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Dysphagia and Aspiration
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Dysphagia is the term used to describe difficulty with swallowing solids, liquids, or both. It implies impairment of one or more of the phases of swallowing. Dysphagia usually arises as a complication of another health condition (see Table 58.1). It can be divided into oropharyngeal (high) dysphagia and oesophageal (low) dysphagia.
A problem swallowing
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Dysphagia can be caused by: obstructiondysmotility.
Stroke and Transient Ischemic Attacks of the Brain and Eye
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
For patients with dysphagia, the effect of various swallowing therapies, feeding, and nutritional and fluid supplementation on functional outcome is uncertain. In stroke patients who have had a tracheotomy, pharyngeal electrical stimulation has been reported to increase the proportion of patients who are ready for decannulation. Nutritional supplementation is associated with reduced pressure sores.
Predicting home discharge after inpatient rehabilitation of stroke patients with aphasia
Published in Neuropsychological Rehabilitation, 2023
Valeria Ginex, Mauro Viganò, Giulia Gilardone, Alessia Monti, Marco Gilardone, Massimo Corbo
Overall, 158 aphasic patients (80 male and 78 female) took part in the study. The patients had a mean age of 73.2 ± 10.9 years and an average number of years of formal education of 9.7 ± 4.4. They were admitted to the IRF between 4 and 178 days after stroke and the mean length of hospitalization was 57.5 ± 18.6 days. Most of the subjects had experienced a first-ever stroke at the time of the enrollment (77.2%) and were functionally independent before the event (78.4%). Fifty-one patients (32.3%) presented with dysphagia at admission. The initial mean M-FIM score was 40.7 ± 20.5 while the mean T-FIM score was 61.1 ± 26.0. Regarding language, admission mean AAT scores were 45.5 ± 12.8 for the Token test, 50.3 ± 14.3 for repetition, 49.3 ± 12.1 for written language, 49.9 ± 13.6 for naming and 45.7 ± 13.0 for comprehension. Fifty-one (32.3%) patients showed impaired pure nonverbal reasoning abilities and nine (5.7%) had right-sided USN. Considering the overall sample, no significant correlation was found between age and other continuous variables (p > 0.05). A moderate negative correlation was identified between LOS and M-FIM (r = −0.445, p < 0.01), while weak negative correlations were found between LOS and AAT subtests scores (−0.306 < r < −0.212, p < 0.01). The M-FIM showed weak to moderate positive correlations with AAT subtest scores (0.207 < r < 0.430, p < 0.01). Finally, among the AAT subtests scores, moderate to strong correlations were identified (0.593 < r < 0.743, p < 0.01).
Clinical features and diagnostic tools in idiopathic inflammatory myopathies
Published in Critical Reviews in Clinical Laboratory Sciences, 2022
Konstantinos I. Tsamis, Constantinos Boutsoras, Evripidis Kaltsonoudis, Eleftherios Pelechas, Ilias P. Nikas, Yannis V. Simos, Paraskevi V. Voulgari, Ioannis Sarmas
sIBM is a disease of insidious onset that often presents after the age of 45 years with a slowly progressive asymmetric weakness of over a year and that involves proximal and distal muscles of the upper and lower extremities. The pattern of selective weakness and atrophy of quadriceps femoris and finger flexors in the forearm at the early stages indicates the disease. Thus, patients complain of frequent falls due to “knee instability,” trouble in rising from a chair, and difficulties in everyday activities such as opening jars and using keys. Other muscles involved include biceps brachii, triceps, wrist flexor muscles, and ankle dorsiflexion. Facial muscles are often affected mildly but spare the oculomotor muscle. Dysphagia is a common manifestation as the disease progresses, and complications such as aspiration and respiratory failure may occur. Rarely dysphagia is marked at presentation. Clinical patterns such as finger flexion weakness that is greater than shoulder abduction weakness and knee extension weakness that is greater than hip flexor weakness are indicators for sIBM and are included in the clinical criteria, although neither are necessary or specific. The tendon reflexes diminish linearly with disease progression although knee jerks may be lost earlier. As no therapy exists at present to halt or alter disease progression, most patients suffer essential loss of ambulation in 10–20 years after onset and depend on a cane or other assistance. However, life expectancy is not significantly shorted because the disease commences at an older age and progression is slow [93–99] (Table 1).
Swallowing-related quality of life among oral-feeding Chinese patients with Parkinson’s disease – a preliminary study using Chinese SWAL-QOL
Published in Disability and Rehabilitation, 2022
Hiu Fung Chan, Manwa Lawrence Ng, HyangHee Kim, Deog Young Kim
C-SWAL-QOL questionnaire has been used in previous studies investigating the long-term swallowing-related quality of life in stroke survivors in the post-acute phase [11] and laryngeal cancer patients [17]. In this preliminary study, we hope to identify self-perceived swallowing-related quality of life of PD patients in Hong Kong. As discussed previously, PD patients suffer a varying range of dysphagia. The relationship between swallowing function and self-perceived swallowing ability in Hong Kong community-dwelling PD patients is not available, specifically using C-SWAL-QOL. Since the patient-reported outcomes (PROs) of C-SWAL-QOL in a purely Chinese PD population have not been described, there is a knowledge gap of swallowing-related quality of life in Hong Kong PD patients. Knowing how dysphagia affects swallowing-related quality of life can help clinicians to understand PD patients’ experience of living with dysphagia. Given the paucity of research about swallowing-related quality of life in patients with PD, this study attempted to examine the self-reported swallowing-related quality of life of Chinese PD patients in Hong Kong.