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

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

[Cardiac troponins - biomarkers for cardiovascular disease in chronic obstructive pulmonary disease]. / Kardiellt troponin ­ en biomarkör för hjärt­kärlsjukdom vid KOL.

Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) are frequently associated and share common risk factors, pathophysiological processes, symptoms and clinical signs. Ischemic heart disease, heart failure, pulmonary hypertension and atrial fibrillation are common comorbidities of COPD. COPD has been described as an independent risk factor for CVD. Cardiac troponin elevation, indicating myocardial injury, is associated with both the stable state of COPD and acute exacerbation of COPD. The mechanisms of elevated troponin levels in these conditions are multiple and not fully understood. The aim of this article is to discuss the association between COPD, CVD and cardiac troponins.