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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-eight CVA patients with swallowing disorders were studied videofluorographically (VFG) to determine: (1) the nature of their swallowing disorders, (2) the relationship between the site of the cerebrovascular accident and the nature of the swallowing disorder(s) exhibited and (3) the frequency and etiology of any aspiration present. The 38 CVA patients exhibited a variety of physiologic disturbances in swallowing, usually occurring in combination rather than as isolated disorders. A delayed swallowing reflex was the most frequent disorder seen in all patient groups. Reduced pharyngeal peristalsis was the next most frequent disorder, followed by reduced tongue control. Only brainstem CVA patients exhibited reduced laryngeal closure. Two patients (no right CVAs) experienced cricopharyngeal dysfunction. Few differences in nature of swallowing disorders were seen according to lesion location. Approximately one third of the patients aspirated, most frequently because of delayed triggering of the swallowing reflex. All aspiration occurred because of disorders in the pharyngeal stage of the swallow, emphasizing the importance of VFG evaluation of dysphagia in CVA patients.
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PMID:Swallowing disorders in persons with cerebrovascular accident. 400 34

17 parameters of vital activity (VA) were scanned in 35 female and 12 male dependent geriatric patients (mean age 81). These included mental testing, Barthel score, lung function, urinanalysis, creatinine clearance, Hb, albumin, globulin and electrolytes, skin-folds, locomotion, presence of IHD, hemodynamic state, continence, infections, WBC and lymphocyte count, pressure sores and dysphagia, 4 main templates of VA deterioration identified were: IHD, hemisyndrome (due to CVA), vegetative state (post-CVA) and senile dementia (SDAT). The IHD template was characterized by marked variations in VA, ending in death due to cardiac complications (pulmonary edema, ischemia, etc.). In the 3 other templates VA gradually deteriorated. Gradual declining VA allowed assessment of individual mortality prognosis. Assessment was by approximation of the computed exponent of the extrapolated VA curves; the longer the observation, the fewer the mistakes in assessment. Epidemiologic prognosis data of 48 dependent patients is described; mean age was about 81 years. Hospitalization mean was 853.5 +/- 601 days and for patients with dementia, 1158.6 +/- 622.7 days.
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PMID:[Assessment of vital activity in geriatric patients]. 781 43

Increasing international recognition of the high incidence of oropharyngeal dysphagia has incited Speech and Language Therapists to establish a service for the management of this life-threatening disorder. This study evaluates the first such Irish service instigated in St. James's Hospital four years ago. Retrospective analysis of Speech and Language Therapy departmental records for a twelve month period examined incidence of referral for dysphagia, subsequent clinical and objective assessment findings and management recommendations. A referral rate of 52% emerged with a mean of 74 years. CVA was found to be the commonest etiology. Therapeutic intervention was implemented with 68% of dysphagic subjects considered suitable candidates and improvement evidenced in 78% of treated cases. These results highlight the prevalence of oropharyngeal dysphagia in a neurologically impaired Irish adult population and the efficacy of a dysphagia service in its management, while categorically stating the need for such service provision nationwide.
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PMID:Oropharyngeal dysphagia--the need for effective management. 786 Feb 62

The purpose of this study was to examine the effects of age, gender, disease, and multisystem involvement on SpO2 levels of 104 dysphagic patients and 77 nondysphagic persons. Results indicated that solid aspirators had lower SpO2 levels than liquid aspirators, penetrators, and nondysphagics. In addition, SpO2 levels varied by age, with older persons having lower levels than younger persons among dysphagics but not among nondysphagics. Patients with COPD had lower SpO2 levels than dysphagics with other disorders. Significant interactions were found among age, gender, and disease. Multisystem involvement was found not to be a factor in SpO2 levels. It was concluded that although normal aging processes reduce swallowing and pulmonary functioning, it became a significant factor only when combined with an assault to the system, such as CVA or COPD.
Dysphagia 2001
PMID:Effects of age, gender, disease, and multisystem involvement on oxygen saturation levels in dysphagic persons. 1121 46

Aspiration pneumonia is a serious problem for the elderly institutionalized person, often requiring transfer to a hospital and a lengthy stay there. It is associated with a high mortality rate and is very costly to the health care system. The current study sought to determine the key predictors of aspiration pneumonia in a nursing home population with the hope that health care providers could identify those residents at highest risk and focus more efforts on prevention of this serious disease. A cross-sectional, retrospective analysis was done, using the Minimum Data Set (MDS) nursing home assessment data for three states (New York, Mississippi, Maine) from 1993 to 1994 (N = 102842). Nursing home residents were aged 65+. Standardized MDS summary scales and their component items were used, including: the Activities of Daily Living (ADL) scale, the cognitive performance scale (CPS), and the Resource Utilization Groups (RUGs). Results of these analyses showed the prevalence of pneumonia among this population was 3% (n = 3118). Results from the logistic regression models indicated 18 significant predictors of aspiration pneumonia. The strongest to weakest predictors of pneumonia were, respectively, suctioning use, COPD, CHF, presence of feeding tube, bedfast, high case mix index, delirium, weight loss, swallowing problems, urinary tract infections, mechanically altered diet, dependence for eating, bed mobility, locomotion, number of medications, and age, while both CVA and tracheotomy care were inversely predictive of pneumonia. The emergence of these significant predictors suggested a different pathogenesis of pneumonia in the elderly nursing home resident from the acute care patient or the outpatient. Nursing home residents have chronic medical conditions that gradually lead to "decompensation" in functional status, nutritional status, and pulmonary clearance. Dysphagia and aspiration are common complications of their medical conditions and may slowly worsen as their status deteriorates. Alternatively, a sudden adverse event may dramatically increase the amount aspirated or the ability to resist infection and lead to sudden decompensation. Clinical staff must identify residents with dysphagia and aspiration and work to prevent decline in functional status in all residents. They must be aware of the dangers of adverse events that lead to sudden inactivity or illness and increase the risk of aspiration pneumonia. Prevention of this disease whenever possible will reduce costs, improve health outcomes, and improve our quality of care.
Dysphagia 2002
PMID:Predictors of aspiration pneumonia in nursing home residents. 1235 45

This article examines the nursing care that should be given to patients who have suffered a stroke (cerebrovascular accident or CVA) that has caused them to have dysphagia. It focuses on the maintenance of their nutrition and hydration needs through safe oral feeding practices and how the risk of aspiration can be managed. This is an important nursing issue, particularly as the Royal College of Physicians of Edinburgh (RCP, 2000) states that nutrition and hydration needs are often not met.
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PMID:Nutrition and hydration tips for stroke patients with dysphagia. 1635 May 15