RESUMO
Bickerstaff brainstem encephalitis (BBE) is a rare inflammatory demyelinating disease with rapid progression typically followed by complete recovery. Reports of dysphagia in this population are limited and general. The purpose of this article is to heighten awareness of the potential for silent aspiration in patients with BBE. This article details the nature of dysphagia during the recovery phase of BBE and includes findings from serial videofluoroscopic swallowing evaluations. In addition, it shows the impact of cognitive impairment on the ability to eat safely. Early instrumental swallowing evaluation, close monitoring, and conservative management are essential to ensure safety in patients recovering from BBE.
Assuntos
Tronco Encefálico , Transtornos de Deglutição/etiologia , Deglutição/fisiologia , Encefalite/complicações , Recuperação de Função Fisiológica , Adulto , Transtornos de Deglutição/fisiopatologia , Seguimentos , Humanos , MasculinoRESUMO
OBJECTIVE: NT-proBNP level is used for the detection of acute CHF and as a predictor of survival. However, a number of factors, including renal function, may affect the NT-proBNP levels. This study aims to provide a more precise way of interpreting NT-proBNP levels based on GFR, independent of age. METHODS: This study includes 247 pts in whom CHF and known confounders of elevated NT-proBNP were excluded, to show the relationship of GFR in association with age. The effect of eGFR on NT-proBNP level was adjusted by dividing 1000 x log(NT-proBNP) by eGFR then further adjusting for age in order to determine a normalized NT-proBNP value. RESULTS: The normalized NT-proBNP levels were affected by eGFR independent of the age of the patient. CONCLUSION: A normalizing function based on eGFR eliminates the need for an age-based reference ranges for NT-proBNP.