rate constants were determined for tree swallow nestlings and compared between the two contaminated sites. The estimated PCB congener uptake rate constants were 0.008-0.02 d-1 based on uptake in nestlings until day 15 post-hatch. The rate constants were comparable between the two study areas and may be used to predict nestling contamination at other locations. Our studies confirm the utility of nestling tree swallows to evaluate localized PCB contamination.

  15. 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.

  16. Effect of aging on oral and swallowing function after meal consumption

    Directory of Open Access Journals (Sweden)

    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

  17. Swallowing dysfunction among patients with laryngeal cleft: More than just aspiration?

    Science.gov (United States)

    Strychowsky, Julie E; Dodrill, Pamela; Moritz, Ethan; Perez, Jennifer; Rahbar, Reza

    2016-03-01

    The Modified Barium Swallow (MBS) is the most widely utilized instrumental assessment of swallowing disorders in children; however, the exact role in the evaluation of laryngeal clefts remains controversial. This study was an IRB-approved retrospective review on patients diagnosed with laryngeal cleft from 2002 to 2014. The objective was to describe the range of swallowing dysfunction that may be present in patients with laryngeal clefts both pre- and post-intervention (conservative management versus surgery). A speech-language pathologist reviewed MBS studies and medical records to determine Penetration-Aspiration Scale (PAS) and Functional Oral Intake Scale (FOIS) scores. One hundred seventy-five patients who underwent laryngeal cleft repair during the study period (type 1, n=111; type 2, n=54; type 3, n=9; type 4, n=1) were included. Fifty patients who were managed conservatively (type 1) were also included. Swallowing impairment was demonstrated in all phases of swallowing for all cleft types. Oral phase impairment ranged from 27-67% pre-intervention to 19-75% post-intervention, triggering impairment from 24-42% pre-intervention to 24-75% post-intervention, and pharyngeal phase impairment (laryngeal penetration and aspiration) from 57-100% pre-intervention to 40-100% post-intervention. Laryngeal penetration and aspiration on thin and thick liquids, silent aspiration, PAS, and FOIS scores are reported. Significant improvements in swallowing function (p<0.05) were documented in all of the conservatively and surgically managed sub-groups. The MBS study is a useful tool for evaluating swallowing function in patients with laryngeal cleft and provides information beyond the lack or presence of aspiration. Understanding impairments in all phases of swallowing may be beneficial for perioperative management. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Age-related Differences in Tongue-Palate Pressures for Strength and Swallowing Tasks

    OpenAIRE

    Fei, Tiffany; Polacco, Rebecca Cliffe; Hori, Sarah E.; Molfenter, Sonja M.; Peladeau-Pigeon, Melanie; Tsang, Clemence; Steele, Catriona M.

    2013-01-01

    The tongue plays a key role in the generation of pressures for transporting liquids and foods through the mouth in swallowing. Recent studies suggest that there is an age-related decline in tongue strength in healthy adults. However, whether age-related changes occur in tongue pressures generated for the purpose of swallowing remains unclear. Prior literature in this regard does not clearly explore the influence of task on apparent age-related differences in tongue pressure amplitudes. Furthe...

  19. Favorable Swallowing Outcomes following Vagus Nerve Sacrifice for Vagal Schwannoma Resection.

    Science.gov (United States)

    Patel, Mira A; Eytan, Danielle F; Bishop, Justin; Califano, Joseph A

    2017-02-01

    Objective To determine the impact of unilateral vagal sacrifice for vagal schwannoma on postoperative swallowing function. Study Design Case series, chart review. Setting Academic medical institution. Subjects and Methods Ten patients underwent vagus nerve sacrifice for vagal schwannoma resection. Archived pathology records dating from 1985 through 2012 at our institution were retrospectively queried for cases of vagal schwannoma with vagus nerve sacrifice. Medical records were abstracted for demographic and disease information as well as cranial nerve and swallowing function. Preoperative and postoperative cranial nerve function, subjective and objective measures of swallowing function, Functional Oral Intake Scale (FOIS) level, and need for vocal fold medialization were variables collected. Data were analyzed with summary statistics. Results The patients who underwent vagal sacrifice for vagal schwannoma at our institution had a mean age of 42.3 years (median, 44 years; range, 15-63 years) and follow-up of 35.6 months (median, 9 months; range, 1-115 months). Most presented with no preoperative cranial nerve deficit or difficulty swallowing. Immediately postoperatively, 90% had a vagus nerve deficit, but 50% had no subjective difficulty swallowing, and 70% had a FOIS level of 7 at postoperative hospital discharge. Within 1 month after surgery, 70% had normal swallowing function according to a modified barium swallow study. A full diet was tolerated by mouth within an average of 2.7 days (median, 2 days; range, 1-6 days) after surgery in this cohort. Seventy percent required vocal fold medialization postoperatively for incomplete glottic closure. Conclusion Vagal nerve sacrifice during resection of vagal schwannoma can be performed with normal postoperative swallowing function.

  20. Impact of rhythmic oral activity on the timing of muscle activation in the swallow of the decerebrate pig.

    Science.gov (United States)

    Thexton, Allan J; Crompton, A W; Owerkowicz, Tomasz; German, Rebecca Z

    2009-03-01

    The pharyngeal swallow can be elicited as an isolated event but, in normal animals, it occurs within the context of rhythmic tongue and jaw movement (RTJM). The response includes activation of the multifunctional geniohyoid muscle, which can either protract the hyoid or assist jaw opening; in conscious nonprimate mammals, two bursts of geniohyoid EMG activity (GHemg) occur in swallow cycles at times consistent with these two actions. However, during experimentally elicited pharyngeal swallows, GHemg classically occurs at the same time as hyoglossus and mylohyoid activity (short latency response) but, when the swallow is elicited in the decerebrate in the absence of RTJM, GHemg occurs later in the swallow (long latency response). We tested the hypothesis that it was not influences from higher centers but a brain stem mechanism, associated with RTJM, which caused GHemg to occur earlier in the swallow. In 38 decerebrate piglets, RTJM occurred sporadically in seven animals. Before RTJM, GHemg had a long latency, but, during RTJM, swallow related GHemg occurred synchronously with activity in hyoglossus and mylohyoid, early in the swallow. Both early and late responses were present during the changeover period. During this changeover period, duplicate electrodes in the geniohyoid could individually detect either the early or the late burst in the same swallow. This suggested that two sets of geniohyoid task units existed that were potentially active in the swallow and that they were differentially facilitated or inhibited depending on the presence or absence of rhythmic activity originating in the brain stem.

  1. Stable carbon and nitrogen isotopes of tree swallows influenced by oil sands aquatic reclamation

    Energy Technology Data Exchange (ETDEWEB)

    Farwell, A.; Dixon, D. [Waterloo Univ., ON (Canada); Harms, J. [Saskatchewan Univ., Saskatoon, SK (Canada); Smits, J. [Calgary Univ., AB (Canada)

    2010-07-01

    This presentation reported on a study in which tree swallows (Tachycineta bicolor) were studied to evaluate reclamation strategies used by oil sand operators in Alberta. Wetland reclamation involves the transformation of tailings water and solids into functioning aquatic ecosystems. Naphthenic acids (NAs) and polycyclic aromatic compounds (PACs) in tailing/reclamation material are toxic constituents that pose concern for growth rate, reproductive function and immune function in tree swallows. Exposure to xenobiotics from these tailings-based sites was determined by increased detoxification enzyme (EROD) activity. The dietary exposure of tree swallows to oil sands constituents was determined through stable isotope analysis. Previous studies revealed trends of 13C depletion and 15N enrichment in benthic invertebrates from reclaimed wetlands on the oil sands. Since most food consumed by tree swallow nestlings is aquatic, the isotope signatures in tree swallows should provide evidence of exposure to oil sands constituents. Tree swallow feather and muscle tissues were examined in this study to determine if stable isotopes could be used to identify dietary contributions from oil sands reclamation sites versus reference sites containing no tailings materials.

  2. Cine MRI of swallowing in patients with advanced oral or oropharyngeal carcinoma: a feasibility study.

    Science.gov (United States)

    Kreeft, Anne Marijn; Rasch, Coen R N; Muller, Sara H; Pameijer, Frank A; Hallo, Eeke; Balm, Alfons J M

    2012-06-01

    Treatment of oral and oropharyngeal cancer may cause dysphagia. Purpose is to examine whether cine magnetic resonance imaging (MRI) yields additional information compared to standard examination in the evaluation of posttreatment dysphagia and mobility of oral and oropharyngeal structures. Thirty-four cine MRIs were made in 23 patients with advanced oral and oropharyngeal cancer, consisting of an MR image every 800 ms during swallowing which is compared to videofluoroscopy and quality of life questionnaires. A scoring system was applied to assess mobility on cine MR and videofluoroscopy leading to a score ranging from 9 to 17. Cine MRI of the swallowing in a midsagittal plane visualized the tumor (if located in the same plane), important anatomic structures and surgical reconstructions. Posttreatment mobility on cine MRI and videofluoroscopy was significantly diminished compared to pretreatment, mean pretreatment cine MRI score was 10.8 and posttreatment 12.4 (p = 0.017). Impaired mobility on cine MRI was significantly correlated to more swallowing problems (Spearman's correlation coefficient 0.73, p = 0.04), on videofluoroscopy not. Cine MRI is a promising new technique as an adjunct to standard examinations for evaluation of swallowing in patients with oral and oropharyngeal cancer. Cine MRI directly visualizes the dynamics of swallowing and allows evaluation of pre- and posttreatment differences. Abnormal findings are significantly correlated with subjective swallowing complaints of patients.

  3. A model experiment to study swallowing of spherical and elongated particles

    Science.gov (United States)

    Marconati, Marco; Raut, Sharvari; Charkhi, Farshad; Burbidge, Adam; Engmann, Jan; Ramaioli, Marco

    2017-06-01

    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.

  4. Intensive swallowing and orofacial contracture rehabilitation after severe burn: A pilot study and literature review.

    Science.gov (United States)

    Clayton, Nicola A; Ward, Elizabeth C; Maitz, Peter K

    2017-02-01

    Dysphagia following severe burns can be significant and protracted, yet there is little evidence describing the rehabilitation principles, process or outcomes. Outline current evidence and detail the clinical outcomes of two cases who underwent a multifaceted intensive treatment programme aimed at rehabilitating dysphagia by strengthening swallow function and minimising orofacial contractures after severe head and neck burns. Two men (54 and 18 years) with full-thickness head and neck burns and inhalation injury underwent intensive orofacial scar management and dysphagia rehabilitation. Therapy was prescribed, consisting of scar stretching, splinting and pharyngeal swallow tasks. Horizontal and vertical range of movement (HROM; VROM), physiological swallow features, functional swallowing outcomes and related distress, were collected at baseline and routinely until dysphagia resolution and scar stabilisation. At presentation, both cases demonstrated severely reduced HROM and VROM, profound dysphagia and moderate dysphagia related distress. Therapy adherence was high. Resolution of dysphagia to full oral diet, nil physiological swallowing impairment, and nil dysphagia related distress was achieved by 222 and 77 days post injury respectively. VROM and HROM achieved normal range by 237 and 204 days. Active rehabilitation achieved full functional outcomes for swallowing and orofacial range of movement. A protracted duration of therapy can be anticipated in this complex population. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  5. Development of a Portable Non-Invasive Swallowing and Respiration Assessment Device

    Directory of Open Access Journals (Sweden)

    Wann-Yun Shieh

    2015-05-01

    Full Text Available Dysphagia is a condition that happens when a person cannot smoothly swallow food from the mouth to the stomach. It causes malnourishment in patients, or can even cause death due to aspiration pneumonia. Recently, more and more researchers have focused their attention on the importance of swallowing and respiration coordination, and the use of non-invasive assessment systems has become a hot research trend. In this study, we aimed to integrate the timing and pattern monitoring of respiration and swallowing by using a portable and non-invasive approach which can be applied at the bedside in hospitals or institutions, or in a home environment. In this approach, we use a force sensing resistor (FSR to detect the motions of the thyroid cartilage in the pharyngeal phase. We also use the surface electromyography (sEMG to detect the contraction of the submental muscle in the oral phase, and a nasal cannula to detect nasal airflow for respiration monitoring during the swallowing process. All signals are received and processed for swallowing event recognition. A total of 19 volunteers participated in the testing and over 57 measurements were made. The results show that the proposed approach can effectively distinguish the swallowing function in people of different ages and genders.

  6. Swallowing outcomes following surgical and non-surgical treatment for advanced laryngeal cancer.

    Science.gov (United States)

    Burnip, E; Owen, S J; Barker, S; Patterson, J M

    2013-11-01

    Treatment for advanced laryngeal cancer includes surgery, and/or chemoradiotherapy or radiotherapy. Each of these treatments results in major changes to the swallowing mechanism. Dysphagia is strongly correlated with poorer quality of life. A good understanding of outcomes is needed for well-informed treatment decisions. This study reports on patients' swallowing outcomes following surgical and non-surgical treatments based on the results of three different swallowing tests. A total of 123 data sets were collected in out-patient clinics across two hospitals in North East England. There were no significant differences between treatment groups for patient-reported swallowing outcomes or swallowing performance. However, patients who had undergone chemoradiotherapy or radiotherapy (with or without laryngectomy) had significantly more diet restrictions than other groups. Long-term dysphagia is a common outcome of treatment for advanced laryngeal cancer. Patients treated with chemoradiotherapy and laryngectomy reported the worst overall outcomes. More longitudinal prospective research with large treatment groups is needed to investigate swallowing outcomes following different treatment methods.

  7. Swallowing function outcomes following nonsurgical therapy for advanced-stage laryngeal carcinoma.

    Science.gov (United States)

    Dworkin, James Paul; Hill, Samuel L; Stachler, Robert J; Meleca, Robert J; Kewson, Danny

    2006-01-01

    The purposes of this study were to (1) evaluate swallowing function using both subjective and objective measures in patients treated nonsurgically for stages III and IV laryngeal squamous cell carcinoma, (2) assess the effect of time from treatment completion on swallowing function, and (3) assess sequelae associated with modality of treatment. To achieve these objectives, a retrospective study of 14 patients was conducted. Fiberoptic endoscopic evaluation of swallowing (FEES) was performed and evaluated by three independent judges for seven functional criteria: standing secretions, valleculae spillage, valleculae residue, postcricoid residue, laryngeal penetration, aspiration, and cough. Patient interviews were performed to establish patient perception of swallowing and his/her current posttreatment diet. Results revealed that each patient exhibited swallowing abnormalities in at least one of the seven objective functional categories studied. Ten patients suffered from variable degrees of dysphagia, ranging from mild to severe, on all measures. No significant differences were noted between those patients with less than or greater than 12 months posttreatment. Common treatment sequelae included PEG tube placement for nutritional supplementation, tracheostomy placement for airway security and/or pulmonary toilet, repeated episodes of aspiration pneumonia requiring hospital admission, and radiation-induced oropharyngeal stricture. Further studies using subjective and objective swallowing function measures for patients treated with alternative chemoradiation regimens versus surgery (with or without adjuvant therapies) for advanced stage laryngeal cancer are needed.

  8. A model experiment to study swallowing of spherical and elongated particles

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    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.

  9. Swallowing Disorders after Oral Cavity and Pharyngolaryngeal Surgery and Role of Imaging

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    Caterina Giannitto

    2017-01-01

    Full Text Available Head and neck squamous cell carcinoma is the sixth most common cancer diagnosed worldwide and the eighth most common cause of cancer death. Malignant tumors of the oral cavity, oropharynx, and larynx can be treated by surgical resection or radiotheraphy with or without chemotheraphy and have a profound impact on quality of life functions, including swallowing. When surgery is the chosen treatment modality, the patient may experience swallowing impairment in the oral and pharyngeal phases of deglutition. A videofluoroscopic study of swallow enables the morphodynamics of the pharyngeal-esophageal tract to be accurately examined in patients with prior surgery. These features allow an accurate tracking of the various phases of swallowing in real time, identifying the presence of functional disorders and of complications during the short- and long-term postoperative recovery. The role of imaging is fundamental for the therapist to plan rehabilitation. In this paper, the authors aim to describe the videofluoroscopic study of swallow protocol and related swallowing impairment findings in consideration of different types of surgery.

  10. Viscosity threshold that allows safe swallow in elderly with post-stroke dysphagia

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    Rodolfo Peña

    2017-08-01

    Full Text Available Objective: To determine the viscosity threshold that allows safe swallowing in older adults with post-stroke dysphagia. Method: Cross-sectional analytical study. 6 patients over 60 years old with dysphagia participated. Were given six viscosities (50mPa s, 110mPa s, 170mPa s, 230mPa s, 290mPa s and 350mPa s made from no carbonated water and a corn starch-based thickener. Swallowing safety signs (wet voice, cough and oxygen saturation were assessed in each viscosity by Fiberoptic Endoscopic Evaluation of Swallowing (FEES. Viscosities’ performances in swallowing safety signs were compared in order to know which viscosity would be the safest. Results: 100% of swallowing safety signs did not appear in any viscosity assessed. Conclusions: It is not possible to determine the viscosity threshold that allows safe swallowing in patients with post-stroke dysphagia in the viscosities assessed. We discuss about multiple factors that had had affect our results: size sample, use of FEES to assess low viscosities, and viscosities’ intervals used.

  11. Efficacy of EMG/bioimpedance-triggered functional electrical stimulation on swallowing performance

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    Corinna Schultheiss

    2016-08-01

    Full Text Available In order to support swallowing, the efficacy of functional electrical stimulation for different stimulation settings of the submental musculature has been investigated. The stimulation was administrated at rest and synchronously to voluntary initiated swallows. The onset of a swallow was detected in real-time by a combined electromyography/ bioimpedance measurement at the neck in order to trigger the stimulation. The amplitude and speed of larynx elevation caused by the FES has been assessed by the observed change in bioimpedance whereas a reduction of bioimpedance corresponds to an increase in larynx elevation. Study results from 40 healthy subjects revealed that 73% of the subjects achieved a larger and faster larynx elevation during swallowing with triggered FES and therefor a better protection of their airways. However, we also observed a decrease in larynx elevation compared to normal swallowing in 11 out of the 40 subjects what might not benefit from such a treatment. The largest improvement of larynx elevation and speed during swallowing could be achieved with three stimulation channels formed by four electrodes in the submental region.

  12. 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.

  13. Taste and Temperature in Swallowing Transit Time after Stroke

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    Paula C. Cola

    2012-09-01

    Full Text Available Background: Oropharyngeal dysphagia is common in individuals after stroke. Taste and temperature are used in dysphagia rehabilitation. The influence of stimuli, such as taste and temperature, on swallowing biomechanics has been investigated in both healthy individuals and in individuals with neurological disease. However, some questions still remain unanswered, such as how the sequence of offered stimuli influences the pharyngeal response. The goal of the present study was to determine the influence of the sequence of stimuli, sour taste and cold temperature, on pharyngeal transit time during deglutition in individuals after stroke. Methods: The study included 60 individuals with unilateral ischemic stroke, 29 males and 31 females, aged 41–88 years (mean age: 66.2 years examined 0–50 days after ictus (median: 6 days, with mild to moderate oropharyngeal dysphagia. Exclusion criteria were hemorrhagic stroke patients, patients with decreased level of consciousness, and clinically unstable patients, as confirmed by medical evaluation. The individuals were divided into two groups of 30 individuals each. Group 1 received a nonrandomized sequence of stimuli (i.e. natural, cold, sour, and sour-cold and group 2 received a randomized sequence of stimuli. A videofluoroscopic swallowing study was performed to analyze the pharyngeal transit time. Four different stimuli (natural, cold, sour, and sour-cold were offered. The images were digitalized and specific software was used to measure the pharyngeal transit time. Since the values did not present regular distribution and uniform variances, nonparametric tests were performed. Results: Individuals in group 1 presented a significantly shorter pharyngeal transit time with the sour-cold stimulus than with the other stimuli. Individuals in group 2 did not show a significant difference in pharyngeal transit time between stimuli. Conclusions: The results showed that the sequence of offered stimuli influences

  14. Regaining water swallowing function in the rehabilitation of critically ill patients with intensive-care-unit acquired muscle weakness.

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    Thomas, Simone; Sauter, Wolfgang; Starrost, Ulrike; Pohl, Marcus; Mehrholz, Jan

    2017-03-21

    Treatment in intensive care units (ICUs) often results in swallowing dysfunction. Recent longitudinal studies have described the recovery of critically ill people, but we are not aware of studies of the recovery of swallowing function in patients with ICU-acquired muscle weakness. This paper aims to describe the time course of regaining water swallowing function in patients with ICU-acquired weakness in the post-acute phase and to describe the risks of regaining water swallowing function and the risk factors involved. This cohort study included patients with ICU-acquired muscle weakness in our post-acute department, who were unable to swallow. We monitored the process of regaining water swallowing function using the 3-ounce water swallowing test. We included 108 patients with ICU-acquired muscle weakness. Water swallowing function was regained after a median of 12 days (interquartile range =17) from inclusion in the study and after a median of 59 days (interquartile range= 36) from the onset of the primary illness. Our multivariate Cox Proportional Hazard model yielded two main risk factors for regaining water swallowing function: the number of medical tubes such as catheters at admission to the post-acute department (adjusted hazard ratio [HR] = 1.282; 95% confidence interval [CI]: 1.099-1.495) and the time until weaning from the respirator in days (adjusted HR =1.02 per day; 95%CI: 0.998 to 1.008). We describe a time course for regaining water swallowing function based on daily tests in the post-acute phase of critically ill patients. Risk factors associated with regaining water swallowing function in rehabilitation are the number of medical tubes and the duration of weaning from the respirator. Implications for rehabilitation Little guidance is available for the management of swallowing dysfunction in the rehabilitation of critically ill patients with intensive-care-units acquired muscle weakness. There is a time dependent pattern of recovery from

  15. Swallowing and respiratory distress in hospitalized patients with bronchiolitis.

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    Maffey, Alberto; Moviglia, Teresita; Mirabello, Catalina; Blumenthal, Lidia; Gentile, Luis; Niremberg, Mabel; Gilligan, Guillermo; Teper, Alejandro

    2013-12-01

    The aim of this study was to evaluate the risk of airway and/or pulmonary food or saliva aspiration in infants with moderate respiratory distress who are hospitalized with respiratory syncytial virus (RSV) bronchiolitis. This prospective, descriptive study was conducted during two epidemic RSV seasons at the Ricardo Gutiérrez Children's Hospital in Buenos Aires, Argentina. Included were otherwise healthy infants in their first wheezing episode with a modified Tal clinical score between 5 and 9. Swallowing was evaluated using a dynamic technetium-99 m colloid radionuclide salivagram using a gamma camera, followed by video fluoroscopy using nonionic and ionic contrast material. Fifteen patients (7 boys) were included. Age at evaluation (mean ± SD) was 4.3 ± 1.5 months; clinical score was 7.5 ± 1.4. Patients required (mean ± SD) supplemental oxygen and hospitalization 7.5 ± 3.7 and 8.8 ± 4.3 days, respectively. All technetium-99 m salivagram (10/10, as the gamma camera equipment was out of service during part of the study) and video fluoroscopy (15/15) studies were normal. No episodes of aspiration or laryngeal penetration were detected in any patient. Our study found that infants hospitalized with moderate respiratory distress due to RSV bronchiolitis did not show aspiration.

  16. Severe breathing and swallowing difficulties during routine restorative dentistry.

    Science.gov (United States)

    Lococo, Filippo; Trabucco, Laura; Leuzzi, Giovanni; Salvo, Fulvio; Paci, Massimiliano; Sgarbi, Giorgio; Ferrari, Anna Maria

    2015-04-30

    Although sporadically reported after dental examination, subcutaneous emphysema may be erroneously confused with an allergic, or anaphylactic, reaction. We herein report a case of a 57-year-old Caucasian woman who came to our attention after restorative treatment for a carious mandibular right second primary molar. During dental examination, an air driven hand-piece was used to restore occlusal caries. Suddenly, swallowing and breathing difficulties and a facial swelling involving the neck and, partially, the face occurred. She was urgently transported to the Emergency Department with the suspicious of allergic reaction. Clinical examination revealed palpable crepitus at the level of the head, neck and pre-sternal region but no inflammation, trismus or fluid collection was detected. A Chest X-ray first and a computed tomography scan later showed air in the deeper regions from the peri-mandibular and retro-mandibular spaces to the sub-maxillary and latero-cervical area along the vascular sulcus and retropharyngeal space descending into the mediastinal space. So, the patient was admitted for respiratory monitoring and started intravenous administration of largespectrum antibiotics and analgesics. Her hospital course was unremarkable and 5 days later she was discharged after regression of symptoms and complete radiological resolution. Three months after discharge, the patient was clinically free of recurrence. Dental care, Pneumomediastinum, Restorative dentistry.

  17. [Functional endoscopic evaluation of swallowing in infants with deglutition disorders].

    Science.gov (United States)

    Partida-Justo, I; Israel Grijalva-Otero, J E; Ramírez-Figueroa, J L; Sepúlveda-Vildosola, A C; Zurita-Cruz, J N

    2017-10-25

    Functional endoscopic evaluation of swallowing (FEES) is a recognized method for Deglutition Disorders (DD) in adults, with anecdotal experience in children, obtaining not conclusive results. To compare the accuracy of test FEES in infants with high suspicion of altered DD seen in a third level hospital with the gold standard Videofluoroscopic (VF). The results and findings by FEES and VF of 66 children with clinical diagnosis of DD were compared. An estimate of the sensitivity and specificity of FEES was performed. As well as calculating positive predictive value (PPV), negative predictive value (NPV) and likelihood ratios. 60 patients enrolled, 4 and FEES showed high sensitivity to identify the presence of aspiration and penetration (9 98%) and high specificity for the arrest of spillage and waste (94% and 95%). Gastroesophageal reflux to make the diagnosis of DD with FEES had a sensitivity of 80% and specificity of 84%. Spill and penetration had the highest agreement with respect to the gold standard of 0.81. FEES in infants diagnosed with DD had a sensitivity of 80.8% and specificity 85.3%. 0696 concordance regarding to the VFD in the diagnosis of DD, and to identify suction stroke had a kappa of 0815.

  18. Swallowing performance after radiation therapy for carcinoma of the esophagus

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    O' Rourke, I.C.; Tiver, K.; Bull, C.; Gebski, V.; Langlands, A.O.

    1988-05-15

    The purpose of the study reported in this article was to tabulate the incidence and etiologic factors of importance in the development of strictures after radiotherapy for carcinoma of the esophagus and to analyze the outcome of patients who develop such strictures. Eighty patients were treated with radiotherapy, 50 having radical and 30 having palliative treatment. Sixty-nine patients had squamous cell carcinoma, four had adenocarcinoma, one had sarcoma, one had mucoepidermoid carcinoma, and five had undifferentiated tumors. Forty percent developed no stricture, 30% had benign fibrotic stricture, and 28% developed malignant stricture. The etiologic factors analysed included age, pretreatment swallowing score, histology and length (size) of tumor; stage of disease, dose of radiotherapy, and use of chemotherapy. None of these factors were shown to be of etiologic importance. The survival of patients who developed benign strictures was found to be significantly longer (1-year survival 88%) than those who developed no stricture (50%) or malignant stricture (19%). Using a success score for palliation of dysphagia, it was found that the majority of patients (71%) who developed a benign stricture had a moderately successful outcome--they were able to tolerate a full or soft diet and required dilatation with a median duration between dilatations of 5 months. Patients who developed a malignant stricture were palliated poorly by dilatation alone, and most required esophageal intubation.

  19. The mechanics and behavior of cliff swallows during tandem flights.

    Science.gov (United States)

    Shelton, Ryan M; Jackson, Brandon E; Hedrick, Tyson L

    2014-08-01

    Cliff swallows (Petrochelidon pyrrhonota) are highly maneuverable social birds that often forage and fly in large open spaces. Here we used multi-camera videography to measure the three-dimensional kinematics of their natural flight maneuvers in the field. Specifically, we collected data on tandem flights, defined as two birds maneuvering together. These data permit us to evaluate several hypotheses on the high-speed maneuvering flight performance of birds. We found that high-speed turns are roll-based, but that the magnitude of the centripetal force created in typical maneuvers varied only slightly with flight speed, typically reaching a peak of ~2 body weights. Turning maneuvers typically involved active flapping rather than gliding. In tandem flights the following bird copied the flight path and wingbeat frequency (~12.3 Hz) of the lead bird while maintaining position slightly above the leader. The lead bird turned in a direction away from the lateral position of the following bird 65% of the time on average. Tandem flights vary widely in instantaneous speed (1.0 to 15.6 m s(-1)) and duration (0.72 to 4.71 s), and no single tracking strategy appeared to explain the course taken by the following bird. © 2014. Published by The Company of Biologists Ltd.

  20. Swallow-induced esophageal shortening in patients without hiatal hernia is associated with gastroesophageal reflux.

    Science.gov (United States)

    Masuda, T; Singhal, S; Akimoto, S; Bremner, R M; Mittal, S K

    2017-12-21

    Longitudinal esophageal body shortening with swallow-induced peristalsis has been reported in healthy individuals. Esophageal shortening is immediately followed by esophageal re-elongation, and the lower esophageal sphincter (LES) returns to the baseline position. High-resolution manometry (HRM) allows for objective assessment of extent of shortening and duration of shortening. In patients without hiatal hernia at rest, swallow-induced esophageal shortening can lead to transient hiatal hernia (tHH) which at times may persist after the completion of swallow. This manometric finding has not been investigated in the literature, but a question arises whether this swallow-induced transient herniation can effect on the likelihood of gastroesophageal reflux. This study aims to assess the relationship between gastroesophageal reflux and the subtypes of swallow-induced esophageal shortening, i.e. tHH and non-tHH, in patients without hiatal hernia at rest. After Institutional Review Board (IRB) approval, we queried a prospectively maintained database to identify patients who underwent HRM evaluation and 24-hour pH study between January to December 2015. Patients with type-I esophagogastric junction (EGJ) morphology (i.e. no hiatal hernia) according to the Chicago classification v3.0 were included. The patterns of the esophageal shortening with swallows were divided into two subtypes, i.e. tHH and non-tHH. tHH was defined as an EGJ double high-pressure zones (≥1 cm) at the second inspiration after the termination of swallow-induced esophageal body contraction. The number of episodes of tHH was counted per 10 swallows and tHH size was measured for each patient. In total, 41 patients with EGJ morphology Type-I met the inclusion criteria. The mean age was 47.2 years, 35 patients (85.4%) were women, and the mean body mass index was 33.9 kg/m2. The mean number of tHH episodes was 3 out of 10 swallows; mean maximal tHH size was 1.3 cm. Patients who had tHH in ≥3 out of 10

  1. 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

  2. Impact of proprioception during the oral phase on initiating the swallowing reflex.

    Science.gov (United States)

    Takeda, Hikaru; Saitoh, Kazuya

    2016-07-01

    We hypothesized that proprioceptive signals during the oral phase play a pivotal role in the initiation of pharyngeal phase during volitional swallowing. Therefore, we tested if swallowing could be modified by changing the amount of proprioceptive feedback from a number of different receptors while holding a food bolus in the mouth and clenching. Basic research. Surface electromyography (sEMG) recordings of the masticatory muscles were obtained during volitional swallowing movements from seven healthy adults with no clinical history of swallowing difficulties. The swallowing procedure involved holding 5 ml of jelly on the tongue before swallowing it completely, according to visual cues on a computer display. Initiation of the swallowing reflex was detected by an anterior shift of the thyroid cartilage using a laser displacement sensor and by submental sEMG signals. To vary the proprioceptive input, the participants were instructed to occlude their teeth at various intensities (weak, intermediate, and strong) while holding the 5-ml jelly bolus on the tongue. Rectified and integrated sEMG (iEMG) signals obtained from the submental area showed two upward deflections. Contractile forces of the masseter muscles showed significant negative values for Pearson correlation coefficient against time intervals from the onset of the second submental iEMG deflection to the onset of the anterior shift of the thyroid cartilage in six of the seven participants (average -0.534, standard deviation 0.176). Contractile forces of the masseter muscles during occlusion tended to correlate negatively with electromechanical delays on suprahyoid muscle contraction. NA Laryngoscope, 126:1595-1599, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  3. Effects of early intervention of swallowing therapy on recovery from dysphagia following stroke.

    Science.gov (United States)

    Bakhtiyari, Jalal; Sarraf, Payam; Nakhostin-Ansari, Noureddin; Tafakhori, Abbas; Logemann, Jeri; Faghihzadeh, Soghrat; Harirchian, Mohammad Hossein

    2015-07-06

    Dysphagia is common after stroke. The onset time of swallowing rehabilitation following stroke has an important role in the recovery of dysphagia and preventing of its complications, but it was either highly variable or was not stated in previous trials. The aim of this study was investigation effects of onset time of swallowing therapy on recovery from dysphagia following stroke. Sixty dysphagia patients due to stroke range of age 60-74 (67.1 ± 3.8), participated in this randomized clinical trial study. The patients allocated in Early, Medium and Late groups, on the base of initiation of swallowing therapy after the stroke. After basic clinical and video fluoroscopic swallowing study assessments, traditional swallowing therapy was initiated 3 times per week for 3 months. The outcome measures were North-Western dysphagia patient check sheet, functional oral intake scale, video fluoroscopy, and frequency of pneumonia. Statistical analysis was done by repeated measure ANOVA, Bonferroni and χ(2) tests. Three groups of patients in terms of demographic and clinical characteristics were similar in the pre-treatment P > 0.050. Onset time of swallowing therapy after stroke was effective on swallowing recovery on the main outcome variables. So that in first group patients, recovery was rather than other groups P < 0.050. Furthermore, the frequency of pneumonia in the early group was less than other groups and in the early group no patients experienced pneumonia P = 0.002. Our data suggested that early interventions for dysphagia in stroke have an important role in recovery from dysphagia and prevention of complications like aspiration pneumonia.

  4. Comparison of ease of swallowing of dietary supplement products for age-related eye disease.

    Science.gov (United States)

    Brotherman, Donald P; Bayraktaroglu, Tolgar O; Garofalo, Renee J

    2004-01-01

    To examine patients' perceptions on the relative importance of the physical characteristics and appearance of dietary supplements, and to evaluate two supplements with the same combination of vitamins and minerals used in the Age-Related Eye Disease Study (AREDS) with respect to ease of swallowing and other features in elderly patients. A single-site, single-visit, crossover design, subject-masked comparison of two dietary supplements (ICaps AREDS Formula--Alcon; Ocuvite PreserVision-Bausch & Lomb). Ophthalmology practice. 50 patients aged 50 years or older. Patients ranked the importance of eight physical characteristics of a vitamin tablet or capsule (ease of swallowing, size, shape, color, smell, coating, texture, and taste) irrespective of the test products used in the study and then took both test products randomly and were asked to indicate which product they preferred based on the same eight characteristics. Overall patient preference and preference for swallowing two tablets at once. The highest rated (most important) characteristic in a vitamin supplement was ease of swallowing, with a median score of 9.0 on a 0-10 visual analogue scale. The characteristic of least importance was tablet color, with the lowest median score of 1.0. Statistically significant differences were detected between the products with regard to preferences for ease of swallowing, swallowing two tablets at once, size, and coating (P preferred the ICaps AREDS formula to Ocuvite PreserVision with respect to these characteristics and overall preference (P preferences. Based on the results of this study, ease of swallowing is the most important characteristic of dietary supplement tablets for elderly patients, followed by taste, size, and smell. Significant differences in preference exist between the study products, which contain similar formulations but have different physical characteristics.

  5. Effects of coal fly ash on tree swallow reproduction in Watts Bar Reservoir, Tennessee.

    Science.gov (United States)

    Walls, Suzanne J; Meyer, Carolyn B; Iannuzzi, Jacqueline; Schlekat, Tamar H

    2015-01-01

    Coal-fly ash was released in unprecedented amounts (4.1 × 10(6) m(3) ) into the Emory River from the Tennessee Valley Authority Kingston Fossil Plant on Watts Bar Reservoir in Tennessee. Tree swallows were exposed to ash-related constituents at the ash release via their diet of emergent aquatic insects, whose larval forms can accumulate constituents from submerged river sediments. Reproduction of tree swallow colonies was assessed over a 2-year period by evaluating whether 1) ash constituent concentrations were elevated in egg, eggshell, and nestling tissues at colonies near ash-impacted river reaches compared to reference colonies, 2) production of fledglings per nesting female was significantly lower in ash-impacted colonies versus reference colonies, and 3) ash constituent concentrations or diet concentrations were correlated with nest productivity measures (clutch size, hatching success, and nestling survival, and fledglings produced per nest). Of the 26 ash constituents evaluated, 4 (Se, Sr, Cu, and Hg) were significantly elevated in tissues potentially from the ash, and 3 (Se, Sr, and Cu) in tissues or in swallow diet items were weakly correlated to at least one nest-productivity measure or egg weight. Tree swallow hatching success was significantly reduced by 12%, but fledgling production per nest was unaffected due to larger clutch sizes in the impacted than reference colonies. Bioconcentration from the ash to insects in the diet to tree swallow eggs appears to be low. Overall, adverse impacts of the ash on tree swallow reproduction were not observed, but monitoring is continuing to further ensure Se from the residual ash does not adversely affect tree swallow reproduction over time. Integr Environ Assess Manag 2015;11:56-66. © 2014 SETAC. © 2014 SETAC.

  6. 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.

  7. Interactions between fauna and environment in recent alluvial soils (Dunajec River, SE Poland)

    Science.gov (United States)

    Mikuś, Paweł; Uchman, Alfred

    2017-04-01

    Recent riverine system is a particular place for interactions between fauna and the deposited sediments containing young and old alluvial soils. It is characterized by large energy gradients in relatively short time, which forces special adaptations of burrowing animals recorded in bioturbation structures. Predators produce mainly shelter burrows (interpreted as domichnia), and saprofags, especially earthworms, produce locomotion and feeding structures (pascichnia). Such structures have been studied in non- or poorly vegetated, sandy or muddy Holocene alluvia in the lower reach of the Dunajec River flowing through the Carpathian Foredeep in SE Poland. The observed burrows are mostly produced by a variety of organisms, including the European mole (Talpa europaea), common earthworm (Lumbricus terrestris), ground beetles (Carabidae), solitary bees (Ammophila), red fox (Vulpes vulpes), European beaver (Castor fiber), shrews (Soricidae), European otter (Lutra lutra), several species of mice (Muridae), voles (Myodae, Microtae), and the swallow sand martin (Riparia riparia). Burrows of a few species of ground beetles have been subjected to more detailed studies. Fertile deposits of older (early to middle Holocene) terraces, formed with many long-term interruptions in sedimentation processes, have a well-developed soil levels, more vulnerable to burrowing than recently deposited sediments. The terraces contain layers of sands and muds, which primary sedimentary structures and layer boundaries are completely or partly disturbed by bioturbation. Organic-rich muds have been moved up and down and mixed with sand. Moreover, sediments have been leached into open burrows during floods or rainfalls. In the natural levee sediments, mostly fine to medium sands, are horizontally burrowed, foremost by earthworms (Lumbricidae). Vertical, long (over 2 m deep) burrows of larger earthworms cross cut the natural levee sediments and enter buried soils. They were formed during a long period

  8. 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

  9. On the Physiology of Normal Swallowing as Revealed by Magnetic Resonance Imaging in Real Time

    Directory of Open Access Journals (Sweden)

    Arno Olthoff

    2014-01-01

    Full Text Available The aim of this study was to assess the physiology of normal swallowing using recent advances in real-time magnetic resonance imaging (MRI. Therefore ten young healthy subjects underwent real-time MRI and flexible endoscopic evaluations of swallowing (FEES with thickened pineapple juice as oral contrast bolus. MRI movies were recorded in sagittal, coronal, and axial orientations during successive swallows at about 25 frames per second. Intermeasurement variation was analyzed and comparisons between real-time MRI and FEES were performed. Twelve distinct swallowing events could be quantified by real-time MRI (start time, end time, and duration. These included five valve functions: oro-velar opening, velo-pharyngeal closure, glottal closure, epiglottic retroflexion, and esophageal opening; three bolus transports: oro-velar transit, pharyngeal delay, pharyngeal transit; and four additional events: laryngeal ascent, laryngeal descent, vallecular, and piriform sinus filling and pharyngeal constriction. Repetitive measurements confirmed the general reliability of the MRI method with only two significant differences for the start times of the velo-pharyngeal closure (t(8=-2.4, P≤0.046 and laryngeal ascent (t(8=-2.6, P≤0.031. The duration of the velo-pharyngeal closure was significantly longer in real-time MRI compared to FEES (t(8=-3.3, P≤0.011. Real-time MRI emerges as a simple, robust, and reliable tool for obtaining comprehensive functional and anatomical information about the swallowing process.

  10. 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.

  11. Barium swallow study in routine clinical practice: a prospective study in patients with chronic cough.

    Science.gov (United States)

    Nin, Carlos Shuler; Marchiori, Edson; Irion, Klaus Loureiro; Paludo, Artur de Oliveira; Alves, Giordano Rafael Tronco; Hochhegger, Daniela Reis; Hochhegger, Bruno

    2013-01-01

    To assess the routine use of barium swallow study in patients with chronic cough. Between October of 2011 and March of 2012, 95 consecutive patients submitted to chest X-ray due to chronic cough (duration > 8 weeks) were included in the study. For study purposes, additional images were obtained immediately after the oral administration of 5 mL of a 5% barium sulfate suspension. Two radiologists systematically evaluated all of the images in order to identify any pathological changes. Fisher's exact test and the chi-square test for categorical data were used in the comparisons. The images taken immediately after barium swallow revealed significant pathological conditions that were potentially related to chronic cough in 12 (12.6%) of the 95 patients. These conditions, which included diaphragmatic hiatal hernia, esophageal neoplasm, achalasia, esophageal diverticulum, and abnormal esophageal dilatation, were not detected on the images taken without contrast. After appropriate treatment, the symptoms disappeared in 11 (91.6%) of the patients, whereas the treatment was ineffective in 1 (8.4%). We observed no complications related to barium swallow, such as contrast aspiration. Barium swallow improved the detection of significant radiographic findings related to chronic cough in 11.5% of patients. These initial findings suggest that the routine use of barium swallow can significantly increase the sensitivity of chest X-rays in the detection of chronic cough-related etiologies.

  12. Application of Kinesio Taping method for newborn swallowing difficultly: A case report and literature review.

    Science.gov (United States)

    Lin, Chien-Lin; Wu, Wei-Ting; Chang, Ke-Vin; Lin, Hong-Yi; Chou, Li-Wei

    2016-08-01

    Preterm infants are at an increased risk of sucking problems, swallowing difficulty, and poor nourishment. During the neonatal period, the neurobehavioral organization of a preterm baby is poor compared with that of appropriate gestational age infants. Kinesio Taping has been widely used for edema control, joint protection, and proprioception training. With the help of augmentation of the sensory input for muscle facilitation and inhibition through tapping, the coordination of the target muscle groups can be improved. Until now, no research is available on the use of Kinesio Taping for the swallowing difficulty of infant. We reported a preterm infant suffering from brain edema at birth and swallowing difficultly until 40 weeks. The swallowing reflex was delayed. Moreover, lip closure and rooting reflex combined with the dysfunction grade of jaw movement were poor. We performed KT methods on the baby under the theory of the direction of the tape for facilitate or inhibit the muscle. After the Kinesio Taping treatment, the sucking function was improved with good lip closure.One week later, the baby was discharged without the use of an oral gastric tube. Kinesio Taping contributed significantly to the improvement of impaired sucking and swallowing and could be implemented as a regular rehabilitative approach for infants suffering from these difficulties.

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

    Science.gov (United States)

    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.

  14. Barium swallow study in routine clinical practice: a prospective study in patients with chronic cough

    Directory of Open Access Journals (Sweden)

    Carlos Shuler Nin

    2013-12-01

    Full Text Available OBJECTIVE: To assess the routine use of barium swallow study in patients with chronic cough.METHODS: Between October of 2011 and March of 2012, 95 consecutive patients submitted to chest X-ray due to chronic cough (duration > 8 weeks were included in the study. For study purposes, additional images were obtained immediately after the oral administration of 5 mL of a 5% barium sulfate suspension. Two radiologists systematically evaluated all of the images in order to identify any pathological changes. Fisher's exact test and the chi-square test for categorical data were used in the comparisons.RESULTS: The images taken immediately after barium swallow revealed significant pathological conditions that were potentially related to chronic cough in 12 (12.6% of the 95 patients. These conditions, which included diaphragmatic hiatal hernia, esophageal neoplasm, achalasia, esophageal diverticulum, and abnormal esophageal dilatation, were not detected on the images taken without contrast. After appropriate treatment, the symptoms disappeared in 11 (91.6% of the patients, whereas the treatment was ineffective in 1 (8.4%. We observed no complications related to barium swallow, such as contrast aspiration.CONCLUSIONS: Barium swallow improved the detection of significant radiographic findings related to chronic cough in 11.5% of patients. These initial findings suggest that the routine use of barium swallow can significantly increase the sensitivity of chest X-rays in the detection of chronic cough-related etiologies.

  15. Impacts of palatal coverage on bolus formation during mastication and swallowing and subsequent adaptive changes.

    Science.gov (United States)

    Sato, T; Furuya, J; Tamada, Y; Kondo, H

    2013-10-01

    Palatal coverage is often required for elderly edentulous patients with complete dentures. The purpose of this study was to clarify impacts of palatal coverage on bolus formation and subsequent adaptive changes. Subjects were 18 healthy young dentulous adults who wore 1·5-mm-thick palatal plates. Subjects were asked to feed 12 g of bicoloured rice as usual, and the bolus formation by mastication and swallowing in the pharynx was observed using a nasal videoendoscopy. The bolus formation index (BFI), number of mastication strokes until swallowing, visual analogue scale about swallowing easiness and masticatory performance using colour-changeable gum were measured under three conditions: before placement of the palatal plate (day 0), immediately after placement (day 1) and after 7 days of wearing the plate (day 7). BFI and visual analogue scale on day 1 were significantly lower than those on day 0, but those on day 7 significantly recovered to the level of day 0. The number of mastication strokes did not change from day 0 to day 1, however, that on day 7 was significantly higher. Masticatory performance on days 1 and 7 was significantly lower than that on day 0. Although palatal coverage inhibits bolus formation during feeding, subjects increased the number of mastication strokes until swallowing threshold as they adapted to palatal coverage over time. This adaptive change was due to compensate for the lowered masticatory performance to achieve bolus formation for comfortable swallowing. © 2013 John Wiley & Sons Ltd.

  16. Swallowing rehabilitation of dysphagic tracheostomized patients under mechanical ventilation in intensive care units: a feasibility study.

    Science.gov (United States)

    Rodrigues, Katia Alonso; Machado, Flávia Ribeiro; Chiari, Brasília Maria; Rosseti, Heloísa Baccaro; Lorenzon, Paula; Gonçalves, Maria Inês Rebelo

    2015-01-01

    The aim of the present study was to assess the feasibility of the early implementation of a swallowing rehabilitation program in tracheostomized patients under mechanical ventilation with dysphagia. This prospective study was conducted in the intensive care units of a university hospital. We included hemodynamically stable patients under mechanical ventilation for at least 48 hours following 48 hours of tracheostomy and with an appropriate level of consciousness. The exclusion criteria were previous surgery in the oral cavity, pharynx, larynx and/or esophagus, the presence of degenerative diseases or a past history of oropharyngeal dysphagia. All patients were submitted to a swallowing rehabilitation program. An oropharyngeal structural score, a swallowing functional score and an otorhinolaryngological structural and functional score were determined before and after swallowing therapy. We included 14 patients. The mean duration of the rehabilitation program was 12.4 ± 9.4 days, with 5.0 ± 5.2 days under mechanical ventilation. Eleven patients could receive oral feeding while still in the intensive care unit after 4 (2 - 13) days of therapy. All scores significantly improved after therapy. In this small group of patients, we demonstrated that the early implementation of a swallowing rehabilitation program is feasible even in patients under mechanical ventilation.

  17. 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.

  18. Multisensor classification system for triggering FES in order to support voluntary swallowing

    Directory of Open Access Journals (Sweden)

    Benjamin Riebold

    2016-08-01

    Full Text Available In dysphagia the ability of elevating the larynx and hyoid is usually impaired. Electromyography (EMG and Bioimpedance (BI measurements at the neck can be used to trigger functional electrical stimulation (FES of swallowing related muscles. Nahrstaedt et al.1 introduced an algorithm to trigger the stimulation in phase with the voluntary swallowing to improve the airway closure and elevation speed of the larynx and hyoid. However, due to non-swallow related movements like speaking, chewing or head turning, stimulations might be unintentionally triggered. So far a switch was used to enable the BI/EMG-triggering of FES when the subject was ready to swallow, which is inconvenient for practical use. In this contribution, a range image camera system is introduced to obtain data of head, mouth, and jaw movements. This data is used to apply a second classification step to reduce the number of false stimulations. In experiments with healthy subjects, the amount of potential false stimulations could be reduced by 47% while 83% of swallowing intentions would have been correctely supported by FES.

  19. 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

  20. Longitudinal study on a rehabilitative model for correction of atypical swallowing.

    Science.gov (United States)

    Giuca, M R; Pasini, M; Pagano, A; Mummolo, S; Vanni, A

    2008-12-01

    The aim of the study is to analyse the prevalence of anomalous function of the orofacial muscles and their aetiological factors in a small sample of paediatric patients, to evaluate the correlation between anomalous functions of the orofacial muscles and malocclusions, and finally to verify the effects of a myofunctional protocol, composed of a series of exercises aimed at correcting the anomalous function and position of the tongue. The protocol that has been used in this research is a re-elaboration of the diagnostic and therapeutic methods set by two authors, Daniel Garliner and Aurelio Levrini. A group of 57 children (aged 5 to 13, mean age 8.2) with atypical swallowing diagnosis, has been treated for almost 3 years. Physiologic swallowing was achieved in 47% of the children treated. The results show the benefits of the myofunctional therapy in the treatment of children with abnormal swallowing.

  1. Anatomy and Physiology of Feeding and Swallowing – Normal and Abnormal

    Science.gov (United States)

    Matsuo, Koichiro; Palmer, Jeffrey B.

    2008-01-01

    SYNOPSIS Eating and swallowing are complex behaviors involving volitional and reflexive activities of more than 30 nerves and muscles. They have two crucial biological features: food passage from the oral cavity to stomach and airway protection. The swallowing process is commonly divided into oral, pharyngeal, and esophageal stages according to the location of the bolus. The movement of the food in the oral cavity and to the oropharynx differs between eating solid food and drinking liquid. Dysphagia can result from a wide variety of functional or structural deficits of the oral cavity, pharynx, larynx or esophagus. The goal of dysphagia rehabilitation is to identify and treat abnormalities of feeding and swallowing while maintaining safe and efficient alimentation and hydration. PMID:18940636

  2. Simulation of swallowing dysfunction and mechanical ventilation after a Montgomery T-tube insertion.

    Science.gov (United States)

    Trabelsi, O; Malvè, M; Mena Tobar, A; Doblaré, M

    2015-01-01

    The Montgomery T-tube is used as a combined tracheal stent and airway after laryngotracheoplasty, to keep the lumen open and prevent mucosal laceration from scarring. It is valuable in the management of upper and mid-tracheal lesions, while invaluable in long and multisegmental stenting lesions. Numerical simulations based on real-patient-tracheal geometry, experimental tissue characterization, and previous numerical estimation of the physiological swallowing force are performed to estimate the consequences of Montgomery T-tube implantation on swallowing and assisted ventilation: structural analysis of swallowing is performed to evaluate patient swallowing capacity, and computational fluid dynamics simulation is carried out to analyze related mechanical ventilation. With an inserted Montgomery T-tube, vertical displacement (Z-axis) reaches 8.01 mm, whereas in the Y-axis, it reaches 6.63 mm. The maximal principal stress obtained during swallowing was 1.6 MPa surrounding the hole and in the upper contact with the tracheal wall. Fluid flow simulation of the mechanical ventilation revealed positive pressure for both inhalation and exhalation, being higher for inspiration. The muscular deflections, considerable during normal breathing, are nonphysiological, and this aspect results in a constant overload of the tracheal muscle. During swallowing, the trachea ascends producing a nonhomogeneous elongation. This movement can be compromised when prosthesis is inserted, which explains the high incidence of glottis close inefficiency. Fluid simulations showed that nonphysiological pressure is established inside the trachea due to mechanical ventilation. This may lead to an overload of the tracheal muscle, explaining several related problems as muscle thinning or decrease in contractile function.

  3. Adapting human videofluoroscopic swallow study methods to detect and characterize dysphagia in murine disease models.

    Science.gov (United States)

    Lever, Teresa E; Braun, Sabrina M; Brooks, Ryan T; Harris, Rebecca A; Littrell, Loren L; Neff, Ryan M; Hinkel, Cameron J; Allen, Mitchell J; Ulsas, Mollie A

    2015-03-01

    This study adapted human videofluoroscopic swallowing study (VFSS) methods for use with murine disease models for the purpose of facilitating translational dysphagia research. Successful outcomes are dependent upon three critical components: test chambers that permit self-feeding while standing unrestrained in a confined space, recipes that mask the aversive taste/odor of commercially-available oral contrast agents, and a step-by-step test protocol that permits quantification of swallow physiology. Elimination of one or more of these components will have a detrimental impact on the study results. Moreover, the energy level capability of the fluoroscopy system will determine which swallow parameters can be investigated. Most research centers have high energy fluoroscopes designed for use with people and larger animals, which results in exceptionally poor image quality when testing mice and other small rodents. Despite this limitation, we have identified seven VFSS parameters that are consistently quantifiable in mice when using a high energy fluoroscope in combination with the new murine VFSS protocol. We recently obtained a low energy fluoroscopy system with exceptionally high imaging resolution and magnification capabilities that was designed for use with mice and other small rodents. Preliminary work using this new system, in combination with the new murine VFSS protocol, has identified 13 swallow parameters that are consistently quantifiable in mice, which is nearly double the number obtained using conventional (i.e., high energy) fluoroscopes. Identification of additional swallow parameters is expected as we optimize the capabilities of this new system. Results thus far demonstrate the utility of using a low energy fluoroscopy system to detect and quantify subtle changes in swallow physiology that may otherwise be overlooked when using high energy fluoroscopes to investigate murine disease models.

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

    Science.gov (United States)

    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 comprised of sensors, related hardware and software for multimodal 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 twenty one 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 5 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. PMID:18427161

  5. MRI of the Swallow Tail Sign: A Useful Marker in the Diagnosis of Lewy Body Dementia?

    Science.gov (United States)

    Shams, S; Fällmar, D; Schwarz, S; Wahlund, L-O; van Westen, D; Hansson, O; Larsson, E-M; Haller, S

    2017-09-01

    There are, to date, no MR imaging diagnostic markers for Lewy body dementia. Nigrosome 1, containing dopaminergic cells, in the substantia nigra pars compacta is hyperintense on SWI and has been called the swallow tail sign, disappearing with Parkinson disease. We aimed to study the swallow tail sign and its clinical applicability in Lewy body dementia and hypothesized that the sign would be likewise applicable in Lewy body dementia. This was a retrospective cross-sectional multicenter study including 97 patients (mean age, 65 ± 10 years; 46% women), consisting of the following: controls (n = 21) and those with Lewy body dementia (n = 19), Alzheimer disease (n = 20), frontotemporal lobe dementia (n = 20), and mild cognitive impairment (n = 17). All patients underwent brain MR imaging, with susceptibility-weighted imaging at 1.5T (n = 46) and 3T (n = 51). The swallow tail sign was assessed independently by 2 neuroradiologists. Interrater agreement was moderate (κ = 0.4) between raters. An abnormal swallow tail sign was most common in Lewy body dementia (63%; 95% CI, 41%-85%; P Lewy body dementia with an odds ratio of 9 (95% CI, 3-28; P Lewy body dementia showed a sensitivity of 63%, a specificity of 79%, a negative predictive value of 89%, and an accuracy of 76%; values were higher on 3T compared with 1.5T. The usefulness of the swallow tail sign was rater-dependent with the highest sensitivity equaling 100%. The swallow tail sign has diagnostic potential in Lewy body dementia and may be a complement in the diagnostic work-up of this condition. © 2017 by American Journal of Neuroradiology.

  6. Speech and swallowing following tongue cancer surgery and free flap reconstruction--a systematic review.

    Science.gov (United States)

    Lam, Lisetta; Samman, Nabil

    2013-06-01

    This was a systematic review of the current research on speech and swallowing outcomes and the factors affecting these outcomes after primary resection of tongue cancer and free flap reconstruction. A structured search in various electronic databases and relevant journals was performed. Retrieved articles were critically appraised in three rounds according to the level of evidence, the methodological quality, and the specific domain of speech and swallowing. A total of 21 articles were in the final review and the findings were categorized according to the area of tongue resection. For patients with resection and free flap reconstruction limited to either the oral tongue or the base of tongue (BOT), significant decline in speech and swallowing function was evident in the early postoperative phase, but the majority recovered close to preoperative level after 1 year. Poorer speech and swallowing outcomes were found following resections involving both oral and base of tongue (OBOT) regardless of the type of free flap reconstruction. Results overall were influenced by multiple factors including tumor size, area of resection, method of reconstruction and the use of adjuvant therapy. The use of free flaps in the immediate reconstruction of the tongue after tumor resection should aim at the maintenance of the mobility of the residual tongue and restoration of tongue bulk in order to optimize the recovery of speech and swallowing function. Future research in this field should employ standardized and reliable evaluation of speech and swallowing outcomes using multiple modalities in well-designed cohort studies with longer follow-up. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Hybrid fuzzy logic committee neural networks for recognition of swallow acceleration signals.

    Science.gov (United States)

    Das, A; Reddy, N P; Narayanan, J

    2001-02-01

    Biological signals are complex and often require intelligent systems for recognition of characteristic signals. In order to improve the reliability of the recognition or automated diagnostic systems, hybrid fuzzy logic committee neural networks were developed and the system was used for recognition of swallow acceleration signals from artifacts. Two sets of fuzzy logic-committee networks (FCN) each consisting of seven member networks were developed, trained and evaluated. The FCN-I was used to recognize dysphagic swallow from artifacts, and the second committee FCN-II was used to recognize normal swallow from artifacts. Several networks were trained and the best seven were recruited into each committee. Acceleration signals from the throat were bandpass filtered, and several parameters were extracted and fed to the fuzzy logic block of either FCN-I or FCN-II. The fuzzified membership values were fed to the committee of neural networks which provided the signal classification. A majority opinion of the member networks was used to arrive at the final decision. Evaluation results revealed that FCN correctly identified 16 out of 16 artifacts and 31 out of 33 dysphagic swallows. In two cases, the decision was ambiguous due to the lack of a majority opinion. FCN-II correctly identified 24 out of 24 normal swallows, and 28 out of 29 artifacts. In one case, the decision was ambiguous due to the lack of a majority opinion. The present hybrid intelligent system consisting of fuzzy logic and committee networks provides a reliable tool for recognition and classification of acceleration signals due to swallowing.

  8. A new subfascial approach in open thyroidectomy: efficacy for postoperative voice, sensory, and swallowing symptoms. A randomized controlled study.

    Science.gov (United States)

    Jung, Seung Pil; Kim, Sung Hoon; Bae, Soo Youn; Lee, Se Kyung; Kim, Sangmin; Choi, Min-Young; Kim, Jiyoung; Kim, Minkuk; Kil, Won Ho; Choe, Jun-Ho; Kim, Jung-Han; Nam, Seok Jin; Kim, Jee Soo

    2013-11-01

    After open thyroidectomy, patients usually complain of voice, sensory, and swallowing symptoms. We approached the thyroid via the subfascial method to reduce these symptoms and compared postthyroidectomy symptoms with the conventional subplatysmal method. Eighty-six patients undergoing thyroidectomy were recruited and randomized into either a conventional subplatysmal approach group (subplatysmal, 42 patients) group or a subanterior fascia of strap muscle approach group (subfascial, 44 patients). Voice symptoms were assessed using the Voice Handicap Index questionnaire and acoustic voice analysis. Sensory alterations were evaluated by the light touch and pain touch methods. Swallowing symptoms were assessed using the Swallowing Impairment Score (SIS) questionnaire, barium swallowing time, and hyoid bone movement range. Each variable was measured preoperatively, and at 2 weeks and 3 months after thyroidectomy. In both groups, the subjective symptoms of voice, sensation, and swallowing were significantly worsened at 2 weeks after operation, but improved 3 months after operation. Patients in the subplatysmal group had worse SIS scores than patients in the subfascial group (p = 0.016) and delayed barium swallowing time 2 weeks after operation (p = 0.008 compared to preoperative level). In the cohort over 50 years of age, SIS score did not recover to preoperative levels in the subplatysmal group 3 months after operation (p = 0.005 compared to preoperative level). The subfascial approach may be an effective method for reducing postthyroidectomy swallowing symptoms based on swallowing impairment score, especially in patients over 50 years of age.

  9. Changes in Swallowing after Anterior Cervical Discectomy and Fusion with Instrumentation: A Presurgical versus Postsurgical Videofluoroscopic Comparison

    Science.gov (United States)

    Muss, Lydia; Wilmskoetter, Janina; Richter, Kerstin; Fix, Constanze; Stanschus, Soenke; Pitzen, Tobias; Drumm, Joerg; Molfenter, Sonja

    2017-01-01

    Purpose: The purpose of this study was to explore the impact of anterior cervical discectomy and fusion (ACDF) with anterior instrumentation on swallowing function and physiology as measured on videofluoroscopic swallowing studies. Method: We retrospectively analyzed both functional measures (penetration-aspiration, residue) and…

  10. Nitric Oxide and Histamine Signal Attempts to Swallow: A Component of Learning that Food Is Inedible in "Aplysia"

    Science.gov (United States)

    Katzoff, Ayelet; Miller, Nimrod; Susswein, Abraham J.

    2010-01-01

    Memory that food is inedible in "Aplysia" arises from training requiring three contingent events. Nitric oxide (NO) and histamine are released by a neuron responding to one of these events, attempts to swallow food. Since NO release during training is necessary for subsequent memory and NO substitutes for attempts to swallow, it was suggested that…

  11. Sensory regulation of swallowing and airway protection: a role for the internal superior laryngeal nerve in humans

    Science.gov (United States)

    Jafari, Samah; Prince, Rebecca A; Kim, Daniel Y; Paydarfar, David

    2003-01-01

    During swallowing, the airway is protected from aspiration of ingested material by brief closure of the larynx and cessation of breathing. Mechanoreceptors innervated by the internal branch of the superior laryngeal nerve (ISLN) are activated by swallowing, and connect to central neurones that generate swallowing, laryngeal closure and respiratory rhythm. This study was designed to evaluate the hypothesis that the ISLN afferent signal is necessary for normal deglutition and airway protection in humans. In 21 healthy adults, we recorded submental electromyograms, videofluoroscopic images of the upper airway, oronasal airflow and respiratory inductance plethysmography. In six subjects we also recorded pressures in the hypopharynx and upper oesophagus. We analysed swallows that followed a brief infusion (4–5 ml) of liquid barium onto the tongue, or a sip (1–18 ml) from a cup. In 16 subjects, the ISLN was anaesthetised by transcutaneous injection of bupivacaine into the paraglottic compartment. Saline injections using the identical procedure were performed in six subjects. Endoscopy was used to evaluate upper airway anatomy, to confirm ISLN anaesthesia, and to visualise vocal cord movement and laryngeal closure. Comparisons of swallowing and breathing were made within subjects (anaesthetic or saline injection vs. control, i.e. no injection) and between subjects (anaesthetic injection vs. saline injection). In the non-anaesthetised condition (saline injection, 174 swallows in six subjects; no injection, 522 swallows in 20 subjects), laryngeal penetration during swallowing was rare (1.4 %) and tracheal aspiration was never observed. During ISLN anaesthesia (16 subjects, 396 swallows), all subjects experienced effortful swallowing and an illusory globus sensation in the throat, and 15 subjects exhibited penetration of fluid into the larynx during swallowing. The incidence of laryngeal penetration in the anaesthetised condition was 43 % (P deglutition, especially for

  12. Swallowing and speech function after intraoral soft tissue reconstruction with lateral upper arm free flap and radial forearm free flap.

    Science.gov (United States)

    Hara, I; Gellrich, N-C; Duker, J; Schön, R; Fakler, O; Smelzeisen, R; Honda, T; Satoru, O

    2003-06-01

    Swallowing, speech, and morbidity were assessed postoperatively in 25 patients, 18 of whom had had intraoral defects reconstructed by lateral upper arm free flaps (LUFF) and 7 by radial forearm free flaps (RFFF). Video fluoroscopy was used to assess swallowing, the Freiburger audiometric test to assess speech; and measurement of arm circumference to assess donor site morbidity. A questionnaire was used to evaluate swallowing, speech, and donor site morbidity subjectively. The degree of impairment in swallowing depended on the site of resection. Anterior and posterior resections affected swallowing more than lateral resections. Anterior resection and the use of LUFFs reduced intelligibility. There was no significant difference in impairment between LUFF and RFFF. We conclude that the LUFFs are superior to RFFFs because they can be closed primary and the incidence of donor site morbidity is slight.

  13. Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises.

    Science.gov (United States)

    Kraaijenga, Sophie A C; van der Molen, Lisette; Jacobi, Irene; Hamming-Vrieze, Olga; Hilgers, Frans J M; van den Brekel, Michiel W M

    2015-11-01

    Concurrent chemoradiotherapy (CCRT) for advanced head and neck cancer (HNC) is associated with substantial early and late side effects, most notably regarding swallowing function, but also regarding voice quality and quality of life (QoL). Despite increased awareness/knowledge on acute dysphagia in HNC survivors, long-term (i.e., beyond 5 years) prospectively collected data on objective and subjective treatment-induced functional outcomes (and their impact on QoL) still are scarce. The objective of this study was the assessment of long-term CCRT-induced results on swallowing function and voice quality in advanced HNC patients. The study was conducted as a randomized controlled trial on preventive swallowing rehabilitation (2006-2008) in a tertiary comprehensive HNC center with twenty-two disease-free and evaluable HNC patients as participants. Multidimensional assessment of functional sequels was performed with videofluoroscopy, mouth opening measurements, Functional Oral Intake Scale, acoustic voice parameters, and (study specific, SWAL-QoL, and VHI) questionnaires. Outcome measures at 6 years post-treatment were compared with results at baseline and at 2 years post-treatment. At a mean follow-up of 6.1 years most initial tumor-, and treatment-related problems remained similarly low to those observed after 2 years follow-up, except increased xerostomia (68%) and increased (mild) pain (32%). Acoustic voice analysis showed less voicedness, increased fundamental frequency, and more vocal effort for the tumors located below the hyoid bone (n = 12), without recovery to baseline values. Patients' subjective vocal function (VHI score) was good. Functional swallowing and voice problems at 6 years post-treatment are minimal in this patient cohort, originating from preventive and continued post-treatment rehabilitation programs.

  14. Relationship between swallow-specific quality of life and fiber-optic endoscopic evaluation of swallowing findings in patients with head and neck cancer.

    Science.gov (United States)

    Florie, Michelle; Baijens, Laura; Kremer, Bernd; Kross, Kenneth; Lacko, Martin; Verhees, Femke; Winkens, Bjorn

    2016-04-01

    The purpose of this study was to determine the relationship between swallow-specific quality of life (QOL) using the MD Anderson Dysphagia Inventory (MDADI) and the swallowing function using a standardized fiber-optic endoscopic evaluation of swallowing (FEES) protocol in patients with dysphagia with head and neck cancer. Sixty-three patients with dysphagia and head and neck cancer were enrolled in the study. Patients completed the MDADI questionnaire and underwent a standardized FEES examination. Ordinal FEES variables were measured. Descriptive statistics and 1-way analysis of variance tests were carried out. For all FEES variables, the observer agreement level was sufficient (kappa ≥0.7).These preliminary results show statistically significant mean differences of MDADI subscales between the ordinal scale levels for several FEES variables. The MDADI questionnaire can be used to assess the impact of dysphagia on the patients' health-related QOL. Despite clear trends, it remains unclear if the MDADI questionnaire can be used as an indicator for the severity of oropharyngeal dysphagia. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1848-E1856, 2016. © 2015 Wiley Periodicals, Inc.

  15. A Continent-Wide Migratory Divide in North American Breeding Barn Swallows (Hirundo rustica.

    Directory of Open Access Journals (Sweden)

    Keith A Hobson

    Full Text Available Populations of most North American aerial insectivores have undergone steep population declines over the past 40 years but the relative importance of factors operating on breeding, wintering, or stopover sites remains unknown. We used archival light-level geolocators to track the phenology, movements and winter locations of barn swallows (Hirdundo rustica; n = 27 from populations across North America to determine their migratory connectivity. We identified an east-west continental migratory divide for barn swallows with birds from western regions (Washington State, USA (n = 8 and Saskatchewan, Canada (n = 5 traveling shorter distances to wintering areas ranging from Oregon to northern Colombia than eastern populations (Ontario (n = 3 and New Brunswick (n = 10, Canada which wintered in South America south of the Amazon basin. A single swallow from a stable population in Alabama shared a similar migration route to eastern barn swallows but wintered farther north in northeast Brazil indicating a potential leap frog pattern migratory among eastern birds. Six of 9 (67% birds from the two eastern populations and Alabama underwent a loop migration west of fall migration routes including around the Gulf of Mexico travelling a mean of 2,224 km and 722 km longer on spring migration, respectively. Longer migration distances, including the requirement to cross the Caribbean Sea and Gulf of Mexico and subsequent shorter sedentary wintering periods, may exacerbate declines for populations breeding in northeastern North America.

  16. Variability of NTCP prediction of swallowing organs at risk, due to variation in delineation guidelines

    NARCIS (Netherlands)

    Gort, E.M.; Brouwer, C.L.; Lotz, H.T.; Steenbakkers, R.J.H.M.; Wopken, K.; Van Der Laan, H.P.; Langendijk, J.A.

    2012-01-01

    Purpose/Objective: In daily practice, several different delineation guidelines can be used for the delineation of organs at risk that are involved in swallowing (SWOARs). Based on these delineation guidelines, predictive models have been developed for the different aspects of post treatment

  17. Predictive modelling for swallowing dysfunction after primary (chemo)radiation : Results of a prospective observational study

    NARCIS (Netherlands)

    Christianen, Miranda E M C; Schilstra, Cornelis; Beetz, Ivo; Muijs, C.T.; Chouvalova, Olga; Burlage, Fred R.; Doornaert, P.; Koken, P.W.; Leemans, C.R.; Rinkel, R.N.; de Bruijn, M.J.; de Bock, G.H.; Roodenburg, J.L.; van der Laan, B.F.; Slotman, B.J.; Verdonck-de Leeuw, I.M.; Bijl, Hendrik P.; Langendijk, J.A.

    2012-01-01

    Background and purpose: The purpose of this large multicentre prospective cohort study was to identify which dose volume histogram parameters and pre-treatment factors are most important to predict physician-rated and patient-rated radiation-induced swallowing dysfunction (RISD) in order to develop

  18. Predictive modelling for swallowing dysfunction after primary (chemo)radiation: Results of a prospective observational study

    NARCIS (Netherlands)

    Christianen, M.E.M.C.; Schilstra, C.; Beetz, I.; Muijs, C.T.; Chouvalova, O.; Burlage, F.R.; Doornaert, P.A.H.; Koken, P.W.; Leemans, C.R.; Rinkel, R.N.P.M.; de Bruijn, M.J.; de Bock, G.H.; Roodenburg, J.L.N.; van Laan, B.F.A.M.; Slotman, B.J.; de Leeuw, I.M.; Bijl, H.P.; Langendijk, J.A.

    2012-01-01

    Background and purpose: The purpose of this large multicentre prospective cohort study was to identify which dose volume histogram parameters and pre-treatment factors are most important to predict physician-rated and patient-rated radiation-induced swallowing dysfunction (RISD) in order to develop

  19. Recent advances in laryngeal sensorimotor control for voice, speech and swallowing.

    Science.gov (United States)

    Ludlow, Christy L

    2004-06-01

    This article reviews advances in knowledge on laryngeal sensorimotor control affecting the assessment, understanding, and treatment of laryngeal motor control disorders in voice, speech, and swallowing. Three topics are covered: new knowledge on laryngeal innervation and central nervous system control from basic research studies, the role of laryngeal sensation in normal swallowing and dysphagia in patients, and new approaches to the restoration of laryngeal motor control after recurrent laryngeal nerve disorders. A significant advance this year was tracing the efferent pathways from the cortex to the brainstem in monkeys. This provided new information on subcortical and brainstem connections in the laryngeal efferent pathways. Laryngeal sensory feedback continued to receive attention, and the role of sensory feedback in the control of the pharyngeal phase of swallowing is now well established. Further developments in neuromotor monitoring of the recurrent laryngeal nerve during thyroidectomy were seen, and a large case series recommended that these techniques become standard practice for surgery for thyroid benign recurrence or malignancy. Finally, the first tissue engineering papers in the field of vocal fold tissue and nerve restoration were published this year, beginning an exciting new approach to restoration of laryngeal motor control. Considerable attention has been given to laryngeal muscle physiology, denervation, and sensation in neurolaryngology. Relatively limited understanding is available regarding the central nervous system integrative control of laryngeal function for speech, respiration, and swallowing.

  20. Swallowing sounds in speech therapy practice: a critical analysis of the literature.

    Science.gov (United States)

    Ferrucci, Juliana Lopes; Mangilli, Laura Davison; Sassi, Fernanda Chiarion; Limongi, Suelly Cecilia Olivan; Andrade, Claudia Regina Furquim de

    2013-12-01

    This study aimed to investigate international scientific papers published on the subject of cervical auscultation and its use in speech therapy. The study involved a qualitative review of the literature spanning the last 10 years. Articles were selected from the PubMed database using the following keywords: cervical auscultation, swallowing and swallowing disorders. Research was included that was conducted on adult humans (over 18 years of age) and was written in English. Each citation retrieved from the database was analyzed independently by each of the study researchers to ascertain its relevance for inclusion in the study. The methodology involved formulating the research question, locating and selecting studies and critically evaluating the articles according to the precepts of the Cochrane Handbook. As a result, 35 studies were identified; 13 articles were analyzed because they allowed access to the full text and were related directly to the subject. We found that the studies were performed with groups of healthy subjects and subjects with different types of base pathology. Some studies compared the patterns found in the different groups. Some of the research sought to study the pattern of swallowing sounds with different factors - evaluator experience, the specificity and sensitivity of the method and how to improve the technique of cervical auscultation through the use of instruments other than the stethoscope. The conclusion of this critical analysis is that cervical auscultation is an important tool to be used in conjunction with other assessment methods in the routine clinical evaluation of swallowing.

  1. Swallows Rugby Football Club, South Africa: The story of a century ...

    African Journals Online (AJOL)

    Swallows Rugby Football Club, South Africa: The story of a century, 1911-2011. ... Limited secondary sources pertinent to the topic were accessed and analysed for the purpose of cross-referencing the emerging \\facts. from the interviews and primary sources. Content analysis was administered on the collected data; ...

  2. Occurrence of communication and swallowing problems in neurological disorders: analysis of forty patients.

    Science.gov (United States)

    Jani, Mansi Pankaj; Gore, Geeta Bharat

    2014-01-01

    Communication and swallowing problems are common as a result of neurological conditions like stroke, traumatic brain injury, neoplasms of the nervous systems, viral encephalitis, diseases affecting neuromuscular junction and neuro degenerative conditions. The most frequently encountered problems are dysarthria, aphasia, dysphagia and apraxia of speech. Although these disorders are mentioned in literature, very few studies describing the occurrence in different neurological conditions are available in Indian context. Hence, a need was felt to carry out such a study. A heterogenous group of forty patients with neurological conditions were assessed for presence of speech, language and swallowing problems. A percent analysis was carried out to determine the occurrence of aphasia, dysarthria and dysphagia in general, in specific diseases and also to describe type of aphasia and dysarthria according to the characteristics presented. It was seen that the most frequently occurring disorder was dysarthria (60%), followed by dysphagia (55%) and aphasia (18%). It was also noted that dysarthria and dysphagia co-existed in around 45% patients with neurological diseases. It can be concluded that speech, language and swallowing problems are frequent in individuals with neurological conditions. Speech language pathologist plays an important role as a member of the rehabilitation team in a neurological setup with respect to identifying these problems and initiating intervention at the earliest. Hence, it is necessary for speech language pathologist to be well versed with the features each disorder may present with in terms of communication and swallowing.

  3. Surface Electromyography for Speech and Swallowing Systems: Measurement, Analysis, and Interpretation

    Science.gov (United States)

    Stepp, Cara E.

    2012-01-01

    Purpose: Applying surface electromyography (sEMG) to the study of voice, speech, and swallowing is becoming increasingly popular. An improved understanding of sEMG and building a consensus as to appropriate methodology will improve future research and clinical applications. Method: An updated review of the theory behind recording sEMG for the…

  4. Development of a system to monitor laryngeal movement during swallowing using a bend sensor.

    Directory of Open Access Journals (Sweden)

    Qiang Li

    Full Text Available BACKGROUND: Swallowing dysfunction (also known as dysphagia, which results in a deterioration of nutritional intake, slows rehabilitation and causes aspiration pneumonia, is very common following neurological impairments. Although videofluorographic (VF examination is widely used for detecting aspiration, an objective and non-invasive method for assessing swallowing function has yet to be established because of a lack of adequate devices and protocols. In this paper, a bend sensor whose resistance is altered by bending was introduced to monitor swallowing-related laryngeal movement. METHODS: Six healthy male volunteers were recruited in the present study. Specific time points on the signal waveform produced by the bend sensor were defined to describe laryngeal movement by differential analysis. Additionally, the physiological significance of the obtained waveform was confirmed by analyzing the sequential correlations between the signal waveform from the bend sensor and hyoid bone kinetics simultaneously recorded by VF. RESULTS: Seven time points were successfully defined on the signal waveform to reference laryngeal movement. Each time point was well correlated with certain VF events, with evidence of no significant time lags, and there were positive correlations between waveform time points and matched VF events. Furthermore, obvious similarities were noticed between the duration of each phase on the signal waveform and the duration of the matched hyoid bone activity. CONCLUSIONS: The present monitoring system using a bend sensor might be useful for observing the temporal aspects of laryngeal movement during swallowing, and it was well coordinated with hyoid bone movement.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Time budget of South African cliff swallows during breeding | Earlé ...

    African Journals Online (AJOL)

    The use of time by the South African cliff swallow was determined and use of energy calculated by using equations for predicting standard metabolic rate and the cost of flight. The highest daily energy expenditure was during the feeding of nestlings when 9,22 h were spent foraging. The cost of 127 kJ for building a nest is ...

  7. Swallowing and Dysphagia Rehabilitation: Translating Principles of Neural Plasticity into Clinically Oriented Evidence

    Science.gov (United States)

    Robbins, JoAnne; Butler, Susan G.; Daniels, Stephanie K.; Gross, Roxann Diez; Langmore, Susan; Lazarus, Cathy L.; Martin-Harris, Bonnie; McCabe, Daniel; Musson, Nan; Rosenbek, John

    2008-01-01

    Purpose: This review presents the state of swallowing rehabilitation science as it relates to evidence for neural plastic changes in the brain. The case is made for essential collaboration between clinical and basic scientists to expand the positive influences of dysphagia rehabilitation in synergy with growth in technology and knowledge. The…

  8. Barium versus Nonbarium Stimuli: Differences in Taste Intensity, Chemesthesis, and Swallowing Behavior in Healthy Adult Women

    Science.gov (United States)

    Nagy, Ahmed; Steele, Catriona M.; Pelletier, Cathy A.

    2014-01-01

    Purpose: The authors examined the impact of barium on the perceived taste intensity of 7 different liquid tastant stimuli and the modulatory effect that these differences in perceived taste intensity have on swallowing behaviors. Method: Participants were 80 healthy women, stratified by age group (60) and genetic taste status…

  9. [Cine-MRI contribution to assess swallowing mechanism and oro-pharyngeal dysphagia].

    Science.gov (United States)

    Fauvet, F; Charpiot, A; Schultz, P; Riehm, S; Vetter, D; Veillon, F; Hémar, P; Debry, C

    2008-01-01

    This study aimed at evaluating the performance of Cine-MRI to assess swallowing in patients previously treated for head and neck cancer. 10 healthy control subjects and a cohort of 10 patients with 8 partial glossectomies, 1 total laryngectomy and 1 glossolaryngectomy underwent imaging from October 2005 to February 2007. The MRI examinations were performed on a 1.5 Tesla system (Siemens Avanto), with True-Fisp sequences (TR = 170 ms, TE = 1 ms, slice thickness = 10 mm) at a rate of 8 pictures per second, during dry swallowing. Results are relevant for real-time spatial resolution from lips to larynx and dynamic motions analyses of tongue, velum, posterior pharyngeal wall and larynx during dry swallowing. Oro-pharyngo-laryngeal occlusion deficiency induces aspiration in case of partial glossectomy. Total laryngectomy modifies tongue, velum and pharynx landmarks. Cine-MRI i) provides functional insight from the oral cavity to the larynx, ii) gives accurate informations about impairments due to the pathology and its treatment, iii) completes others investigations like fiberoptic endoscopy or transit time, iiii) allows a precise analysis of the muscular movements involved in the deficient swallowing mechanism, in order to optimize rehabilitative strategies and results.

  10. Biomechanical events of swallowing are determined more by bolus consistency than by age or gender

    NARCIS (Netherlands)

    J. Hendriks; Bert de Swart; Alexander Geurts; L. van den Engel-Hoek; B. Gorissen; E. Esser; I. Groot

    2012-01-01

    The biomechanics of swallowing saliva and substances of different consistencies were investigated in healthy children and adults. To this end, the duration and mean amplitude value (MAV) of surface electromyography (sEMG) of the submental muscle group (SMG) activity, the maximum anterior tongue

  11. Expiratory muscle strength training improves swallowing and respiratory outcomes in people with dysphagia: a systematic review.

    Science.gov (United States)

    Brooks, Marinda; McLaughlin, Emma; Shields, Nora

    2017-11-01

    To investigate the effects of expiratory muscle strength training on communication and swallowing outcomes in adults with acquired motor based communication and/or swallowing difficulties of any aetiology. A systematic review was conducted. Six databases (CINAHL, MEDLINE, EMBASE, SPEECHBYTE, AMED and PUBMED) were searched from inception until end of May 2016. Randomised and non-randomised controlled studies and pre-test/post-test studies published in English that investigated the effects of expiratory muscle strength training were included. Study quality was assessed using the PEDro scale. Data were analysed descriptively and effect sizes and associated 95% confidence intervals were calculated. Seven articles reporting data from five studies were included. Preliminary data suggests expiratory muscle strength training improved airway safety during swallowing in people with dysphagia and increased the strength of the expiratory muscles in all patient groups. There was little evidence to suggest changes in communication outcomes after expiratory muscle strength training. Speech-language pathologists might consider using expiratory muscle strength training to improve airway safety in adults with swallowing disorders.

  12. Quantitative Lingual, Pharyngeal and Laryngeal Ultrasonography in Swallowing Research: A Technical Review

    Science.gov (United States)

    Chi-Fishman, Gloria

    2005-01-01

    Because of its distinct advantage in radiation-free soft tissue imaging, ultrasonography has been widely used to study lingual, pharyngeal, hyoid, laryngeal, and even esophageal action during swallowing in individuals of all ages. Qualitative ultrasonographic observations have made considerable contributions to our understanding of deglutition.…

  13. Neurorehabilitation strategies for poststroke oropharyngeal dysphagia: from compensation to the recovery of swallowing function.

    Science.gov (United States)

    Cabib, Christopher; Ortega, Omar; Kumru, Hatice; Palomeras, Ernest; Vilardell, Natalia; Alvarez-Berdugo, Daniel; Muriana, Desirée; Rofes, Laia; Terré, Rosa; Mearin, Fermín; Clavé, Pere

    2016-09-01

    Oropharyngeal dysphagia (OD) is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment. This review covers advances in the pathophysiology, diagnosis, and physiologically based neurorehabilitation strategies for poststroke OD. The pathophysiology of oropharyngeal biomechanics can be assessed by videofluoroscopy, as delayed laryngeal vestibule closure is closely associated with aspiration. Stroke may affect afferent or efferent neuronal circuits participating in deglutition. The integrity of oropharyngeal-cortical afferent pathways can be assessed by electroencephalography through sensory-evoked potentials by pharyngeal electrical stimulation, while corticopharyngeal efferent pathways can be characterized by electromyography through motor-evoked potentials by transcranial magnetic stimulation. Dysfunction in both cortico-mediated evoked responses is associated with delayed swallow response and aspiration. Studies have reported hemispherical asymmetry on motor control of swallowing and the relevance of impaired oropharyngeal sensitivity on aspiration. Advances in treatment include improvements in compensatory strategies but are mainly focused on (1) peripheral stimulation strategies and (2) central, noninvasive stimulation strategies with evidence of their clinical benefits. Characterization of poststroke OD is evolving from the assessment of impaired biomechanics to the sensorimotor integration processes involved in deglutition. Treatment is also changing from compensatory strategies to promoting brain plasticity, both to recover swallow function and to improve brain-related swallowing dysfunction. © 2016 New York Academy of Sciences.

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

    Science.gov (United States)

    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.

  15. Peer-Mediated Procedures to Induce Swallowing and Food Acceptance in Young Children.

    Science.gov (United States)

    Greer, R. Douglas; And Others

    1991-01-01

    A peer modeling procedure was shown to induce swallowing in a young child with dysphagia, and to increase food acceptance in a young child who consistently declined food. A peer-mediated procedure, consisting of rotated opportunities to consume food with a peer, increased consumption more than did modeling alone. (Author/JDD)

  16. Swallowing Mechanics Associated with Artificial Airways, Bolus Properties, and Penetration-Aspiration Status in Trauma Patients

    Science.gov (United States)

    Dietsch, Angela M.; Rowley, Christopher B.; Solomon, Nancy Pearl; Pearson, William G., Jr.

    2017-01-01

    Purpose: Artificial airway procedures such as intubation and Sare common in the treatment of traumatic injuries, and bolus modifications may be implemented to help manage swallowing disorders. This study assessed artificial airway status, bolus properties (volume and viscosity), and the occurrence of laryngeal penetration and/or aspiration in…

  17. Functional results of speech and swallowing after oral microvascular free flap reconstruction.

    Science.gov (United States)

    Archontaki, Maria; Athanasiou, Athanasios; Stavrianos, Spyros D; Korkolis, Dimitris P; Faratzis, Gregory; Papadopoulou, Flora; Kokkalis, Georgios; Rapidis, Alexander D

    2010-11-01

    To study speech and swallowing in patients who underwent microvascular free flap reconstruction after major surgery of the oral cavity. Twenty patients, 17 men and 3 women, with a mean age of 58.5 years (range 27-79 years) were included in the study. Squamous cell carcinoma was the most common malignancy. Swallowing assessment was performed through videofluoroscopy, using three consistencies of barium meal. The recorded swallows were assessed for the ability to hold the bolus during the oral phase, lip seal, tongue movement, residue in the floor of the mouth, laryngeal penetration and aspiration. Speech function regarding intelligibility and articulation was objectively assessed. Fifteen out of 20 patients (75%) had a good lip seal. Fourteen patients (73.6%) had adequate control of bolus, while in 89.4% the neotongue motility was satisfactory. Vallecular residue was noted in 25% of patients, laryngeal penetration in two (10%), while three patients (15%) continued to have significant aspiration, which necessitated continuous feeding through a gastrostomy. Postoperative speech intelligibility and articulation was satisfactory in 75 and 62.5% of the patients, respectively. Microvascular free flap reconstruction of major defects after oral resections rehabilitates the functions of swallowing and speech in acceptable levels, improving quality of life in these patients.

  18. Impact of Hypena opulenta on invasive swallow-worts (Vincetoxicum spp.) under different light environments

    Science.gov (United States)

    Pale and black swallow-wort (Vincetoxicum rossicum and V. nigrum; Apocynaceae, subfamily Asclepiadoideae) are European viny milkweeds that have become invasive in many habitats in the northeastern U.S.A. and southeastern Canada. A defoliating moth from the Ukraine, Hypena opulenta (Christoph) (Lepid...

  19. Towards biological control of swallow-worts: the good, the bad and the ugly

    Science.gov (United States)

    Native from Eurasia, the ugly swallow-worts (Vincetoxicum rossicum and V. nigrum - Apocynaceae) invaded forested landscapes and prevent native plant regeneration in eastern North America. We first aimed to understand where do the invasive populations of both species come from, then we evaluated the ...

  20. Impact of Abrostola asclepiadis and plant competition on invasive swallow-worts (Vincetoxicum spp.)

    Science.gov (United States)

    Pale and black swallow-wort (Vincetoxicum rossicum and V. nigrum; Apocynaceae, subfamily Asclepiadoideae) are perennial vines from Europe that have become invasive in various terrestrial habitats in the northeastern USA and southeastern Canada. A classical weed biological control program has been in...

  1. The Invasive Swallow-worts: What Do We Know About Their Biology and Management?

    Science.gov (United States)

    The swallow-worts [Vincetoxicum rossicum (Kleopow) Barbar. and V. nigrum (L.) Moench] are nonnative, perennial, herbaceous vines in the Apocynaceae that are invading natural areas in the northeastern U.S.A. and southeastern Canada. The species form dense monospecific stands across a wide range of mo...

  2. Instrumental and sensory quantification of oral coatings retained after swallowing semi-solid foods

    NARCIS (Netherlands)

    Prinz, J.F.; Huntjens, L.; Wijk, de R.A.

    2006-01-01

    After a mouthful of food has been swallowed, some food material is always retained in the mouth. With semi-solid foods this is in the form of a coating that adheres to the oral mucosa. The amount and location of this material may play an important role in food sensations. In this study two

  3. Swallowing performance in patients with head and neck cancer: a simple clinical test.

    Science.gov (United States)

    Patterson, Joanne M; McColl, Elaine; Carding, Paul N; Kelly, Charles; Wilson, Janet A

    2009-10-01

    Few simple clinical measures are available to monitor swallowing performance in head and neck cancer. Water swallow tests (WST) have been used as a part of clinical assessments in neurological dysphagia. The aim of this paper is to evaluate the utility of the 100 mL WST in head and neck cancer patients. The 100 mL WST was performed on 167 head and neck cancer patients. Measures were compared with respect to tumor site/stage, gender and age. The cohort was compared with published healthy controls. The test was quick to administer with excellent compliance. Patients had significantly poorer swallows than the published control group (mean reduction 1.6 mL/s). Function worsened with increased tumor stage and for patients with pharyngeal tumors. The 100 mL WST is an effective swallowing performance measure and is easily incorporated into a clinical examination. This paper provides benchmark data on the 100 mL WST for individuals with head and neck cancer.

  4. Effect of IQoro(R) training in hiatal hernia patients with misdirected swallowing and esophageal retention symptoms.

    Science.gov (United States)

    Hägg, Mary; Tibbling, Lita; Franzén, Thomas

    2015-07-01

    Misdirected swallowing can be triggered by esophageal retention and hiatal incompetence. The results show that oral IQoro(R) screen (IQS) training improves misdirected swallowing, hoarseness, cough, esophageal retention, and globus symptoms in patients with hiatal hernia. The present study investigated whether muscle training with an IQS influences symptoms of misdirected swallowing and esophageal retention in patients with hiatal hernia. A total of 28 adult patients with hiatal hernia suffering from misdirected swallowing and esophageal retention symptoms for more than 1 year before entry to the study were evaluated before and after training with an IQS. The patients had to fill out a questionnaire regarding symptoms of misdirected swallowing, hoarseness, cough, esophageal retention, and suprasternal globus, which were scored from 0-3, and a VAS on the ability to swallow food. The effect of IQS traction on diaphragmatic hiatus (DH) pressure was recorded in 12 patients with hiatal hernia using high resolution manometry (HRM). Upon entry into the study, misdirected swallowing, globus sensation, and esophageal retention symptoms were present in all 28 patients, hoarseness in 79%, and cough in 86%. Significant improvement was found for all symptoms after oral IQS training (p < 0.001). Traction with an IQS resulted in a 65 mmHg increase in the mean HRM pressure of the DH.

  5. Coordination of sucking, swallowing, and breathing and oxygen saturation during early infant breast-feeding and bottle-feeding.

    Science.gov (United States)

    Goldfield, Eugene C; Richardson, Michael J; Lee, Kimberly G; Margetts, Stacey

    2006-10-01

    This prospective study compared the coordination of sucking, swallowing, and breathing and its relationship to oxygen saturation in infants during breast-feeding and bottle-feeding. After 4 to 6 wk of exclusive breast-feeding, infants began bottle-feedings of expressed human milk using one of two systems: a soft-walled bottle and nipple (system 1, Playtex) or a hard-walled bottle and nipple (system 2, Avent). Infants' sucking, swallowing, breathing, and oxygenation were measured during breast-feeding and bottle-feeding, and coordination of these activities during breast-feeding and bottle-feeding were compared. During breast-feeding, swallowing occurred nonrandomly between breaths and did not interfere with breathing. The same distribution of swallowing occurred in infants fed with system 1, while swallowing occurred randomly in infants fed with system 2. Swallowing significantly increased during bottle-feeding among infants using system 2, but decreased among infants using system 1. Infants using system 2 also had a greater instability in the coordination of sucking, swallowing, and breathing and more perturbation of breathing. Oxygen saturation was significantly higher in infants fed with system 1 compared with system 2. These results suggest that the overall feeding pattern and oxygenation of system 1 are closer to the physiologic norm than system 2.

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

    Science.gov (United States)

    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

  7. Cortical processing of swallowing in ALS patients with progressive dysphagia--a magnetoencephalographic study.

    Directory of Open Access Journals (Sweden)

    Inga K Teismann

    Full Text Available Amyotrophic lateral sclerosis (ALS is a rare disease causing degeneration of the upper and lower motor neuron. Involvement of the bulbar motor neurons often results in fast progressive dysphagia. While cortical compensation of dysphagia has been previously shown in stroke patients, this topic has not been addressed in patients suffering from ALS. In the present study, we investigated cortical activation during deglutition in two groups of ALS patients with either moderate or severe dysphagia. Whole-head MEG was employed on fourteen patients with sporadic ALS using a self-paced swallowing paradigm. Data were analyzed by means of time-frequency analysis and synthetic aperture magnetometry (SAM. Group analysis of individual SAM data was performed using a permutation test. We found a reduction of cortical swallowing related activation in ALS patients compared to healthy controls. Additionally a disease-related shift of hemispheric lateralization was observed. While healthy subjects showed bilateral cortical activation, the right sensorimotor cortex was predominantly involved in ALS patients. Both effects were even stronger in the group of patients with severe dysphagia. Our results suggest that bilateral degeneration of the upper motor neuron in the primary motor areas also impairs further adjusted motor areas, which leads to a strong reduction of 'swallowing related' cortical activation. While both hemispheres are affected by the degeneration a relatively stronger activation is seen in the right hemisphere. This right hemispheric lateralization of volitional swallowing observed in this study may be the only sign of cortical plasticity in dysphagic ALS patients. It may demonstrate compensational mechanisms in the right hemisphere which is known to predominantly coordinate the pharyngeal phase of deglutition. These results add new aspects to our understanding of the pathophysiology of dysphagia in ALS patients and beyond. The compensational

  8. Cliff swallows Petrochelidon pyrrhonota as bioindicators of environmental mercury, Cache Creek Watershed, California

    Science.gov (United States)

    Hothem, Roger L.; Trejo, Bonnie S.; Bauer, Marissa L.; Crayon, John J.

    2008-01-01

    To evaluate mercury (Hg) and other element exposure in cliff swallows (Petrochelidon pyrrhonota), eggs were collected from 16 sites within the mining-impacted Cache Creek watershed, Colusa, Lake, and Yolo counties, California, USA, in 1997-1998. Nestlings were collected from seven sites in 1998. Geometric mean total Hg (THg) concentrations ranged from 0.013 to 0.208 ??g/g wet weight (ww) in cliff swallow eggs and from 0.047 to 0.347 ??g/g ww in nestlings. Mercury detected in eggs generally followed the spatial distribution of Hg in the watershed based on proximity to both anthropogenic and natural sources. Mean Hg concentrations in samples of eggs and nestlings collected from sites near Hg sources were up to five and seven times higher, respectively, than in samples from reference sites within the watershed. Concentrations of other detected elements, including aluminum, beryllium, boron, calcium, manganese, strontium, and vanadium, were more frequently elevated at sites near Hg sources. Overall, Hg concentrations in eggs from Cache Creek were lower than those reported in eggs of tree swallows (Tachycineta bicolor) from highly contaminated locations in North America. Total Hg concentrations were lower in all Cache Creek egg samples than adverse effects levels established for other species. Total Hg concentrations in bullfrogs (Rana catesbeiana) and foothill yellow-legged frogs (Rana boylii) collected from 10 of the study sites were both positively correlated with THg concentrations in cliff swallow eggs. Our data suggest that cliff swallows are reliable bioindicators of environmental Hg. ?? Springer Science+Business Media, LLC 2007.

  9. Spatiotemporal Patterns in Nest Box Occupancy by Tree Swallows Across North America

    Directory of Open Access Journals (Sweden)

    Dave Shutler

    2012-06-01

    Full Text Available Data from the North American Breeding Bird Survey (BBS suggest that populations of aerial insectivorous birds are declining, particularly in northeastern regions of the continent, and particularly since the mid-1980s. Species that use nest boxes, such as Tree Swallows (Tachycineta bicolor, may provide researchers with large data sets that better reveal finer-scale geographical patterns in population trends. We analyzed trends in occupancy rates for ca. 40,000 Tree Swallow nest-box-years from 16 sites across North America. The earliest site has been studied intensively since 1969 and the latest site since 2004. Nest box occupancy rates declined significantly at five of six (83% sites east of -78° W longitude, whereas occupancy rates increased significantly at four of ten sites (40% west of -78° W longitude. Decreasing box occupancy trends from the northeast were broadly consistent with aspects of a previous analysis of BBS data for Tree Swallows, but our finding of instances of increases in other parts of the continent are novel. Several questions remain, particularly with respect to causes of these broad-scale geographic changes in population densities of Tree Swallows. The broad geographic patterns are consistent with a hypothesis of widespread changes in climate on wintering, migratory, or breeding areas that in turn may differentially affect populations of aerial insects, but other explanations are possible. It is also unclear whether these changes in occupancy rates reflect an increase or decrease in overall populations of Tree Swallows. Regardless, important conservation steps will be to unravel causes of changing populations of aerial insectivores in North America.

  10. Cortical Processing of Swallowing in ALS Patients with Progressive Dysphagia – A Magnetoencephalographic Study

    Science.gov (United States)

    Teismann, Inga K.; Warnecke, Tobias; Suntrup, Sonja; Steinsträter, Olaf; Kronenberg, Linda; Ringelstein, E. Bernd; Dengler, Reinhard; Petri, Susanne; Pantev, Christo; Dziewas, Rainer

    2011-01-01

    Amyotrophic lateral sclerosis (ALS) is a rare disease causing degeneration of the upper and lower motor neuron. Involvement of the bulbar motor neurons often results in fast progressive dysphagia. While cortical compensation of dysphagia has been previously shown in stroke patients, this topic has not been addressed in patients suffering from ALS. In the present study, we investigated cortical activation during deglutition in two groups of ALS patients with either moderate or severe dysphagia. Whole-head MEG was employed on fourteen patients with sporadic ALS using a self-paced swallowing paradigm. Data were analyzed by means of time-frequency analysis and synthetic aperture magnetometry (SAM). Group analysis of individual SAM data was performed using a permutation test. We found a reduction of cortical swallowing related activation in ALS patients compared to healthy controls. Additionally a disease-related shift of hemispheric lateralization was observed. While healthy subjects showed bilateral cortical activation, the right sensorimotor cortex was predominantly involved in ALS patients. Both effects were even stronger in the group of patients with severe dysphagia. Our results suggest that bilateral degeneration of the upper motor neuron in the primary motor areas also impairs further adjusted motor areas, which leads to a strong reduction of ‘swallowing related’ cortical activation. While both hemispheres are affected by the degeneration a relatively stronger activation is seen in the right hemisphere. This right hemispheric lateralization of volitional swallowing observed in this study may be the only sign of cortical plasticity in dysphagic ALS patients. It may demonstrate compensational mechanisms in the right hemisphere which is known to predominantly coordinate the pharyngeal phase of deglutition. These results add new aspects to our understanding of the pathophysiology of dysphagia in ALS patients and beyond. The compensational mechanisms observed

  11. Evaluation of Swallowing Functions in Patients with Sjögren's Syndrome.

    Science.gov (United States)

    Eyigör, Sibel; Sezgin, Baha; Karabulut, Gonca; Öztürk, Kerem; Göde, Sercan; Kirazlı, Tayfun

    2017-04-01

    Patients with Sjögren's syndrome (SS) manifest symptoms such as dry eyes, dry mouth, and dysphagia. This study aims to evaluate the swallowing functions of the patients with SS. 69 patients with SS (65 females, 4 males) and 40 healthy individuals (33 females, 7 males) were included as study and control groups, respectively. Mean ages were 52.86 and 48.25 years for study and control groups, respectively. Swallowing functions were evaluated by fiberoptic endoscopic evaluation of swallowing (FEES). All the patients underwent FEES and were given 3, 5, and 10 ml water, yogurt, and fish-shaped crackers twice, respectively. The presence of bolus control, residue, penetration, and aspiration were evaluated. Additionally, certain types of foods triggering the dysphagia, any difficulties in bolus control, need to clean the throat, sensation of having a lump in the throat, sensation of choking, and xerostomia were included in the questionnaire. The MD Anderson Dysphagia Inventory and the Beck Depression Inventory were administered to patients. Considering the presence of residue with yogurt and fish cracker, there was a significant difference between groups (P  0.05). Regarding the MD Anderson Dysphagia Inventory, the average scores were 48.18 ± 13.21 and 87.6 ± 10.67 for study and control groups, respectively, and a statistically significant difference was detected (P < 0.05). Regarding the Beck Depression Inventory, the average scores were 11.83 ± 9.37 and 8.03 ± 6.84 for study and control groups, respectively (P < 0.05). SS affected the swallowing functions significantly. The presence of residue with yogurt and cracker was the most obvious finding, whereas penetration/aspiration was not clinically significant. Swallowing dysfunction reduced the quality of life in patients with SS.

  12. Effects of Strengthening Exercises on Swallowing Musculature and Function in Senior Healthy Subjects: a Prospective Effectiveness and Feasibility Study.

    Science.gov (United States)

    Kraaijenga, S A C; van der Molen, L; Stuiver, M M; Teertstra, H J; Hilgers, F J M; van den Brekel, M W M

    2015-08-01

    Head and neck cancer (HNC) patients may develop dysphagia due to muscle atrophy and fibrosis following chemoradiotherapy. Strengthening of the swallowing muscles through therapeutic exercise is potentially effective for improving swallowing function. We hypothesize that a customized Swallow Exercise Aid (SEA), developed for isometric and isokinetic strengthening exercises (against resistance), can help to functionally strengthen the suprahyoid musculature, which in turn can improve swallowing function. An effectiveness/feasibility study was carried out with ten senior healthy volunteers, who performed exercises 3 times per day for 6 weeks. Exercises included chin tuck against resistance (CTAR), jaw opening against resistance (JOAR), and effortful swallow exercises with the SEA. Multidimensional assessment consisted of measurements of maximum chin tuck and jaw opening strength, maximum tongue strength/endurance, suprahyoid muscle volume, hyoid bone displacement, swallowing transport times, occurrence of laryngeal penetration/aspiration and/or contrast residue, maximum mouth opening, feasibility/compliance (questionnaires), and subjective swallowing complaints (SWAL-QOL). After 6-weeks exercise, mean chin tuck strength, jaw opening strength, anterior tongue strength, suprahyoid muscle volume, and maximum mouth opening significantly increased (p < .05). Feasibility and compliance (median 86 %, range 48-100 %) of the SEA exercises were good. This prospective effectiveness/feasibility study on the effects of CTAR/JOAR isometric and isokinetic strengthening exercises on swallowing musculature and function shows that senior healthy subjects are able to significantly increase swallowing muscle strength and volume after a 6-week training period. These positive results warrant further investigation of effectiveness and feasibility of these SEA exercises in HNC patients with dysphagia.

  13. Esophageal contractions, bolus transit and perception of transit after swallows of liquid and solid boluses in normal subjects

    Directory of Open Access Journals (Sweden)

    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.

  14. 'Pharyngocise': Randomized Controlled Trial of Preventative Exercises to Maintain Muscle Structure and Swallowing Function During Head-and-Neck Chemoradiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Carnaby-Mann, Giselle, E-mail: gmann@phhp.ufl.edu [Department of Behavioral Science and Community Health, University of Florida, Gainesville, FL (United States); Crary, Michael A. [Department of Speech Language and Hearing Sciences, University of Florida, Gainesville, FL (United States); Schmalfuss, Ilona [Department of Radiology, North Florida/South Georgia Veterans Health System, Gainesville, FL (Georgia); Amdur, Robert [Department of Radiation Oncology, University of Florida, Gainesville, FL (United States)

    2012-05-01

    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{sub 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.

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

    Directory of Open Access Journals (Sweden)

    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

  16. Late swallowing dysfunction and dysphagia after radiotherapy for pharynx cancer: frequency, intensity and correlation with dose and volume parameters

    DEFF Research Database (Denmark)

    Jensen, Kenneth; Lambertsen, Karin; Grau, Cai

    2007-01-01

    BACKGROUND AND PURPOSE: Dysphagia and swallowing problems are common in pharynx cancer patients treated with radiotherapy. Dysfunction of the upper aerodigestive tract may lead to reduced quality of life, malnutrition and aspiration pneumonia. The aim of the current study was to describe swallowing...... examined with EORTC quality of life questionnaires and functional endoscopic evaluation of swallowing. Organs at risk were delineated on planning CT scans, available for 25 patients. RESULTS: Eighty-three percent of patients had some degree of dysphagia. Reduced sensitivity was observed in 94%, residues...

  17. 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.

  18. Invasive alien plants and South African rivers: a proposed approach to the prioritisation of control operations

    CSIR Research Space (South Africa)

    Van Wilgen, BW

    2007-01-01

    Full Text Available es Blac k wattl e (Acaci a mearns ii D e Wild .) Riparia n zo n es o fper ennia l rivers ;upla nd s In cr ea se s to ta le v a po ra tio n a n d de cr ea se s st re a m flo w ; di sp la ce... s rip ar ia n v eg et at io n a n d de st ab ili se s riv er ba nk s V er y widesp rea d a n d abun dan t 43 2 Gre y po pla r( Pop ulu s cane scen s [Ai ton ]Sm. ) Riparia n zo n es o fper ennia...

  19. Grasshoppers, crickets (Orthoptera and earwigs (Dermaptera of Tovačov gravel pit (central Moravia, Czech Republic: New locality for several thermophilous species in anthropogenic secondary habitat

    Directory of Open Access Journals (Sweden)

    Trnka Filip

    2015-12-01

    Full Text Available Study of Orthoptera and earwigs was conducted in Tovačov gravel pit in 2014. We have recorded 18 species of Orthoptera and 3 species of earwigs. The most significant recorded species are Cepero’s ground-hopper (Tetrix ceperoi, pygmy mole cricket (Xya variegata, Italian tree cricket (Oecanthus pellucens and riparian earwig (Labidura riparia. Tovačov gravel pit poses the northernmost locality of T. ceperoi and X. variegata in the Czech Republic and the northernmost known locality in Moravia for O. pellucens. For the L. riparia, we present a founding from Tovačov together with another finding from Olomouc vicinity, which is currently the northernmost locality within Moravia. Our findings display recent spatial expansion of some thermophilous species. Moreover, we emphasize importance of (post-industrial areas as secondary habitats for specialised endangered species.

  20. Excessive anterior cervical muscle tone affects hyoid bone kinetics during swallowing in healthy individuals

    Directory of Open Access Journals (Sweden)

    Yamazaki Y

    2017-11-01

    Full Text Available Yasuhiro Yamazaki, Haruka Tohara, Koji Hara, Ayako Nakane, Yoko Wakasugi, Kohei Yamaguchi, Shunsuke Minakuchi Department of Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan Purpose: This study aimed to determine whether excessive neck muscle tone affects hyoid bone kinetics during swallowing using videofluorography (VF in an unnatural posture in healthy individuals. Subjects and methods: Subjects were 28 healthy adults (12 men, 16 women; mean age, 39.75±9.50 years without any history or present complaints of swallowing disorders. We first established the participant’s posture a reclining wheelchair that was adjusted to a 30-degree angle with the headrest (without excessive neck muscle tone or without headrest (with excessive neck muscle tone, used an electromyogram above the mylohyoid muscle to represent the suprahyoid muscles and above the sternohyoid muscle to represent the infrahyoid muscles to confirm neck muscle tone, and then conducted VF of swallowing measurements. Videofluorographic images were obtained when 5 mL of 50% (w/v barium sulfate was being swallowed, and hyoid bone coordinate (the resting position and the elevated position, extent of horizontal and vertical hyoid bone elevation, as well as duration and velocity of hyoid bone elevation were evaluated (x-axis and y-axis coordinates for the resting position of hyoid bone are referred to as Xr and Yr, respectively; those for the elevated hyoid bone position induced during swallowing are referred to as Xs and Ys, respectively. Results: In the resting position of the hyoid bone, the Yr coordinates in those with excessive neck muscle tone were significantly lower than in those without excessive neck muscle tone. Vertical hyoid bone elevation and hyoid bone elevation velocity were significantly higher with excessive neck muscle tone than without excessive neck muscle tone, whereas horizontal elevation showed no significant differences. Conclusion: Our findings

  1. Improving medication administration in nursing home residents with swallowing difficulties: sustainability of the effect of a multifaceted medication safety programme

    NARCIS (Netherlands)

    Stuijt, Clementine C. M.; Klopotowska, Joanna E.; Kluft-van Driel, Chantal; Le, Nhut; Binnekade, Jan; van der Kleij, Bea; van der Schors, Tjalling; van den Bemt, Patricia; Lie-A-Huen, Loraine

    2013-01-01

    Crushing solid oral dosage forms is an important risk factor for medication administration errors (MAEs) in patients with swallowing difficulties. Nursing home (NH) residents, especially those on psychogeriatric wards, have a high prevalence of such difficulties. Six different psychogeriatric wards

  2. The Mendelsohn Maneuver and its Effects on Swallowing: Kinematic Analysis in Three Dimensions Using Dynamic Area Detector CT.

    Science.gov (United States)

    Inamoto, Yoko; Saitoh, Eiichi; Ito, Yuriko; Kagaya, Hitoshi; Aoyagi, Yoichiro; Shibata, Seiko; Ota, Kikuo; Fujii, Naoko; Palmer, Jeffrey B

    2017-12-26

    This study investigated the effects of Mendelsohn maneuver with three-dimensional kinematic analysis. Nine female speech-language pathologists (nine females, mean ± SD 27.1 ± 3.5 years old) underwent 320-row area detector scan during swallows of 4-ml nectar-thick liquid using with no maneuvers (control) and with Mendelsohn maneuver (MM). Critical event timing (hyoid, soft palate, epiglottis, laryngeal vestibule, true vocal cords (TVC), UES), hyoid and laryngeal excursion, cross-sectional area of UES, and volume of pharyngeal cavity and bolus were measured and compared between two swallows. In MM, all the events were significantly prolonged with delayed termination time (p dysphagia. The changes in the timing and magnitude of hyoid displacements and prolonged closure of the pharynx during swallowing suggest the utility of MM for improving the safety and efficiency of swallowing in selected cases.

  3. Phytophthora Species in Rivers and Streams of the Southwestern United States.

    Science.gov (United States)

    Stamler, Rio A; Sanogo, Soumalia; Goldberg, Natalie P; Randall, Jennifer J

    2016-08-01

    Phytophthora species were isolated from rivers and streams in the southwestern United States by leaf baiting and identified by sequence analysis of internal transcribed spacer (ITS) ribosomal DNA (rDNA). The major waterways examined included the Rio Grande River, Gila River, Colorado River, and San Juan River. The most prevalent species identified in rivers and streams were Phytophthora lacustris and P. riparia, both members of Phytophthora ITS clade 6. P. gonapodyides, P. cinnamomi, and an uncharacterized Phytophthora species in clade 9 were also recovered. In addition, six isolates recovered from the Rio Grande River were shown to be hybrids of P. lacustris × P. riparia Pathogenicity assays using P. riparia and P. lacustris failed to produce any disease symptoms on commonly grown crops in the southwestern United States. Inoculation of Capsicum annuum with P. riparia was shown to inhibit disease symptom development when subsequently challenged with P. capsici, a pathogenic Phytophthora species. Many Phytophthora species are significant plant pathogens causing disease on a large variety of crops worldwide. Closer examinations of streams, rivers, and forest soils have also identified numerous Phytophthora species that do not appear to be phytopathogens and likely act as early saprophytes in aquatic and saturated environments. To date, the Phytophthora species composition in rivers and streams of the southwestern United States has not been evaluated. This article details a study to determine the identity and prevalence of Phytophthora species in rivers and streams located in New Mexico, Arizona, Colorado, Utah, and Texas. Isolated species were evaluated for pathogenicity on crop plants and for their potential to act as biological control agents. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  4. Arabidopsis CDS blastp result: AK243548 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK243548 J100079E11 At2g47780.1 68415.m05964 rubber elongation factor (REF) protein...-related similar to Small rubber particle protein (SRPP) (22 kDa rubber particle protein) (22 kDa RPP) (Late...x allergen Hev b 3) (27 kDa natural rubber allergen) (Swiss-Prot:O82803) [Hevea brasiliensis]; similar to Stress-related protein (Swiss-Prot:Q9SW70) [Vitis riparia] 5e-27 ...

  5. Dysphagia in lateral medullary infarction (Wallenberg's syndrome): an acute disconnection syndrome in premotor neurons related to swallowing activity?

    Science.gov (United States)

    Aydogdu, I; Ertekin, C; Tarlaci, S; Turman, B; Kiylioglu, N; Secil, Y

    2001-09-01

    We have investigated the pathophysiological mechanisms of dysphagia in Wallenberg's syndrome (WS) that are due to lateral medullary infarction (LMI). Twenty patients with WS were evaluated by means of clinical and electrophysiological methods that measured the oropharyngeal phase of voluntarily initiated swallowing. For comparison, 22 patients with unilateral hemispheric infarction were investigated during the acute stage of stroke, and 4 patients with unilateral peripheral 9th and 10th cranial nerve palsies were studied. Age-matched 30 healthy control subjects were also included in the study. It was found that dysphagia was clinically more severe in WS patients than in the patients in the other groups. The pharyngeal phase of swallowing was predominantly impaired, whereas in patients with hemispheric stroke, dysphagia was related only to the delay of triggering of the voluntarily induced swallowing. In WS patients, the swallowing reflex was extremely slow in spite of the unilateral involvement due to LMI, whereas the pharyngeal phase of reflex swallowing remained within normal limits in patients with unilateral hemispheric stroke and patients with unilateral peripheral 9th and 10th cranial nerve palsies. Although in WS the lesion due to LMI is unilateral, its effect on oropharyngeal swallowing is bilateral. In LMI, primarily the premotor neurons in the nucleus ambiguous and their connections seem to be affected. Consequently, a disruption and/or disconnection of their linkage to swallowing-related cranial motor neuron pools bilaterally and to the contralateral nucleus ambiguous could produce the swallowing disorders in WS. However, the remaining intact ipsilateral premotor neurons and the contralateral center in the medulla oblongata may eventually begin to operate and overcome the severity and long-term persistence of dysphagia.

  6. A VALIDATION STUDY OF THE FACIAL-ORAL TRACT THERAPY SWALLOWING ASSESSMENT OF SALIVA

    DEFF Research Database (Denmark)

    Mortensen, Jesper; Jensen, Ditte; Kjærsgaard, Annette

    Introduction Facial-Oral Tract Therapy (F.O.T.T.) (1) is an approach that provides both clinical assessment and treatment of oropharyngeal dysphagia. In the F.O.T.T. approach, a prerequisite for the initiation of oral intake is safe swallowing of saliva. A recent randomized controlled trial (2......) showed that patients assessed for initiation of oral intake with an F.O.T.T. based clinical assessment, hereinafter referred to as the Swallowing Assessment of Saliva (SAS), were no more likely to develop aspiration pneumonia that patients who were assessed with an endoscopic evaluation. The objective...... coefficient of 0.87 ±0.17 in detection of aspiration risk. Furthermore, analyses showed that experienced and inexperienced occupational therapists performed equally in detection of aspiration risk. Conclusion The F.O.T.T.-SAS is a simple, sensitive and reliable assessment for detecting aspiration risk...

  7. Videofluoroscopy of the oral phase of swallowing in eight to twelve years old children with dental malocclusion.

    Science.gov (United States)

    Junqueira, Patricia; Costa, Milton Melciades

    2013-11-01

    The objective of this study was to describe the oral phase of swallowing in individuals with dental malocclusion and to generate data that would contribute to the rehabilitation of those patients. The study was based on the evaluation of the swallowing system through videofluoroscopy on thirty-four children of both genders, aged eight to twelve years old who present with Angle Class II and III dental malocclusions. Thirteen children of similar age and gender presenting normal dental occlusion formed the control group. The results indicated that the oral phase of swallowing is different between individuals with normal occlusion and malocclusion. Dental occlusion types Angle Class II and III did not present a swallowing pattern, independently of the amount of liquid ingested. The swallowing appeared effective in the oral phase of individuals with dental malocclusion, even though adaptations were identified. The outcome, in the absence of a single pattern and the efficiency of the adapted swallowing demonstrates, first a need for additional research investigating orofacial myofunctional treatment for patients with malocclusion and second how such analyses should focus on contributing positively to the rehabilitation of these patients.

  8. Conjunctivitis, rhinitis, and sinusitis in cliff swallows (Petrochelidon pyrrhonota) found in association with Mycoplasma sturni infection and cryptosporidiosis.

    Science.gov (United States)

    Ley, David H; Moresco, Anneke; Frasca, Salvatore

    2012-01-01

    Fledgling cliff swallows were cared for at a rehabilitation facility when clinical signs of ocular disease, characterized by conjunctivitis, epiphora, and hyperaemia of palpebrae and nictitans, were recognized. Treatment consisted of topical and oral antibiotic therapy and one topical steroid administration. However, one cliff swallow died and three were killed due to poor therapeutic response. Conjunctival swabs were obtained ante-mortem from the three cliff swallows and were submitted for mycoplasma culture and molecular diagnostics. Heads of the three birds were fixed in 10% neutral buffered formalin and submitted for histopathologic examination of oculonasal tissues. Mycoplasma cultures and molecular evaluation of isolates identified Mycoplasma sturni, but not Mycoplasma gallisepticum, from each specimen. Histopathologic examination revealed lymphoplasmacytic conjunctivitis, rhinitis and infraorbital sinusitis with follicular lymphoid hyperplasia, epithelial hyperplasia, and protozoal stages compatible with Cryptosporidium spp. arranged in and along the apical surfaces of epithelial cells. Identification of concurrent M. sturni and Cryptosporidium spp. infections in these cliff swallows demonstrates an alternative infectious condition that can produce gross and microscopic lesions comparable with those commonly observed in M. gallisepticum infections of house finches and other passerine species. Conjunctivitis associated with M. sturni and Cryptosporidium spp. in cliff swallows may represent an emerging disease risk to a naïve, high-density and colonial species such as colony-nesting cliff swallows.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Kinematic Visual Biofeedback Improves Accuracy of Learning a Swallowing Maneuver and Accuracy of Clinician Cues During Training.

    Science.gov (United States)

    Azola, Alba M; Sunday, Kirstyn L; Humbert, Ianessa A

    2017-02-01

    Submental surface electromyography (ssEMG) visual biofeedback is widely used to train swallowing maneuvers. This study compares the effect of ssEMG and videofluoroscopy (VF) visual biofeedback on hyo-laryngeal accuracy when training a swallowing maneuver. Furthermore, it examines the clinician's ability to provide accurate verbal cues during swallowing maneuver training. Thirty healthy adults performed the volitional laryngeal vestibule closure maneuver (vLVC), which involves swallowing and sustaining closure of the laryngeal vestibule for 2 s. The study included two stages: (1) first accurate demonstration of the vLVC maneuver, followed by (2) training-20 vLVC training swallows. Participants were randomized into three groups: (a) ssEMG biofeedback only, (b) VF biofeedback only, and (c) mixed biofeedback (VF for the first accurate demonstration achieving stage and ssEMG for the training stage). Participants' performances were verbally critiqued or reinforced in real time while both the clinician and participant were observing the assigned visual biofeedback. VF and ssEMG were continuously recorded for all participants. Results show that accuracy of both vLVC performance and clinician cues was greater with VF biofeedback than with either ssEMG or mixed biofeedback (p < 0.001). Using ssEMG for providing real-time biofeedback during training could lead to errors while learning and training a swallowing maneuver.

  11. Electromyography and Mechanomyography Signals During Swallowing in Healthy Adults and Head and Neck Cancer Survivors.

    Science.gov (United States)

    Constantinescu, Gabriela; Hodgetts, William; Scott, Dylan; Kuffel, Kristina; King, Ben; Brodt, Chris; Rieger, Jana

    2017-02-01

    Surface electromyography (sEMG) is used as an adjuvant to dysphagia therapy to demonstrate the activity of submental muscles during swallowing exercises. Mechanomyography (MMG) has been suggested as a potential superior alternative to sEMG; however, this advantage is not confirmed for signal acquired from submental muscles. This study compared the signal-to-noise ratio (SNR) obtained from sEMG and MMG sensors during swallowing tasks, in healthy participants and those with a history of head and neck cancer (HNC), a population with altered anatomy and a high incidence of dysphagia. Twenty-two healthy adults and 10 adults with a history of HNC participated in this study. sEMG and MMG signals were acquired during dry, thin liquid, effortful, and Mendelsohn maneuver swallows. SNR was compared between the two sensors using repeated measures ANOVAs and subsequent planned pairwise comparisons. Test-retest measures were collected on 20 % of participants. In healthy participants, MMG SNR was higher than that of sEMG for dry [t(21) = -3.02, p = 0.007] and thin liquid swallows [t(21) = -4.24, p < 0.001]. Although a significant difference for sensor was found in HNC participants F(1,9) = 5.54, p = 0.043, planned pairwise comparisons by task revealed no statistically significant difference between the two sensors. sEMG also showed much better test-retest reliability than MMG. Biofeedback provided as an adjuvant to dysphagia therapy in patients with HNC should employ sEMG technology, as this sensor type yielded better SNR and overall test-retest reliability. Poor MMG test-retest reliability was noted in both healthy and HNC participants and may have been related to differences in sensor application.

  12. A Timely Intervention: Endoscopic Retrieval of a Swallowed Magnetized Activity Watch

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    Jason S. Radowsky

    2016-01-01

    Full Text Available The accidental ingestion of a foreign object often presents a difficult scenario for the clinician. This includes not only the decision to retrieve the material but also the appropriate technique to use. We present the case of a young asymptomatic girl who swallowed a magnetic activity watch, which was then successfully retrieved with an endoscopic snare. To our knowledge, this is the first documented case of salvaging an operational watch from the stomach using an endoscopic technique.

  13. Speech–Language Pathology Evaluation and Management of Hyperkinetic Disorders Affecting Speech and Swallowing Function

    Directory of Open Access Journals (Sweden)

    Julie M. Barkmeier-Kraemer

    2017-09-01

    Full Text Available Background: Hyperkinetic dysarthria is characterized by abnormal involuntary movements affecting respiratory, phonatory, and articulatory structures impacting speech and deglutition. Speech–language pathologists (SLPs play an important role in the evaluation and management of dysarthria and dysphagia. This review describes the standard clinical evaluation and treatment approaches by SLPs for addressing impaired speech and deglutition in specific hyperkinetic dysarthria populations.Methods: A literature review was conducted using the data sources of PubMed, Cochrane Library, and Google Scholar. Search terms included 1 hyperkinetic dysarthria, essential voice tremor, voice tremor, vocal tremor, spasmodic dysphonia, spastic dysphonia, oromandibular dystonia, Meige syndrome, orofacial, cervical dystonia, dystonia, dyskinesia, chorea, Huntington’s Disease, myoclonus; and evaluation/treatment terms: 2 Speech–Language Pathology, Speech Pathology, Evaluation, Assessment, Dysphagia, Swallowing, Treatment, Management, and diagnosis.Results: The standard SLP clinical speech and swallowing evaluation of chorea/Huntington’s disease, myoclonus, focal and segmental dystonia, and essential vocal tremor typically includes 1 case history; 2 examination of the tone, symmetry, and sensorimotor function of the speech structures during non-speech, speech and swallowing relevant activities (i.e., cranial nerve assessment; 3 evaluation of speech characteristics; and 4 patient self-report of the impact of their disorder on activities of daily living. SLP management of individuals with hyperkinetic dysarthria includes behavioral and compensatory strategies for addressing compromised speech and intelligibility. Swallowing disorders are managed based on individual symptoms and the underlying pathophysiology determined during evaluation.Discussion: SLPs play an important role in contributing to the differential diagnosis and management of impaired speech and

  14. Electromyographic comparisons between clenching, swallowing and chewing in jaw muscles with varying occlusal parameters

    OpenAIRE

    Moreno Hay, Isabel; Sánchez Sánchez, Teresa; Ardizone García, Ignacio; Aneiros, Fernando; Celemín Viñuela, Alicia

    2008-01-01

    The aim of this study is to determine the influence of Angle molar class, presence of a posterior crossbite, anterior guidance, as well as gender in the muscular activity of the masticatory system in a population of healthy dental students. Study design: Surface electromyography recordings are made for the masseter, anterior and posterior temporalis and digastric muscles; in three different tests: clenching at maximum intercuspation, swallowing and chewing. Results: The results obtained s...

  15. Pilot Date on Swallow Function in Nondysphagic Patients Requiring a Tracheotomy Tube

    OpenAIRE

    Brady, Susan L.; Michele Wesling; Joseph Donzelli

    2009-01-01

    Objective. To evaluate the effects of occlusion status (i.e., open, finger, capped) of the tracheotomy tube and removal of the tracheotomy tube that may have upon bolus flow and durational measurements in nondysphagic persons requiring a tracheotomy tube. Study Design. Prospective, single subject, repeated measure design. Methods. Participants had their swallow evaluated with 5 mL pureed boluses using nasal endoscopy with the tracheotomy tube in place, removed, and under the following ...

  16. Quantitative analysis of oropharyngeal swallowing in Neuronal Ceroid Lipofuscinosis with gastrostomy: case report

    OpenAIRE

    André Vinicius Marcondes Natel Sales; Paula Cristina Cola; Adriana Gomes Jorge; Fernanda Matias Peres; Rarissa Rúbia Dallaqua dos Santos; Célia Maria Giacheti; Roberta Gonçalves da Silva

    2013-01-01

    The presence of oropharyngeal dysphagia in the pediatric population with genetic diseases it is still poorly studied. The aim of this study was to analyze the oral total transit time and pharyngeal transit time, in an individual with neuronal ceroid lipofucinosis (NCL) with severe oropharyngeal dysphagia. Individual with NCL, 3 years old, 2 years with gastrostomy and no oral feeding, weighting loss, but without pulmonary complications. Oropharyngeal swallowing was studied by videofluoroscopy ...

  17. EFFECT OF SWALLOWED BOLUS VISCOSITY AND BODY POSITION ON ESOPHAGEAL TRANSIT, CONTRACTION AND PERCEPTION OF TRANSIT

    Directory of Open Access Journals (Sweden)

    Juciléia DALMAZO

    2015-03-01

    Full Text Available Background The esophagus has a different response in relation to the characteristics of a swallowed bolus. Bolus viscosity and body position may affect esophageal contraction and transit. Objectives To investigate the effect of bolus viscosity and body position on esophageal contraction, transit and perception. Methods Esophageal contraction, transit and perception of transit were evaluated in 26 asymptomatic volunteers, 13 men and 13 women aged 18-60 years, mean: 33.6 (12.2 years. Esophageal contraction (manometry and transit (impedance were measured with a solid state catheter with sensors located 5, 10, 15, and 20 cm from the lower esophageal sphincter. Each volunteer swallowed in duplicate and in random sequence a 5 mL low viscous (LV liquid bolus of an isotonic drink with pH 3.3, and a 5 mL high viscous (HV paste bolus, which was prepared with 7.5 g of instant food thickener diluted in 50 mL of water (pH: 6.4. Results Total bolus transit time, in the sitting position, was longer with the HV bolus than with the LV bolus. Esophageal transit was longer in the supine position than in the sitting position. Bolus head advance time was longer with the HV bolus than with the LV bolus in both positions. Contraction esophageal amplitude was higher in the supine position than in the sitting position. The perception of bolus transit was more frequent with the HV bolus than with the LV bolus, without differences related to position. Conclusions The viscosity of the swallowed bolus and body position during swallows has an influence on esophageal contractions, transit and perception of transit.

  18. Visualization of swallowing using real-time TrueFISP MR fluoroscopy

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  19. Speech-Language Pathology Evaluation and Management of Hyperkinetic Disorders Affecting Speech and Swallowing Function.

    Science.gov (United States)

    Barkmeier-Kraemer, Julie M; Clark, Heather M

    2017-01-01

    Hyperkinetic dysarthria is characterized by abnormal involuntary movements affecting respiratory, phonatory, and articulatory structures impacting speech and deglutition. Speech-language pathologists (SLPs) play an important role in the evaluation and management of dysarthria and dysphagia. This review describes the standard clinical evaluation and treatment approaches by SLPs for addressing impaired speech and deglutition in specific hyperkinetic dysarthria populations. A literature review was conducted using the data sources of PubMed, Cochrane Library, and Google Scholar. Search terms included 1) hyperkinetic dysarthria, essential voice tremor, voice tremor, vocal tremor, spasmodic dysphonia, spastic dysphonia, oromandibular dystonia, Meige syndrome, orofacial, cervical dystonia, dystonia, dyskinesia, chorea, Huntington's Disease, myoclonus; and evaluation/treatment terms: 2) Speech-Language Pathology, Speech Pathology, Evaluation, Assessment, Dysphagia, Swallowing, Treatment, Management, and diagnosis. The standard SLP clinical speech and swallowing evaluation of chorea/Huntington's disease, myoclonus, focal and segmental dystonia, and essential vocal tremor typically includes 1) case history; 2) examination of the tone, symmetry, and sensorimotor function of the speech structures during non-speech, speech and swallowing relevant activities (i.e., cranial nerve assessment); 3) evaluation of speech characteristics; and 4) patient self-report of the impact of their disorder on activities of daily living. SLP management of individuals with hyperkinetic dysarthria includes behavioral and compensatory strategies for addressing compromised speech and intelligibility. Swallowing disorders are managed based on individual symptoms and the underlying pathophysiology determined during evaluation. SLPs play an important role in contributing to the differential diagnosis and management of impaired speech and deglutition associated with hyperkinetic disorders.

  20. Características de los paseriformes europeos que invernan en el Parque Nacional de las Aves del Djoudj (África occidental

    Directory of Open Access Journals (Sweden)

    Juan Arizaga, Daniel Alonso, Ivan Maggini, Luis Romero, Antonio Vilches, Gorka Belamendia

    2011-01-01

    Full Text Available El Sahel es una de las regiones más importantes para las especies de paseriformes europeos que invernan en África subsahariana. En el invierno de 2010 (diciembre se desarrolló una expedición al Parque Nacional de las Aves del Djoudj (Senegal, en África occidental. Durante la expedición se capturaron varias especies de paseriformes europeos, en ocho de las cuales las capturas fueron superiores a 5 ejemplares: Acrocephalus schoenobaenus (L., 1758, A. scirpaceus Herman, 1804, Luscinia svecica (L., 1758, Motacilla flava L., 1758, Phylloscopus collybita (Vieillot, 1817, P. ibericus (Ticehurst, 1937, Riparia riparia (L., 1758, Sylvia cantillans (Pallas, 1764. El objetivo del artículo es contribuir al conocimiento básico de las características de las especies europeas de paseriformes invernantes en el Parque Nacional de las Aves del Djoudj. Se capturaron gran número de individuos en muda activa, particularmente en el caso de R. riparia (50% de la población y, en menor grado, A. schoenobaenus, M. flava y S. cantillans, lo cual pone de manifiesto el empleo de la zona como área de muda para especies europeas. Por otro lado, en todos los casos la cantidad de reservas de grasa fue baja, sugiriendo que los individuos capturados invernaban en la zona. En concordancia, el rango de vuelo estimado fue también muy bajo (menor de 300 km.

  1. A new hybrid optimization method inspired from swarm intelligence: Fuzzy adaptive swallow swarm optimization algorithm (FASSO

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    Mehdi Neshat

    2015-11-01

    Full Text Available In this article, the objective was to present effective and optimal strategies aimed at improving the Swallow Swarm Optimization (SSO method. The SSO is one of the best optimization methods based on swarm intelligence which is inspired by the intelligent behaviors of swallows. It has been able to offer a relatively strong method for solving optimization problems. However, despite its many advantages, the SSO suffers from two shortcomings. Firstly, particles movement speed is not controlled satisfactorily during the search due to the lack of an inertia weight. Secondly, the variables of the acceleration coefficient are not able to strike a balance between the local and the global searches because they are not sufficiently flexible in complex environments. Therefore, the SSO algorithm does not provide adequate results when it searches in functions such as the Step or Quadric function. Hence, the fuzzy adaptive Swallow Swarm Optimization (FASSO method was introduced to deal with these problems. Meanwhile, results enjoy high accuracy which are obtained by using an adaptive inertia weight and through combining two fuzzy logic systems to accurately calculate the acceleration coefficients. High speed of convergence, avoidance from falling into local extremum, and high level of error tolerance are the advantages of proposed method. The FASSO was compared with eleven of the best PSO methods and SSO in 18 benchmark functions. Finally, significant results were obtained.

  2. Early identification and treatment of communication and swallowing deficits in Parkinson disease.

    Science.gov (United States)

    Ciucci, Michelle R; Grant, Laura M; Rajamanickam, Eunice S Paul; Hilby, Breanna L; Blue, Katherine V; Jones, Corinne A; Kelm-Nelson, Cynthia A

    2013-08-01

    Parkinson disease (PD) is a complex, progressive, neurodegenerative disorder that leads to a wide range of deficits including fine and gross sensorimotor impairment, autonomic dysfunction, mood disorders, and cognitive decline. Traditionally, the focus for diagnosis and treatment has been on sensorimotor impairment related to dopamine depletion. It is now widely recognized, however, that PD-related pathology affects multiple central nervous system neurotransmitters and pathways. Communication and swallowing functions can be impaired even in the early stages, significantly affecting health and quality of life. The purpose of this article is to review the literature on early intervention for communication and swallowing impairment in PD. Overarching themes were that (1) studies and interpretation of data from studies in early PD are limited; (2) best therapy practices have not been established, in part due to the heterogeneous nature of PD; and (3) as communication and swallowing problems are pervasive in PD, further treatment research is essential. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  3. Spontaneous swallow frequency compared with clinical screening in the identification of dysphagia in acute stroke.

    Science.gov (United States)

    Crary, Michael A; Carnaby, Giselle D; Sia, Isaac

    2014-09-01

    The aim of this study was to compare spontaneous swallow frequency analysis (SFA) with clinical screening protocols for identification of dysphagia in acute stroke. In all, 62 patients with acute stroke were evaluated for spontaneous swallow frequency rates using a validated acoustic analysis technique. Independent of SFA, these same patients received a routine nurse-administered clinical dysphagia screening as part of standard stroke care. Both screening tools were compared against a validated clinical assessment of dysphagia for acute stroke. In addition, psychometric properties of SFA were compared against published, validated clinical screening protocols. Spontaneous SFA differentiates patients with versus without dysphagia after acute stroke. Using a previously identified cut point based on swallows per minute, spontaneous SFA demonstrated superior ability to identify dysphagia cases compared with a nurse-administered clinical screening tool. In addition, spontaneous SFA demonstrated equal or superior psychometric properties to 4 validated, published clinical dysphagia screening tools. Spontaneous SFA has high potential to identify dysphagia in acute stroke with psychometric properties equal or superior to clinical screening protocols. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  4. The Balloon-Based Manometry Evaluation of Swallowing in Patients with Amyotrophic Lateral Sclerosis

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    Jerzy Tomik

    2017-03-01

    Full Text Available The aim of the study was to analyse the disturbances of the oro-pharyngeal swallowing phase of dysphagia in amyotrophic lateral sclerosis (ALS patients with the use of specific manometric measurements and to evaluate their plausible association with the duration of the disease. Seventeen patients with ALS were evaluated with manometric examinations of the oral and pharyngeal part of the gastrointestinal tract. Tests were carried out by using the oesophageal balloon-based method with four balloon transducers located 5 cm away from each other. The following manometric parameters were analysed: the base of tongue contraction (BTC and the upper oesophageal sphincter pressure (UESP, and the hypopharyngeal suction pump (HSP as well as the oro-pharyngeal, pharyngeal and hypopharyngeal transit time and average pharyngeal bolus velocity (oropharyngeal transit time (OTT, pharyngeal transit time (PTT, hypopharyngeal transit time (HTT and average pharyngeal bolus velocity (APBV, respectively. Manomatric examinations during swallowing in patients with ALS showed significant weakness of BTC, a decrease of HSP and a decrease of the velocity of bolus transit inside the pharynx which were particularly marked between the first and the third examination. Manometric examinations of the oro-pharyngeal part of the gastrointestinal tract are useful and supportive methods in the analysis of swallowing disturbances in ALS patients.

  5. Clinical and fiberoptic endoscopic assessment of swallowing in patients with chronic obstructive pulmonary disease

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    Macri, Marina Rodrigues Bueno

    2014-01-01

    Full Text Available Introduction: Chronic obstructive pulmonary disease is characterized by progressive and partially reversible obstruction of pulmonary airflow. Aim: To characterize swallowing in patients with chronic obstructive pulmonary disease and correlate the findings with the degree chronic obstructive pulmonary disease, heart and respiratory rate, oxygen saturation, and smoking. Method: We conducted a prospective cohort study of 19 patients (12 men and 7 women; age range, 50–85 years with confirmed medical diagnosis of chronic obstructive pulmonary disease. This study was performed in 2 stages (clinical evaluation and functional assessment using nasolaryngofibroscopy on the same day. During both stages, vital signs were checked by medical personnel. Results: Clinical evaluation of swallowing in all patients showed the clinical signs of cough. The findings of nasolaryngofibroscopy highlighted subsequent intraoral escape in 5 patients (26.5%. No patient had tracheal aspiration. There was no association of subsequent intraoral escape with degree of chronic obstructive pulmonary disease, heart and respiratory rate, oxygen saturation, or smoking. Conclusion: In patients with chronic obstructive pulmonary disease, there was a prevalence of oral dysphagia upon swallowing and nasolaryngofibroscopy highlighted the finding of subsequent intraoral escape. There was no correlation between intraoral escape and the degree of chronic obstructive pulmonary disease, heart and respiratory rate, oxygen saturation, or smoking.

  6. Quality of Life in Swallowing Disorders after Nonsurgical Treatment for Head and Neck Cancer

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    Silveira, Marta Halina

    2014-12-01

    Full Text Available Introduction Radiotherapy or chemoradiotherapy can result in severe swallowing disorders with potential risk for aspiration and can negatively impact the patient's quality of life (QOL. Objective To assess swallowing-related QOL in patients who underwent radiotherapy/chemoradiotherapy for head and neck cancer. Methods We interviewed 110 patients (85 men and 25 women who had undergone exclusive radiotherapy (25.5% or concomitant chemoradiotherapy (74.5% from 6 to 12 months before the study. The Quality of Life in Swallowing Disorders (SWAL-QOL questionnaire was employed to evaluate dysphagia-related QOL. Results The QOL was reduced in all domains for all patients. The scores were worse among men. There was a relationship between oral cavity as the primary cancer site and the fatigue domain and also between advanced cancer stage and the impact of food selection, communication, and social function domains. Chemoradiotherapy association, the presence of nasogastric tube and tracheotomy, and the persistence of alcoholism and smoking had also a negative effect on the QOL. Conclusions According to the SWAL-QOL questionnaire, the dysphagia-related impact on QOL was observed 6 to 12 months after the treatment ended.

  7. Designing for Safety: Implications of a Fifteen Year Review of Swallowed and Aspirated Dentures

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    Samuel J. W. Kent

    2016-06-01

    Full Text Available Objectives: Dentures are worn by around 20% of the population, yet if they become displaced they may enter the gastrointestinal or respiratory system, sometimes with grave consequences. The aim of this study was to review recent published literature in order to identify the epidemiology of patients and characteristics of swallowed and aspirated dental prostheses, and propose strategies to minimise these risks. Material and Methods: A fifteen year retrospective of published case series and case reports was carried out. Photographs, radiographs and descriptions of the dental prostheses were gathered, as well as the patient’s presenting complaint, the anatomical site where the denture was caught and the procedure required to remove the denture. Results: Ninety one separate events of swallowed or aspirated dentures were identified from 83 case reports and series from 28 countries. Average age was 55 years, and these were 74% male. Photographs were retrieved for 49 of these dentures. Clasps were present in 25 of the dentures. There was no significant difference between clasped and unclasped dentures for perforation rates, need for open surgery and spontaneously passed dentures. Conclusions: We discuss the implications of this study regarding denture designs, specifically the importance of using a radiopaque acrylic, using clasps when required even if there is a risk of aspiration, advising patients to return if a denture is loose or damaged, and finally that all patients who wear a denture are at risk of aspiration and swallowing events, and associated morbidity and mortality.

  8. Assessment of swallowing and masticatory performance in obturator wearers: a clinical study

    Science.gov (United States)

    Vero, Nungotso; Mishra, Niraj; Singh, Kamleshwar; Jurel, Sunit Kumar; Kumar, Vijay

    2015-01-01

    PURPOSE To assess function by identifying changes in swallowing and masticatory performance in maxillary obturator prosthesis wearers. MATERIALS AND METHODS Sixty subjects were recruited for the study, of which 20 were obturator wearers, 20 were completely dentulous and 20 had removable partial/complete dentures with similar Eichner's Index. Swallowing ability was evaluated with and without obturator using the "Water Drinking Test"; Masticatory performance was evaluated with the Sieve test; and maximum occlusal force was recorded with the help of a digital bite sensor. The data was analyzed using the Statistical Package for Social Science version 15.0 with a confidence level at 95%. RESULTS Profile, behavior of drinking and time taken to drink were significantly improved (PMasticatory performance was not significantly different (P=.252) in obturator wearer when compared with dentulous or removable partial/complete denture wearer, but significantly (Pmasticatory performance and maximum occlusal force was not significant (P=.124). CONCLUSION Swallowing ability was significantly improved after wearing obturator but masticatory performance was not significantly different from those having similar occlusal support zone in their dentition. PMID:25722831

  9. Influence of repetitive peripheral magnetic stimulation on neural plasticity in the motor cortex related to swallowing.

    Science.gov (United States)

    Momosaki, Ryo; Kakuda, Wataru; Yamada, Naoki; Abo, Masahiro

    2016-09-01

    The aim of this study was to evaluate the effect of repetitive peripheral magnetic stimulation at two different frequencies (20 and 30 Hz) on cortical excitability in motor areas related to swallowing in healthy individuals. The study participants were 10 healthy normal volunteers (two women and eight men, age range 25-36 years). Repetitive peripheral magnetic stimulation was applied to the submandibular muscle using a parabolic coil at the site where contraction of the suprahyoid muscles was elicited. Stimulation was continued for 10 min (total 1200 pulses) at 20 Hz on 1 day and at 30 Hz on another day, with the stimulation strength set at 90% of the intensity that elicited pain. The motor-evoked potential amplitude of suprahyoid muscles was assessed before, immediately after, and 30 min after stimulation. Stimulations at both 20 and 30 Hz significantly increased motor-evoked potential amplitude (Pstimulation. The motor-evoked potential amplitude immediately after stimulation was not significantly different between the 20 and 30 Hz frequencies. The results indicated that repetitive magnetic stimulation increased motor-evoked potential amplitude of swallowing muscles, suggesting facilitation of the motor cortex related to swallowing in healthy individuals.

  10. Dynamic evaluation of swallowing disorders with electron-beam tomography; Funktionelle Schluckaktuntersuchungen mit der Elektronenstrahlcomputertomographie

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    Raith, J. [Universitaetsklinik fuer Radiologie, Graz (Austria); Lindbichler, F. [Universitaetsklinik fuer Radiologie, Graz (Austria); Kern, R. [Universitaetsklinik fuer Radiologie, Graz (Austria); Groell, R. [Universitaetsklinik fuer Radiologie, Graz (Austria); Rienmueller, R. [Universitaetsklinik fuer Radiologie, Graz (Austria)

    1996-03-01

    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.) [Deutsch] Videofluorographie und Kinematographie gelten derzeit als Goldstandard fuer die Abklaerung von Schluckstoerungen. Methodisch bedingt ist jedoch keine ueberlagerungsfreie Darstellung der

  11. 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

    2017-07-05

    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 ingestion. This research programme investigated test development indices and established normative data for the TOMASS to support translation to clinical dysphagia assessment. A total of 228 healthy adults (ages 20-80+ years) stratified by age and sex participated in one or more of four consecutive studies evaluating test-retest and interrater reliability and validity to instrumental assessment. For each study the test required participants to ingest a commercially available cracker with instructions to 'eat this as quickly as is comfortably possible'. Further averaged measures were derived including the number of masticatory cycles and swallows per bite, and time per bite, masticatory cycle and swallow. Initial analyses identified significant differences on salient measures between two commercially available crackers that are nearly identical in shape, size and ingredients, suggesting the need for separate normative samples for specific regional products. Additional analyses on a single cracker identified that the TOMASS was sensitive at detecting changes in performance based on age and sex. Test-retest reliability across days and interrater reliability between clinicians was high, as was validation of observational measures to instrumental correlates of the same behaviours. Therefore, normative data are provided for the TOMASS from a minimum of 80 healthy controls, stratified by age and sex, for each of seven commercially available crackers from broad regions worldwide. Analyses on a single cracker identified Arnott's Salada, and that TOMASS measures were sensitive for detecting changes in performance based on age and sex. Interrater

  12. Immediate effects of thermal-tactile stimulation on timing of swallow in idiopathic Parkinson's disease.

    LENUS (Irish Health Repository)

    Regan, Julie

    2012-02-01

    Oropharyngeal dysphagia frequently presents in people with idiopathic Parkinson\\'s disease (IPD). Clinical sequelae of dysphagia in this group include weight loss and aspiration pneumonia, the latter of which is the leading cause of hospital admissions and death in IPD. Thermal-tactile stimulation (TTS) is a sensory technique whereby stimulation is provided to the anterior faucial pillars to speed up the pharyngeal swallow. The effects of TTS on swallowing have not yet been investigated in IPD. The aim of this study was to investigate the immediate effects of TTS on the timing of swallow in a cohort of people with IPD and known oropharyngeal dysphagia. Thirteen participants with IPD and known dysphagia attended for videofluoroscopy during which standardised volumes of liquid barium and barium paste were administered preceding and immediately subsequent to TTS. The immediate effects of TTS on swallowing were examined using oral, pharyngeal, and total transit times and pharyngeal delay times as outcome measures. TTS significantly reduced median pharyngeal transit time on fluids (0.20 s, 95% CI = 0.12-0.28, p = 0.004) and on paste (0.3 s, 95% CI = 0.08-0.66, p = 0.01). Median total transit time was also reduced on fluids (0.48 s, 95% CI = 0.00-1.17, p = 0.049) and on paste (0.52 s, 95% CI = 0.08-1.46, p = 0.033). Median pharyngeal delay time was reduced on fluids (0.20 s, 95% CI = 0.12-0.34, p = 0.002). TTS did not significantly alter median oral transit time on either fluid or paste consistency. TTS significantly reduced temporal measures of the pharyngeal phase of swallowing in the IPD population. Significant results may be attributed to the role of sensory stimulation in improving motor function in IPD, with emphasis on the impaired glossopharyngeal and vagus nerves in this population. It is still unclear whether these findings will translate into a clinically beneficial effect.

  13. Swallowed Fluticasone Propionate Is an Effective Long-Term Maintenance Therapy for Children With Eosinophilic Esophagitis.

    Science.gov (United States)

    Andreae, Doerthe A; Hanna, Matthew G; Magid, Margret S; Malerba, Stefano; Andreae, Michael H; Bagiella, Emilia; Chehade, Mirna

    2016-08-01

    Although effective in the treatment of eosinophilic esophagitis (EoE) in children, limited data exist on long-term safety and efficacy of swallowed topical corticosteroids. We investigated whether long-term use of swallowed fluticasone in children with EoE leads to sustained reduction in esophageal eosinophils, and endoscopic and clinical improvement. In an open-label, prospective, single-center study, we offered pediatric patients with active EoE fluticasone 2 puffs to swallow twice a day (strengths in μg/puff: 2-4 years: 44, 5-11 years: 110, ≥12 years: 220). Clinical, endoscopic, and histological assessments were performed at baseline and shortly after therapy. If histological remission was seen, fluticasone was continued with clinical follow-ups every 4 months and endoscopic and histological follow-ups yearly. Clinical scores were derived from eight symptoms (abdominal pain, nausea, vomiting, regurgitation, chest pain, dysphagia, food impaction, and early satiety). Endoscopic scores were derived from six features (rings, exudates, furrows, edema, stricture, and shearing). Scores were expressed as ratio (features present/total). In addition to peak eosinophils/high power field (HPF) (primary outcome), histological features (eosinophilic microabscesses, degranulation, superficial layering, basal zone hyperplasia, dilated intercellular spaces, and lamina propria fibrosis) were assessed. Median clinical and endoscopic scores and individual histologic features were compared over 4 time intervals: 24 months. Growth and adverse effects were monitored. We enrolled 54 patients, 80% male, median age 6.5 years (range 2-17 years), 85% atopic (57% asthma, 68% allergic rhinitis, and 31% atopic dermatitis), and 74% with food allergy. Mean follow-up was 20.4 months, the longest being 68 months (5.7 years). Esophageal eosinophil counts significantly decreased (median peak eosinophils/HPF at baseline 72, 24 months: 12, all P24 months: 39, all P24 months: 0.1, all P24 months: P

  14. Immune responses of a native and an invasive bird to Buggy Creek Virus (Togaviridae: Alphavirus and its arthropod vector, the swallow bug (Oeciacus vicarius.

    Directory of Open Access Journals (Sweden)

    Carol A Fassbinder-Orth

    Full Text Available Invasive species often display different patterns of parasite burden and virulence compared to their native counterparts. These differences may be the result of variability in host-parasite co-evolutionary relationships, the occurrence of novel host-parasite encounters, or possibly innate differences in physiological responses to infection between invasive and native hosts. Here we examine the adaptive, humoral immune responses of a resistant, native bird and a susceptible, invasive bird to an arbovirus (Buggy Creek virus; Togaviridae: Alphavirus and its ectoparasitic arthropod vector (the swallow bug; Oeciacus vicarius. Swallow bugs parasitize the native, colonially nesting cliff swallow (Petrochelidon pyrrhonota and the introduced house sparrow (Passer domesticus that occupies nests in cliff swallow colonies. We measured levels of BCRV-specific and swallow bug-specific IgY levels before nesting (prior to swallow bug exposure and after nesting (after swallow bug exposure in house sparrows and cliff swallows in western Nebraska. Levels of BCRV-specific IgY increased significantly following nesting in the house sparrow but not in the cliff swallow. Additionally, house sparrows displayed consistently higher levels of swallow bug-specific antibodies both before and after nesting compared to cliff swallows. The higher levels of BCRV and swallow bug specific antibodies detected in house sparrows may be reflective of significant differences in both antiviral and anti-ectoparasite immune responses that exist between these two avian species. To our knowledge, this is the first study to compare the macro- and microparasite-specific immune responses of an invasive and a native avian host exposed to the same parasites.

  15. Immune Responses of a Native and an Invasive Bird to Buggy Creek Virus (Togaviridae: Alphavirus) and Its Arthropod Vector, the Swallow Bug (Oeciacus vicarius)

    Science.gov (United States)

    Fassbinder-Orth, Carol A.; Barak, Virginia A.; Brown, Charles R.

    2013-01-01

    Invasive species often display different patterns of parasite burden and virulence compared to their native counterparts. These differences may be the result of variability in host-parasite co-evolutionary relationships, the occurrence of novel host-parasite encounters, or possibly innate differences in physiological responses to infection between invasive and native hosts. Here we examine the adaptive, humoral immune responses of a resistant, native bird and a susceptible, invasive bird to an arbovirus (Buggy Creek virus; Togaviridae: Alphavirus) and its ectoparasitic arthropod vector (the swallow bug; Oeciacus vicarius). Swallow bugs parasitize the native, colonially nesting cliff swallow (Petrochelidon pyrrhonota) and the introduced house sparrow (Passer domesticus) that occupies nests in cliff swallow colonies. We measured levels of BCRV-specific and swallow bug-specific IgY levels before nesting (prior to swallow bug exposure) and after nesting (after swallow bug exposure) in house sparrows and cliff swallows in western Nebraska. Levels of BCRV-specific IgY increased significantly following nesting in the house sparrow but not in the cliff swallow. Additionally, house sparrows displayed consistently higher levels of swallow bug-specific antibodies both before and after nesting compared to cliff swallows. The higher levels of BCRV and swallow bug specific antibodies detected in house sparrows may be reflective of significant differences in both antiviral and anti-ectoparasite immune responses that exist between these two avian species. To our knowledge, this is the first study to compare the macro- and microparasite-specific immune responses of an invasive and a native avian host exposed to the same parasites. PMID:23460922

  16. Dysphagia in Amyotrophic Lateral Sclerosis: Relationships between disease progression and Fiberoptic Endoscopic Evaluation of Swallowing.

    Science.gov (United States)

    Fattori, Bruno; Siciliano, Gabriele; Mancini, Valentina; Bastiani, Luca; Bongioanni, Paolo; Caldarazzo Ienco, Elena; Barillari, Maria R; Romeo, Salvatore O; Nacci, Andrea

    2017-06-01

    Our aim was to evaluate the relationship between the disease severity of Amyotrophic Lateral Sclerosis (ALS) and the following parameters of Fiberoptic Endoscopic Evaluation of Swallowing (FEES): premature spillage, post-swallowing residue and aspiration. We studied 202 patients (95 women and 107 men) with ALS; of these, 136 had spinal and 66 had bulbar onset. They were analyzed according to the Amyotrophic Lateral Sclerosis Functioning Rating Scale (ALSFRS) and the b-ALSFRS subscale (bulbar scale). All subjects underwent FEES. Post-swallowing residue was classified into four classes (0-3); premature spillage and aspiration were considered either present or absent. Spearman's correlation test showed a highly significant correlation (p<0.0001) between the value of ALSFRS and b-ALSFRS and the FEES parameters as the following: disease severity and dysphagia severity are closely related, both in spinal and bulbar onset, no matter what bolus texture was used. Spearman's Rho was more significant for post-swallowing residue, ≤-0.500 with all three consistencies (p<0.0001) in spinal onset and -0.520 only with liquid bolus (p<0.0001) in bulbar onset. Independent T-Test revealed a significant difference (p<0.0001) between the mean ALSFRS and b-ALSFRS scores and the presence/absence of aspiration. For the premature spillage in spinal onset (ALSFRS), we found a statistically significant difference for all three bolus textures (p<0.0001). Analysis of variance for the post-swallowing residue in spinal onset (ALSFRS) revealed a statistically significant difference (p<0.0001) for most of the comparisons between groups for all three textures. For the premature spillage in bulbar onset (b-ALSFRS), we found a statistically significant difference for all three textures (p<0.0001). Analysis of variance for the post-swallowing residue in bulbar onset (b-ALSFRS) showed a statistically significant difference (p<0.0001) for most of the comparisons between groups for all three textures

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

    Science.gov (United States)

    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 < 0.001), lower median frequency (U = 2674.0, p < 0.001), and lower 15th percentile of the power spectrum density [t(176.9) = 2.07, p < 0.001] than healthy participants. The automated swallow-detection algorithm 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.

  18. Tongue-to-palate resistance training improves tongue strength and oropharyngeal swallowing function in subacute stroke survivors with dysphagia.

    Science.gov (United States)

    Kim, H D; Choi, J B; Yoo, S J; Chang, M Y; Lee, S W; Park, J S

    2017-01-01

    Tongue function can affect both the oral and pharyngeal stages of the swallowing process, and proper tongue strength is vital for safe oropharyngeal swallowing. This trial investigated the effect of tongue-to-palate resistance training (TPRT) on tongue strength and oropharyngeal swallowing function in stroke with dysphagia patients. This trial was performed using a 4-week, two-group, pre-post-design. Participants were allocated to the experimental group (n = 18) or the control group (n = 17). The experimental group performed TPRT for 4 weeks (5 days per week) and traditional dysphagia therapy, whereas the control group performed traditional dysphagia therapy on the same schedule. Tongue strength was measured using the Iowa Oral Performance Instrument. Swallowing function was measured using the videofluoroscopic dysphagia scale (VDS) and penetration-aspiration scale (PAS) based on a videofluoroscopic swallowing study. Experimental group showed more improved in the tongue strength (both anterior and posterior regions, P = 0·009, 0·015). In addition, the experimental group showed more improved scores on the oral and pharyngeal phase of VDS (P = 0·029, 0·007), but not on the PAS (P = 0·471), compared with the control group. This study demonstrated the effectiveness of TPRT in increasing tongue muscle strength and improving swallowing function in patients with post-stroke dysphagia. Therefore, we recommend TPRT as an easy and simple rehabilitation strategy for improving swallowing in patients with dysphagia. © 2016 John Wiley & Sons Ltd.

  19. Swallowing Tablets and Capsules Increases the Risk of Penetration and Aspiration in Patients with Stroke-Induced Dysphagia.

    Science.gov (United States)

    Schiele, Julia T; Penner, Heike; Schneider, Hendrik; Quinzler, Renate; Reich, Gabriele; Wezler, Nikolai; Micol, William; Oster, Peter; Haefeli, Walter E

    2015-10-01

    We evaluated the prevalence of difficulties swallowing solid dosage forms in patients with stroke-induced dysphagia and whether swallowing tablets/capsules increases their risk of penetration and aspiration. Concurrently, we explored whether routinely performed assessment tests help identify patients at risk. Using video endoscopy, we evaluated how 52 patients swallowed four different placebos (round, oval, and oblong tablets and a capsule) with texture-modified water (TMW, pudding consistency) and milk and rated their swallowing performance according to the Penetration Aspiration Scale (PAS). Additionally, Daniels Test, Bogenhausener Dysphagiescore, Scandinavian Stroke Scale, Barthel Index, and Tinetti's Mobility Test were conducted. A substantial proportion of the patients experienced severe difficulties swallowing solid oral dosage forms (TMW: 40.4 %, milk: 43.5 %). Compared to the administration of TMW/milk alone, the placebos increased the PAS values in the majority of the patients (TMW: median PAS from 1.5 to 2.0; milk: median PAS from 1.5 to 2.5, each p value <0.0001) and residue values were significantly higher (p < 0.05). Whereas video-endoscopic examination reliably identified patients with difficulties swallowing medication, neither patients' self-evaluation nor one of the routinely performed bedside tests did. Therefore, before video-endoscopic evaluation, many drugs were modified unnecessarily and 20.8 % of these were crushed inadequately, although switching to another dosage form or drug would have been possible. Hence, safety and effectiveness of swallowing tablets and capsules should be evaluated routinely in video-endoscopic examinations, tablets/capsules should rather be provided with TMW than with milk, and the appropriateness of "non per os except medication" orders for dysphagic stroke patients should be questioned.

  20. The effects of a xanthan gum-based thickener on the swallowing function of patients with dysphagia.

    Science.gov (United States)

    Rofes, L; Arreola, V; Mukherjee, R; Swanson, J; Clavé, P

    2014-05-01

    Increasing bolus viscosity of thin liquids is a basic therapeutic strategy to protect patients with oropharyngeal dysphagia (OD) from aspiration. However, conventional starch thickeners increase post-deglutitive residue. To assess the therapeutic effect of a new xanthan gum-based thickener, Resource ThickenUp Clear (Nestlé Health Science, Vevey, Switzerland) on patients with oropharyngeal dysphagia. We studied the effect of Resource ThickenUp Clear using a clinical method and videofluoroscopy on 120 patients with oropharyngeal dysphagia (66 with stroke, 41 older and 13 with neurodegenerative diseases) and 14 healthy volunteers while swallowing thin-liquid, nectar-like and spoon-thick boluses. We assessed the prevalence of signs of impaired safety and efficacy of swallow and the physiology of the swallow response. Increasing bolus viscosity with Resource ThickenUp Clear: (i) improved safety of swallow demonstrated by a reduction in the prevalence of cough and voice changes in the clinical study and penetrations and aspirations during video fluoroscopy. Prevalence of aspirations was 12.7% with thin liquid, 7.7% with nectar-like (P < 0.01) and 3.4% with spoon-thick (P < 0.01) viscosities. Penetration-Aspiration Scale was reduced from 3.24 ± 0.18 at thin liquid to 2.20 ± 0.18 at nectar-like (P < 0.001) and to 1.53 ± 0.13 at spoon-thick (P < 0.001) viscosities; (ii) did not enhance pharyngeal residue; (iii) nectar-like viscosity did not affect bolus velocity nor timing of swallow response and (iv) spoon-thick viscosity reduced bolus velocity. Resource ThickenUp Clear improves the safety of swallow without increasing residue providing a viscosity-dependent therapeutic effect for patients with oropharyngeal dysphagia. At nectar viscosity, the effect is due to intrinsic texture properties, spoon-thick viscosity adding changes in swallow physiology. NCT01158313. © 2014 John Wiley & Sons Ltd.

  1. New measures of upper esophageal sphincter distensibility and opening patterns during swallowing in healthy subjects using EndoFLIP®

    LENUS (Irish Health Repository)

    Regan, J

    2013-01-01

    Background  This paper aims to measure upper esophageal sphincter (UES) distensibility and extent and duration of UES opening during swallowing in healthy subjects using EndoFLIP(®) . Methods  Fourteen healthy subjects (20-50 years) were recruited. An EndoFLIP(®) probe was passed trans-orally and the probe balloon was positioned across the UES. Two 20-mL ramp distensions were completed and UES cross-sectional area (CSA) and intra-balloon pressure (IBP) were evaluated. At 12-mL balloon volume, subjects completed dry, 5- and 10-mL liquid swallows and extent (mm) and duration (s) of UES opening and minimum IBP (mmHg) were analyzed across swallows. Key Results  Thirteen subjects completed the study protocol. A significant change in UES CSA (P < .001) and IBP (P < .000) was observed during 20-mL distension. UES CSA increased up to 10-mL distension (P < .001), from which point IBP raised significantly (P = 0.004). There were significant changes in UES diameter (mm) (P < .000) and minimum IBP (mmHg) (P < .000) during swallowing events. Resting UES diameter (4.9 mm; IQR 0.02) and minimum IBP (18.8 mmHg; IQR 2.64) changed significantly during dry (9.6 mm; IQR 1.3: P < .001) (3.6 mmHg; IQR 4.1: P = 0.002); 5 mL (8.61 mm; IQR 2.7: P < .001) (4.8 mmHg; IQR 5.7: P < .001) and 10-mL swallows (8.3 mm; IQR 1.6: P < 0.001) (3 mmHg; 4.6: P < .001). Median duration of UES opening was 0.5 s across dry and liquid swallows (P = 0.91). Color contour plots of EndoFLIP(®) data capture novel information regarding pharyngo-esophageal events during swallowing. Conclusions & Inferences  Authors obtained three different types of quantitative data (CSA, IBP, and timing) regarding UES distensibility and UES opening patterns during swallowing in healthy adults using only one device (EndoFLIP(®) ). This new measure of swallowing offers fresh information regarding UES dynamics which may ultimately improve patient

  2. Relationship between Class III malocclusion and hyoid bone displacement during swallowing: a cine-magnetic resonance imaging study.

    Science.gov (United States)

    Gokce, Sila Mermut; Gokce, Hasan Suat; Gorgulu, Serkan; Karacay, Seniz; Akca, Eralp; Olmez, Huseyin

    2012-08-01

    The displacement of the hyoid bone (HB) is a critical biomechanical component of the swallowing function. The aim of this study was to evaluate the swallowing-induced vertical and horizontal displacements of the HB in subjects with 2 different magnitudes of skeletal Class III malocclusion, by means of real-time, balanced turbo-field-echo (B-TFE) cine-magnetic resonance imaging. The study population comprised 19 patients with mild skeletal Class III malocclusion, 16 with severe skeletal Class III malocclusion, and 20 with a skeletal Class I relationship. Before the commencement of the study, all subjects underwent cephalometric analysis to identify the nature of skeletal malformations. B-TFE images were obtained for the 4 consecutive stages of deglutition as each patient swallowed 10 mL of water, and the vertical and horizontal displacements of the HB were measured at each stage. At all stages of swallowing, the vertical position of the HB in the severe Class III malocclusion group was significantly lower than those in the mild Class III and Class I malocclusion groups. Similarly, the horizontal displacement of the HB was found to be significantly associated with the severity of malocclusion, i.e., the degree of Class III malocclusion, while the amount of anterior displacement of the HB decreased with an increase in the severity of the Class III deformity. Our findings indicate the existence of a relationship between the magnitude of Class III malocclusion and HB displacement during swallowing.

  3. Effect of Modified Shaker Exercise on the Amplitude and Duration of Swallowing Sounds: Evidence from Cervical Auscultation.

    Science.gov (United States)

    Babu, Sonia; Balasubramaniam, Radish Kumar; Varghese, Ancy

    2017-01-01

    Anecdotal evidence shows that the Shaker exercise and its modifications improve pharyngeal muscle contraction. However, there is no experimental evidence for the same. Thus, the present study examined the effect of modified Shaker exercise on the amplitude and duration of pharyngeal muscle contraction using cervical auscultation. The study follows a cross-sectional study design, where 50 healthy individuals (23 males and 27 females) performed modified Shaker exercise and noneffortful swallow during 10 ml water swallowing. Swallow sound characteristics were analyzed with and without modified Shaker exercise using cervical auscultation. The results of mixed ANOVA revealed significant differences for the amplitude of swallow sound with modified Shaker exercise (mean = 47.24, SD = 20.64) when compared to noneffortful swallow (mean = 28.19, SD = 10.26) at p Shaker exercise at p > 0.05. No significant difference across the genders was also noted at p > 0.05. The outcomes of the study suggest that modified Shaker exercise improves the amplitude of pharyngeal muscle contraction. Further studies are needed to confirm this finding using gold standard tools like videofluoroscopy.

  4. Swallowing in the first year after chemoradiotherapy for head and neck cancer: clinician- and patient-reported outcomes.

    Science.gov (United States)

    Patterson, Joanne M; McColl, Elaine; Carding, Paul N; Hildreth, Anthony J; Kelly, Charles; Wilson, Janet A

    2014-03-01

    This prospective study evaluated swallowing outcomes prechemoradiotherapy (pre-CRT) up to 1 year post-CRT, in a substantial cohort of patients with head and neck cancer and explored factors predicting outcome. One hundred twelve patients were assessed pretreatment and at 3, 6, and 12 months posttreatment using a questionnaire, endoscopic assessment, water swallow test, and diet score. Seventy-one patients were retained, the majority had oropharyngeal (53%) or hypopharyngeal cancer (20%). A marked deterioration occurred between pretreatment and 3 months posttreatment (p ≤ .01). Significant improvement between 3 and 12 months was found on 2 swallowing measures, but not self reported. Three of the 4 pretreatment assessments predicted outcomes at 1 year. CRT results in a marked deterioration on different paradigms of swallowing measurements. Improvement occurs on some clinical measures, but limited change is observed in patients' perceptions. Pretreatment measures are important indicators of long-term dysphagia. Swallowing recovery is complex, taking different courses between clinical tests and perspectives. Copyright © 2013 Wiley Periodicals, Inc., A Wiley Company.

  5. Voice and swallowing outcomes of an organ-preservation trial for advanced laryngeal cancer.

    Science.gov (United States)

    Fung, Kevin; Lyden, Teresa H; Lee, Julia; Urba, Susan G; Worden, Frank; Eisbruch, Avraham; Tsien, Christina; Bradford, Carol R; Chepeha, Douglas B; Hogikyan, Norman D; Prince, Mark E P; Teknos, Theodoros N; Wolf, Gregory T

    2005-12-01

    Organ-preservation treatment approaches for advanced laryngeal cancer patients that use combination chemoradiotherapy result in cure rates similar to primary laryngectomy with postoperative radiotherapy. In the national VA Larynx Cancer Trial, successful organ preservation was associated with an overall improvement in quality of life but not in subjective speech compared with long-term laryngectomy survivors. As part of a Phase II clinical trial, a prospective study of speech and swallowing results was conducted to determine if larynx preservation is associated with improved voice and swallowing compared with results in patients who require salvage laryngectomy. A total of 97 patients with advanced laryngeal cancer (46 Stage III, 51 Stage IV) were given a single course of induction chemotherapy (cisplatin 100 mg/m2 on Day 1 and 5-FU 1,000 mg/m2/day x 5 days), followed by assessment of response. Patients with less than 50% response underwent early salvage laryngectomy, and patients with 50% or better response underwent concurrent chemoradiation (72 Gy and cisplatin 100 mg/m2 on Days 1, 22, and 43), followed by two cycles of adjuvant chemotherapy (DDP/5-FU). Direct laryngoscopy and biopsy were performed 8 weeks after radiation therapy to determine final tumor response. Late salvage surgery was performed on patients with persistent or recurrent disease. Completed survey data on voice and swallowing utilizing the Voice-Related Quality of Life Measure (V-RQOL) and the List Performance Status Scale for Head and Neck Cancer Patients (PSS-HN) were obtained from 56 patients who were alive and free of disease at the time of survey, with a minimum follow-up of 8 months. Comparisons were made between patients with an intact larynx (n = 37) vs. laryngectomy (n = 19), as well as early (n = 12) vs. late salvage laryngectomy (n = 7). Multivariate analysis was performed to determine factors predictive of voice and swallowing outcomes. Overall 3-year determinant survival was 87

  6. Temperature effects on food supply and chick mortality in tree swallows (Tachycineta bicolor).

    Science.gov (United States)

    Winkler, David W; Luo, Miles K; Rakhimberdiev, Eldar

    2013-09-01

    Tree swallow (Tachycineta bicolor) breeding success in Ithaca, NY, USA, over the past quarter century has shown generally healthy fledgling production punctuated by years of high nestling mortality. This study tested the potential effects that temperature may have on the food supply and breeding success of swallows. Data from 17 years of daily insect samples were used to relate flying insect abundances to daily maximum temperatures and to define "cold snaps" as strings of consecutive days when the maximum temperatures did not exceed critical temperatures. The distributions of cold snaps and chick mortality events were investigated both through detailed reconstructions of the fates and fate dates of individual chicks, focused on the three breeding seasons of lowest fledging success, and with less detailed brood-level analyses of a larger 11-year dataset including years of more moderate mortality. Mark-recapture analyses of daily brood survival rate (DSR) reveal very strong support for the effects of cold temperatures on brood survival rates, and all the top models agree on a critical temperature of 18.5 °C for insect flight activity in Ithaca. The individual-level analyses, focused on years of higher mortality, favored a 3-day cold snap definition as the most predictive of DSR effects, whereas the larger-scale brood-level analyses revealed 1- and 2-day cold snaps as having the most significant effects on DSR. Regardless, all analyses reveal that, in an age of generally warmer climates, the largest effect of weather on swallow fledgling production is from cold temperatures.

  7. Barium swallow for hiatal hernia detection is unnecessary prior to primary sleeve gastrectomy.

    Science.gov (United States)

    Goitein, David; Sakran, Nasser; Rayman, Shlomi; Szold, Amir; Goitein, Orly; Raziel, Asnat

    2017-02-01

    Hiatal hernia (HH) is common in the bariatric population. Its presence imposes various degrees of difficulty in performing laparoscopic sleeve gastrectomy (LSG). Preoperative upper gastrointestinal evaluation consists of fluoroscopic and or endoscopic studies OBJECTIVES: To evaluate the efficacy of routine, preoperative barium swallow in identifying HH in patients undergoing LSG, and determine if such foreknowledge changes operative and immediate postoperative course regarding operative time, intraoperative adverse events, and length of hospital stay (LOS). In addition, to quantify HH prevalence in these patients and correlate preoperative patient characteristics with its presence. High-volume bariatric practice in a private hospital in Israel METHODS: Retrospective analysis of prospectively collected data between October 2010 and March 2015: anthropometrics, co-morbidities, previous barium swallow, preoperative HH workup (type and result), operative and immediate postoperative course. Primary LSG was performed in 2417 patients. The overall prevalence of HH was 7.3%. Preoperative diagnosis of gastroesophageal reflux disease and female gender were independent risk factors for HH presence. Operative times were significantly longer when HH was concomitantly repaired but "foreknowledge" thereof did not assist in shortening this time. Looking for an HH that was suggested in preoperative upper gastrointestinal evaluation slightly prolonged surgery. LOS was not changed in a significant fashion by HH presence and repair, whether suspected or incidentally found. Routine, pre-LSG barium swallow does not seem to offer an advantage over selective intraoperative hiatal exploration, in the discovery and management of HH. Conversely, when preoperative workup yields a false-positive result, surgery is slightly prolonged. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  8. Long-term functional speech and swallowing outcomes following pharyngolaryngectomy with free jejunal flap reconstruction.

    Science.gov (United States)

    Sharp, David A; Theile, David R; Cook, Renee; Coman, William B

    2010-06-01

    Surgery for advanced cancer of the hypopharynx is a complex issue. Surgical intervention needs to take into consideration the resultant quality of life, in particular fundamental functional outcomes such as speech and swallowing. The aim of this study is to look at these long-term functional outcomes, following pharyngolaryngectomy and free jejunal reconstruction. A total of 19 patients, each undergoing a pharyngolaryngectomy with free jejunal graft was included. Each had a primary tracheoesophageal puncture for insertion of an indwelling voice prosthesis for speech. Functional outcomes of speech and swallow were assessed by a qualified speech pathologist. The impact on patients' quality of life was assessed under 4 domains: impairment, disability, handicap, and well being. The mean time period to follow-up was 4 years. Eighteen of the 19 patients were tolerating an oral diet, with one patient reliant on percutaneous endoscopic gastrostomy feeds. Seventeen patients (89%) were assessed as either having either no--or only a mild degree--of dysphagia, with no evidence of aspiration. Of the 19 patients, 15 were utilizing tracheosophageal speech for communication with 11 (73%) having no--or only a mild degree--of dsyphonia. Patients assessed as having no evidence of dysphagia or dysphonia also reported reduced levels of handicap and distress compared with patients experiencing any degree of dysphagia (P = 0.46) or dysphonia (P = 0.01). While rates of pharyngolaryngectomy increase, most patients have a poor long-term prognosis, heightening the significance of postoperative outcomes. The results of this study highlight the importance of speech and swallow outcomes, and demonstrate the direct correlation between these functions and resultant quality of life.

  9. Spatio-temporal variability in the distribution of ground-dwelling riparian spiders and their potential role in water-to-land energy transfer along Hong Kong forest streams

    Directory of Open Access Journals (Sweden)

    Elaine Y.L. Yuen

    2015-07-01

    Full Text Available Terrestrial predators have been shown to aggregate along stream margins during periods when the emergence of adult aquatic insects is high. Such aggregation may be especially evident when terrestrial surroundings are relatively unproductive, and there are steep productivity gradients across riparia. In tropical forests, however, the productivity of inland terrestrial habitats may decrease the resource gradient across riparia, thus lessening any tendency of terrestrial predators to aggregate along stream margins. We elucidated the spatio-temporal variability in the distribution of ground-dwelling spiders and terrestrial arthropod prey within the riparia of two forest streams in tropical Hong Kong by sampling arthropods along transects at different distances from the streams during the wet and dry seasons. Environmental variables that may have influenced spider distributions were also measured. The vast majority of ground-dwelling predators along all transects at both sites were spiders. Of the three most abundant spiders captured along stream margins, Heteropoda venatoria (Sparassidae and Draconarius spp. (Agelenidae were terrestrially inclined and abundant during both seasons. Only Pardosa sumatrana (Lycosidae showed some degree of aggregation at the stream banks, indicating a potential reliance on aquatic insect prey. Circumstantial evidence supports this notion, as P. sumatrana was virtually absent during the dry season when aquatic insect emergence was low. In general, forest-stream riparia in Hong Kong did not appear to be feeding hotspots for ground-dwelling predators. The lack of aggregation in ground-dwelling spiders in general may be attributed to the low rates of emergence of aquatic insects from the study streams compared to counterpart systems, as well as the potentially high availability of terrestrial insect prey in the surrounding forest. Heteropoda venatoria, the largest of the three spiders maintained a high biomass (up to 28 mg

  10. Swallowing therapy and progressive resistance training in head and neck cancer patients undergoing radiotherapy treatment

    DEFF Research Database (Denmark)

    Hajdú, Sara F; Wessel, Irene; Johansen, Christoffer

    2017-01-01

    BACKGROUND: Head and neck cancer (HNC) patients are often challenged by treatment induced dysphagia and trismus. Traditionally, rehabilitation is initiated when loss of function has already occurred. There is increasing evidence that it is of benefit to patients to initiate an early rehabilitation...... process before and during treatment. HNC patients have a unique set of functional challenges such as pre- and post-treatment dysphagia, pain and weight loss. The aim of the trial is to investigate the effects of swallowing and mouth-opening exercises combined with progressive resistance training (PRT...

  11. Mercury and other element exposure to tree swallows (Tachycineta bicolor) nesting on Lostwood National Wildlife Refuge, North Dakota

    Energy Technology Data Exchange (ETDEWEB)

    Custer, Thomas W. [US Geological Survey, Upper Midwest Environmental Sciences Center, 2630 Fanta Reed Road, La Crosse, WI 54603 (United States)], E-mail: tcuster@usgs.gov; Custer, Christine M. [US Geological Survey, Upper Midwest Environmental Sciences Center, 2630 Fanta Reed Road, La Crosse, WI 54603 (United States); Johnson, Kevin M. [US Fish and Wildlife Service, North Dakota Field Office, 3425 Miriam Avenue, Bismarck, ND 58501-7926 (United States); Hoffman, David J. [US Geological Survey, Patuxent Wildlife Research Center, 12011 Beech Forest Road, Laurel, MD 20708 (United States)

    2008-09-15

    Elevated mercury concentrations in water were reported in the prairie wetlands at Lostwood National Wildlife Refuge, ND. In order to determine whether wildlife associated with these wetlands was exposed to and then accumulated higher mercury concentrations than wildlife living near more permanent wetlands (e.g. lakes), tree swallow (Tachycineta bicolor) eggs and nestlings were collected from nests near seasonal wetlands, semi-permanent wetlands, and lakes. Mercury concentrations in eggs collected near seasonal wetlands were higher than those collected near semi-permanent wetlands or lakes. In contrast, mercury concentrations in nestling livers did not differ among wetland types. Mercury and other element concentrations in tree swallow eggs and nestlings collected from all wetlands were low. As suspected from these low concentrations, mercury concentrations in sample eggs were not a significant factor explaining the hatching success of the remaining eggs in each clutch. - Mercury concentrations in tree swallows nesting in the prairie wetlands at Lostwood National Wildlife Refuge were not elevated.

  12. Efficacy of a novel swallowing exercise program for chronic dysphagia in long-term head and neck cancer survivors.

    Science.gov (United States)

    Kraaijenga, Sophie A C; Molen, Lisette van der; Stuiver, Martijn M; Takes, Robert P; Al-Mamgani, Abrahim; Brekel, Michiel W M van den; Hilgers, Frans J M

    2017-10-01

    The efficacy of rehabilitative exercises for chronic dysphagia treatment in head and neck cancer survivors has not been studied extensively and is ambiguous. A prospective clinical phase II study using an intensive strength training program was carried out in 17 head and neck cancer survivors with chronic dysphagia. Both swallow and nonswallow exercises were performed for 6-8 weeks with a newly developed tool allowing for progressive muscle overload, including chin tuck, jaw opening, and effortful swallow exercises. Outcome parameters were feasibility, compliance, and parameters for effect. Feasibility in terms of the program completion rate was 88%. Compliance with the exercises was 97%. After the training period, chin tuck, jaw opening, and anterior tongue strength had substantially improved. All but 1 patient reported to benefit from the exercises. Feasibility and compliance were high. Some objective and subjective effects of progressive load on muscle strength and swallowing function could be demonstrated. © 2017 Wiley Periodicals, Inc.

  13. Exposure and effects of perfluoroalkyl compounds on tree swallows nesting at Lake Johanna in east central Minnesota, USA.

    Science.gov (United States)

    Custer, Christine M; Custer, Thomas W; Schoenfuss, Heiko L; Poganski, Beth H; Solem, Laura

    2012-07-01

    Tree swallow (Tachycineta bicolor) samples were collected at a reference lake and a nearby lake (Lake Johanna) in east central Minnesota, USA contaminated with perfluorinated carboxylic and sulfonic acids. Tissues were analyzed for a suite of 13 perfluoroalkyl compounds (PFCs) to quantify exposure and to determine if there was an association between egg concentrations of PFCs and reproductive success of tree swallows. Concentrations of perfluoroocatane sulfonate (PFOS) were elevated in all tree swallow tissues from Lake Johanna compared to tissues collected at the reference lake. Other PFCs, except for two, were elevated in blood plasma at Lake Johanna compared to the reference lake. PFOS was the dominant PFC (>75%) at Lake Johanna, but accounted for lake. There was a negative association between concentrations of PFOS in eggs and hatching success. Reduced hatching success was associated with PFOS levels as low as 150ng/g wet weight. Published by Elsevier Inc.

  14. Fiberoptic Endoscopic Evaluation of Swallowing: A Multidisciplinary Alternative for Assessment of Infants With Dysphagia in the Neonatal Intensive Care Unit.

    Science.gov (United States)

    Reynolds, Jenny; Carroll, Sandra; Sturdivant, Chrysty

    2016-02-01

    The standard procedure to assess an infant in the neonatal intensive care unit (NICU) who is suspected of aspirating on oral feedings is a videofluoroscopic swallowing study (VFSS). The VFSS has been used for more than 30 years to assess dysphagia and is considered the gold standard. However, there are challenges to the VFSS, including radiation exposure, transport to radiology, usage of barium, limited positioning options, and cost. An alternative approach is fiberoptic endoscopic evaluation of swallowing (FEES), which uses a flexible endoscope passed transnasally into the pharynx to assess anatomy, movement/sensation of structures, swallow function, and response to therapeutic interventions. Fiberoptic endoscopic evaluation of swallowing has been established as a valid tool for evaluating dysphagia and utilized as an alternative or supplement to the VFSS in both adults and children. This article provides an overview of the current challenges in the NICU with assessing aspiration and introduces a multidisciplinary FEES program for bottle and breastfeeding. A review of the literature of dysphagia, VFSS, and FEES in the adult, pediatric, infant, and neonatal populations was performed. Clinical competency standards were researched and then implemented through an internal process of validation. Finally, a best practice protocol was designed as it relates to FEES in the NICU. Fiberoptic endoscopic evaluation of swallowing is a safe alternative to the VFSS. It can be utilized at the infant's bedside in a NICU for the diagnosis and treatment of swallowing disorders by allowing the clinician the ability to replicate a more accurate feeding experience, therefore, determining a safe feeding plan. Competency and training are essential to establishing a multidisciplinary FEES program in the NICU. Further research is needed to compare the efficacy and validity of FEES versus VFSS for infants in the NICU. Furthermore, evaluating the efficacy of FEES during breastfeeding is

  15. First Steps Towards Development of an Instrument for the Reproducible Quantification of Oropharyngeal Swallow Physiology in Bottle-Fed Children.

    Science.gov (United States)

    Lefton-Greif, Maureen A; McGrattan, Katlyn Elizabeth; Carson, Kathryn A; Pinto, Jeanne M; Wright, Jennifer M; Martin-Harris, Bonnie

    2017-09-11

    The incidence of feeding/swallowing impairments (deglutition disorders) in young children is rising and poses serious acute and long-term health consequences. Accurate detection and prompt intervention can lessen the impact of dysphagia-induced sequelae. Videofluoroscopic Swallow Studies (VFSSs) are used to make critical decisions for medically fragile children despite procedural variability and the lack of agreed upon measures for interpreting and reporting results. This investigation represents the first steps in the development of a novel tool for the quantification of oropharyngeal swallow physiology from full-length VFSS examinations in bottle-fed children. The Modified Barium Swallow Impairment Profile MBSImP™© served as the conceptual assessment model for development of components and operational score variants to characterize distinguishable VFSS observations. Twenty-four components of swallowing physiology were validated via expert consensus. Training materials included a library of 94 digitized video images comprised of distinct score variants for each component. Materials were disseminated to seven speech-language pathologists (SLPs) who participated in didactic and self-training sessions, and rated components. All SLPs achieved ≥80% reliability criterion after completing two or three training sessions. Agreement for 17 (71%) components was achieved after two sessions. Nutritive sucking/oral and airway-related components were most difficult to distinguish. Three sessions were required for 2 (33%) of the sucking/oral components and 4 (57%) of the airway-related components. These findings support the feasibility to standardize training and reliably score swallowing physiology using precise definitions and unambiguous visual images, and represent preliminary steps towards content validity and reliability of a standardized VFSS tool for bottle-fed children.

  16. Influence of the Perceived Taste Intensity of Chemesthetic Stimuli on Swallowing Parameters Given Age and Genetic Taste Differences in Healthy Adult Women

    Science.gov (United States)

    Pelletier, Cathy A.; Steele, Catriona M.

    2014-01-01

    Purpose: This study examined whether the perceived taste intensity of liquids with chemesthetic properties influenced lingua-palatal pressures and submental surface electromyography (sEMG) in swallowing, compared with water. Method: Swallowing was studied in 80 healthy women, stratified by age group and genetic taste status. General Labeled…

  17. Clinical Experience Using the Mann Assessment of Swallowing Ability for Identification of Patients at Risk for Aspiration in a Mixed-Disease Population

    Science.gov (United States)

    Gonzalez-Fernandez, Marlis; Sein, Michael T.; Palmer, Jeffrey B.

    2011-01-01

    Purpose: To determine the clinical performance characteristics of the Mann Assessment of Swallowing Ability (MASA) for predicting aspiration (determined by videofluoroscopic swallowing study [VFSS]) in a mixed population. Method: We selected 133 cases clinically evaluated using MASA and VFSS from January through June 2007. Ordinal risk rating…

  18. First report of blight caused by Sclerotium rolfsii on the invasive exotic weed, Vincetoxicum rossicum (pale swallow-wort) in western New York

    Science.gov (United States)

    Pale (Vincetoxicum rossicum) and black swallow-wort (V. nigrum) are invasive, perennial twining vines that are becoming increasingly problematic in the northeastern U.S. and southeastern Canada. Observations at one natural area heavily populated by pale swallow-wort in Monroe County, NY, revealed a ...

  19. Identification of behaviour change components in swallowing interventions for head and neck cancer patients: protocol for a systematic review.

    Science.gov (United States)

    Govender, Roganie; Smith, Christina H; Taylor, Stuart A; Grey, Daphne; Wardle, Jane; Gardner, Benjamin

    2015-06-20

    Dysphagia (difficulty in swallowing) is a predictable consequence of head and neck cancer and its treatment. Loss of the ability to eat and drink normally has a devastating impact on quality of life for survivors of this type of cancer. Most rehabilitation programmes involve behavioural interventions that include swallowing exercises to help improve swallowing function. Such interventions are complex; consisting of multiple components that may influence outcomes. These interventions usually require patient adherence to recommended behaviour change advice. To date, reviews of this literature have explored whether variation in effectiveness can be attributed to the type of swallowing exercise, the use of devices to facilitate use of swallowing muscles, and the timing (before, during or after cancer treatment). This systematic review will use a behavioural science lens to examine the content of previous interventions in this field. It aims to identify (a) which behaviour change components are present, and (b) the frequency with which they occur in interventions deemed to be effective and non-effective. Clinical trials of behavioural interventions to improve swallowing outcomes in patients with head and neck cancers will be identified via a systematic and comprehensive search of relevant electronic health databases, trial registers, systematic review databases and Web of Science. To ascertain behaviour change intervention components, we will code the content for its theory basis, intervention functions and specific behaviour change techniques, using validated tools: the Theory Coding Scheme, Behaviour Change Wheel and Behaviour Change Technique Taxonomy v1. Study quality will be assessed for descriptive purposes only. Given the specialisation and focus of this review, a small yield of studies with heterogeneous outcome measures is anticipated. Therefore, narrative synthesis is considered more appropriate than meta-analysis. We will also compare the frequency of

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

    Directory of Open Access Journals (Sweden)

    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

  1. Effectiveness of Chin-tuck Maneuver to Facilitate Swallowing in Neurologic Dysphagia

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    Saconato, Mariana

    2015-10-01

    Full Text Available Introduction The chin-tuck maneuver is the most frequently employed postural maneuver in the treatment of neurogenic oropharyngeal dysphagia caused by encephalic vascular strokes and degenerative diseases. Objective The purpose of this study was to investigate the effectiveness of this maneuver in patients with neurogenic dysphagia and factors that could interfere in it. Methods In this retrospective cohort, we analyzed the medical files and videofluoroscopy exams of 35 patients (19 male – 54% and 16 female – 46%; age range between 20 and 89 years old; mean = 69 years. Results The results suggest that the effectiveness of chin-tuck maneuver is related to the overall degree of dysphagia: the more severe the dysphagia, the less effective the maneuver. Conclusion Chin-tuck maneuver should benefit dysphagic patients with delay in the swallowing trigger, reduced laryngeal elevation, and difficulties to swallow liquids, but is not the best compensatory strategy for patients with severe dysphagia.

  2. Electromyographic evaluation of mastication and swallowing in elderly individuals with mandibular fixed implant-supported prostheses

    Directory of Open Access Journals (Sweden)

    Giédre Berretin-Felix

    2008-04-01

    Full Text Available This study evaluated the effect of implant-supported oral rehabilitation in the mandible on the electromyographic activity during mastication and swallowing in edentulous elderly individuals. Fifteen patients aged more than 60 years were evaluated, being 10 females and 5 males. All patients were edentulous, wore removable complete dentures on both dental arches, and had the mandibular dentures replaced by implant-supported prostheses. All patients were submitted to electromyographic evaluation of the masseter, superior orbicularis oris muscles, and the submental muscles, before surgery and 3, 6 and 18 months postoperatively, using foods of different textures. The results obtained at the different periods were analyzed statistically by Kruskal-Wallis non-parametric test. Statistical analysis showed that only the masseter muscle had a significant loss in electromyographic activity (p<0.001, with a tendency of similar response for the submental muscles. Moreover, there was an increase in the activity of the orbicularis oris muscle during rubber chewing after treatment, yet without statistically significant difference. Mandibular fixed implant-supported prostheses in elderly individuals revealed a decrease in electromyographic amplitude for the masseter muscles during swallowing, which may indicate adaptation to new conditions of stability provided by fixation of the complete denture in the mandibular arch.

  3. Preliminary Study of a Caregiver-based Infant and Child Feeding and Swallowing Screening Tool.

    Science.gov (United States)

    Barkmeier-Kraemer, Julie M; Linn, Chris; Thompson, Heather L; Byrd, Robert S; Steinfeld, Mary B; Hoffmann, Raymond G; Silverman, Alan H

    2017-06-01

    The Infant and Child Feeding Questionnaire (ICFQ) was created to facilitate early detection of feeding and swallowing problems. This is achieved by promoting effective communication between caregivers and health care providers resulting in referral for evaluation and treatment of feeding and swallowing problems by specialists. The purpose of this pilot study was to determine whether items from the ICFQ could be used to screen for differences between children with known feeding problems (FP) and without known feeding problems (NFP). Caregivers of children ages 36 months or younger with FP and NFP were recruited to complete the ICFQ and demographic questions. T tests were completed to compare demographic characteristics of the research groups. Responses to ICFQ items were analyzed using receiver operating characteristic analysis and odds ratios to determine whether questionnaire items distinguished between study groups. Sixty-four caregivers of children with FP and 57 caregivers of NFP children were recruited. Three participants in the NFP group did not meet inclusion criteria and were excluded from analysis. A combination of 4 ICFQ questions distinguished between groups (receiver operating characteristic = 0.974). Significant odds ratios were also found for 9 feeding behaviors that distinguished between groups. A subset of items from the ICFQ showed promise for distinguishing FP from NFP groups. Future work will expand the regional representation of the participant samples and obtain equal representation of participants across all age-adjusted questionnaires to determine whether the same combination of ICFQ items continues to distinguish between FP and NFP groups.

  4. Fitness loss and germline mutations in barn swallows breeding in Chernobyl

    Energy Technology Data Exchange (ETDEWEB)

    Ellegren, Hans; Lindgren, Gabriella; Primmer, C.R. [Swedish Univ. of Agricultural Sciences, Animal Breeding and Genetics Dept., Uppsala (Sweden); Moeller, A.P. [Universite Pierre et Marie Curie. Lab. d`Ecologie, Paris, 75 (France)

    1997-10-09

    The severe nuclear accident at Chernobyl in 1986 resulted in the worst reported accidental exposure of radioactive material to free-living organisms. Short-term effects on human populations inhabiting polluted areas include increased incidence of thyroid cancer, infant leukaemia, and congenital malformations in newborns. Two recent studies have reported, although with some controversy, that germline mutation rates were increased in humans and voles living close to Chernobyl, but little is known about the viability of the organisms affected. Here we report an increased frequency of partial albinism, a morphological aberration associated with a loss of fitness, among barn swallows, Hirundo rustica, breeding close to Chernobyl. Heretability estimates indicate that mutations causing albinism were at least partly of germline origin. Furthermore, evidence for an increased germline mutation rate was obtained from segregation analysis at two hypervariable microsatellite loci, indicating that mutation events in barn swallows from Chernobyl were two- to tenfold higher than in birds from control areas in Ukraine and Italy. (author).

  5. Validation of the Persian Translation of the Swallowing Disturbance Questionnaire in Parkinson’s Disease Patients

    Directory of Open Access Journals (Sweden)

    Ali Rajaei

    2014-01-01

    Full Text Available Dysphagia, as a common finding in Parkinson’s disease (PD patients, was estimated to be present in 80–95% of this population during different stages of the disease. The Swallowing Disturbance Questionnaire (SDQ was created as a self-rated dysphagia screening tool in PD. According to the guidelines for cross-cultural adaptation, Persian version of this questionnaire (SDQ-P was developed. 59 Persian patients (39 men and 20 women participated in the study. They responded to the SDQ-P and underwent videofluoroscopic swallowing study (VFSS. Aspiration during VFSS was compared with questionnaire results for each individual. Cronbach’s alpha coefficient for the questionnaire was 0.86 and based on SDQ-P 15 patients (25.4% were dysphagic, while 10 patients (16.9% showed aspiration during VFSS. SDQ-P sensitivity and specificity in predicting aspiration were 96.7 and 91.2%; therefore, the SDQ-P could be a prognostic tool for aspiration. The positive predictive value (PPV, the negative predictive value (NPV, and the pre- and posttest probabilities of aspiration were 0.67, 1, 16.9%, and 66.7%, respectively. In summary, this study demonstrated the reliability and also the feasibility of SDQ-P for screening of aspiration in Iranian patients with PD. Further evaluation of SDQ-P in larger subject population would be suggested.

  6. Flow and Grit by Design: Exploring Gamification in Facilitating Adherence to Swallowing Therapy.

    Science.gov (United States)

    Constantinescu, Gabriela; Rieger, Jana; Mummery, Kerry; Hodgetts, William

    2017-11-08

    Delivery of swallowing therapy is faced with challenges regarding access to in-clinic services and adherence to prescribed home programs. Mobile health (mHealth) technologies are being developed at a rapid pace to address these difficulties. Whereas some benefits to using these modern tools for therapy are obvious (e.g., electronic reminders), other advantages are not as well understood. One example is the potential for mHealth devices and apps to enhance adherence to treatment regimens. This article introduces a number of psychological concepts that relate to adherence and that can be leveraged by mHealth. Elements that contribute to flow (optimal experience) during an activity and those that reinforce grit (perseverance to achieve a long-term goal) can be used to engage patients in their own rehabilitation. The experience of flow can be targeted by presenting the rehabilitation exercise as an optimally challenging game, one that offers a match between challenge and ability. Grit can be supported by reinforcing routine and by varying the therapy experience using different games. A combination of hardware and software design approaches have the potential to transform uninteresting and repetitive activities, such as those that make up swallowing therapy regimens, into engaging ones. The field of gamification, however, is still developing, and gamified mHealth apps will need to withstand scientific testing of their claims and demonstrate effectiveness in all phases of outcome research.

  7. Swallowing Kinematics and Factors Associated with Laryngeal Penetration and Aspiration in Stroke Survivors with Dysphagia.

    Science.gov (United States)

    Seo, Han Gil; Oh, Byung-Mo; Han, Tai Ryoon

    2016-04-01

    The purpose of this study was to investigate swallowing kinematics and explore kinematic factors related with penetration-aspiration in patients with post-stroke dysphagia. Videofluoroscopic images of 68 patients with post-stroke dysphagia and 34 sex- and age-matched healthy controls swallowing a thin liquid were quantitatively analyzed using two-dimensional motion digitization. The measurements included the movement distances and velocities of the hyoid and larynx, and the maximal tilt angles and angular velocities of the epiglottis. All velocity variables were significantly decreased in the stroke patients compared to the controls. There was a significant difference in the maximal horizontal displacement of the larynx, but there were no significant differences in other displacements of the larynx, the maximal displacements of the hyoid bone, and the maximum tilt angle of the epiglottis between the two groups. The maximal tilt angle of the epiglottis was lower in the aspiration subgroup than in the no penetration/aspiration and penetration subgroups as well as the controls. The maximal tilt angle from the y axis showed a dichotomous pattern at 90° of the angle, and all 11 patients with an angle dysphagia. The association of reduced epiglottic movement with the risk of aspiration in patients with post-stroke dysphagia was supported by the quantitative analysis.

  8. Testosterone, plumage colouration and extra-pair paternity in male North-American barn swallows.

    Directory of Open Access Journals (Sweden)

    Cas Eikenaar

    Full Text Available In most monogamous bird species, circulating testosterone concentration in males is elevated around the social female's fertile period. Variation in elevated testosterone concentrations among males may have a considerable impact on fitness. For example, testosterone implants enhance behaviours important for social and extra-pair mate choice. However, little is known about the relationship between natural male testosterone concentration and sexual selection. To investigate this relationship we measured testosterone concentration and sexual signals (ventral plumage colour and tail length, and determined within and extra-pair fertilization success in male North American barn swallows (Hirundo rustica erythrogaster. Dark rusty coloured males had higher testosterone concentrations than drab males. Extra-pair paternity was common (42% and 31% of young in 2009 and 2010, respectively, but neither within- nor extra-pair fertilization success was related to male testosterone concentration. Dark rusty males were less often cuckolded, but did not have higher extra-pair or total fertilization success than drab males. Tail length did not affect within- or extra-pair fertilization success. Our findings suggest that, in North American barn swallows, male testosterone concentration does not play a significant direct role in female mate choice and sexual selection. Possibly plumage colour co-varies with a male behavioural trait, such as aggressiveness, that reduces the chance of cuckoldry. This could also explain why dark males have higher testosterone concentrations than drab males.

  9. Innate immunity is not related to the sex of adult Tree Swallows during the nestling period

    Science.gov (United States)

    Houdek, Bradley J.; Lombardo, Michael P.; Thorpe, Patrick A.; Hahn, D. Caldwell

    2011-01-01

    Evolutionary theory predicts that exposure to more diverse pathogens will result in the evolution of a more robust immune response. We predicted that during the breeding season the innate immune function of female Tree Swallows (Tachycineta bicolor) should be more effective than that of males because (1) the transmission of sexually transmitted microbes during copulation puts females at greater risk because ejaculates move from males to females, (2) females copulate with multiple males, exposing them to the potentially pathogenic microbes in semen, and (3) females spend more time in the nest than do males so may be more exposed to nest microbes and ectoparasites that can be vectors of bacterial and viral pathogens. In addition, elevated testosterone in males may suppress immune function. We tested our prediction during the 2009 breeding season with microbicidal assays in vitro to assess the ability of the innate immune system to kill Escherichia coli. The sexes did not differ in the ability of their whole blood to kill E. coli. We also found no significant relationships between the ability of whole blood to kill E. coli and the reproductive performance or the physical condition of males or females. These results indicate that during the nestling period there are no sexual differences in this component of the innate immune system. In addition, they suggest that there is little association between this component of innate immunity and the reproductive performance and physical condition during the nestling period of adult Tree Swallows.

  10. Mark-recapture and behavioral ecology: a case study of Cliff Swallows

    Directory of Open Access Journals (Sweden)

    Brown, C. R.

    2004-06-01

    Full Text Available Mark–recapture and the statistical analysis methods associated with it offer great potential for investigating fitness components associated with particular behavioral traits. However, few behavioral ecologists have used these techniques. We illustrate the insights that have come from a long–term mark–recapture study of social behavior in Cliff Swallows (Petrochelidon pyrrhonota. The number of transient swallows passing through a colony per hour increased with colony size and was responsible in part for increased rates of ectoparasite introduction from outside the group into the larger colonies. Annual survival probabilities of males engaging in extra–pair copulation attempts were lower than those of males not seen to commit extra–pair copulations, suggesting that males who engage in this behavior may be inferior individuals and that females do not benefit from copulating with them. Females engaging in intraspecific brood parasitism had higher annual survival probabilities than ones either parasitized by others or not known to be either hosts or parasites. This suggests that parasitic females are high–quality birds and that brood parasitism is an effective reproductive tactic for increasing their fitness. By estimating first–year survival of chicks, we found that a clutch size of 4 eggs is often the most productive, on average, as measured by recruitment of offspring as breeders, although birds laying the more uncommon clutch size of 5 fledge more young on average. This helps to explain the observed clutch–size distribution in which clutch size 4 is the most commonly produced.

  11. Swallowing function following extensive resection of oral or oropharyngeal cancer with laryngeal suspension and cricopharyngeal myotomy.

    Science.gov (United States)

    Fujimoto, Yasushi; Hasegawa, Yasuhisa; Yamada, Hiroko; Ando, Atsushi; Nakashima, Tsutomu

    2007-08-01

    To investigate factors that influence postoperative swallowing function in patients who underwent tongue and oropharynx resection. Sixty-two subjects who had undergone extensive resection of oral or oropharyngeal cancer between 1993 and 2005 participated in this study. All surgical procedures involved excision of the bilateral suprahyoid muscles or of >or=50% of the tongue base. Laryngeal suspension and cricopharyngeal myotomy were performed on all subjects. A multivariate analysis of the effects of extensive tongue and oropharynx resection on swallowing function was performed. A total of 53 (85.5%) of the 62 subjects achieved independent oral intake and no longer required tube feeding. Six months after surgery, better eating capabilities had been attained by younger patients as compared with older patients; patients with less extensive tongue base resections; patients who had not undergone radiotherapy; and patients reconstructed with free flaps rather than pedicled flaps. Age was found to be the most important factor in determining whether a patient could achieve independent oral intake after extensive oral or oropharyngeal resection. The main factors in determining the quality of diet attained by the patient were found to be age, the percentage of tongue base resection, and the method of postoperative reconstruction.

  12. Denture Mis-swallowing in the Sliding Esophageal Hiatal Hernia Mimics Esophageal Perforation

    Directory of Open Access Journals (Sweden)

    Chao-Yang Chen

    2008-08-01

    Full Text Available Mis-swallowing of a foreign body in the esophagus coexisting with sliding hernia might be misdiagnosed as esophageal perforation with mediastinal abscess. We report an 89-year-old woman, bedridden for a long period in a nursing home after a previous cerebrovascular accident, who was sent to our emergency department in a state of sepsis because she had swallowed a radio-opaque partial denture. The retention of the denture as an esophageal foreign body was complicated with mediastinitis and bilateral pleural effusion. The inability of the patient to give a reliable clinical history delayed the diagnosis. This report highlights the difficulty in precisely locating a partial denture because of conflicting radiologic findings and the coexistence of esophageal sliding hernia, all of which led to a misdiagnosis of possible esophageal perforation. A right posterolateral thoracotomy with gastrostomy was performed to remove the lower esophageal foreign body after esophagoscopy failed. The surgical finding of a coincidental sliding esophageal hiatal hernia correlated well with the clinical presentation. Managing such a complicated esophageal foreign body in this elderly patient was challenging.

  13. Aspiration Pneumonia in Children with Cerebral Palsy after Videofluoroscopic Swallowing Study

    Directory of Open Access Journals (Sweden)

    Lagos-Guimarães, Hellen Nataly Correia

    2015-10-01

    Full Text Available Introduction Dysphagia is a common symptom in children with cerebral palsy, either in oral or pharyngeal phases. Children who face such difficulties tend to show health problems such as food aspiration, malnutrition and respiratory infections. Videofluoroscopic swallowing study is the most recommended for these cases, as it reveals the real situation during swallowing. Objective The study aimed to verify the occurrence of aspiration pneumonia in children with cerebral palsy after videofluoroscopy. Methods The population for this prospective cross-sectional study involved 103 children with cerebral palsy, referred for videofluoroscopic who had returned for medical examination after a week to search for signs and symptoms of pneumonia. Results The study involved 46 girls (44.66% and 57 boys (55.34%, aged between 0 and 14 years of age. Of the total, 84 (81.5% had dysphagia, of which 24 (23.3% were severe, 8 (7.7% were moderate and 52 (50.4% were mild dysphagia. None of the children presented aspiration pneumonia or infectious complications during the course of videofluoroscopy or after the procedure. Conclusion In the population studied, the authors found no cases of aspiration pneumonia, even with tracheal aspiration present in 32 (31.07% cases.

  14. Swallowing Disorders

    Science.gov (United States)

    ... dystrophy, a rare, progressive genetic disorder. View Full Definition Treatment Changing a person's diet by adding thickeners helps many people, as does learning different ways to eat and chew that reduce ...

  15. Identification of the most significant electrode positions in electromyographic evaluation of swallowing-related movements in humans.

    Science.gov (United States)

    Zaretsky, E; Pluschinski, P; Sader, R; Birkholz, P; Neuschaefer-Rube, C; Hey, Christiane

    2017-02-01

    Surface electromyography (sEMG) is a well-established procedure for recording swallowing-related muscle activities. Because the use of a large number of sEMG channels is time consuming and technically sophisticated, the aim of this study was to identify the most significant electrode positions associated with oropharyngeal swallowing activities. Healthy subjects (N = 16) were tested with a total of 42 channels placed in M. masseter, M. orbicularis oris, submental and paralaryngeal regions. Each test subject swallowed 10 ml of water five times. After having identified 16 optimal electrode positions, that is, positions with the strongest signals quantified by the highest integral values, differences to 26 other ones were determined by a Mann-Whitney U test. Kruskal-Wallis H test was utilized for the analysis of differences between single subjects, subject subgroups, and single electrode positions. Factors associated with sEMG signals were examined in a linear regression. Sixteen electrode positions were chosen by a simple ranking of integral values. These positions delivered significantly higher signals than the other 26 positions. Differences between single electrode positions and between test subjects were also significant. Sixteen most significant positions were identified which represent swallowing-related muscle potentials in healthy subjects.

  16. Plugging the Patient Evidence Gap: What Patients with Swallowing Disorders Post-Stroke Say about Thickened Liquids

    Science.gov (United States)

    McCurtin, Arlene; Healy, Chiara; Kelly, Linda; Murphy, Fiona; Ryan, Jean; Walsh, Joanne

    2018-01-01

    Background: Oropharyngeal dysphagia post-stroke is well known, with its presence increasing the risk of poor outcomes in particular aspiration and aspiration pneumonia. Management to minimize the risk of aspiration and improve swallow safety post-stroke includes the treatment of thickened liquids (TL), an established bolus modification…

  17. Swallowing rehabilitation with nutrition therapy improves clinical outcome in patients with dysphagia at an acute care hospital.

    Science.gov (United States)

    Iwamoto, Masako; Higashibeppu, Naoki; Arioka, Yasutaka; Nakaya, Yutaka

    2014-01-01

    Dysphagia is associated with nutritional deficits and increased risk of aspiration pneumonia. The aim of the present study was to evaluate the impact of nutrition therapy for the patients with dysphagia at an acute care hospital. We also tried to clarify the factors which improve swallowing function in these patients. Seventy patients with dysphagia were included in the present study. Multidisciplinary nutrition support team evaluated swallowing function and nutrition status. Most patients were fed by parenteral or enteral nutrition at the time of the first round. Of these 70 patients, 36 became able to eat orally. The improvement of swallowing function was associated with higher BMI in both genders and higher AMC in men. Mortality was high in the patients with lower BMI and %AMC, suggesting importance of maintaining muscle mass. Thirteen (38.2%) of 34 patients who did not show any improvement in swallowing function died, but no patients who showed improvement died (pnutrition intake about22 kcal/kg/day. These results suggest that it is important to maintain nutritional status to promote rehabilitation in patients with dysphagia even in an acute care hospital.

  18. Identification of dysphagia using the Toronto Bedside Swallowing Screening Test (TOR-BSST©): are 10 teaspoons of water necessary?

    Science.gov (United States)

    Martino, Rosemary; Maki, Ellen; Diamant, Nicholas

    2014-06-01

    Dysphagia screening often includes administration of water. This study assessed the accuracy in identifying dysphagia with each additional teaspoon of water. The original research of the TOR-BSST(©) permitted this assessment. Trained nurses from acute and rehabilitation facilities prospectively administered the TOR-BSST(©) to 311 eligible stroke inpatients. A sensitivity analysis was conducted for the water item using 10 teaspoons plus a sip as the standard. The proportion of positive screenings was 59.2% in acute and 38.5% in rehabilitation. Of all four items that form the TOR-BSST(©), the water swallow item contributed to the identification of dysphagia in 42.7% in acute and 29.0% in rehabilitation patients. Across all patients, dysphagia accuracy was that five teaspoons resulted in a sensitivity of 79% (95% confidence interval [CI] = 70-86), eight a sensitivity of 92% (95% CI = 85-96) and 10 a sensitivity of 96% (95% CI = 90-99). Although a primary contributor, the water swallow item alone does not identify all patients with dysphagia. For a water swallow to accurately identify dysphagia, it is critical to administer 10 teaspoons. The TOR-BSST(©) water swallow item contributes largely to the total TOR-BSST(©)'s screening score and in making the test highly accurate and reliable.

  19. Neural representation of swallowing is retained with age. A functional neuroimaging study validated by classical and Bayesian inference.

    Science.gov (United States)

    Windel, Anne-Sophie; Mihai, Paul Glad; Lotze, Martin

    2015-06-01

    We investigated the neural representation of swallowing in two age groups for a total of 51 healthy participants (seniors: average age 64 years; young adults: average age 24 years) using high spatial resolution functional magnetic resonance imaging (fMRI). Two statistical comparisons (classical and Bayesian inference) revealed no significant differences between subject groups, apart from higher cortical activation for the seniors in the frontal pole 1 of Brodmann's Area 10 using Bayesian inference. Seniors vs. young participants showed longer reaction times and higher skin conductance response (SCR) during swallowing. We found a positive association of SCR and fMRI-activation only among seniors in areas processing sensorimotor performance, arousal and emotional perception. The results indicate that the highly automated swallowing network retains its functionality with age. However, seniors with higher SCR during swallowing appear to also engage areas involved in attention control and emotional regulation, possibly suggesting increased attention and emotional demands during task performance. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Reproducibility and validity of patient-rated assessment of speech, swallowing, and saliva control in Parkinson’s Disease

    NARCIS (Netherlands)

    Machiel Zwarts; Johanna Kalf; Bastiaan Bloem; George Borm; Marten Munneke; Bert de Swart

    2012-01-01

    To report on the development and psychometric evaluation of the Radboud Oral Motor Inventory for Parkinson's Disease (ROMP), a newly developed patient-rated assessment of speech, swallowing, and saliva control in patients with Parkinson's disease (PD). To evaluate reproducibility, 60 patients

  1. Reproducibility and validity of patient-rated assessment of speech, swallowing, and saliva control in Parkinson's disease

    NARCIS (Netherlands)

    Kalf, J.G.; Borm, G.F.; Swart, B.J.M. de; Bloem, B.R.; Zwarts, M.J.; Munneke, M.

    2011-01-01

    OBJECTIVE: To report on the development and psychometric evaluation of the Radboud Oral Motor Inventory for Parkinson's Disease (ROMP), a newly developed patient-rated assessment of speech, swallowing, and saliva control in patients with Parkinson's disease (PD). DESIGN: Reliability and validity

  2. Swallowing action immediately before intravenous fentanyl at induction of anesthesia prevents fentanyl-induced coughing: a randomized controlled study.

    Science.gov (United States)

    Sako, Saori; Tokunaga, Shoji; Tsukamoto, Masanori; Yoshino, Jun; Fujimura, Naoyuki; Yokoyama, Takeshi

    2017-04-01

    Fentanyl is a strong µ-opioid analgesic which attenuates the stimulation of surgical invasion and tracheal intubation. However, intravenous fentanyl often induces coughing [fentanyl-induced coughing (FIC)] during induction of anesthesia. We found that the swallowing action, when requested at induction of anesthesia, attenuated FIC. In the current study, we investigated the relationship between the occurrence of FIC and the swallowing action. The study included American Society of Anesthesiologists physical status I or II patients, aged 20-64 years, who were undergoing elective surgery. They were divided into two groups-one group was urged to perform the swallowing action immediately before intravenous fentanyl (S group), and the other group performed no swallowing action (non-S group). The patients first received intravenous fentanyl and were observed for 90 s. Each patient's background, dose of fentanyl and occurrence of coughing were investigated from their records and a motion picture recording. The incidence of FIC was evaluated by chi-squared test, and severity was tested by Wilcoxon rank-sum test. P fentanyl may be a simple and clinically feasible method for preventing FIC effectively. Clinical trial number: UMIN000012086 ( https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=Rn000014126&language=J ).

  3. Two-dimensional perceptual videofluoroscopic swallowing analysis of the pharyngeal phase in patients older than 50 years.

    Science.gov (United States)

    Chaves, Rosane de Deus; Mangilli, Laura Davison; Sassi, Fernanda Chiarion; Jayanthi, Shri Krishna; Zilberstein, Bruno; de Andrade, Claudia Regina Furquim

    2013-01-01

    Videofluoroscopy is considered the "gold standard" procedure for the evaluation of swallowing by most units that treat patients with dysphagia, having a great impact in decision making, not only in therapeutic terms, but also in determining the prognosis. To propose and to verify the reproducibility of the results of a perceptual two-dimensional videofluoroscopic protocol for the analysis of the pharyngeal phase of swallowing in a population of healthy adults. Participants were 20 healthy adults, of both genders, with ages between 50 and 65 years. Videofluoroscopy was performed during the swallow of the following consistencies: 10 ml of liquid; 7 ml of paste; and half a "salt and water" biscuit. The protocol was composed by four parts: assessment of the pharyngeal transit time; assessment of the duration of the tongue base movement to the posterior pharyngeal wall; valleculae residue ratio; assessment of penetration/aspiration. Statistical analysis involved the assessment of data reproducibility between raters and analysis of the quantitative data regarding gender. Comparison among raters indicated that data was highly reproducible. No significant differences were found between genders for pharyngeal transit time; for the duration of the tongue base movement to the posterior pharyngeal wall; and for the valleculae residue ratio. The perceptual two-dimensional videofluoroscopy analysis demonstrated to be a reproducible method. Valleculae residue was present in 40% of the study sample, suggesting that this parameter alone does not indicate alterations of the pharyngeal phase of swallowing.

  4. Differences in size between first and replacement clutches match the seasonal decline in single clutches in Tree Swallows

    NARCIS (Netherlands)

    Karagicheva, J.; Liebers, M.; Rakhimberdiev, E.; Hallinger, K.; Saveliev, A.; Winkler, D.W.

    2016-01-01

    The seasonal decline in clutch size in birds can be a response to the environmentallyconditioned decrease in prospects for offspring or a consequence of a lower physical abilityof late-breeding females. To find out which of the explanations apply in Tree SwallowsTachycineta bicolor, we assessed

  5. Dysarthria and dysphagia in Amyotrophic Lateral Sclerosis with spinal onset: a study of quality of life related to swallowing.

    Science.gov (United States)

    da Costa Franceschini, Andressa; Mourão, Lucia Figueiredo

    2015-01-01

    Dysarthria and dysphagia are the most common clinical problems encountered in Amyotrophic Lateral Sclerosis and may reduce the quality of life. Evaluate the association of dysarthria and dysphagia and to evaluate the impact of dysphagia on swallowing quality of life in patients with ALS with spinal onset. Seventeen patients underwent to speech and swallowing evaluation and filled out self-report assessment of the Swallowing Quality of Life (SWAL-QOL). The dysarthria severity was graded using the Speech Subscale of ALS Severity Scale. The dysphagia severity was graded using a scale proposed by Dziweas et al., and the Functional Oral Intake Scale. Over 70% of the ALS patients with spinal onset had dysarthria and dysphagia. The correlation of dysarthria and dysphagia scales was statistically significant (p dysarthria and dysphagia severity and SWAL-QOL outcomes was significant for the same domains: "symptom frequency", "communication" and "fear of eating". The SWAL-QOL domains presented a mild to moderate impact on quality of life. Disease duration did not impact on SWAL-QOL. Dysarthria and dysphagia were common symptoms in patients with spinal onset of ALS and the swallowing quality of life decrease was directly related to with severity of dysarthria and dysphagia.

  6. Impact of the defoliating moth Hypena opulenta on invasive swallow-worts (Vincetoxicum species) under different light environments

    Science.gov (United States)

    Black and pale swallow-wort (Vincetoxicum nigrum and V. rossicum, Apocynaceae: Asclepiadoideae) are twining vines from Europe that have become invasive in the northeastern USA and southeastern Canada. Hypena opulenta (Christoph) (Lepidoptera: Erebidae), a defoliating forest moth from the Ukraine, ha...

  7. Abrostola clarissa (Lepidoptera, Noctuidae), a new potential biocontrol agent for invasive swallow-worts, Vincetoxicum rossicum and V. nigrum

    Science.gov (United States)

    Pale and black swallow-worts (Vincetoxicum rossicum and V. nigrum; Apocynaceae, subfamily Asclepiadoideae), perennial vines native to Eurasia, are now invading natural and anthropogenic habitats in the northeastern U.S.A. and southeastern Canada, threatening natural biodiversity and increasing contr...

  8. Potential effects of environmental contaminants on P450 aromatase activity and DNA damage in swallows from the Rio Grande and Somerville, Texas

    Science.gov (United States)

    Sitzlar, M.A.; Mora, M.A.; Fleming, J.G.W.; Bazer, F.W.; Bickham, J.W.; Matson, C.W.

    2009-01-01

    Cliff swallows (Petrochelidon pyrrhonota) and cave swallows (P. fulva) were sampled during the breeding season at several locations in the Rio Grande, Texas, to evaluate the potential effects of environmental contaminants on P450 aromatase activity in brain and gonads and DNA damage in blood cells. The tritiated water-release aromatase assay was used to measure aromatase activity and flow cytometry was used to measure DNA damage in nucleated blood cells. There were no significant differences in brain and gonadal aromatase activities or in estimates of DNA damage (HPCV values) among cave swallow colonies from the Lower Rio Grande Valley (LRGV) and Somerville. However, both brain and gonadal aromatase activities were significantly higher (P DNA damage estimates were significantly higher (P DNA damage in cliff swallows. We did not observe any differences in aromatase activity or DNA damage in cave swallows that could be associated with contaminant exposure. Also, the differences in aromatase activity and DNA damage between male cliff swallows from Laredo and Somerville could not be explained by contaminants measured at each site in previous studies. Our study provides baseline information on brain and gonadal aromatase activity in swallows that could be useful in future studies. ?? 2008 Springer Science+Business Media, LLC.

  9. Hyoid bone displacement as parameter for swallowing impairment in patients treated for advanced head and neck cancer.

    Science.gov (United States)

    Kraaijenga, Sophie A C; van der Molen, Lisette; Heemsbergen, Wilma D; Remmerswaal, Gawein B; Hilgers, Frans J M; van den Brekel, Michiel W M

    2017-02-01

    Reduced hyoid displacement is thought to contribute to aspiration and pharyngeal residues in head and neck cancer (HNC) patients with dysphagia. To further study hyoid elevation and anterior excursion in HNC patients, this study reports on temporal/kinematic measures of hyoid displacement, with the additional goal to investigate correlations with clinical swallowing impairment. A single-blind analysis of data collected as part of a larger prospective study was performed at three time points before and after chemoradiotherapy. Twenty-five patients had undergone clinical swallowing assessments at baseline, 10-weeks, and 1-year post-treatment. Analysis of videofluoroscopic studies was done on different swallowing consistencies of varying amounts. The studies were independently reviewed frame-by-frame by two clinicians to assess temporal (onset and duration) and kinematic (anterior/superior movement) measures of hyoid displacement (ImageJ), laryngeal penetration/aspiration, and presence of vallecula/pyriform sinus residues. Patient-reported oral intake and swallowing function were also evaluated. Mean maximum hyoid displacement ranged from 9.4 mm (23 % of C2-4 distance) to 12.6 mm (27 %) anteriorly, and from 18.9 mm (41 %) to 24.9 mm (54 %) superiorly, depending on bolus volume and consistency. Patients with reduced superior hyoid displacement perceived significantly more swallowing impairment. No correlation between delayed or reduced hyoid excursion and aspiration or residue scores could be demonstrated. Hyoid displacement is subject to variability from a number of sources. Based on the results, this parameter seems not very valuable for clinical use in HNC patients with dysphagia.

  10. Respiratory muscle training on pulmonary and swallowing function in patients with Huntington's disease: a pilot randomised controlled trial.

    Science.gov (United States)

    Reyes, Alvaro; Cruickshank, Travis; Nosaka, Kazunori; Ziman, Mel

    2015-10-01

    To examine the effects of 4-month of respiratory muscle training on pulmonary and swallowing function, exercise capacity and dyspnoea in manifest patients with Huntington's disease. A pilot randomised controlled trial. Home based training program. Eighteen manifest Huntington's disease patients with a positive genetic test and clinically verified disease expression, were randomly assigned to control group (n=9) and training group (n=9). Both groups received home-based inspiratory (5 sets of 5 repetitions) and expiratory (5 sets of 5 repetitions) muscle training 6 times a week for 4 months. The control group used a fixed resistance of 9 centimeters of water, and the training group used a progressively increased resistance from 30% to 75% of each patient's maximum respiratory pressure. Spirometric indices, maximum inspiratory pressure, maximum expiratory pressure, six minutes walk test, dyspnoea, water-swallowing test and swallow quality of life questionnaire were assessed before, at 2 and 4 months after training. The magnitude of increases in maximum inspiratory (d=2.9) and expiratory pressures (d=1.5), forced vital capacity (d=0.8), forced expiratory volume in 1 second (d=0.9) and peak expiratory flow (d=0.8) was substantially greater for the training group in comparison to the control group. Changes in swallowing function, dyspnoea and exercise capacity were small (d ≤ 0.5) for both groups without substantial differences between groups. A home-based respiratory muscle training program appeared to be beneficial to improve pulmonary function in manifest Huntington's disease patients but provided small effects on swallowing function, dyspnoea and exercise capacity. © The Author(s) 2015.

  11. Adherence to a Prophylactic Swallowing Therapy Program During (Chemo) Radiotherapy: Impact of Service-Delivery Model and Patient Factors.

    Science.gov (United States)

    Wall, Laurelie R; Ward, Elizabeth C; Cartmill, Bena; Hill, Anne J; Porceddu, Sandro V

    2017-04-01

    Intensive, prophylactic swallowing therapy programs have been developed to improve dysphagia outcomes for patients with head/neck cancer (HNC) receiving (chemo)radiotherapy ([C]RT). Across studies, variable therapy adherence rates have been reported. Preliminary research suggests that service-delivery mode and demographic factors may influence adherence. This study examined patient adherence to a prophylactic swallowing therapy protocol across three service-delivery models: (1) clinician-directed face-to-face therapy, (2) technology-assisted therapy using the telepractice application, SwallowIT and (3) independent patient-directed therapy. The secondary aim explored the impact of patient factors on adherence. Patients with oropharyngeal HNC receiving definitive (C)RT were randomised to receive the Pharyngocise exercise protocol via clinician-directed (n = 26), patient-directed (n = 27) or SwallowIT-assisted (n = 26) models. Adherence was calculated as the percentage of prescribed exercise completed. Multiple patient factors were recorded at baseline. Adherence across the 6 weeks in all groups was low (27%), and declined from week 4 of (C)RT. The clinician-directed model yielded significantly (p = 0.014) better adherence than patient-directed therapy in weeks 1-3. There was also a trend for higher adherence in the SwallowIT group compared to patient-directed in weeks 1-3 (p = 0.064). Multivariable linear modelling identified active smoking at baseline (p Telepractice may provide an alternate model to support adherence where service constraints limit intensive clinician-directed therapy.

  12. Simultaneous videoradiography and solid state intraluminal pharyngeal manometry during barium swallow; videomanometry

    Energy Technology Data Exchange (ETDEWEB)

    Olsson, Rolf

    1995-08-01

    The technique was used in nondysphagic volunteers and in dysphagic patients. Our normal values in nondysphagic volunteers are in accordance with normal values in the literature. Regarding catheter movement we found the a previously not described sensor movement where the sensor in the upper esophageal sphincter followed the laryngeal elevation with no response to soft palate elevation. We found a longitudinal asymmetry in the pharynx with higher contraction pressures at lower levels. In the experimental model we found that intrabolus pressure was dependent on bolus volume, lumen narrowing, sensor position, flow rate, and bolus viscosity. In patients with a cricopharyngeal indentation we found weak pharyngeal constrictors with outpouching of the lumen above and below. Finally, in dysphagic patients with a normal radiologic investigation, videomanometry displayed abnormalities in 74% of the patients. We conclude that barium swallow and manometry are complementary and we suggest the addition of pharyngeal solid state manometry, preferably with simultaneous videoradiography, in dysphagic patients. 128 refs, 4 figs.

  13. Volumetric Assessment of Swallowing Muscles: A Comparison of CT and MRI Segmentation.

    Science.gov (United States)

    Sporns, Kim Barbara; Hanning, Uta; Schmidt, Rene; Muhle, Paul; Wirth, Rainer; Zimmer, Sebastian; Dziewas, Rainer; Suntrup-Krueger, Sonja; Sporns, Peter Bernhard; Heindel, Walter; Schwindt, Wolfram

    2017-11-03

    Purpose Recent retrospective studies have proposed a high correlation between atrophy of swallowing muscles, age, severity of dysphagia and aspiration status based on computed tomography (CT). However, ionizing radiation poses an ethical barrier to research in prospective non-patient populations. Hence, there is a need to prove the efficacy of techniques that rely on noninvasive methods and produce high-resolution soft tissue images such as magnetic resonance imaging (MRI). The objective of this study was therefore to compare the segmentation results of swallowing muscles using CT and MRI. Methods Retrospective study of 21 patients (median age: 46.6; gender: 11 female) who underwent CT and MRI of the head and neck region within a time frame of less than 50 days because of suspected head and neck cancer using contrast agent. CT and MR images were segmented by two blinded readers using Medical Imaging Toolkit (MITK) and both modalities were tested (with the equivalence test) regarding the segmented muscle volumes. Adjustment for multiple testing was performed using the Bonferroni test and the potential time effect of the muscle volumes and the time interval between the modalities was assessed by a spearman correlation. The study was approved by the local ethics committee. Results The median volumes for each muscle belly of the digastric muscle derived from CT were 3051 mm(3) (left) and 2969 mm(3) (right), and from MRI they were 3218 mm(3) (left) and 3027 mm(3) (right). The median volume of the geniohyoid muscle was 6580 mm(3) on CT and 6648 mm(3) on MRI. The interrater reliability was high for all segmented muscles. The mean time interval between the CT and MRI examinations was 34 days (IQR 25; 41). The muscle differences of each muscle between the two modalities did not reveal significant correlation to the time interval between the examinations (digastric left r = 0.003 and digastric right r = -0.008; geniohyoid muscle r = 0

  14. History and Evolution of the Barium Swallow for Evaluation of the Pharynx and Esophagus.

    Science.gov (United States)

    Levine, Marc S; Rubesin, Stephen E

    2017-02-01

    This article reviews the history of the barium swallow from its early role in radiology to its current status as an important diagnostic test in modern radiology practice. Though a variety of diagnostic procedures can be performed to evaluate patients with dysphagia or other pharyngeal or esophageal symptoms, the barium study has evolved into a readily available, non-invasive, and cost-effective technique that can facilitate the selection of additional diagnostic tests and guide decisions about medical, endoscopic, or surgical management. This article focuses on the evolution of fluoroscopic equipment, radiography, and contrast media for evaluating the pharynx and esophagus, the importance of understanding pharyngoesophageal relationships, and major advances that have occurred in the radiologic diagnosis of select esophageal diseases, including gastroesophageal reflux disease, infectious esophagitis, eosinophilic esophagitis, esophageal carcinoma, and esophageal motility disorders.

  15. Outcome of Rehabilitation and Swallowing Therapy after Percutaneous Endoscopic Gastrostomy in Dysphagia Patients.

    Science.gov (United States)

    Toh Yoon, Ezekiel Wong; Hirao, Jun; Minoda, Naoko

    2016-12-01

    The objective of this study was to investigate the outcomes of rehabilitation (with swallowing therapy) after percutaneous endoscopic gastrostomy (PEG) in patients with neurogenic dysphagia. Forty-seven patients (29 males and 18 females) who were transferred to the rehabilitation ward of our hospital after receiving PEG tube placements during a 5-year period were enrolled in this study. Patients' demographic data, comorbidities, nutritional statuses, and laboratory biomarkers before the PEG procedure were collected. Rehabilitation (with swallowing therapy) outcomes such as changes in Functional Independence Measure (FIM) and dysphagia grade (using Fujishima's classification) were evaluated. Significant improvements in FIM scores and dysphagia grades after rehabilitation therapy were observed. Twenty-seven patients (57.4 %) were discharged with some oral intake and 10 patients (21.3%) were discharged PEG-free (defined as the PEG tube not being used or removed). Factors associated with being discharged with some oral intake were increase in FIM score (adjusted OR 1.10, 95 % CI 1.02-1.19) and higher baseline dysphagia grade (adjusted OR 1.88, 95 % CI 1.04-3.39). Factors associated with being discharged PEG-free were longer rehabilitation period (OR 1.03, 95 % CI 1.01-1.04), absence of respiratory disorders (OR 0.12, 95 % CI 0.03-0.35), and increase in FIM score (OR 1.17, 95 % CI 1.08-1.28). Changes in dysphagia grade were significantly correlated with changes in FIM score (r 2  = 0.46, p dysphagia.

  16. Impaired swimming behaviour and morphology of sperm from barn swallows Hirundo rustica in Chernobyl.

    Science.gov (United States)

    Møller, A P; Mousseau, T A; Lynn, C; Lynnn, C; Ostermiller, S; Rudolfsen, G

    2008-02-29

    We investigated the motility and morphology of live sperm from barn swallows Hirundo rustica breeding in radioactively contaminated areas around Chernobyl and control areas in Ukraine in order to test the hypothesis that swimming behaviour and morphology of sperm was impaired by radioactive contamination. We obtained sperm samples from 98% of sampled birds, thus avoiding sampling bias due to the fraction of males not producing sperm samples. Analyses of within- and between-sample repeatability revealed significant and intermediate to large estimates for all sperm parameters. There were significant differences between the Chernobyl area and the control area for two of 11 sperm behaviour parameters, and significant interactions between area and year for six of these parameters. The proportion of sperm with abnormal morphology was elevated in barn swallows from Chernobyl. A principal component (PC) analysis revealed four significant axes that explained 88% of the variance in sperm behaviour parameters. One of these principal components differed between areas, and three components showed significant year by area interactions. PC2 representing the frequency of slow sperm increased with increasing radiation in one year, but not another. PC3 representing sperm with high linearity, small amplitude of lateral head displacement and low track velocity decreased with increasing background radiation level. PC4 reflecting a large proportion of static sperm with high beat cross frequency increased with increasing background radiation level. Sperm behaviour as reflected by principal components was predictable among years from information on level of radiation, and it was predictable among sites in different years. These results are consistent with the hypothesis that sperm behaviour and morphology have been affected by radiation due to the Chernobyl accident.

  17. Alternative antiretroviral therapy formulations for patients unable to swallow solid oral dosage forms.

    Science.gov (United States)

    Duggan, Joan M; Akpanudo, Barbara; Shukla, Vipul; Gutterson, Glen; Eitniear, Lindsey; Sahloff, Eric G

    2015-09-15

    Evidence-based guidance is presented to assist clinicians in selecting alternative formulations of antiretroviral (ARV) agents for patients with human immunodeficiency virus (HIV) infection who are unable to swallow tablets or capsules. The inability to take medications in standard oral dosage forms can be associated with nonadherence or the use of alternative administration strategies such as capsule or tablet breaking, crushing, or chewing. Patients with HIV infection require long-term ARV therapy to maintain viral suppression; ARV agents are predominately available as tablets and capsules that may pose swallowing difficulties for some patients. Using a variety of sources (the primary literature, pharmaceutical package inserts, and requests for unpublished data from drug manufacturers), available evidence on the bioavailability of ARV medications after disruption of the capsule or tablet matrix was reviewed; information on alternative formulations of ARV agents was also assessed. With several ARV agents, disruption of the solid oral dosage form by crushing, chewing, or breaking tablets or opening capsules prior to ingestion has been shown to result in altered bioavailability or pharmacokinetics and thus the potential for incomplete virological suppression, increased adverse effects, and suboptimal health outcomes. Of the 33 single-agent ARV medications and combination ARV products in five classes available at the time of review, approximately half exist as powders, liquids, injectables, or chewable or dissolvable tablets. If alternative ARV formulations or administration methods are used, close monitoring for achievement of virological and immunologic success and potential toxicities is recommended. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  18. Conducting Real-Time Videofluoroscopic Swallow Study via Telepractice: A Preliminary Feasibility and Reliability Study.

    Science.gov (United States)

    Burns, Clare L; Ward, Elizabeth C; Hill, Anne J; Phillips, Nick; Porter, Linda

    2016-06-01

    A small number of studies have examined the feasibility of conducting videofluoroscopic swallow studies (VFSS) via telepractice. While the results have confirmed this potential, the systems tested to date have either reported issues that impacted the ability to analyze/interpret the VFSS recordings in real time, or they were not designed to enable real-time interpretation. Further system design is needed to establish a telepractice model that enables the VFSS assessment to be both guided and interpreted live in real time. The aim of this study was to test the feasibility and reliability of using a telepractice system to enable live VFSS assessment. Twenty adult patients underwent a VFSS assessment directed by a telepractice SLP with competency in VFSS located in another room of the hospital. The telepractice clinician led the sessions using a C20 Cisco TelePresence System. This was linked in real time via a secure telehealth network (at 4 megabits per second (Mbit/s)) to a C60 Cisco TelePresence System located in a fluoroscopy suite, connected to the digital fluoroscopy system. Levels of agreement were calculated between the telepractice clinician and a face-to-face clinician who simultaneously rated the VFSS in real time. High levels of agreement for swallowing parameters (range = 75-100 %; k = -0.34 to 1.0) and management decisions (range = 70-100 %, k = 0.64-1.0) were found. A post-session questionnaire revealed clinicians agreed that the telepractice system enabled successful remote assessment of VFSS. The findings support the potential to conduct live VFSS assessment via a telepractice model.

  19. Viability is associated with melanin-based coloration in the barn swallow (Hirundo rustica.

    Directory of Open Access Journals (Sweden)

    Nicola Saino

    Full Text Available Pigmentation of body surface in animals can have multiple determinants and accomplish diverse functions. Eumelanin and pheomelanin are the main animal pigments, being responsible of yellow, brownish-red and black hues, and have partly common biosynthetic pathways. Many populations of vertebrates show individual variation in melanism, putatively with large heritable component. Genes responsible for eu- or pheomelanogenesis have pleiotropic but contrasting effects on life-history traits, explaining the patterns of covariation observed between melanization and physiology (e.g. immunity and stress response, sexual behavior and other characters in diverse taxa. Yet, very few studies in the wild have investigated if eu- and pheomelanization predict major fitness traits like viability or fecundity. In this correlative study, by contrasting adult barn swallows (Hirundo rustica matched for age, sex, breeding site, and year and date of sampling, we show that males but not females that survived until the next year had paler, relatively more eu- than pheomelanic pigmentation of ventral body feathers. Better performance of individuals that allocate relatively more to eumelanogenesis was expected based on previous evidence on covariation between eumelanic pigmentation and specific traits related to immunity and susceptibility to stress. However, together with the evidence of no covariation between viability and melanization among females, this finding raises the question of the mechanisms that maintain variation in genes for melanogenesis. We discuss the possibility that eu- and pheomelanization are under contrasting viability and sexual selection, as suggested by larger breeding and sperm competition success of darker males from other barn swallow subspecies.

  20. Development of A MEMS Based Manometric Catheter for Diagnosis of Functional Swallowing Disorders

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, H Y [Centre for Advanced Manufacturing Research, University of South Australia, Adelaide (Australia); Hariz, A J [School of Electrical and Information Engineering, University of South Australia (Australia); Omari, T [Centre for Paediatric and Adolescent Gastroenterology, Women' s and Children' s Hospital, Adelaide (Australia); Teng, M F [Centre for Advanced Manufacturing Research, University of South Australia, Adelaide (Australia); Sii, D [Centre for Advanced Manufacturing Research, University of South Australia, Adelaide (Australia); Chan, S [Centre for Advanced Manufacturing Research, University of South Australia, Adelaide (Australia); Lau, L [Centre for Advanced Manufacturing Research, University of South Australia, Adelaide (Australia); Tan, S [Centre for Advanced Manufacturing Research, University of South Australia, Adelaide (Australia); Lin, G [Centre for Advanced Manufacturing Research, University of South Australia, Adelaide (Australia); Haskard, M [School of Electrical and Information Engineering, University of South Australia (Australia); Mulcahy, D; Bakewell, M [Centre for Paediatric and Adolescent Gastroenterology, Women' s and Children' s Hospital, Adelaide (Australia)

    2006-04-01

    Silicon pressure sensors based on micro-electro-mechanical-systems (MEMS) technologies are gaining popularity for applications in bio-medical devices. In this study, a silicon piezo-resistive pressure sensor die is used in a feasibility study of developing a manometric catheter for functional swallowing disorders diagnosis. The function of a manometric catheter is to measure the peak and intrabolus pressures along the esophageal segment during the swallowing action. Previous manometric catheters used the water perfusion technique to measure the pressure changes. This type of catheter is reusable, large in size and the pressure reading is recorded by an external transducer. Current manometric catheters use a solid state pressure sensor on the catheter itself to measure the pressure changes. This type of catheter reduces the discomfort to the patient but it is reusable and is very expensive. We carried out several studies and experiments on the MEMS-based pressure sensor die, and the results show the MEMS-based pressure sensors have a good stability and a good linearity output response, together with the advantage of low excitation biasing voltage and extremely small size. The MEMS-based sensor is the best device to use in the new generation of manometric catheters. The concept of the new MEMS-based manometric catheter consists of a pressure sensing sensor, supporting ring, the catheter tube and a data connector. Laboratory testing shows that the new calibrated catheter is capable of measuring pressure in the range from 0 to 100mmHg and maintaining stable condition on the zero baseline setting when no pressure is applied. In-vivo tests are carried out to compare the new MEMS based catheter with the current version of catheters used in the hospital.

  1. Instrumental and sensory quantification of oral coatings retained after swallowing semi-solid foods.

    Science.gov (United States)

    Prinz, J F; Huntjens, L; de Wijk, R A

    2006-12-01

    After a mouthful of food has been swallowed, some food material is always retained in the mouth. With semi-solid foods this is in the form of a coating that adheres to the oral mucosa. The amount and location of this material may play an important role in food sensations. In this study two quantitative methods of describing the coatings, generated by a set of 16 model custards varying in degree of lubrication (fat content) and degree of viscosity (starch concentration) are investigated. In the first method, a trained quantitative descriptive analysis panel (N=8) was instructed to take single mouthfuls of semi-solid foods, swallow and then rinse twice for 5s with water and spit out. The turbidity of the rinse water was then measured. During the same session, sensory assessments of the products were obtained. In the second method the thickness of the coating on the anterior and middle one-thirds of the tongue was quantified using a pair of opto-electronic reflectance sensors mounted on a probe which was placed on the tongue, one sensor measuring the anterior part of the tongue the other the posterior (middle third) of the tongue. Turbidity of the first rinse related strongly to the food's viscosity, as well as to sensory attributes associated with the food's fat content and viscosity, such as perceived thickness, creaminess and fattiness. Turbidity of subsequent rinses related primarily to fat content. These results indicate that turbidity of rinse water is a useful tool in fundamental (e.g., food texture research) as well as applied research (e.g., product development and quality assurance in food industry). Reflectance varied primarily with fat content and did not relate well to sensory attributes.

  2. Timing of molt of barn swallows is delayed in a rare Clock genotype

    Directory of Open Access Journals (Sweden)

    Nicola Saino

    2013-02-01

    Full Text Available Photoperiodic responses are major factors entraining circannual life-cycles, functioning to adaptively synchronize annual routines to seasonal fluctuations in ecological conditions. Photoperiodism in physiology and behaviour is enforced by genes, including the vertebrate Clock orthologues, which are associated, for example, with phenology of migration in fish and breeding in birds. However, the role of Clock in photoperiodic plumage molt processes is unknown. We analyzed variation in molt schedules in relation to Clock genotype, using the long-distance migratory barn swallow (Hirundo rustica as a model and by identifying males and females using molecular sexing techniques. Consistently with previous studies, we found one very common (Q7 and two rare (Q6, Q8 variants of a functionally significant Clock polyglutamine repeat. Molt schedules of primary wing feathers of swallows during their wintering period in Nigeria differed among Clock genotypes: rare (1.1% Q7/Q8 heterozygotes had significantly delayed molt compared to the other genotypes. Molt schedules did not differ between males and females, and no differential association between molt and Clock in relation to sex emerged. The same rare Clock genotype that exhibited delayed breeding in Europe was here found to delay molt in Africa. Though based on a limited number of Q7/Q8 individuals from an otherwise very large sample, these novel results suggest that Clock is involved in the photoperiodic control of both molt and breeding, potentially also via reciprocal carry-over effects. If confirmed in species with higher Clock polymorphism, present results may have far-reaching consequences for the study of photoperiodic control of molt and expression of annual routines.

  3. Multimodal Guided Self-Help Exercise Program to Prevent Speech, Swallowing, and Shoulder Problems Among Head and Neck Cancer Patients: A Feasibility Study

    National Research Council Canada - National Science Library

    Cnossen, Ingrid C; van Uden-Kraan, Cornelia F; Rinkel, Rico N. P. M; Aalders, IJke J; de Goede, Cees J. T; de Bree, Remco; Doornaert, Patricia; Rietveld, Derek H. F; Langendijk, Johannes A; Witte, Birgit I; Leemans, C. Rene; Verdonck-de Leeuw, Irma M

    2014-01-01

    .... Pretreatment counseling combined with self-help exercises could be provided to inform patients and possibly prevent them from having speech, swallowing, and shoulder problems during and after treatment. Objective...

  4. Starch gel and cellulose acetate electrophoretic analysis of allozyme frequencies in barn swallow (Hirundo rustica) populations at a dioxin contaminated site in northern Louisiana

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This study compared the genetic variability of Louisiana barn swallows at a dioxin-contaminated wetland to two reference populations. Allozyme frequencies,...

  5. Relationship Between the Eating Assessment Tool-10 and Objective Clinical Ratings of Swallowing Function in Individuals with Head and Neck Cancer.

    Science.gov (United States)

    Arrese, Loni C; Carrau, Ricardo; Plowman, Emily K

    2017-02-01

    The Eating Assessment Tool-10 (EAT-10) represents a validated, easy to administer patient report dysphagia severity scale. Although its ability to detect swallowing impairment has been investigated in other patient populations, the utility of this instrument in individuals with head and neck cancer (HNC) has not been studied. The aim of the current investigation was to determine the relationship between patient ratings of swallowing impairment (EAT-10) and objective clinical ratings of swallow physiology in individuals with HNC. Forty-four HNC participants completed the EAT-10 and a standardized videofluoroscopy swallow study. Blinded raters determined airway safety using the penetration-aspiration scale (PAS) and swallowing function using the modified barium swallow impairment profile (MBSImP™©). Participants were stratified into three groups (pre-treatment through 1 year post-treatment, 1-5 years post-treatment, and >5 years post-treatment). Independent t tests, Pearson's and Spearman's Rho correlations, and a Bonferroni correction for multiple comparisons were performed. EAT-10 scores were significantly higher in HNC patients with unsafe swallowing (M 24.45, SD 8.32) compared to those with safe swallowing (M 16.20, SD 12.14), t(21) = -2.36, p  < 0.04. Significant correlations were revealed between EAT-10 scores and the MBSImP™© (pharyngeal composite), and PAS scores (p < 0.05) for the pre-treatment to within 1 year post-treatment group. No associations, however, were observed for HNC patients in the time groups representing greater than 1-year post cancer treatment.

  6. Swallow syncope in association with Schatzki ring and hypertensive esophageal peristalsis: report of three cases and review of the literature.

    Science.gov (United States)

    Gawrieh, Samer; Carroll, Ty; Hogan, Walter J; Soergel, Konrad H; Shaker, Reza

    2005-01-01

    Syncope caused by swallowing-induced cardiac arrhythmia is an uncommon condition. The recognition of this syndrome is paramount but often difficult. We report three cases of deglutition syncope evaluated at our institution over a three-year period. Two patients had distal esophageal (Schatzki) ring and two had hypertensive peristaltic waves (commonly referred to as "nutcracker esophagus"), neither of which had been described before in association with deglutition syncope. Two patients underwent placement of a demand cardiac pacemaker with subsequent resolution of their syncopal symptoms, while the third patient refused any further intervention. Swallow syncope usually follows a benign course from a cardiac standpoint. Placement of a demand cardiac pacemaker can prevent recurrence of presyncopal and syncopal attacks and their untoward consequences.

  7. A biomechanical model of swallowing for understanding the influence of saliva and food bolus viscosity on flavour release

    CERN Document Server

    De Loubens, Clément; Doyennette, Marion; Tréléa, Ioan Cristian; Souchon, Isabelle

    2013-01-01

    After swallowing a liquid or a semi-liquid food product, a thin film responsible for the dynamic profile of aroma release coats the pharyngeal mucosa. The objective of the present article was to understand and quantify physical mechanisms explaining pharyngeal mucosa coating. An elastohydrodynamic model of swallowing was developed for Newtonian liquids that focused on the most occluded region of the pharyngeal peristaltic wave. The model took lubrication by a saliva film and mucosa deformability into account. Food bolus flow rate and generated load were predicted as functions of three dimensionless variables: the dimensionless saliva flow rate, the viscosity ratio between saliva and the food bolus, and the elasticity number. Considering physiological conditions, the results were applied to predict aroma release kinetics. Two sets of conditions were distinguished. The first one was obtained when the saliva film is thin, in which case food bolus viscosity has a strong impact on mucosa coating and on flavour rel...

  8. Predictors of recovery of functional swallow after gastrostomy tube placement for Dysphagia in stroke patients after inpatient rehabilitation: a pilot study.

    Science.gov (United States)

    Crisan, Diana; Shaban, Amir; Boehme, Amelia; Dubin, Perry; Juengling, Jenifer; Schluter, Laurie A; Albright, Karen C; Beasley, T Mark; Martin-Schild, Sheryl

    2014-08-01

    To determine predictors of early recovery of functional swallow in patients who had gastrostomy (percutaneous endoscopic gastrostomy [PEG]) placement for dysphagia and were discharged to inpatient rehabilitation (IPR) after stroke. A retrospective study of prospectively identified patients with acute ischemic and hemorrhagic stroke from July 2008 to August 2012 was conducted. Patients who had PEG during stroke admission and were discharged to IPR, were studied. We compared demographics, stroke characteristics, severity of dysphagia, stroke admission events and medications in patients who remained PEG-dependent after IPR with those who recovered functional swallow. Patients who remained PEG dependent were significantly older (73 vs. 54 years, p=0.009). Recovery of swallow was more frequent for hemorrhagic stroke patients (80% vs. 47%, p=0.079). Age, adjusting for side of stroke (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.82-0.98; p=0.016) and left-sided strokes, adjusting for age (OR, 15.15; 95% CI, 1.32-173.34; p=0.028) were significant predictors of swallow recovery. Patients who recovered swallowing by discharge from IPR were more likely to be discharged home compared to those who remained PEG-dependent (90% vs. 42%, p=0.009). Younger age and left-sided stroke may be predictive factors of early recovery of functional swallow in patients who received PEG. Prospective validation is important as avoidance of unnecessary procedures could reduce morbidity and healthcare costs.

  9. Benefit from the Chin-Down Maneuver in the Swallowing Performance and Self-Perception of Parkinson’s Disease Patients

    Directory of Open Access Journals (Sweden)

    Annelise Ayres

    2017-01-01

    Full Text Available Aims. To verify the effectiveness of the maneuver application in swallowing therapy with PD. Materials and Method. We performed an open-label trial, with three groups compounds by PD individuals: the experimental group, control group, and orientation group. The study included PD patients with dysphagia. A cognitive screening, through a questionnaire about depression and quality of life, was conducted. Swallowing assessment was performed through (1 fiberoptic endoscopic evaluation of swallowing (FEES; (2 clinical evaluation and Functional Oral Intake Scale (FOIS; and (3 assessment of the quality life related to swallowing (SWALQOL. A therapeutic program, which consisted of chin-down postural maneuver and orientations on feeding, was applied. Both groups (EG and OG received on-month therapeutic program. Results. A significant improvement in swallowing, evaluated by clinical assessment, was observed in solid (p<0.001 and liquid (p=0.022 consistencies in EG when compared to OG and CG. Patients in EG presented improvement in QoL, with the significant difference in comparison with the other groups, about domain frequency of symptoms (p=0.029 in SWALQOL questionnaire. Conclusion. The postural maneuver chin-down improved swallowing performance and self-perception, but not the laryngeal signs. This trial is registered with registration number NCT02973698.

  10. A Pilot Study of Perceived Mouth Dryness, Perceived Swallowing Effort, and Saliva Substitute Effects in Healthy Adults Across the Age Range.

    Science.gov (United States)

    Rogus-Pulia, Nicole M; Gangnon, Ronald; Kind, Amy; Connor, Nadine P; Asthana, Sanjay

    2017-09-06

    Xerostomia, or perceived mouth dryness, increases with advancing age, but its influence on swallowing effort is unknown. This study: (1) quantified relationships among age, perceived sense of swallowing effort, and ratings of perceived mouth dryness, and (2) examined changes in swallowing effort following application of a gel-based saliva substitute in healthy participants. This was a cross-sectional observational study and data were collected from attendees of a community healthy aging fair. Forty-two healthy participants (mean age = 65 years; 20 female) were enrolled. Each participant rated perceived effort with swallowing and perceived mouth dryness on a 10-cm horizontal, undifferentiated line. After participants applied a gel-based saliva substitute (Biotene(®) Oral Balance) to their tongue and oral mucosa, they rated perceived effort with swallowing again. Age was associated with greater perceived mouth dryness (r = 0.37, p substitute (mean difference = 9.39 mm, p substitute lowered perceived swallowing effort.

  11. Sexual dimorphism and population differences in structural properties of barn swallow (Hirundo rustica) wing and tail feathers

    OpenAIRE

    Pap, Péter L.; Gergely Osváth; José Miguel Aparicio; Lőrinc Bărbos; Piotr Matyjasiak; Diego Rubolini; Nicola Saino; Vágási, Csongor I.; Orsolya Vincze; Anders Pape Møller

    2015-01-01

    Sexual selection and aerodynamic forces affecting structural properties of the flight feathers of birds are poorly understood. Here, we compared the structural features of the innermost primary wing feather (P1) and the sexually dimorphic outermost (Ta6) and monomorphic second outermost (Ta5) tail feathers of barn swallows (Hirundo rustica) from a Romanian population to investigate how sexual selection and resistance to aerodynamic forces affect structural differences among these feathers. Fu...

  12. European Society for Swallowing Disorders – European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome

    Science.gov (United States)

    Baijens, Laura WJ; Clavé, Pere; Cras, Patrick; Ekberg, Olle; Forster, Alexandre; Kolb, Gerald F; Leners, Jean-Claude; Masiero, Stefano; Mateos-Nozal, Jesús; Ortega, Omar; Smithard, David G; Speyer, Renée; Walshe, Margaret

    2016-01-01

    This position document has been developed by the Dysphagia Working Group, a committee of members from the European Society for Swallowing Disorders and the European Union Geriatric Medicine Society, and invited experts. It consists of 12 sections that cover all aspects of clinical management of oropharyngeal dysphagia (OD) related to geriatric medicine and discusses prevalence, quality of life, and legal and ethical issues, as well as health economics and social burden. OD constitutes impaired or uncomfortable transit of food or liquids from the oral cavity to the esophagus, and it is included in the World Health Organization’s classification of diseases. It can cause severe complications such as malnutrition, dehydration, respiratory infections, aspiration pneumonia, and increased readmissions, institutionalization, and morbimortality. OD is a prevalent and serious problem among all phenotypes of older patients as oropharyngeal swallow response is impaired in older people and can cause aspiration. Despite its prevalence and severity, OD is still underdiagnosed and untreated in many medical centers. There are several validated clinical and instrumental methods (videofluoroscopy and fiberoptic endoscopic evaluation of swallowing) to diagnose OD, and treatment is mainly based on compensatory measures, although new treatments to stimulate the oropharyngeal swallow response are under research. OD matches the definition of a geriatric syndrome as it is highly prevalent among older people, is caused by multiple factors, is associated with several comorbidities and poor prognosis, and needs a multidimensional approach to be treated. OD should be given more importance and attention and thus be included in all standard screening protocols, treated, and regularly monitored to prevent its main complications. More research is needed to develop and standardize new treatments and management protocols for older patients with OD, which is a challenging mission for our societies

  13. Clock gene variation is associated with breeding phenology and maybe under directional selection in the migratory barn swallow.

    Directory of Open Access Journals (Sweden)

    Manuela Caprioli

    Full Text Available BACKGROUND: In diverse taxa, photoperiodic responses that cause seasonal physiological and behavioural shifts are controlled by genes, including the vertebrate Clock orthologues, that encode for circadian oscillator mechanisms. While the genetic network behind circadian rhythms is well described, relatively few reports exist of the phenological consequences of and selection on Clock genes in the wild. Here, we investigated variation in breeding phenology in relation to Clock genetic diversity in a long-distance migratory bird, the barn swallow (Hirundo rustica. METHODOLOGY/PRINCIPAL FINDINGS: In a sample of 922 adult barn swallows from a single population breeding in Italy we found one very common (Q(7 and three rare (Q(5, Q(6, Q(8 length variants of a functionally significant polyglutamine repeat. Rare (2.9% Q(7/Q(8 heterozygous females, but not males, bred significantly later than common (91.5% Q(7/Q(7 females, consistent with the expectation that 'long' alleles cause late breeding, as observed in a resident population of another bird species. Because breeding date depends on arrival date from migration, present results suggest that the association between breeding date and Clock might be mediated by migration phenology. In addition, fecundity selection appears to be operating against Q(7/Q(8 because late migrating/breeding swallows have fewer clutches per season, and late breeding has additional negative selection effects via reduced offspring longevity. Genotype frequencies varied marginally non-significantly with age, as Q(7/Q(8 frequency showed a 4-fold reduction in old individuals. This result suggests negative viability selection against Q(7/Q(8, possibly mediated by costs of late breeding. CONCLUSIONS/SIGNIFICANCE: This is the first study of migratory birds showing an association between breeding phenology and Clock genotype and suggesting that negative selection occurs on a phenologically deviant genotype. Low polymorphism at Clock may

  14. Evolutionary divergence in sexual signals: Insights from within and among barn swallow populations

    Science.gov (United States)

    Wilkins, Matthew Reed

    A wealth of studies across diverse animal groups indicate the importance of sexual selection in shaping phenotypes within and across breeding populations. In recent decades, much research has focused on how divergent sexual selection pressures among populations may lead to speciation. For my first dissertation chapter, I performed a literature review on the causes and consequences of evolutionary divergence in acoustic signals and developed the acoustic window conceptual framework for understanding the contributions of selection, genetic drift, and evolutionary constraint to signal divergence. Further, I found that sexual selection explains acoustic differences between recently diverged populations of the best-studied taxa. However, the relative contributions of ecological selection, sexual selection, and drift to acoustic divergence have not typically been considered within the same study systems. The remainder of my dissertation used the Northern Hemisphere-distributed barn swallow ( Hirundo rustica) species complex as a model system to study sender-receiver dynamics, intra- and intersexual selection pressures, and visual and acoustic signal interactions at the local scale, and signal divergence across populations at the global scale. From song recordings taken across 19 sampling sites, spanning five of six described subspecies, I demonstrated considerable conservation in song structure. However, temporal traits were highly divergent across subspecies, and in particular, the speed of the terminal trill of songs. In a detailed study of the multimodal communication system of the barn swallow (including visual and acoustic traits), I demonstrated that males and females use different types of signals to mediate competition and mate choice. One of the only exceptions to this rule was trill rate, which was also implicated in song divergence across populations. In order to test the function of trill rate in communication, I performed a two-year playback study within the

  15. Assessment of swallowability and palatability of oral dosage forms in children: Report from an M-CERSI pediatric formulation workshop.

    Science.gov (United States)

    Ternik, Robert; Liu, Fang; Bartlett, Jeremy A; Khong, Yuet Mei; Thiam Tan, David Cheng; Dixit, Trupti; Wang, Siri; Galella, Elizabeth A; Gao, Zhihui; Klein, Sandra

    2017-08-24

    The acceptability of pediatric pharmaceutical products to patients and their caregivers can have a profound impact on the resulting therapeutic outcome. However, existing methodology and approaches used for acceptability assessments for pediatric products is fragmented, making robust and consistent product evaluations difficult. A pediatric formulation development workshop took place in Washington, DC in June 2016 through the University of Maryland's Center of Excellence in Regulatory Science and Innovation (M-CERSI). A session at the workshop was dedicated to acceptability assessments and focused on two major elements that affect the overall acceptability of oral medicines, namely swallowability and palatability. The session started with presentations to provide an overview of literature, background and current state on swallowability and palatability assessments. Five parallel breakout discussions followed the presentations on each element, focusing on three overarching themes, risk-based approaches, methodology and product factors. This article reports the key outcomes of the workshop related to swallowability and palatability assessments. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Organic contamination in tree swallow (Tachycineta bicolor) nestlings at United States and binational great Lakes Areas of Concern

    Science.gov (United States)

    Custer, Thomas W.; Custer, Christine M.; Dummer, Paul; Goldberg, Diana R.; Franson, J. Christian; Erickson, Richard A.

    2017-01-01

    Contaminant exposure of tree swallows, Tachycineta bicolor, nesting in 27 Areas of Concern (AOCs) in the Great Lakes basin was assessed from 2010 to 2014 to assist managers and regulators in their assessments of Great Lakes AOCs. Contaminant concentrations in nestlings from AOCs were compared with those in nestlings from nearby non-AOC sites. Polychlorinated biphenyl (PCB) and polybrominated diphenyl ether concentrations in tree swallow nestling carcasses at 30% and 33% of AOCs, respectively, were below the mean concentration for non-AOCs. Polycyclic aromatic hydrocarbon (PAH) concentrations in nestling stomach contents and perfluorinated compound concentrations in nestling plasma at 67% and 64% of AOCs, respectively, were below the mean concentration for non-AOCs. Concentrations of PCBs in nestling carcasses were elevated at some AOCs but modest compared with highly PCB-contaminated sites where reproductive effects have been documented. Concentrations of PAHs in diet were sufficiently elevated at some AOCs to elicit a measurable physiological response. Among AOCs, concentrations of the perfluorinated compound perfluorooctane sulfonate in plasma were the highest on the River Raisin (MI, USA; geometric mean 330 ng/mL) but well below an estimated toxicity reference value (1700 ng/mL). Both PAH and PCB concentrations in nestling stomach contents and PCBs in carcasses were significantly correlated with concentrations in sediment previously reported, thereby reinforcing the utility of tree swallows to assess bioavailability of sediment contamination.

  17. Proposed Use of Thickener According to Fluid Intake on Videofluoroscopic Swallowing Studies: Preliminary Study in Normal Healthy Persons.

    Science.gov (United States)

    Lee, Kyung Duck; Song, Sun Hong; Koo, Jung Hoi; Park, Hee Seon; Kim, Jae Sin; Jang, Ki Hyo

    2016-04-01

    To examine the characteristics and changes in the pharyngeal phase of swallowing according to fluid viscosity in normal healthy persons, to help determine fluid intake methods in more detail than the use of standardized fluid. This was a prospective observational study involving 10 normal healthy adults. While the participants sequentially took in fluids with 10 different viscosities changes in the pharyngeal phase of the swallowing process were monitored using videofluoroscopic swallowing studies (VFSS). Twenty parameters of the pharyngeal phase, including epiglottis contact, laryngeal elevation, pharyngeal constriction, and upper esophageal sphincter opening, were determined and compared. No significant viscosity-based changes in epiglottis contact, laryngeal elevation, or upper esophageal sphincter-opening duration of the pharyngeal phase were observed. However, pharyngeal transit time and time from the start of the pharyngeal phase to peak pharyngeal constriction were significantly delayed upon intake of fluid with viscosities of 150.0 centipoise (cP) and 200.0 cP. VFSS analysis of fluid intake may require the use of fluids of various concentrations to determine a suitable viscosity of thickener mixture for each subject.

  18. Effects of powdered versus liquid barium on the viscosity of fluids used in modified swallow studies

    Energy Technology Data Exchange (ETDEWEB)

    Baron, J.; Alexander, T. [Univ. of Alberta, Dept. of Radiology, Edmonton, Alberta (Canada)

    2003-06-01

    To determine if the viscosity of thickened juice mixtures used in modified barium swallow studies significantly changes with the addition of powdered barium. We also describe a test formulation created using liquid barium, which has a negligible effect on juice viscosity. The viscosities of water and standardized honey- and nectar-consistency juices mixed with different amounts of powdered barium were measured by timing the laminar flow of a given initial hydrostatic head of fluid under gravity though an orifice of fixed diameter. Standardized juices were then mixed with a liquid formulation of barium and with measured quantities of water to produce viscosities that more closely equated with those of the standardized juices. With the addition of powdered barium, viscosity increased in all fluids, most markedly with the nectar-consistency juice. Liquid barium formulations maintained the viscosities of the original thickened juices. Rendering juices radio-opaque with barium powder results in dramatic increases in the viscosity of the resulting mixture and compromises diagnostic accuracy. Liquid barium preparations have the advantage that they can be rapidly and accurately dispensed by syringe, and their use does not significantly increase the viscosity of the preparation. (author)

  19. Suicide attempt by swallowing sponge or pica disorder: a case report.

    Science.gov (United States)

    Zganjer, Vlasta; Zganjer, Mirko; Cizmić, Ante; Pajid, Anto; Zupancić, Bozidar

    2011-01-01

    There are many ways how children with mental illness have actually tried to hurt themselves. Suicidal thinking or attempts always indicate that professional help is needed (2). Every object which can be potential dangerous should be removed but this is very difficult to do. Some of children with these symptoms had Pica diseases. Pica is a medical disorder characterized by an appetite for substances largely non-nutritive (e.g. metal, coal, soil, feces, paper, soap, gum, etc.) or an abnormal appetite for some things that may be considered foods. The patient swallow sponge from a pillow over a long period of time and she came into our hospital with abdominal pain. She was 16 years old and had abdominal distension, vomiting, abdominal cramping and failure to pass gas or stool. Immediately we suspected mechanical blockade of the intestine. Diagnosis was clinically confirmed by X-rays of the abdomen and with ultrasound. The operative treatment was indicated and we found the proximal bowel distended and the distal segment collapsed. The part of bowel necrosis was removed and anastomosis was done. When patients are determined to attempt suicide or have Pica disorder it is very difficult to prevent.

  20. Electromyographic comparisons between clenching, swallowing and chewing in jaw muscles with varying occlusal parameters.

    Science.gov (United States)

    Moreno, Isabel; Sánchez, Teresa; Ardizone, Ignacio; Aneiros, Fernando; Celemin, Alicia

    2008-03-01

    The aim of this study is to determine the influence of Angle molar class, presence of a posterior crossbite, anterior guidance, as well as gender in the muscular activity of the masticatory system in a population of healthy dental students. Surface electromyography recordings are made for the masseter, anterior and posterior temporalis and digastric muscles; in three different tests: clenching at maximum intercuspation, swallowing and chewing. The results obtained show that: men achieve a higher masseter activity at maximum effort than women. Women achieve higher values than men, for the digastric muscles in deglution. Angle class II show higher activity than other classes for the temporalis muscle in deglution, while class III show higher activity than other classes for all muscles in maximum effort. The anterior guidance does not cause significant differences. The presence of a posterior crossbite affects the behaviour of anterior temporalis and masseter muscles. The results of this study show the influence of the occlusal parameters on the muscular activity of the stomatognatic system.

  1. Distinct roles for hu li tai shao and swallow in cytoskeletal organization during Drosophila oogenesis.

    Science.gov (United States)

    Pokrywka, Nancy Jo; Zhang, Huadi; Raley-Susman, Kathleen

    2014-07-01

    Cytoskeletal organization is essential for localization of developmentally significant molecules during Drosophila oogenesis. Swallow (Swa) and an isoform of Hu li tai shao (Ovhts-RC) have been implicated in the organization of actin filaments in developing oocytes but their precise roles have been obscured by the dependence of hts RNA localization on swa function. The functional significance of hts RNA localization in the oocyte has not been established. In this study we examine Ovhts-RC distribution and cytoskeletal organization under conditions in which Swa protein and/or hts RNA localization are perturbed. We find Swa is required for overall actin organization and for the maintenance of a distinct subset of microtubules in the oocyte. hts RNA localization modulates the distribution of Ovhts-RC in the oocyte and, in turn, local actin filament proliferation. Our results support separate contributions of Swa and hts RNA localization to actin organization during oogenesis. Swa is crucial for the organization of actin networks that lead to the formation of a specialized microtubule population, while Ovhts-RC acts to modulate spatially restricted actin filament growth at the oocyte cortex. This suggests RNA localization can lead to modifications of both the actin and microtubule cytoskeletons at specific subcellular locales. © 2014 The Authors Developmental Dynamics published by Wiley Periodicals, Inc. on behalf of American Association of Anatomists.

  2. Suicide Attempt by Swallowing Sponge or Pica Disorder: A Case Report

    Directory of Open Access Journals (Sweden)

    Vlasta Žganjer

    2011-01-01

    Full Text Available Introduction: There are many ways how children with mental illness have actually tried to hurt themselves. Suicidal thinking or attempts always indicate that professional help is needed (2. Every object which can be potential dangerous should be removed but this is very difficult to do. Some of children with these symptoms had Pica diseases. Pica is a medical disorder characterized by an appetite for substances largely non-nutritive (e.g. metal, coal, soil, feces, paper, soap, gum, etc. or an abnormal appetite for some things that may be considered foods. Material and Methods: The patient swallow sponge from a pillow over a long period of time and she came into our hospital with abdominal pain. She was 16 years old and had abdominal distension, vomiting, abdominal cramping and failure to pass gas or stool. Immediately we suspected mechanical blockade of the intestine. Diagnosis was clinically confirmed by X-rays of the abdomen and with ultrasound. Results: The operative treatment was indicated and we found the proximal bowel distended and the distal segment collapsed. The part of bowel necrosis was removed and anastomosis was done. Conclusion: When patients are determined to attempt suicide or have Pica disorder it is very difficult to prevent.

  3. A postmortem experience of Indian rock python (Python molurus molurus that swallowed a whole barking deer

    Directory of Open Access Journals (Sweden)

    Amam Zonaed Siddiki

    2013-06-01

    Full Text Available The object of this study was to report a post mortem findings of a female Indian Rock Python with a length of 406 cm (13.32 feet and approximate weight of 60 kg (including a whole deer that was swallowed by the python, that was brought to the Teaching Veterinary Hospital, Chittagong Veterinary and Animal Sciences University (CVASU by the Forest Department of Kumira Range Office, Chittagong. The local inhabitants accidently found the python at the forest area of Kumira and they frightenedly injured and killed the snake eventually. The postmortem (PM examination was performed according to standard protocols. Gross examination revealed bloody discharge was come out through mouth and a couple of skin lacerations observed on the right dorso-lateral part of the abdominal region. The whole barrel-shaped body cavity was opened and whole deer (partially decomposed was recovered from the stomach. Furthermore, three fractured ribs were found on right thorax. The PM examination team believes that the possible cause of python death was traumatic injury inflicted by the local people. [Vet World 2013; 6(3.000: 163-165

  4. Measurement uncertainties when determining heat rate, isentropic efficiency and swallowing capacity

    Energy Technology Data Exchange (ETDEWEB)

    Snygg, U.

    1996-05-01

    The objective of the project was to determine the uncertainties when calculating heat rate, isentropic efficiencies and swallowing capacities of power plants. Normally when a power plant is constructed, the supplier also guarantee some performance values, e.g. heat rate. When the plant is built and running under normal conditions, an evaluation is done and the guarantee values are checked. Different measured parameters influence the calculated value differently, and therefore a sensitivity factor can be defined as the sensitivity of a calculated value when the measured value is changing. The product of this factor and the uncertainty of the measured parameter gives an error of the calculated value. For every measured parameter, the above given factor has to be determined and then the root square sum gives the overall uncertainty of the calculated parameter. To receive acceptable data during the evaluation of the plant, a test code is to be followed. The test code also gives guidelines how big the errors of the measurements are. In this study, ASME PTC6 and DIN 1943 were used. The results show that not only the test code was of vital importance, but also the distribution of the power output of the HP-IP turbines contra LP turbines. A higher inlet pressure of the LP turbine gives a smaller uncertainty of the isentropic efficiency. An increase from 6 to 13 bar will lower the uncertainty 1.5 times. 10 refs, 24 figs, 23 tabs, 5 appendixes

  5. Certainty of paternity and paternal investment in eastern bluebirds and tree swallows

    Science.gov (United States)

    Kempenaers, Bart; Lanctot, Richard B.; Robertson, Raleigh J.

    1998-01-01

    Extra-pair paternity is common in many socially monogamous passerine birds with biparental care. Thus, males often invest in offspring to which they are not related. Models of optimal parental investment predict that, under certain assumptions, males should lower their investment in response to reduced certainty of paternity. We attempted to reduce certainty of paternity experimentally in two species, the eastern bluebird, Sialia sialis, and the tree swallow, Tachycineta bicolor, by temporarily removing fertile females on two mornings during egg laying. In both species, experimental males usually attempted to copulate with the female immediately after her reappearance, suggesting that they experienced the absence of their mate as a threat to their paternity. Experimental males copulated at a significantly higher rate than control males. However, contrary to the prediction of the model, experimental males did not invest less than control males in their offspring. There was no difference between experimental and control nests in the proportion of male feeds, male and female feeding rates, nestling growth and nestling condition and size at age 14 days. We argue that females might have restored the males’ confidence in paternity after the experiment by soliciting or accepting copulations. Alternatively, males may not reduce their effort, because the fitness costs to their own offspring may outweigh the benefits for the males, at least in populations where females cannot fully compensate for reduced male investment.

  6. [Delay in the acquisition of sucking-swallowing-breathing in the preterm; efects of early stimulation].

    Science.gov (United States)

    La Orden Izquierdo, E; Salcedo Lobato, E; Cuadrado Pérez, I; Herráez Sánchez, M S; Cabanillas Vilaplana, L

    2012-01-01

    Premature baby's oral feeding is not possible until the reflex of sucking-swallowing-breathing adquisition. Its delay extends hospital stay and increases the incidence of oral motor disorders in early childhood. To analyze the transition from enteral to oral nutrition, the comorbidity associated with its delay and the impact of an early suction stimulation in a cohort of premature babies. Retrospective checking of 95 infants less than 32 gestation weeks (GW) admitted to a neonatal ICU in the last 4 years. It was revised the gestational age, anthropometric at birth and discharge, comorbidity, duration of mechanical ventilation, oxygen requirements, time of beginning and end of enteral/oral nutrition, beginning of Kangaroo method and the suction stimulation and the daily weight gain average. Suction stimulation began between weeks 29 and 40 GW (average and median 32 GW). Oral nutrition was initiated between 31-40 GW (average and median 33 GW) and completed between 33-44 GW (average and median 35 GW). Oral nutrition was delayed in patients who required longer mechanical ventilation and oxygen therapy. There was a positive correlation between the beginning of suction stimulation and the time of acquisition of a complete oral nutrition (84% Spearman correlation test) and length of hospital stay (80% Spearman correlation test). [corrected] Early suction stimulation in a preterm patient seems to facilitate full oral nutrition at an early stage and it is associated with a hospital stay decrease and the improvement in the daily weight gain average.

  7. The Effect of Bolus Volume on Hyoid Kinematics in Healthy Swallowing

    Directory of Open Access Journals (Sweden)

    Ahmed Nagy

    2014-01-01

    Full Text Available Hyoid movement in swallowing is biomechanically linked to closure of the laryngeal vestibule for airway protection and to opening of the upper esophageal sphincter. Studies suggest that the range of hyoid movement is highly variable in the healthy population. However, other aspects of hyoid movement such as velocity remain relatively unexplored. In this study, we analyze data from a sample of 20 healthy young participants (10 male to determine whether hyoid movement distance, duration, velocity, and peak velocity vary systematically with increases in thin liquid bolus volume from 5 to 20 mL. The temporal correspondence between peak hyoid velocity and laryngeal vestibule closure was also examined. The results show that maximum hyoid position and peak velocity increase significantly for 20 mL bolus volumes compared to smaller volumes, and that the timing of peak velocity is closely linked to achieving laryngeal vestibule closure. This suggests that generating hyoid movements with increased power is a strategy for handling larger volumes.

  8. Certainty of paternity and paternal investment in eastern bluebirds and tree swallows.

    Science.gov (United States)

    Kempenaers; Lanctot; Robertson

    1998-04-01

    Extra-pair paternity is common in many socially monogamous passerine birds with biparental care. Thus, males often invest in offspring to which they are not related. Models of optimal parental investment predict that, under certain assumptions, males should lower their investment in response to reduced certainty of paternity. We attempted to reduce certainty of paternity experimentally in two species, the eastern bluebird, Sialia sialis, and the tree swallow, Tachycineta bicolor, by temporarily removing fertile females on two mornings during egg laying. In both species, experimental males usually attempted to copulate with the female immediately after her reappearance, suggesting that they experienced the absence of their mate as a threat to their paternity. Experimental males copulated at a significantly higher rate than control males. However, contrary to the prediction of the model, experimental males did not invest less than control males in their offspring. There was no difference between experimental and control nests in the proportion of male feeds, male and female feeding rates, nestling growth and nestling condition and size at age 14 days. We argue that females might have restored the males' confidence in paternity after the experiment by soliciting or accepting copulations. Alternatively, males may not reduce their effort, because the fitness costs to their own offspring may outweigh the benefits for the males, at least in populations where females cannot fully compensate for reduced male investment. Copyright 1998 The Association for the Study of Animal Behaviour. Copyright 1998 The Association for the Study of Animal Behaviour.

  9. An Unusual Case of Spontaneous Esophageal Rupture after Swallowing a Boneless Chicken Nugget

    Directory of Open Access Journals (Sweden)

    Zeenia Aga

    2016-01-01

    Full Text Available A 25-year-old previously healthy man presented to our Emergency Department with shortness of breath and epigastric pain after swallowing a boneless chicken nugget one hour prior to presentation. Physical examination revealed epigastric rigidity and tenderness. Serology was normal except for mildly elevated bilirubin and amylase. Computed tomography (CT scan of the chest revealed a distal esophageal rupture with accompanying pneumomediastinum and left-sided pleural effusion. Treatment was initiated with administration of intravenous fluids and broad-spectrum antibiotics. Subsequently, an esophageal stent was inserted endoscopically in addition to VATS (Video-Assisted Thoracoscopic Surgery drainage of the left-sided pleural space. This case illustrates an unusual presentation of Boerhaave’s syndrome: a rare and life-threatening form of noniatrogenic esophageal rupture most often preceded by forceful vomiting. Our case demonstrates that physicians should maintain an index of suspicion for spontaneous esophageal rupture in patients presenting with shortness of breath