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

To better understand the mechanisms of airway protection during swallow, the authors of this study performed an electromyographic (EMG) analysis on the thyroarytenoid (TA) and interarytenoid (IA) muscles during a variety of tasks. The tasks included high, low, and comfortable pitch phonation, the Valsalva maneuver, saliva swallow, and 5- and 10-mL water swallows. Raw EMG signals were analyzed to obtain root mean square data, which correspond to a relative magnitude of muscle activation. The data show that both TA and IA muscles generate a similar level of relative activation, with the greatest electrical activity observed during swallow tasks followed by the Valsalva maneuver and phonation. The duration, onset, offset, and pattern of activity during the swallowing tasks also showed close synchronization between the two muscles. These data can be used in designing therapy for voice disorders and pharyngeal dysphagia.
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PMID:Laryngeal activity during swallow, phonation, and the Valsalva maneuver: an electromyographic analysis. 891

Laboratory electrolyte and acid-base analyses are important for the characterization and assessment of the severity of disorders of fluid balance, and they enable the veterinarian to institute appropriate corrective therapeutic interventions. Abnormalities of electrolytes or acid-base rarely define the diagnosis, but certain diseases are characterized by predictable trends in these parameters. Important clinical situations in which assessment of electrolyte and acid-base status should be regarded as important to the equine practitioner include diarrhea, severe colic, peritonitis, pleuritis, dysphagia (inability to drink water or ingest food), neurologic dysfunction, exhaustion, renal failure, and rhabdomyolysis.
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PMID:Electrolyte and acid-base disturbances in the horse. 892 22

A 44-year-old woman was admitted to our hospital with acute severe chest pain and dysphagia, without an assignable cause. Radiological investigation of the oesophagus with water soluble contrast revealed an intramural rupture. Conservative management led to complete recovery within eight days. Spontaneous intramural rupture of the oesophagus is a very uncommon disease requiring adequate differentiation from other more serious diseases in order to apply correct therapy.
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PMID:[Acute transit symptoms caused by spontaneous rupture of the esophagus]. 898 71

This study was designed to investigate the ability of normal young adult volunteers to sensorially identify Newtonian fluids of specified viscosities. Twenty subjects, 10 men and 10 women between the ages of 18 and 29 years participated. Seven stimuli, consisting of combinations of corn syrup and water, with viscosities ranging from 2 to 2,240 centipoise (cP) were prepared and characterized using a coaxial rotational viscometer. Subjects were presented with two anchor stimuli representing the extremes of the range of viscosities as a basis from which the experimental stimuli were judged. The seven experimental stimuli were randomly presented to each subject 10 times. The accuracy with which the subjects identified the viscosity of the fluid was significant at p < 0.01. The pattern of response was not significantly different across subjects nor gender. There were no differences in performance throughout the duration of the study. The repeat presentation of the anchor points did not significantly affect performance. Further research on oral perception of viscosity, and the processes that mediate changes in swallow physiology resulting from changes in viscosity is required.
Dysphagia 1997
PMID:Oral sensory discrimination of fluid viscosity. 907 5

The aims of this study were to analyze the following by audiorecording of swallows: (1) the influence on the volume and consistency of ingested substances on the audiosignal recorded during separate swallows; and (2) the characteristics of successive swallows during ingestion of 100 ml of the same substances to define deglutitive behaviors. Volunteers followed two protocols. Protocol (P) 1 comprised ingestion of 100 ml of water or yoghurt in successive swallows and Protocol 2 comprised separate swallows of different volumes of the same substances. Audiosignal recordings were made with a dynamic microphone. The following parameters were measured in P1: total time of ingestion (TT), number of swallows necessary for ingestion (N), and spontaneous swallowing intervals (SI). In P2 the duration (d) of each signal was measured according to consistency and volume. Mean (m) values were then calculated (TTm, Nm, SIm, and dm). During P1, TTm for yoghurt was significantly longer than for water (23.1 vs. 6.5 sec (men) and 21.8 vs. 7.8 sec (women). Nm was also greater for yoghurt (10.1 vs. 4.3 (men) and 10.0 vs. 4.8 (women). Three types of swallowing behavior were defined according to SI: swallowing at regular intervals (Reg) with increasing intervals during ingestion (Prog) and swallowing at variable intervals (Irreg). These patterns did not differ significantly according to sex. In P2 the increase in volume swallowed increased the duration (dm) of the signal for water (600 msec for 5 ml and 960 msec for 15 ml). The dm for yoghurt was significantly less than for water (580 msec for 5 ml and 920 msec for 15 ml). Our technique of recording sounds of pharyngeal swallowing is simple, reproducible, and not expensive. It permitted the analysis of each swallow according to volume and consistency and the determination of three swallowing patterns (Reg, Prog, and Irreg), taking into account the spontaneous swallowing interval. Ingestion by successive swallows could be used to characterize certain pharyngoesophageal motor dysfunctioning in relation to this reference population and to integrate this into a deglutition rehabilitation program.
Dysphagia 1997
PMID:Exploration of pharyngeal swallowing by audiosignal recording. 907 9

131I sodium iodide is the radiopharmaceutical of choice for both diagnosis and therapy in patients with various thyroid abnormalities. The radioiodide capsule has been the preferred dosage form, primarily because it provides a more convenient and safer vehicle for radioiodine administration. However, encapsulated 131I costs approximately twice as much a liquid 131I and does not provide as much flexibility as 131I solution in dosage selection. Also, the bioavailability of the capsular radioiodide preparation is inferior to that of the aqueous dosage form. The patient must swallow multiple capsules when a large amount of 131I activity is used. Capsule form is not suitable for any patient who has difficulty swallowing a capsule, has a feeding tube, or requires intravenous injection of 131I solution. In addition, radioiodide capsules must be analyzed statistically to ensure that the dosage units meet the United States Pharmacopeia uniformity requirements. If liquid radioiodine is used, distilled water rather than tap water should be used for dose preparation. It also is recommended that an antioxidant (e.g., sodium thiosulfate, sodium bisulfite), disodium edetate, and a pH adjustment of 7.5-9.0 be used to reduce radioiodide volatility. Due to the acceleration of the oxidative reaction caused by heat and light, 131I should be stored in a dark, cool environment. To comply with the quality management program implemented by the US Nuclear Regulatory Commission on January 27, 1992, all of the required information (e.g., prescribed dosage, procedure date, and signature of the authorized user) for a valid written directive is preprinted to ensure that the written directive is completed entirely and appropriately. Before each administration of therapeutic 131I solution, the calculated dose is verified by the prescribing physician, and the measured dose of 131I is reconfirmed by a second nuclear medicine technologist. Each patient's identity is verified by two methods (i.e., patient's full name and birth date).
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PMID:Radioiodine dispensing and usage in a centralized hospital nuclear pharmacy. 913 3

Severe esophageal compression due to a vascular ring rarely develops after childhood. We report a case of a 35-year-old man with dysphagia associated with a vascular ring. Radionuclide transit studies were performed before and after surgery for quantitative evaluation of deglutition. Preoperative aortogram disclosed a right sided aortic arch and a retroesophageal left subclavian artery arising from a diverticulum of the arch. Because of the severity of his symptoms, he was taken to surgery. He underwent posterolateral thoracotomy through the fourth intercostal space and division of the ligamentum arteriosum. The esophagus was mobilized from the aortic arch, the arch diverticulum, the pulmonary artery, and the trachea. Postoperatively, he experienced immediate resolution of dysphagia and quickly began eating a regular diet. Although a postoperative esophagogram revealed the esophageal compression, esophageal scintigraphy using 185 MBq 99mTc pertechnetate revealed shortening of the transit time of swallowed water by 1.0 second after surgery. Quantitative evaluation of deglutition in the esophagus by scintigraphy was useful for this patient, since he suffered from psychiatric problems.
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PMID:[A surgical case of vascular ring (Edwards IIIB) with dysphagia evaluated by esophageal scintigraphy]. 921 94

The purpose of this study was to evaluate the results of a fundoplication aimed to avoid complications of the Nissen procedure. The procedure combined a posterior hemifundoplication and a short circular fundoplication and their fixation to crura. A total of 67 consecutive patients were prospectively evaluated before and after surgery (median follow-up 24 months). Typical and atypical signs of reflux were present in 96.9% and 28.1% of cases, respectively, before operation versus 12.5% and 6.3% after. Patients alleged dysphagia in 26.6% of cases before surgery and 20.3% after. After operation belching and vomiting were impossible in 6.3% and 29.7% of cases, respectively. The pH test did not demonstrate any pathologic acid esophageal exposure in 93.3% cases after surgery. The mean duration of acid esophageal exposure was 45.1 +/- 21.8% (10-100%) before operation versus 1.9 +/- 4.9% (0-30%) after (p < 0.001). The mean lower esophageal sphincter pressure increased from 12.4 +/- 6.1 cm H2O (0-28 cm H2O) before operation to 20.5 +/- 7.3 cm H2O (11-50 cm H2O) after (p < 0.0001). The velocity of esophageal waves increased from 2.8 +/- 1.1 cm/sec (1.2-5.5) before surgery to 3.1 +/- 1.5 cm/sec (1.4-7.7 cm/sec) after (p < 0.001). None of the Nissen complications were observed, and it was not necessary to reoperate any patient. In conclusion, this procedure is effective, improves esophageal motor activity, and prevents the occurrence of complications of the Nissen procedure. It does not, however, alleviate side effects.
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PMID:Fundoplication avoiding complications of the Nissen procedure: prospective evaluation. 923 Jun 58

This is a prospective study of 100 consecutive stroke patients. Within 24 h after stroke onset they were asked specifically about swallowing complaints and subjected to a clinical examination including neurologic examination, Mini-Mental test, and Barthel score. Dysphagic patients were examined with the repetitive oral suction swallow test (the ROSS test) for quantitative evaluation of oral and pharyngeal function at 24 h, after 1 week, and after 1 month. At 6 months, the patients were interviewed about persistent dysphagia. Seventy-two patients could respond reliably at 24 h after the stroke onset and 14 of these complained of dysphagia. Non-evaluable patients were either unconscious, aphasic, or demented. The presence of dysphagia was not influenced by age or other risk factors for stroke. Facial paresis, but no other clinical findings, were associated with dysphagia. Dysphagia 24 h after stroke increased the risk of pneumonia but did not influence the length of hospital stay, the manner of discharge from hospital, or the mortality. The initial ROSS test, during which the seated patient ingests water through a straw, was abnormal in all dysphagic stroke patients. One-third of the patients were unable to perform the test completely. Above all, dysfunction was disclosed during forced, repetitive swallow. All phases of the ingestion cycle were prolonged whereas the suction pressures, bolus volumes, and swallowing capacities were low. Abnormalities of quantitative swallowing variables decreased with time whereas the prevalences of swallowing incoordination and abnormal feeding-respiratory pattern became more frequent. After 6 months, 7 patients had persistent dysphagia. Five of these were initially non-evaluable because of unconsciousness, aphasia, or dementia.
Dysphagia 1998
PMID:Dysphagia in stroke: a prospective study of quantitative aspects of swallowing in dysphagic patients. 939 Dec 28

We studied 13 patients before and after Nissen fundoplication and compared them with 11 healthy volunteers and 12 other patients with dysphagia after fundoplication. Esophageal manometry was performed to assess primary and secondary peristalsis induced by esophageal distention with air and water boluses. In patients with reflux disease, secondary peristalsis was initiated at a median rate of 60% of distending episodes, propagation of the secondary peristaltic wave occurred in 40% and lower oesophageal sphincter relaxation occurred with 70% of secondary peristaltic waves. Fundoplication did not alter the initiation or propagation rate of secondary peristalsis but it decreased the median lower esophageal sphincter relaxation rate to 45% (P < 0.03). Fundoplication was not associated with a change in the amplitude of primary peristaltic waves even in patients complaining of dysphagia. In post-fundoplication patients, successful secondary peristaltic waves had significantly lower (P < 0.005) proximal and distal amplitude than primary peristaltic waves. We conclude that there is no improvement in primary or secondary peristalsis after fundoplication and dysphagia after fundoplication is not due to altered peristalsis.
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PMID:A prospective study of the effect of fundoplication on primary and secondary peristalsis in the esophagus. 945 51


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