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1.
J Oral Rehabil ; 48(1): 55-60, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33025615

RESUMO

OBJECTIVE: To verify the validity of the prediction of oral intake recovery for inpatients with aspiration pneumonia using the Hyodo-Komagane score. BACKGROUND: Patients admitted for treatment of aspiration pneumonia sometimes have difficulty in resuming oral intake due to decreased swallowing function. Predicting whether the swallowing function will recover enough to achieve oral ingestion at discharge is an important factor in developing a treatment strategy. No studies have investigated the prediction of oral intake recovery using videoendoscopic examination. METHODS: Subjects were 65 patients who were admitted to an acute care hospital for the treatment of aspiration pneumonia. The patients were divided into two groups, the oral feeding group and the tube feeding group, according to their oral intake status at discharge or transfer. Logistic regression analysis was performed using the condition that tube feeding was not required as an objective variable and the items with significant differences between the two groups as explanatory variables. Additionally, the receiver operating characteristic curve was used to identify patients who could take food orally at discharge. RESULTS: The odds ratios for the Hyodo-Komagane score and the pharyngeal clearance score were 1.485 and 3.379, respectively. When the cut-off values of the Hyodo-Komagane score and the pharyngeal clearance score were 6 and 1, the sensitivity was 0.88 and 0.91, and the specificity was 0.64 and 0.70, respectively. CONCLUSION: The Hyodo-Komagane score and especially the pharyngeal clearance score are useful indices to predict oral intake recovery for inpatients with aspiration pneumonia.


Assuntos
Transtornos de Deglutição , Pneumonia Aspirativa , Deglutição , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/etiologia , Humanos , Pacientes Internados , Japão
2.
Food Chem ; 339: 128078, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33152871

RESUMO

The purpose of this work was to characterize the dynamic texture perception and study the mechanisms occurring in bolus from chewing to swallowing during white bread oral processing. Results indicated that the microstructural and chemical composition properties determined the oral processing behaviors. At the initial stage of oral processing, the roughness, hardness, and dryness perception were the dominant attributes. At the end of oral processing the adhesiveness and softness perception were dominant, which correlated to the higher bolus water content and adhesive properties. The softness and adhesiveness perception were the key factors that trigger swallowing. In vitro artificial mastication experiments confirmed that mucin rapidly increased the adhesive force of bolus at the initial stage of oral processing, whereas α-amylase gradually increased the adhesive force. These results can help to better understand the dynamic texture perception and its change mechanisms during oral processing.


Assuntos
Pão , Deglutição , Mastigação , Sensação , Adesividade , Dureza , Humanos , Triticum
3.
Int J Pediatr Otorhinolaryngol ; 140: 110306, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32829932

RESUMO

BACKGROUND: SLPs have a crucial need to depend on comprehensive clinical swallowing assessments to determine the presence of dysphagia in neonates. A comprehensive clinical swallowing assessment that is ethnoculturally sensitive may help to identify the presence and severity of swallowing problems in neonates. OBJECTIVE: The study aimed to construct and validate the contents of a test for oropharyngeal dysphagia in Indian neonates (TOD-IN). METHOD: The test for oropharyngeal dysphagia in Indian neonates (TOD-IN) was developed using the Delphi process. Five expert panelists served as participants; two rounds of electronic questionnaire-based survey was carried out to develop and validate the contents of TOD-IN. RESULTS: Round one rendered descriptive data that was analyzed quantitatively and qualitatively. At the end of round one, panelists unequivocally agreed on the need for research to develop a validated assessment tool for dysphagia in Indian neonates. The second round dealt with establishing the face and content validity of the final version of TOD-IN. A unanimous consensus was obtained regarding the format, scoring system, and the construct of the final version of the tool. CONCLUSION: Practicing clinicians in India are met with several challenges such as resource constraints, limited infrastructure, increasing caseload, and a lack of trained workforce. We believe that inexperienced clinicians will benefit from the structured guidance provided by TOD-IN in a restrained resource context where prioritization of patients is the key. Further studies investigating the psychometric properties of TOD-IN are in progress.


Assuntos
Transtornos de Deglutição , Deglutição , Feminino , Humanos , Índia , Recém-Nascido , Masculino , Reprodutibilidade dos Testes , Inquéritos e Questionários
6.
J Stroke Cerebrovasc Dis ; 29(12): 105405, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33254381

RESUMO

OBJECTIVE: The aim of our study was to evaluate the associations between baseline hemoglobin (Hb) levels and sarcopenia and outcomes in patients undergoing rehabilitation after stroke. METHODS: This retrospective cohort study included consecutive hospitalized post-stroke patients. Data on serum Hb level were extracted from medical records on tests performed within 24 h of admission. Primary outcome was the presence of sarcopenia at admission, diagnosed based on both low skeletal muscle mass and strength criteria per recently updated Asian Working Group for Sarcopenia 2019 guidelines. Other outcomes included the Functional Independence Measure-motor (FIM-motor) score at discharge and its change from baseline, and the Food Intake Level Scale (FILS) score (measure of dysphagia, FILS score < 7) at discharge. Multivariate analyses were used to determine the association between Hb levels at admission and outcomes of interest, adjusted for potential confounders. RESULTS: Data from 598 patients (mean age 72.1 years; 52.7% men) were included in the analysis. The mean Hb level at admission was 13.2 g/dL, and 86 (27.3%) men and 102 (36.0%) women had low Hb levels, i.e., 13.0 g/dL and 12.0 g/dL, respectively. In multivariate analyses, the baseline Hb level was independently associated with sarcopenia (odds ratio [OR]: 0.794, 95% confidence interval [CI]: 0.677-0.930, p = 0.004), FIM-motor score (ß = 0.096, p = 0.045) at discharge and its change from baseline (ß = 0.191, p = 0.018), and dysphagia (OR: 0.762, 95% CI: 0.595-0.961, p = 0.041) at discharge. CONCLUSION: Baseline low Hb levels were associated with sarcopenia, poorer recovery of physical function, and dysphagia in patients undergoing rehabilitation after stroke.


Assuntos
Anemia/sangue , Composição Corporal , Transtornos de Deglutição/reabilitação , Deglutição , Hemoglobinas/metabolismo , Sarcopenia/fisiopatologia , Reabilitação do Acidente Vascular Cerebral/efeitos adversos , Acidente Vascular Cerebral/terapia , Idoso , Idoso de 80 Anos ou mais , Anemia/diagnóstico , Biomarcadores/sangue , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/fisiopatologia , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Sarcopenia/diagnóstico , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
7.
BMC Infect Dis ; 20(1): 872, 2020 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-33225918

RESUMO

BACKGROUND: World Health Organization estimated that 779 million people are at risk of getting schistosomiasis (SCH) and 240 million people were infected worldwide. SCH due to Schistosoma mansoni (S. mansoni) is a wide public health problem in Ethiopia. The aim of the survey was to quantify national and district disaggregated treatment coverage status for SCH and compare validated coverage with the one reported. METHODS: Community based cross-sectional survey was conducted in April 2019 among households with school age children (SAC) 5-14 years in seven purposively selected districts of the country. Segments to be surveyed were randomly selected and households to be interviewed from each segment were determined using systematic sampling technique. A total of 3378 households visited and 5679 SAC (5-14 years) were interviewed. RESULTS: Overall reported treatment coverage of Praziquantel (PZQ) against SCH was 4286 (75.5%). Males were 27% more likely to swallow the drug (AOR = 1.27; 95% CI: 1.09, 1.47) than females. SAC with age 10-14 years were 45% more likely to swallow the drug compared with their counter parts (5-9 years), (AOR =1.45; 95% CI: 1.25, 1.69). There is statistically significant association between PZQ swallowing status with school enrollment. (AOR = 20.90, 95% CI: 17.41, 25.08). Swallowing status of PZQ against SCH significantly higher for SAC treated in districts applied integrated treatment approach (87.5%) compared with SAC treated in vertical treatment approach (72.5%); P-value < 0.001. SACs were asked for reasons for not taking the drug and the main reported reason for not swallowing PZQ in the present study was none attending of the school. CONCLUSIONS: Over all treatment coverage of PZQ against SCH in the present study was 75.5%. Although it is in accordance with WHO recommendation for Ethiopia, national programmatic improvements are necessary to achieve higher coverage in the future. To increase treatment coverage for PZQ against SCH in Ethiopia, school based training should target all schools. Moreover, mobilization, sensitization and implementation of the community wide treatment need to be improved.


Assuntos
Anti-Helmínticos/uso terapêutico , Assistência à Saúde/métodos , Praziquantel/uso terapêutico , Schistosoma mansoni , Esquistossomose mansoni/tratamento farmacológico , Esquistossomose mansoni/epidemiologia , Adolescente , Fatores Etários , Animais , Criança , Estudos Transversais , Deglutição , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Cooperação do Paciente , Prevalência , Saúde Pública , Esquistossomose mansoni/parasitologia , Fatores Sexuais , Estudantes , Inquéritos e Questionários
8.
Medicine (Baltimore) ; 99(46): e23177, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33181693

RESUMO

Prediction of aspiration pneumonia development in at-risk patients is vital for implementation of appropriate interventions to reduce morbidity and mortality. Unfortunately, studies utilizing a comprehensive approach to risk assessment are still lacking. The objective of this study was to analyze the clinical features and videofluoroscopic swallowing study (VFSS) findings that predict aspiration pneumonia in patients with suspected dysphagia.Medical records of 916 patients who underwent VFSS between September 2014 and June 2018 were retrospectively analyzed. Patients were divided into either a pneumonia group or a non-pneumonia group based on diagnosis of aspiration pneumonia. Clinical information and VFSS findings were evaluated.One hundred seven patients (11.7%) were classified as having pneumonia. Multivariate analysis indicated that aspiration during the 2- cubic centimeter thick-liquid trial of VFSS (odds ratio [OR] = 3.23, 95% confidence interval [CI]: 1.93-5.41), smoking history (OR = 2.63, 95% CI: 1.53-4.53), underweight status (OR = 2.27, 95% CI: 1.31-3.94), abnormal pharyngeal delay time (OR = 1.60, 95% CI: 1.01-2.53), and a Penetration-Aspiration Scale level of 8 (OR = 3.73, 95% CI: 2.11-6.59) were significantly associated with aspiration pneumonia development. Integrated together, these factors were used to develop a predictive model for development of aspiration pneumonia (DAP), with a sensitivity of 82%, specificity of 56%, and an area under the receiver operating characteristic curve of 0.73.The best predictors for DAP included videofluoroscopic findings of aspiration during a 2-cubic centimeter thick-liquid trial, prolonged pharyngeal delay time, a Penetration-Aspiration Scale level of 8, history of smoking, and underweight status. These 5 proposed determinants and the associated DAP score are relatively simple to assess and may constitute a clinical screening tool that can readily identify and improve the management of patients at risk for aspiration pneumonia.


Assuntos
Transtornos de Deglutição/diagnóstico por imagem , Deglutição/fisiologia , Fluoroscopia/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Transtornos de Deglutição/complicações , Feminino , Fluoroscopia/métodos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Pneumonia Aspirativa/etiologia , Pneumonia Aspirativa/fisiopatologia , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Reino Unido , Gravação em Vídeo/instrumentação
9.
Codas ; 32(5): e20190166, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33053090

RESUMO

PURPOSE: The purpose of the present study was to assess the validity of a simple instrument for screening dysphagia used in a large public hospital in Brazil with heterogeneous adult population. METHOD: The Dysphagia Risk Evaluation Protocol (DREP) - screening version contains four items (altered cervical auscultation, altered vocal quality, coughing and choking before / during / after swallowing) that were previously indicated as independent risk factors associated to the presence of dysphagia in the swallowing test with water. Trained speech therapists administered and scored DREP - screening version to consecutive patients referred by hospital's medical team to perform Video Fluoroscopic for Swallowing Study (VFSS). RESULTS: 211 patients received the swallowing screen (DREP): 99 failed and 112 passed. One in every five patients was randomized to receive a VFSS. The DREP screening version demonstrated excellent validity with sensitivity at 92.9%, specificity at 75.0%, negative predictive values at 95.5% and an accuracy of 80.9%. CONCLUSION: The DREP - screening version is a simple and accurate tool to identify the risk for penetration and / or aspiration in patients who are not tube-fed, who have a good level of alertness, have no history of recurrent pneumonia, are not on pneumonia, and that do not use a tracheostomy cannula.


Assuntos
Transtornos de Deglutição , Deglutição , Adulto , Brasil , Transtornos de Deglutição/diagnóstico , Humanos , Sensibilidade e Especificidade , Traqueostomia
10.
Codas ; 32(5): e20180154, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33053079

RESUMO

PURPOSE: To correlate stroke severity with oral intake level of the studied population and compare the two factors at the time of admission and after swallowing management. METHODS: A total of 137 patients hospitalized in the cerebral vascular accident unit (CVAU) of a teaching hospital participated. During the stay at CVAU, the patients were submitted to daily neurological evaluation and application of National Institutes of Health Stroke Scale (NIHSS), to evaluate the severity of stroke, ranging from zero (without evidence of neurological deficit) to 42 (in coma and unresponsive). Functional Oral Intake Scale (FOIS), which is a marker for evolution of oral intake and ranges from level one (nothing oral) to seven (oral total restrictions). Data from the NIHSS and FOIS scales of admission and discharge were analyzed and compared to verify association between improvement of oropharyngeal dysphagia with functional improvement of individuals. RESULTS: At admission, 63 (46.0%) patients had mild strokes, 38 (27.7%) had severe and very severe stroke; 46 (33.6%) had oral intake and need for special preparation or compensations. At discharge, there was an increase in patients with mild stroke (76 - 55.5%); oral intake without special preparation or compensations, but with food restrictions (18 - 13.1%), and oral intake without restrictions (44 - 32.1%). CONCLUSION: The level of oral intake increased as the severity of stroke decreased. Speech and language therapy contributed to a decrease in stroke severity and improvement in oral intake.


Assuntos
Transtornos de Deglutição , Acidente Vascular Cerebral , Deglutição , Transtornos de Deglutição/etiologia , Humanos , Alta do Paciente , Índice de Gravidade de Doença , Acidente Vascular Cerebral/complicações
11.
Codas ; 32(4): e20200222, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33053075

RESUMO

PURPOSE: to describe de functional development of swallowing in Intensive Care Unit (ICU) patients with COVID-19, who were submitted to a swallowing intervention. METHODS: participants of the study were 77 patients (both gender, mean age 53.4±15.9; score on the Glasgow Coma Scale ≥14 and stable respiratory condition). The functional scale of swallowing used for assessment was the American Speech-Language-Hearing Association National Outcome Measurement System (ASHA NOMS). RESULTS: the results indicate that there was a significant recovery of the functional swallowing patterns when comparing the measurements pre and post swallowing intervention. CONCLUSION: 83% of the patients needed up to 3 swallowing interventions to recover a safe swallowing pattern.


Assuntos
Infecções por Coronavirus/prevenção & controle , Deglutição/fisiologia , Unidades de Terapia Intensiva/estatística & dados numéricos , Pneumonia Viral/prevenção & controle , Adulto , Idoso , Betacoronavirus , Coronavirus , Infecções por Coronavirus/epidemiologia , Surtos de Doenças/prevenção & controle , Humanos , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Estados Unidos/epidemiologia
12.
J Stroke Cerebrovasc Dis ; 29(12): 105303, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33039771

RESUMO

BACKGROUND AND PURPOSE: Dysphagia in the acute phase of stroke contributes significantly to poor outcomes and is associated with the development of aspiration pneumonia and malnutrition. Therefore, an accurate evaluation of swallowing is necessary before initiating oral food intake. The modified water swallow test (MWST) and the repetitive saliva swallow test (RSST) are commonly used as bedside screening methods for swallowing dysfunction, but it is unclear whether other factors contribute to dysphagia and consequent aspiration. The purpose of this study was to identify characteristics that might be overlooked in screening tests. METHODS: Participants were prospectively selected from patients hospitalized for stroke at the Suiseikai Kajikawa Hospital between August 1, 2016 and June 30, 2018. Inclusion criteria were conscious and stable medical condition, and patients who were diagnosed with dementia were excluded. A videofluoroscopic (VF) swallowing study was carried out on all patients who met the inclusion/exclusion criteria and who passed both the MWST and the RSST. RESULTS: Aspiration was observed in 16 of 172 patients (9.3%) when swallowing 3 ml of water. These aspirated patients showed significantly delayed swallowing reflex on VF. CONCLUSIONS: Swallowing evaluation using a combination of the MWST and the RSST is reasonably effective. However, patients who show a delayed swallowing reflex might be overlooked by this screening procedure.


Assuntos
Transtornos de Deglutição/diagnóstico , Deglutição , Testes Imediatos , Tempo de Reação , Reflexo , Acidente Vascular Cerebral/diagnóstico , Gravação em Vídeo , Idoso , Idoso de 80 Anos ou mais , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/fisiopatologia , Feminino , Fluoroscopia , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Aspirativa/etiologia , Valor Preditivo dos Testes , Estudos Prospectivos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/fisiopatologia , Fatores de Tempo
13.
BMC Geriatr ; 20(1): 419, 2020 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-33087067

RESUMO

BACKGROUND: Sarcopenia and dysphagia are prevalent health issues as the elderly population continues to grow. However, whether sarcopenia, defined by either reduced handgrip strength or gait speed, would lead to pathological effects on swallowing function is still a matter of debate. Studies focusing on subclinical changes in the swallowing function in the sarcopenic elderly are lacking. This study evaluates the swallowing function in the sarcopenic elderly without dysphagia. METHODS: A cross-sectional study was conducted including subjects recruited from the community. Ninety-four individuals aged 65 and older without dysphagia were divided into two groups: sarcopenia and nonsarcopenia. The swallowing assessment included tongue pressure measurement, hyoid displacement (HD), hyoid velocity (HV) measurement with submental ultrasonography, 100-ml water-swallowing test, and the 10-item Eating Assessment Tool (EAT-10). RESULTS: The average tongue pressure was 47.0 ± 13.7 and 48.6 ± 11.5 kPa in the sarcopenia and nonsarcopenia groups, respectively (p = 0.55), whereas the average HD during swallowing was 15.3 ± 4.4 and 13.0 ± 4.2 mm in the sarcopenia and nonsarcopenia groups, respectively (p < 0.05). The median of HV during swallowing was 19.5 (6.41-45.86) and 15.9 (3.7-39.7) mm/s in the sarcopenia and nonsarcopenia group (p < 0.05). The median of time needed for consuming 100 ml water was 12.43 (3.56-49.34) and 5.66 (2.07-19.13) seconds in the sarcopenia and nonsarcopenia groups, respectively (p < 0.05). The median of the EAT-10 score was 0 (0-2) and 0 (0-1) in the sarcopenia and nonsarcopenia groups, respectively (p < 0.05). CONCLUSIONS: In elderly individuals, swallowing function was significantly impaired with sarcopenia before clinical symptoms become clear. However, tongue muscles exhibited resistance to sarcopenia. We observed compensative strategies in patients with sarcopenia, such as reduced swallowing speed and increased hyoid bone movement.


Assuntos
Transtornos de Deglutição , Sarcopenia , Idoso , Estudos Transversais , Deglutição , Transtornos de Deglutição/diagnóstico , Força da Mão , Humanos , Pressão , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia , Língua
14.
Artigo em Chinês | MEDLINE | ID: mdl-33040517

RESUMO

After treatment, patients with head and neckmalignant tumors may suffer from dysphagia, which may lead to aspiration pneumonia, cough and other complications, even threaten life, seriously affecting patients'quality of life. Through comprehensive evaluation of patients' swallowing function, clinicians can make corresponding rehabilitation plans to improve patients' quality of life.This paper summarizes a variety of subjective and objective evaluation methods for evaluating swallowing function of head and neck malignant tumors.


Assuntos
Transtornos de Deglutição , Neoplasias de Cabeça e Pescoço , Pneumonia Aspirativa , Deglutição , Transtornos de Deglutição/etiologia , Humanos , Qualidade de Vida
15.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2173-2177, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018437

RESUMO

Tracking a liquid or food bolus in videofluoroscopic images during X-ray based diagnostic swallowing examinations is a dominant clinical approach to assess human swallowing function during oral, pharyngeal and esophageal stages of swallowing. This tracking represents a highly challenging problem for clinicians as swallowing is a rapid action. Therefore, we developed a computer-aided method to automate bolus detection and tracking in order to alleviate issues associated with human factors. Specifically, we applied a stateof-the-art deep learning model called Mask-RCNN to detect and segment the bolus in videofluoroscopic image sequences. We trained the algorithm with 450 swallow videos and evaluated with an independent dataset of 50 videos. The algorithm was able to detect and segment the bolus with a mean average precision of 0.49 and an intersection of union of 0.71. The proposed method indicated robust detection results that can help to improve the speed and accuracy of a clinical decisionmaking process.


Assuntos
Transtornos de Deglutição , Deglutição , Cinerradiografia , Transtornos de Deglutição/diagnóstico por imagem , Fluoroscopia , Humanos , Orofaringe
17.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4365-4368, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018962

RESUMO

Aspiration pneumonia is a life-threatening disease for the elderly. To prevent its risk, regular swallowing assessment is necessary; however, current screening tools for swallow assessment are not widely available and medical experts are insufficient. As a portable assessment tool, we have been developing a smartphone-based realtime monitoring device (GOKURI) which can evaluate swallowing ability based on swallow sounds. For better detection accuracy of the system, we integrated a deep learning model which was developed based on the swallowing anatomy. In this paper, we provide a detailed analysis to see how the swallow sounds detected by the deep learning-based monitor correspond to the actual swallow activities. Also, as an example of practical application of the system, we analyzed the changes of the swallow abilities over time by recording swallow sounds twice for the same participants at a nursing home. To minimize the risk of aspiration pneumonia, caregivers need to understand the disability levels of the patient's swallows so that safe feeding assistance can be provided. The result of this paper implies the possibility of using GOKURI as a daily swallowing monitor with minimum interventions.


Assuntos
Transtornos de Deglutição , Pneumonia Aspirativa , Idoso , Aprendizado Profundo , Deglutição , Transtornos de Deglutição/diagnóstico , Humanos , Monitorização Fisiológica
18.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5128-5131, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019140

RESUMO

With the progress of surgical technology, the survival rate after resection of esophageal and tongue carcinomas has improved. However, the surgical protocol for esophageal and tongue surgery is complex, and surgery for elderly esophageal and tongue carcinoma patients with cardiopulmonary dysfunction is difficult. Using an artificial tongue and esophagus will be helpful for patients. However, peristalsis of foods depends on food size, taste, and viscosity. This study developed and evaluated a new diagnosis machine for drinking and peristalsis motion. Before clinical evaluation, animal experiments were performed on healthy adult goats using a stereo camera. After a feasibility study of the diagnosis system for peristalsis, clinical evaluation was conducted on healthy normal volunteers. We observed no aspiration pneumonia. The foods and drinks tested were safe. There was no mis-swallowing, but the participants' feeling with regard to taste differed. Overall, the results indicated that the quantitative swallowing and peristalsis diagnosis system is safe. Evaluation of the visual imaging and spectral analysis gave us useful information about peristalsis, which will help us design an artificial tongue and esophagus with a good control mechanism in the near future.


Assuntos
Deglutição , Peristaltismo , Idoso , Animais , Ingestão de Líquidos , Esôfago/diagnóstico por imagem , Humanos , Língua
19.
Seizure ; 83: 32-37, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33080482

RESUMO

OBJECTIVE: There is a harmful myth that persists in modern culture that one should place objects into a seizing person's mouth to prevent "swallowing the tongue." Despite expert guidelines against this, the idea remains alive in popular media and public belief. We aimed to investigate the myth's origins and discredit it. METHODS: A medical and popular literature review was conducted for the allusions to "swallowing one's tongue" and practice recommendations for and against placing objects into a seizing person's mouth. Current prevalence of these beliefs and relevant anatomy and physiology were summarised. RESULTS: The first English language allusions to placing objects in a patient's mouth occurred in the mid-19th century, and the first allusions to swallowing one's tongue during a seizure occurred in the late 19th century. By the mid-20th century, it was clear that some were recommending against the practice of placing objects in a patient's mouth to prevent harm. Relatively recent popular literature and film continue to portray incorrect seizure first aid through at least 2013. There is ample modern literature confirming the anatomical impossibility of swallowing one's tongue and confirming the potential harm of putting objects in a patient's mouth. CONCLUSION: One cannot swallow their tongue during a seizure. Foreign objects should not be placed into a seizing person's mouth. We must continue to disseminate these ideas to our patients and colleagues. As neurologists, we have an obligation to champion safe practices for our patients, especially when popular media and culture continue to propagate dangerous ones.


Assuntos
Deglutição/fisiologia , Boca/fisiopatologia , Convulsões/fisiopatologia , Língua/fisiopatologia , Primeiros Socorros , Humanos , Saúde Pública , Língua/fisiologia
20.
J Oral Rehabil ; 47(11): 1358-1367, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32895952

RESUMO

BACKGROUND: Quantitative assessment of swallowing function is necessary to prevent swallowing impairment due to ageing. Though surface electromyography (EMG) has been widely used to measure swallowing activity, the relationship between EMG results and swallowing function is unclear. OBJECTIVE: This study examined the relationship between the temporal characteristics of muscle activity and laryngeal elevation (LE) during swallowing. METHODS: This study analysed 60 healthy volunteers in two age groups (young, between 20 and 38 years; old, between 65 and 75 years), each containing the same number of male and female participants. Surface EMG signals were recorded from the suprahyoid and infrahyoid muscle groups (SH-EMG and IH-EMG, respectively). LE was measured using an array of pressure sensors. The participants swallowed 3 mL of water under three swallowing speed conditions: fast, normal and slow swallowing. The EMG duration, EMG time intervals before and after the onset of LE (pre-LE and post-LE intervals, respectively), and the LE velocity were analysed. RESULTS: Both EMG duration and the post-LE interval of IH-EMG were significantly longer in the older group. As for the gender effect, the pre-LE interval of SH-EMG was significantly longer and the LE velocity was significantly higher in men than in women. Furthermore, there was a negative correlation between pre-LE interval and LE velocity in the fast swallowing condition. CONCLUSION: Though ageing slightly prolonged the muscle activity time, gender influenced swallowing activity in a more complex manner. Therefore, it is important to take gender into account when examining swallowing function with increasing age.


Assuntos
Transtornos de Deglutição , Deglutição , Eletromiografia , Feminino , Humanos , Masculino , Músculos do Pescoço
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