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Achados fluoroscópicos da deglutição: comparação entre recém-nascidos pré-termo e recém-nascidos de termo; Fluoroscopic findings of swallowing: comparison between preterm and full-term infants

SILVA-MUNHOZ, Lenice de Fatima da; BÜHLER, Karina Elena Bernadis
Fonte: Sociedade Brasileira de Fonoaudiologia Publicador: Sociedade Brasileira de Fonoaudiologia
Tipo: Artigo de Revista Científica
POR
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46.66%
OBJETIVO: Descrever os achados fluoroscópicos da deglutição de recém-nascidos pré-termo de zero a seis meses de idade, assim como as doenças e os sinais e sintomas clínicos relacionados à alteração na deglutição, e compará-los com os respectivos dados obtidos de recém-nascidos de termo. MÉTODOS: Foram analisados, retrospectivamente, os dados das avaliações fluoroscópicas realizadas no período de um ano em lactentes de zero a seis meses de idade e aos respectivos prontuários. Participaram 40 sujeitos, divididos em dois grupos: Grupo Pré-Termo, constituído de 23 recém-nascidos pré-termo; e Grupo de Termo, constituído por 17 recém-nascidos de termo. RESULTADOS: Os principais achados fluoroscópicos da deglutição observados em ambos os grupos foram refluxo para a nasofaringe e refluxo gastresofágico. Não houve diferença entre os grupos para a presença de alteração na deglutição . O Grupo Pré-Termo apresentou mais problemas cardíacos do que o Grupo de Termo. Não houve diferença entre os grupos para problemas neurológicos e respiratórios. Em relação aos sinais e sintomas clínicos sugestivos de alteração na deglutição, o Grupo Pré-Termo apresentou mais dessaturação de oxigênio e o Grupo de Termo mais vômitos. CONCLUSÃO: Os principais achados fluoroscópicos da deglutição encontrados em recém-nascidos pré-termo de zero a seis meses de idade foram refluxo para a nasofaringe e refluxo gastresofágico. Novos estudos de seguimento desta população devem ser realizados para confirmar a hipótese de que as alterações na deglutição observadas ocorreram devido à imaturidade na função de deglutição.; PURPOSE: To describe the fluoroscopic findings of swallowing in preterm infants with zero to six months of age...

Denoising swallowing sound to improve the evaluator`s qualitative analysis

SPADOTTO, Andre Augusto; PAPA, Joao Paulo; GATTO, Ana Rita; COLA, Paula Cristina; PEREIRA, Jose Carlos; GUIDO, Rodrigo Capobianco; SCHELP, Arthur Oscar; MACIEL, Carlos Dias; MONTAGNOLI, Arlindo Neto
Fonte: PERGAMON-ELSEVIER SCIENCE LTD Publicador: PERGAMON-ELSEVIER SCIENCE LTD
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
46.63%
Swallowing dynamics involves the coordination and interaction of several muscles and nerves which allow correct food transport from mouth to stomach without laryngotracheal penetration or aspiration. Clinical swallowing assessment depends on the evaluator`s knowledge of anatomic structures and of neurophysiological processes involved in swallowing. Any alteration in those steps is denominated oropharyngeal dysphagia, which may have many causes, such as neurological or mechanical disorders. Videofluoroscopy of swallowing is presently considered to be the best exam to objectively assess the dynamics of swallowing, but the exam needs to be conducted under certain restrictions, due to patient`s exposure to radiation, which limits periodical repetition for monitoring swallowing therapy. Another method, called cervical auscultation, is a promising new diagnostic tool for the assessment of swallowing disorders. The potential to diagnose dysphagia in a noninvasive manner by assessing the sounds of swallowing is a highly attractive option for the dysphagia clinician. Even so, the captured sound has an amount of noise, which can hamper the evaluator`s decision. In that way, the present paper proposes the use of a filter to improve the quality of audible sound and facilitate the perception of examination. The wavelet denoising approach is used to decompose the noisy signal. The signal to noise ratio was evaluated to demonstrate the quantitative results of the proposed methodology. (C) 2007 Elsevier Ltd. All rights reserved.

Videofluoroscopic evaluation of mastication and swallowing in individuals with TMD

Maffei, Carla; de Mello, Marcal Motta; de Biase, Noemi Grigoletto; Pasetti, Lilian; Monteiro Camargo, Paulo A.; Alves Silverio, Kelly Cristina; Rebelo Goncalves, Maria Ines
Fonte: ASSOC BRASILEIRA OTORRINOLARINGOLOGIA & CIRURGIA CERVICOFACIAL; SAO PAULO Publicador: ASSOC BRASILEIRA OTORRINOLARINGOLOGIA & CIRURGIA CERVICOFACIAL; SAO PAULO
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
46.68%
To study mastication and swallowing disorders in patients with temporomanclibular disorders (TMD). Objective: To investigate mastication and swallowing disorders in patients with severe TMD referred to surgery. Materials and Methods: Clinical and experimental study involving ten individuals with TMD submitted to deglutition videofluoroscopy. These patients did not have posterior teeth, mastication pain and food replacement in favor of pasty consistence food. The assessment of the oral and pharyngeal phases approached the following aspects: side of onset and preferential side for chewing, premature escape, remains of food residues in the oral cavity or in the pharyngeal recesses, number of necessary swallowing efforts, laryngeal penetration and/or tracheal aspiration. Results: During mastication and the oral phase we observed tongue compensatory movements upon chewing (n = 7; 70%), premature escape (n = 4; 40%), food remains in the cavity after swallowing (n = 5; 50%) and an excessive number of deglutition efforts (n = 5; 50%). On the pharyngeal phase we observed food remains in the valleculae (n = 6; 60%), in the pyriform sinuses (n = 4; 40%); laryngeal penetration (n = 1; 10%) and tracheal aspiration (n = 4; 40%). Conclusion: TMD patients may have alterations in their chewing and swallowing patterns...

Swallowing transit times and valleculae residue in stable chronic obstructive pulmonary disease

Chaves, Rosane de Deus; Sassi, Fernanda Chiarion; Mangilli, Laura Davison; Jayanthi, Shri Krishna; Cukier, Alberto; Zilberstein, Bruno; Andrade, Claudia Regina Furquim de
Fonte: BMC Publicador: BMC
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
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Background Breathing and swallowing are physiologically linked to ensure effortless gas exchange during oronasal breathing and to prevent aspiration during swallowing. Studies have indicated consistent aspiration in chronic obstructive pulmonary disease, mainly related to delayed swallowing reflex and problems with lingual propulsion and pharyngeal peristalsis as a result of bilateral weakness and incoordination of the related muscles. The purpose of the present study was to evaluate swallowing transit times and valleculae residue characteristics of stable COPD patients who have no swallowing complaints. Methods Our study population included 20 stable patients with COPD and no swallowing complaints and 20 healthy controls. Swallowing was assessed through videofluoroscopic examination and involved the analysis of the following parameters: (1) pharyngeal stages of deglutition; (2) the duration of bolus movement through the oral cavity and pharynx (i.e. transit times); (3) valleculae residue ratio; (4) penetration/aspiration. Results Participants of the study did not present any signs of penetration-aspiration for any of the tested consistencies. Patients with COPD presented longer pharyngeal transit times during the ingestion of the liquid consistency and during the ingestion of the paste consistency. Regarding the duration of tongue base contact with the posterior pharyngeal wall...

Estudo da interação respiração - deglutição de pacientes submetidos à intubação orotraqueal e ventilação mecânica prolongada; Study of the interaction breath - swallowing patients undergoing intubation and prolonged mechanical ventilation

Camargo, Fernanda Pereira de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 05/10/2010 PT
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Introdução: Pacientes criticamente doentes frequentemente requerem intubação endotraqueal e suporte ventilatório prolongado. Estudos encontraram e demonstraram uma correlação temporal e fisiológica da deglutição entre a respiração e os componentes envolvidos na proteção de via aérea durante a deglutição, no entanto a contribuição desta interação permanece desconhecida após um período de intubação endotraqueal e ventilação mecânica (VM). Objetivo: O propósito deste estudo prospectivo foi de avaliar a interação da respiração - deglutição em pacientes submetidos à intubação orotraqueal e ventilação mecânica. Método: Avaliamos prospectivamente 10 voluntários saudáveis e 30 pacientes que foram submetidos à VM invasiva 24 horas em três momentos distinto de avaliação (48h; 5º dia e 15º dia) após a extubação. A interação da respiração deglutição foi investigada e gravada simultaneamente beira leito com o uso de eletromiografia de superficie da musculatura infra hióidea associada à acelerometria da deglutição (sensor piezoeletrico) e pletismografia de indutância da respiração durante a deglutição espontânea inicial (1min.), bolo de água com volumes de 3, 5 e 10 ml previamente randomizados e deglutição espontânea final (1min). Resultados: Voluntários saudáveis apresentaram uma deglutição por ciclo respiratório mantendo o padrão de ocorrência da deglutição nos padrões 1 e 2 de acoplamento no ciclo respiratório associado a ocorrência da pausa respiratória da deglutição. Pacientes apresentaram um maior número de deglutições e de ciclos respiratórios com os volumes de 5 e 10 ml (p<0...

Caracterização da deglutição em portadores de distrofia miotônica de Steinert; Characterization of swallowing in patients with myotonic dystrophy of Steinert

Ercolin, Beatriz
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 07/11/2012 PT
Relevância na Pesquisa
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INTRODUÇÃO: A disfagia orofaríngea e os distúrbios de motilidade esofágica são considerados as mais importantes causas de pneumonia aspirativa em pacientes com distrofia miotônica. O objetivo deste estudo foi avaliar as características clínicas da motricidade orofacial e a deglutição de indivíduos com distrofia miotônica (DM1), utilizando um protocolo clínico padronizado e eletromiografia de superfície (EMGs). MÉTODO: Os participantes foram divididos em dois grupos: G1-composto por 20 adultos com DM1; G2-composto por 20 voluntários saudáveis, os participantes foram pareados por idade e gênero com G1 para a análise estatística. Foi realizada a avaliação das estruturas e funções orofaciais, utilizando um protocolo clínico padronizado, e mensurada a atividade mioelétrica da deglutição por meio da EMGs, com eletrodos localizados em quatro grupos musculares: (1) orbicular da boca, (2) masseter, (3) musculatura suprahioidea e (4) extrínseca da laringe. A atividade mioelétrica foi medida durante o repouso muscular e durante a deglutição de saliva e de 16,5ml e 20ml de água. Os traçados da EMGs foram avaliados durante o inicio (onset), pico e o término (offset), dos evento da deglutição. A análise estatística incluiu a ANOVA de duplo fator para intragrupos e intergrupos e o teste de Bonferroni para correções de comparações múltiplas. RESULTADOS: Pacientes com DM1 apresentaram déficits em posição...

Achados clínicos e da análise videofluoroscópica da deglutição em pacientes com doença pulmonar obstrutiva crônica; Clinical and videofluoroscopic evaluation of swallowing in patients with chronic obstructive pulmonary disease

Chaves, Rosane de Deus
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 15/04/2014 PT
Relevância na Pesquisa
46.49%
Indivíduos com doença pulmonar obstrutiva crônica (DPOC) apresentam sintomas de disfagia, indicando a existência de alteração da deglutição nessa população. O objetivo da presente tese foi identificar as características da deglutição nos pacientes com DPOC. A deglutição foi avaliada por meio do exame videofluoroscopia da deglutição. Foi utilizado um protocolo para análise dos seguintes parâmetros: tempo de trânsito faríngeo, duração do contato da base de língua com a parede posterior da faringe, resíduo em valécula e penetração/aspiração. Os resultados foram analisados através de dois estudos. No primeiro estudo foi verificada a reprodutibilidade do protocolo para análise da videofluoroscopia da deglutição em uma população de adultos saudáveis. Foram avaliados 20 indivíduos saudáveis, de ambos os gêneros, com idades entre 50 e 65 anos. O protocolo consistiu na avaliação da deglutição de 10ml de consistência líquida. A análise estatística envolveu a avaliação da reprodutibilidade do método de análise entre juízes e a análise dos dados quantitativos, levando-se em consideração os gêneros. Em relação à análise das respostas dos juízes, foi observada significância estatística...

Denoising swallowing sound to improve the evaluator`s qualitative analysis

SPADOTTO, Andre Augusto; PAPA, Joao Paulo; GATTO, Ana Rita; COLA, Paula Cristina; PEREIRA, Jos Carlos; GUIDO, Rodrigo Capobianco; SCHELP, Arthur Oscar; MACIEL, Carlos Dias; MONTAGNOLI, Arlindo Neto
Fonte: PERGAMON-ELSEVIER SCIENCE LTD Publicador: PERGAMON-ELSEVIER SCIENCE LTD
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
46.63%
Swallowing dynamics involves the coordination and interaction of several muscles and nerves which allow correct food transport from mouth to stomach without laryngotracheal penetration or aspiration. Clinical swallowing assessment depends on the evaluator`s knowledge of anatomic structures and of neurophysiological processes involved in swallowing. Any alteration in those steps is denominated oropharyngeal dysphagia, which may have many causes, such as neurological or mechanical disorders. Videofluoroscopy of swallowing is presently considered to be the best exam to objectively assess the dynamics of swallowing, but the exam needs to be conducted under certain restrictions, due to patient`s exposure to radiation, which limits periodical repetition for monitoring swallowing therapy. Another method, called cervical auscultation, is a promising new diagnostic tool for the assessment of swallowing disorders. The potential to diagnose dysphagia in a noninvasive manner by assessing the sounds of swallowing is a highly attractive option for the dysphagia clinician. Even so, the captured sound has an amount of noise, which can hamper the evaluator`s decision. In that way, the present paper proposes the use of a filter to improve the quality of audible sound and facilitate the perception of examination. The wavelet denoising approach is used to decompose the noisy signal. The signal to noise ratio was evaluated to demonstrate the quantitative results of the proposed methodology. (C) 2007 Elsevier Ltd. All rights reserved.

Swallowing disorders after ischemic stroke

Remesso,Gabriela Camargo; Fukujima,Márcia Maiumi; Chiappetta,Ana Lúcia de Magalhães Leal; Oda,Adriana Leico; Aguiar,Alexandre Santos; Oliveira,Acary de Souza Bulle; Prado,Gilmar Fernandes do
Fonte: Academia Brasileira de Neurologia - ABNEURO Publicador: Academia Brasileira de Neurologia - ABNEURO
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2011 EN
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66.73%
OBJECTIVE: To investigate occurrences of swallowing disorders after ischemic stroke. METHOD: This was a retrospective study on 596 medical files. The inclusion criterion was that the patients needed to have been hospitalized with a diagnosis of ischemic stroke; the exclusion criteria were the presence of associated cardiac problems and hospital stay already more than 14 days. RESULTS: 50.5% were men and 49.5% women; mean age 65.3 years (SD=±11.7) (p<0.001). Among the risk factors, 79.4% had hypertension, 36.7% had diabetes (p<0.001) and 42.7% were smokers. 13.3% of the patients died. Swallowing disorders occurred in 19.6%, among whom 91.5% had mild difficulty and 8.5% had severe difficulty. 87.1% had spontaneous recovery after a mean of 2.4 months. A lesion in the brainstem region occurred in 6.8% (p<0.001). CONCLUSION: Swallowing disorders occurred in almost 20% of the population and most of the difficulty in swallowing found was mild. The predictors for swallowing disorders were older age, diabetes mellitus and lesions in the brainstem region.

Swallowing and quality of life after total laryngectomy and pharyngolaryngectomy

Queija,Débora dos Santos; Portas,Juliana Godoy; Dedivitis,Rogério Aparecido; Lehn,Carlos Neutzling; Barros,Ana Paula Brandão
Fonte: Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial Publicador: Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2009 EN
Relevância na Pesquisa
46.55%
Dysphagia can be a consequence of total laryngectomy even in the absence of symptoms and it could indeed directly or indirectly compromise quality of life. AIM: To evaluate the characteristics of swallowing after total laryngectomy and pharyngolaryngectomy with pharyngeal T closure, correlating them with the Quality of Life in Swallowing Disorders questionnaire. METHODS: A prospective evaluation was performed in 28 patients; fifteen undergoing total laryngectomy and thirteen undergoing total pharyngolaryngectomy. Swallowing was evaluated through videofluoroscopy regarding the preparatory, oral and pharyngeal phases of swallowing, and the quality of life related to swallowing questionnaire was employed to measure quality of life. RESULTS: Anatomical and functional changes were observed under videofluoroscopic evaluation. Dysphagia was diagnosed in 18 patients (64.3%), being mild in 66.6% and moderate/severe in 33.3%. The questionnaire indicated good quality of life in almost all scales. Complaints of dysphagia were associated to the burden (p=0.036) and mental health scale (p=0.031). The questionnaire indicated impact on the mental health scale for patients with severe dysphagia (p=0.012). CONCLUSIONS: High incidence of dysphagia was observed in some quality of life assessments...

Electrical activity of the masseter during swallowing after total laryngectomy

Pernambuco,Leandro de Araújo; Silva,Hilton Justino da; Nascimento,Gerlane Karla Bezerra Oliveira; Silva,Elthon Gomes Fernandes da; Balata,Patrícia Maria Mendes; Santos,Veridiana da Silva; Leão,Jair Carneiro
Fonte: Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial Publicador: Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2011 EN
Relevância na Pesquisa
46.51%
Total laryngectomy is a surgical procedure that can change swallowing biomechanics, including muscle activity of the masseter; this muscle stabilizes the mandible. AIM: To characterize the electrical activity of the masseter muscle during swallowing after total laryngectomy. Series study. MATERIAL AND METHODS: An electromyographic evaluation of swallowing was carried out; three different volumes of water (14.5ml, 20ml and 100ml) were swallowed, and there was a rest condition. The electromyographic signal was normalized by Maximum Resisted Voluntary Activity - considered as 100% of electrical activity of muscles. All other values were calculated as a percentage of this parameter. RESULTS: There is moderate electrical activity of the masseter during swallowing with higher averages on the left. There was no difference between swallowing 14.5ml or 20ml. Natural swallowing of 100ml had the lowest average. Electromyographic signals were recorded at rest on both sides, indicating the existence of electric activity in this situation. CONCLUSION: Patients submitted to total laryngectomy present electrical activity of the masseter muscles during swallowing and at rest. This activity is influenced by the volume of swallowed liquid, and showed significant differences among the tasks. Clinical Trials: NCT01095289

Vocal Variability Post Swallowing in Individuals with and without Oropharyngeal Dysphagia

Santos,Karoline Weber dos; Scheeren,Betina; Maciel,Antonio Carlos; Cassol,Mauriceia
Fonte: Fundação Otorrinolaringologia Publicador: Fundação Otorrinolaringologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2015 EN
Relevância na Pesquisa
46.62%
Introduction Voice modification after swallowing may indicate changes in the transit of the bolus. Objective The aim of this study is to verify the use of perceptual voice analysis to detect oropharyngeal dysphagia. Study Design Case series. Methods Twenty-seven patients with dysphagia as diagnosed by videofluoroscopy and 25 without were evaluated. The sustained vowel /a/ was recorded before this exam and after swallowing different consistencies (pasty, liquid and solid). For the voice evaluation, the GRBAS scale (grade, roughness, breathiness, asthenia and strain) and the parameter "wet voice" were used. Three judges blinded to study group and time of emission performed voice analysis. Results Individuals with dysphagia showed significant decrease in grade of voice and asthenia and increase in strain after swallowing pasty substances, differing from individuals without dysphagia who showed no modification of the parameters after swallowing. The wet voice parameter showed no difference after swallowing in both study groups. Conclusion The decrease in grade and asthenia and increased strain are indicative of a swallowing disorder, indicating increased vocal strain to clean the vocal tract of food. The modification of vocal production after swallowing proved to be a trusted resource for detection of swallowing disorders.

Pharyngeal swallowing disorders: selection for and outcome after myotomy.

Mason, R J; Bremner, C G; DeMeester, T R; Crookes, P F; Peters, J H; Hagen, J A; DeMeester, S R
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /10/1998 EN
Relevância na Pesquisa
46.53%
OBJECTIVE: To develop selection criteria based on the mechanical properties of pharyngoesophageal swallowing that indicate when patients with pharyngeal dysphagia will benefit from a myotomy. SUMMARY BACKGROUND DATA: The pathophysiology of pharyngoesophageal swallowing disorders is complex. The disorder is of interest to several medical specialists (gastroenterologists, otorhinolaryngologists, general and thoracic surgeons), which contributes to confusion about the entity. The management is compounded because it is most frequently seen in the elderly, is often associated with generalized neuromuscular disease, and occurs with a high prevalence of concomitant disease. The selection of patients for myotomy is difficult and of major importance to the quality of life of the affected patients. METHOD: One hundred seven patients without a Zenker diverticulum but with pharyngeal dysphagia underwent a detailed manometric assessment of the upper esophageal sphincter (UES). Cricopharyngeal opening was identified by the presence of a subatmospheric pressure drop before bolus arrival. Impaired pharyngoesophageal segment compliance resulting in a resistance to pharyngoesophageal flow was determined by measuring the intrabolus pressure generated by a 5-ml liquid bolus. RESULTS: Thirty-one of 107 patients underwent a myotomy (29%). Both impaired sphincter opening and increased intrabolus pressure predicted a good outcome. CONCLUSION: Myotomy is beneficial in patients with pharyngeal swallowing disorders and manometric evidence of defective sphincter opening and increased intrabolus pressure.

Swallowing disorders in tracheostomised patients: a multidisciplinary/multiprofessional approach in decannulation protocols

Garuti, Giancarlo; Reverberi, Cristina; Briganti, Angelo; Massobrio, Monica; Lombardi, Francesco; Lusuardi, Mirco
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 20/06/2014 EN
Relevância na Pesquisa
46.47%
Safe removal of tracheal cannula is a major goal in the rehabilitation of tracheostomised patients to achieve progressive independence from mechanical support and reduce the risk of respiratory complications. A tracheal cannula may also cause significant discomfort to the patient, making verbal communication difficult. Particularly when cuffed, tracheal cannula reduces the normal movement of the larynx which can further compromise the basic swallowing defect. A close connection between respiratory, phonating, swallowing and feeding abilities to be recovered, implies a strict integration among different professionals of the rehabilitation team. An appropriate management of tracheostomy cannula is closely connected with assessment and treatment of swallowing disorders in order to limit the development of severe pulmonary and nutritional complications, but at present there are no uniform protocols in the scientific literature. Furthermore, several studies report as an essential criterion for decannulation the presence of good patient consciousness, which is often altered in patients with tracheostomy, but a general agreement is lacking.

Feeding and swallowing disorders

Rommel, N.; Omari, T.
Fonte: Springer; United States Publicador: Springer; United States
Tipo: Parte de Livro
Publicado em //2013 EN
Relevância na Pesquisa
46.62%
Dysphagia is very common in the pediatric population within a wide range of disorders and hinders the provision of adequate nutrition, affecting growth and development and may lead to significant parental anxiety and family disruption. A variety of oropharyngeal swallowing disorders reported in newborns, infants and children are discussed in this chapter which does not intend to offer a complete classification of feeding problems in young children. Classifying feeding and swallowing problems is often difficult because of the fact that similar signs or symptoms may reflect different etiologies. Because of this lack of a one-to-one correspondence between clinical presentations and underlying causes of dysphagia, careful identification of symptoms, documentation of the underlying pharyngo-esophageal motility patterns and their relation to the mealtimes, is necessary to pinpoint the specific cause of a feeding or swallowing disorder. The main message of the chapter is that in assessing feeding and swallowing disorders, it is crucial to assess the biomechanics of swallow physiology in pharynx and esophagus using objective assessment techniques, regardless of the primary medical pathology. Linking clinical signs and symptoms to the objective dysphagic “signature” of the patient is the only way to achieve proper differential diagnosis of dysphagia and to provide effective treatment.; Nathalie Rommel and Taher Omari

Swallowing in moderate and severe phases of Alzheimer's disease; A deglutição nas fases moderada e grave da doença de Alzheimer

CORREIA, Sheilla de Medeiros; MORILLO, Lilian Schafirovits; JACOB FILHO, Wilson; MANSUR, Leticia Lessa
Fonte: Academia Brasileira de Neurologia - ABNEURO Publicador: Academia Brasileira de Neurologia - ABNEURO
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
46.45%
OBJECTIVE: To characterize the problems of feeding and swallowing in individuals with moderate and severe Alzheimer´s disease (AD) and to correlate these with functional aspects. METHOD: Fifty patients with AD and their caregivers participated in this study. The instruments used were: Clinical Dementia Rating (CDR), Mini-Mental State Examination, Index of Activities of Daily Living, Assessment of Feeding and Swallowing Difficulties in Dementia, Functional Outcome Questionnaire for Aphasia, and Swallowing Rating Scale. RESULTS: Problems with passivity, distraction and refusal to eat were encountered in the CDR2 group. Distraction, passivity and inappropriate feeding velocity were predominant in the CDR3 group. The problems were correlated with communication, swallowing severity of AD individuals and caregiver schooling. CONCLUSION: Given the inexorable functional alterations during the course of the disease, it is vital to observe these in patients with a compromised feeding and swallowing mechanism. The present study supplies the instruments to orient caregivers and professionals.; OBJETIVO: Caracterizar os problemas de alimentação e deglutição em indivíduos com doença de Alzheimer (DA) em fases moderada e grave e correlacioná-las com os aspectos funcionais. MÉTODO: Participaram do estudo 50 pacientes com DA e seus 50 cuidadores. Os instrumentos utilizados foram: Estadiamento clínico da demência (CDR)...

Estudo da deglutição em idosos com e sem doença neurológica : videofluoroscopia e Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF); Swallowing study in elderly with and without neurological disease : videofluoroscopy and International Classification of Functioning, Disability and Health (ICF)

Daniella Priscila de Lima
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 28/01/2015 PT
Relevância na Pesquisa
46.52%
No envelhecimento normal, alterações fisiológicas tendem a interferir na deglutição, mas o indivíduo idoso pode ser capaz de manter uma alimentação segura. Todavia, em associação com um quadro neurológico, eleva-se o risco de desenvolvimento de disfagia nessa população. Sabe-se que a funcionalidade da deglutição pode estar associada também à interação com fatores contextuais, o que permite descrever seus múltiplos impactos na vida do indivíduo. Essa concepção vai ao encontro do que preconiza a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Objetivo: Este trabalho tem como objetivo caracterizar a deglutição de idosos com e sem doença neurológica com base na videofluoroscopia (VFC) e na aplicação da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Pretende-se, ainda, verificar se as categorias da CIF, o exame de videofluoroscopia e as escalas de deglutição padronizadas discriminam ou não os grupos de idosos com e sem doença neurológica e se há categorias da CIF ou da VFC que se correlacionam com a presença de penetração e aspiração. Métodos: Compuseram a amostra 63 idosos, organizados em indivíduos sem doença neurológica e com doença neurológica (Esclerose Lateral Amiotrófica...

Swallowing disorders in nursing home residents: how can the problem be explained

Nogueira, D.; Reis, E.
Fonte: DOVE MEDICAL PRESS LTD Publicador: DOVE MEDICAL PRESS LTD
Tipo: Artigo de Revista Científica
Publicado em //2013 ENG
Relevância na Pesquisa
56.73%
WOS:000315187000001 (Nº de Acesso Web of Science); Background: The swallowing mechanism changes significantly as people age, even in the absence of chronic diseases. Presbyphagia, a term that refers to aging-related changes in the swallowing mechanism, may be linked to many health conditions and presents itself in distinct ways. Swallowing disorders are also identified as a major problem amongst the elderly population living in nursing homes. Methods: The study sought to determine the prevalence of swallowing disorders in nursing home residents, to identify the relationship between self-perceived swallowing disorders, cognitive functions, autonomy, and depression, and also to analyze which variables explain the score of the Dysphagia Self-Test (DST). For this purpose, the researchers chose to apply a survey conveying questions on demographic aspects, general health, eating and feeding, as well as instruments to assess functional performance and the 3 ounce Water Swallow Test. Results: The sample consisted of 272 elderly people living in eight nursing homes in Portugal. Six did not sign the informed consent form. Of the total, 29% were totally dependent, 33% were depressed, 45% had cognitive impairment, and 38% needed help with feeding. About 43% of the individuals reported having problems related to eating. Regarding the DST...

Quality of Life in Swallowing Disorders after Nonsurgical Treatment for Head and Neck Cancer

Silveira,Marta Halina; Dedivitis,Rogerio A.; Queija,Débora Santos; Nascimento,Paulo César
Fonte: Fundação Otorrinolaringologia Publicador: Fundação Otorrinolaringologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2015 EN
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Introduction Radiotherapy or chemoradiotherapy can result in severe swallowing disorders with potential risk for aspiration and can negatively impact the patient's quality of life (QOL). Objective To assess swallowing-related QOL in patients who underwent radiotherapy/ chemoradiotherapy for head and neck cancer. Methods We interviewed 110 patients (85 men and 25 women) who had undergone exclusive radiotherapy (25.5%) or concomitant chemoradiotherapy (74.5%) from 6 to 12 months before the study. The Quality of Life in Swallowing Disorders (SWAL-QOL) questionnaire was employed to evaluate dysphagia-related QOL. Results The QOL was reduced in all domains for all patients. The scores were worse among men. There was a relationship between oral cavity as the primary cancer site and the fatigue domain and also between advanced cancer stage and the impact of food selection, communication, and social function domains. Chemoradiotherapy association, the presence of nasogastric tube and tracheotomy, and the persistence of alcoholism and smoking had also a negative effect on the QOL. Conclusions According to the SWAL-QOL questionnaire, the dysphagia-related impact on QOL was observed 6 to 12 months after the treatment ended.

Swallowing disorders in patients with blepharospasm

Cersósimo,María G.; Juri,Silvia; Suárez de Chandler,Silvia; Clerici,Roxana; Micheli,Federico E.
Fonte: Medicina (Buenos Aires) Publicador: Medicina (Buenos Aires)
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2005 EN
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46.46%
Blepharospasm is a focal dystonia characterized by involuntary eye closure due to abnormal contraction of orbicular eyelid muscles. When blepharospasm is associated to the presence of involuntary oromandibular movements, it is termed Meige syndrome. The aim of this study was to investigate the presence of deglutition alterations in patients with concurrent blepharospasm and Meige syndrome. Twenty consecutive patients were studied by video fluoroscopy using a barium technique. The 4 stages of deglutition were investigated. Ninety percent of patients (18 cases) presented deglutition disorders. The more commonly found alterations were premature food drop, 15 cases (83%) and vallecuale residuals, 14 cases (78%). Sixty seven percent of abnormal findings occurred in the third stage of deglutition. Eighty-nine percent of patients (16) presented more than one swallowing alteration. There was a positive and significant correlation between the number of alterations and patient's age or disease duration. Prevalence of swallowing disorders in the healthy elderly population is reported to be 44%. In our series it reached 90%, suggesting that our findings might be related not only with age but also with a more widespread dystonia exceeding the orofacial muscles.