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  • 1
    Electronic Resource
    Electronic Resource
    Dysphagia in Stroke: A Prospective Study of Quantitative Aspects of Swallowing in Dysphagic Patients (1998)
    Springer
    Dysphagia 13 (1998), S. 32-38 
    Details
    ISSN: 1432-0460
    Keywords: Key words: Deglutition disorders — Dysphagia — Stroke — Prospective study — Quantitative test — Deglutition.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. This is a prospective study of 100 consecutive stroke patients. Within 24 h after stroke onset they were asked specifically about swallowing complaints and subjected to a clinical examination including neurologic examination, Mini-Mental test, and Barthel score. Dysphagic patients were examined with the repetitive oral suction swallow test (the ROSS test) for quantitative evaluation of oral and pharyngeal function at 24 h, after 1 week, and after 1 month. At 6 months, the patients were interviewed about persistent dysphagia. Seventy-two patients could respond reliably at 24 h after the stroke onset and 14 of these complained of dysphagia. Non-evaluable patients were either unconscious, aphasic, or demented. The presence of dysphagia was not influenced by age or other risk factors for stroke. Facial paresis, but no other clinical findings, were associated with dysphagia. Dysphagia 24 h after stroke increased the risk of pneumonia but did not influence the length of hospital stay, the manner of discharge from hospital, or the mortality. The initial ROSS test, during which the seated patient ingests water through a straw, was abnormal in all dysphagic stroke patients. One-third of the patients were unable to perform the test completely. Above all, dysfunction was disclosed during forced, repetitive swallow. All phases of the ingestion cycle were prolonged whereas the suction pressures, bolus volumes, and swallowing capacities were low. Abnormalities of quantitative swallowing variables decreased with time whereas the prevalences of swallowing incoordination and abnormal feeding-respiratory pattern became more frequent. After 6 months, 7 patients had persistent dysphagia. Five of these were initially non-evaluable because of unconsciousness, aphasia, or dementia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00009547
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  • 2
    Electronic Resource
    Electronic Resource
    Oral function test for monitoring suction and swallowing in the neurologic patient (1995)
    Springer
    Dysphagia 10 (1995), S. 93-100 
    Details
    ISSN: 1432-0460
    Keywords: Deglutition ; Deglutition disorders ; Oral function ; Pharynx ; Neurological dysphagia ; Diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Disturbances in swallowing are common in neurologic disease but difficult to evaluate in the clinical setting. Fundamental variables such as bolus volume, swallow capacity (volume ingested over time), and the relation between ingestion and time for important events in oral and pharyngeal swallowing have not been sufficiently studied. We therefore employed a composite method for monitoring oral and pharyngeal swallowing function: the test of Repetitive Oral Suction Swallow (the ROSS test). The technical details are described as well as preliminary results from a pilot study of 20 healthy subjects and 5 patients with neurologic swallowing impairment. The correlation with respect to time sequences for major events in bolus ingestion and oral processing as monitored by the ROSS test and by videoradiography is explained. With this simple and rapid bedside test, the immediate and long-time result of therapeutic interventions in dysphagic patients may be monitored.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00440078
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  • 3
    Electronic Resource
    Electronic Resource
    Quantitative aspects of swallowing in an elderly nondysphagic population (1996)
    Springer
    Dysphagia 11 (1996), S. 180-184 
    Details
    ISSN: 1432-0460
    Keywords: Elderly ; Nondysphagic ; Repetitive oral suction swallow test ; Deglutition ; Deglutition disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The prevalence of swallowing impairment increases with age and is a major health care problem in the elderly. It has been assumed that age-related changes in nerves and muscles hamper muscle strength and coordination of swallowing. However, it is unclear what impairment is related to primary aging and what is the consequence of diseases prevalent in the elderly (secondary aging). In order to quantify swallowing in nondysphagic elderly we used the noninvasive ROSS (Repetitive Oral Suction Swallow) test. A total of 53 individuals aged 76±5 years (mean±SD) were examined. We found that the nondysphagic elderly demonstrated significant differences compared with young individuals in 10 of 17 measured variables, i.e., decreased peak suction pressure, increased frequency of multiple swallows after one ingestion, increased frequency of polyphasic laryngeal movements, increased frequency of inspiration after swallowing, and increased frequency of coughing during or after swallowing. Therefore, primary aging mainly seems to influence coordination of swallowing, but oral and pharyngeal swallow per se seem to be unaffected.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00366381
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  • 4
    Electronic Resource
    Electronic Resource
    Pharyngeal constrictor paresis: An indicator of neurologic disease? (1993)
    Springer
    Dysphagia 8 (1993), S. 239-243 
    Details
    ISSN: 1432-0460
    Keywords: Dysphagia ; Pharynx dysfunction ; Gastroesophageal reflux ; Constrictor paresis ; Deglutition ; Deglutition disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Pharyngeal constrictor paresis (PHCP) is sometimes found in videoradiography of the swallowing act in patients complaining of dysphagia. Ten patients with PHCP and 10 dysphagic, age- and sex-matched controls with normal videoradiography were neurologically evaluated and examined with magnetic resonance imaging (MRI) of the brain and brainstem in order to learn the pathogenetic process behind PHCP. The study revealed 8 PHCP patients and 1 dysphagic control with abnormal clinical neurological findings such as myopathy, cerebrovascular disease, or extrapyramidal disease. The neurological examination revealed considerable information of prognostic and therapeutic value in PHCP patients. The MRI was abnormal in 7 PHCP patients and 4 dysphagic controls. However, the findings in MRI were nonspecific but the examination was found to be valuable in selected cases. It is concluded that PHCP is an indicator of neurological disease and accordingly, such patients should be examined by a neurologist to establish the cause of the disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01354545
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  • 5
    Electronic Resource
    Electronic Resource
    Simultaneous videoradiography and pharyngeal solid state manometry (videomanometry) in 25 nondysphagic volunteers (1995)
    Springer
    Dysphagia 10 (1995), S. 36-41 
    Details
    ISSN: 1432-0460
    Keywords: Manometry ; Pharynx ; Dysphagia ; Radiography ; Deglutition ; Deglutition disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Recent technological advances in manometry, including solid state transducers and computerized analysis, allows for reliable interpretation of intraluminal pharyngeal pressures. Simultaneous videoradiography (barium swallow) provides fluoroscopic control of the manometric sensors (videomanometry), thereby eliminating the uncertainty of sensor dislocation during laryngeal elevation. This is the first study describing normal manometric parameters in videomanometry during barium swallow. Seven manometric parameters and six videoradiographic parameters were analyzed. We included 25 nondysphagic volunteers with normal videoradiographic parameters in the study. The examination was performed in an upright physiologic position during 10-ml barium and dry swallows. Mean resting pressure in the upper esophageal sphincter was 89.6±32.6 (±2 SD) mmHg. Mean residual pressure during relaxation of the upper esophageal sphincter was 7.2±8.0 (±2 SD) mmHg during barium swallow and 3.8±6.2 (±2 SD) mmHg during dry swallow. The mean duration of upper esophageal sphincter relaxation was 601±248 (±2 SD) msec. The mean peristaltic contraction of the upper esophageal sphincter was 253.8±142.8 (±2 SD) mmHg. Fourteen (56%) of the 25 had a measurable intrabolus pressure (mean 33.2±17.3 mmHg) at the level of the inferior pharyngeal constrictor. A specific finding was discovered when the epiglottis tilts down hitting the manometric sensor. This epiglottic tilt was identified in 7 subjects (28%) and caused pressures of around 600 mmHg. A standardized manometric technique is important in videomanometry, and normal values as described in this study are essential in clinical use.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00261278
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  • 6
    Electronic Resource
    Electronic Resource
    Autonomic nerve dysfunction in patients with bolus-specific esophageal dysmotility (1995)
    Springer
    Dysphagia 10 (1995), S. 44-48 
    Details
    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
    URL: http://dx.doi.org/10.1007/BF00261280
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  • 7
    Electronic Resource
    Electronic Resource
    Quantitative assessment of swallowing in healthy adults (1996)
    Springer
    Dysphagia 11 (1996), S. 110-116 
    Details
    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
    URL: http://dx.doi.org/10.1007/BF00417900
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  • 8
    Electronic Resource
    Electronic Resource
    Swallowing in hereditary sensory ataxia (1996)
    Springer
    Dysphagia 11 (1996), S. 140-143 
    Details
    ISSN: 1432-0460
    Keywords: Friedreich's disease ; Sensory ataxia ; Deglutition ; Deglutition disorders ; Diagnosis ; Pharyngeal function ; Esophageal function
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The oral, pharyngeal, and esophageal stages of swallowing were evaluated in 8 patients with recessively or dominantly inherited pure sensory ataxia. Six patients had swallowing difficulties: solid bolus obstruction, coughs during eating, and choking episodes. One patient had chronic bronchitis and another had recurrent pneumonia. The patients underwent a biphasic radiological barium swallow, including videofluoroscopy. No patient had a completely normal swallow. All had normal oral function, whereas pharyngeal function was abnormal in 6 patients. Esophageal function was abnormal in 6 patients. The swallowing dysfunction did not correlate with the severity of motor or sensory dysfunction in the limbs, nor with age or duration of ataxia. Our study shows that swallowing dysfunction is common in hereditary sensory ataxia. This dysfunction is likely to be due to involvement of the nucleus of the solitary tract in the brainstem. Despite some of the patients having suffered from choking episodes and others from bronchopulmonary complications, they did not spontaneously admit dysphagia. Swallowing should be evaluated thoroughly in patients with hereditary sensory ataxia since dysphagia in these patients might bring serious and potentially fatal complications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00417904
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  • 9
    Electronic Resource
    Electronic Resource
    Quantitative assessment of oral and pharyngeal function in Parkinson's disease (1996)
    Springer
    Dysphagia 11 (1996), S. 144-150 
    Details
    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
    URL: http://dx.doi.org/10.1007/BF00417905
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  • 10
    Electronic Resource
    Electronic Resource
    Solar heat load on man (1993)
    Springer
    International journal of biometeorology 37 (1993), S. 125-132 
    Details
    ISSN: 1432-1254
    Keywords: Heat load ; Mean skin temperature ; Solar radiation ; Clothing ; Mean radiant temperature
    Source: Springer Online Journal Archives 1860-2000
    Topics: Geography , Physics
    Notes: Abstract Different methods have been compared for the estimation of solar heat load on man. The comparison comprised several methods based on the calculation of absorbed solar radiation and one method for calculation of mean radiant temperature (Mrt). Regression analysis was carried out for predicted values and values calculated for a vertical cylinder, assumed as an analog model of a standing man. Regression of mean skin temperature, measured in 10 subjects exposed to solar radiation under a variety of climatic conditions, on predicted radiant heat load was also analysed. Mean skin temperature correlated best withMrt, accounting for more than 50% of the variance. The results indicated that three methods provide a realistic estimation of the radiation heat load, whereas some methods show deviations of several hundred per cent.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01212621
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