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  • Noninvasive test  (2)
  • Autonomic nerve dysfunction  (1)
  • Cineradiography, pharyngeal  (1)
  • 1
    ISSN: 1432-0460
    Keywords: Esophagus ; Foreign body ; Deglutition ; Deglutition disorders ; Autonomic nerve dysfunction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The pathogenetic mechanisms causing esophageal dysmotility is not well understood. We examined 13 patients with solid bolus dysphagia in a radiologic barium study including, the swallowing of a 14-mm tablet. In all 13 patients the tablet was caught in the proximal or midesophagus. In 8 patients, the entrapment was associated with symptoms (Group 1) whereas in 5 patients (Group 2), no symptoms were reported. All 13 patients together with a control group of 56 healthy, nondysphagic subjects were tested for autonomic nerve function. Autonomic nerve function tests included registration of electrocardiographic R-R interval variation during deep breathing test (E/I ratio), a test of parasympathetic, vagal, nerve function. The results showed that the E/I ratio was significantly lower in patients with symptoms of bolus-specific esophageal dysmotility (-2,19 [1.76]) (median [interquartile range]) compared with patients without symptoms (0.05 [2, 87], p=0.0192) and controls (-0.25 [1.26], p=0.0009). In conclusion, symptomatic bolus-specific esophageal dysmotility is associated with vagal nerve dysfunction.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0460
    Keywords: Swallowing ; Oral function ; Pharynx ; Noninvasive test ; Diagnosis ; Deglutition ; Deglutition disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Swallowing has hitherto been evaluated during physical examination, radiologic barium studies, manometry, and cervical auscultation. Radiography principally demonstrates qualitative aspects of oral and pharyngeal function, whereas quantitative aspects have primarily been documented by manometry. To evaluate swallowing quantitatively, without using invasive methods or radiation, we have applied a combined test of water drinking, i.e., the Repetitive Oral Suction Swallow test (ROSS). The test provides reliable measurements of suction pressure, bolus volume, timing of important events in oral and pharyngeal swallow, and respiration. The test is described and results from 292 healthy, nondysphagic subjects are presented. We found a mean bolus volume of 25.6±8.5 ml during single swallow and 21.1±8.2 ml during stress (forced, repetitive swallow). During forced, repetitive swallow, the bolus volume was more strongly associated with suction time (r2=0.55) than with peak suction pressure (r2=0.04), indicating that suction time is more important than suction pressure in determining the bolus volume. The oral-pharyngeal transit time decreased: single swallow 0.56±0.36 sec, forced repetitive swallow 0.23±0.11 sec, as did the coefficient of variation (48% and 64%, respectively) indicating a more automatic neural process for pharyngeal function in forced, repetitive swallow. The postswallow respiration started with inspiration in 10% of studied individuals, but did not correlate with deviations in other variables in the test. Thus, postswallow inspiration must be considered as normal. The ROSS test offers a rapid and easy quantitative assessment of swallowing.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0460
    Keywords: Parkinson's disease ; Deglutition ; Deglutition disorders ; Oral function ; Pharynx ; Diagnosis ; Noninvasive test
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Oral and pharyngeal dysfunction is common in Parkinson's disease. To reveal the frequency of swallowing dysfunction and correlate swallowing dysfunction with locomotor disturbances, we studied 75 patients with Parkinson's disease staged I–IV according to the Hoehn and Yahr score. We assessed oral and pharyngeal swallow during optimal medication by a quantitative test of swallowing (the ROSS test) measuring the suction pressure, bolus volume, swallowing capacity, and time for important events in the swallowing cycle. We found abnormal results in 7/12 patients (58%) in stage 1 of the Hoehn and Yahr score, in 13/14 patients (93%) in stage 2, in 29/32 patients (91%) in stage 3, and in 16/17 patients (94%) in stage 4. Abnormal test results in stages, 1, 2, and 3 were seldom related to swallowing difficulties noticed by the patients. In advanced disease (Hoehn and Yahr stage 4), the abnormal results were often considerable, with swallowing difficulties obvious to the patient. Two of 17 patients coughed during or immediately after the test and 3/17 patients were unable to complete the test. The degree of swallowing disturbance increased during stress (forced, repetitive swallow). The Hoehn and Yahr score and the results in the ROSS test did not correlate, indicating that swallowing disturbances are due to nondopaminergic degeneration. Silent swallowing impairment may interfere with the nutrition and quality of life in Parkinson's disease, thus it is of interest to monitor this in clinical practice.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Dysphagia 4 (1989), S. 151-154 
    ISSN: 1432-0460
    Keywords: Pharynx ; Endarterectomy carotid ; Radiology, pharyngeal ; Cineradiography, pharyngeal ; Cranial nerves
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Neurologic deficiencies, with special reference to pharyngeal function, were studied prospectively in 12 patients before and after they underwent carotid endarterectomy. Pharyngeal function was monitored with cineradiography. Five patients developed pharyngeal dysfunction: defective closure of the laryngeal vestibule, epiglottic dysmotility, and pharyngeal constrictor paresis 1 week postoperatively. In 2 patients this dysfunction remained, while in 3 it had resolved 4 weeks after the operation. Pharyngeal dysfunction was more common in patients with preoperative minor stroke and a temporary perioperative carotid shunt and in patients with a long operation time. The registered transient pharyngeal dysfunction may be due to manipulation of the cervical structures including the vagus nerve and the pharynx or due to cerebrovascular damage during the operation. Our findings support careful monitoring of postoperative oral feeding in patients at risk.
    Type of Medium: Electronic Resource
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