Dysphagia

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Early motor and non-motor signs of Parkinson disease (PD) include dysphagia, gastrointestinal dysmotility, and constipation. However, because these often manifest prior to formal diagnosis, the study of PD-related swallow and GI dysfunction in early stages is difficult. To overcome this limitation, we used the Pink1-/- rat, a well-established early-onset genetic rat model of PD to assay swallowing and GI motility deficits. Thirty male rats were tested at 4 months (Pink1-/- = 15, wildtype (WT) control = 15) and 6 months (Pink1-/- = 7, WT = 6) of age; analogous to early-stage PD in humans...

Parkinson's disease (PD) is a degenerative disorder that can cause dysphagia and dysphonia. We studied upper esophageal sphincter (UES) function and vocal tests using high-resolution videomanometry (HRVM) in PD. Ten healthy volunteers and 20 patients with PD performed swallowings (5 ml and 10 ml) and vocal tests using HRVM synchronized to the vocal acoustic recording. Mean age of the Parkinson group was 68.7 ± 9.7 years and mean disease stage of 2.7 ± 1.1 (Hoehn & Yahr scale)...

Puree is commonly prescribed for patients with mastication and bolus formation difficulties, but its appearance might negatively impact appetite and intake. Molded puree is marketed to be an alternative to traditional puree, but the process of molding puree could alter the properties of the food significantly and lead to different swallowing physiology as compared to puree. The current study investigated the differences between traditional and molded puree in terms of swallowing physiology and perception in healthy individuals...

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Respiratory-related dysphagia and aspiration pneumonia can be attributed to multiple causes. However, reproduction of multiple factor-related respiratory distress and aspiration pneumonia in a single animal model is challenging. To validate animals with vagal nerve palsy as novel models for severe aspiration pneumonia associated with respiratory distress, we investigated the effects of unilateral vagotomy on the swallowing function and severity of pneumonia after forced aspiration in mice. Unilateral vagotomy was performed in C57BL6 male mice that subsequently underwent evaluation of swallowing function by videofluoroscopic swallow study (VFSS) and histological assessments for aspiration pneumonia induced by lipopolysaccharide (LPS)...

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This systematic review examined (i) prevalence, severity, and impact of persistent post-extubation laryngeal injury beyond hospital discharge and (ii) differences in persistent laryngeal injury between COVID-19 and non-COVID-19 populations. The review was completed following PRISMA-2020 guidelines. Four databases (PubMed, CINHAL complete, EMBASE, Web of Science) were searched (inception to March 2021). Screening, full text review and data extraction were completed by two reviewers. Primary outcomes were swallow, voice and cough and airway measures obtained after hospital discharge...

Dysphagia is a largely inevitable symptom in both progressive supranuclear palsy (PSP) and Parkinson's disease (PD). To date, comparative studies in these diseases have failed to detect differences in the severity of impairments in swallowing safety or efficiency, potentially due to small sample sizes and outcome measures with low sensitivity. Therefore, this study sought to address these limitations by using novel measurement methodology to comprehensively compare swallowing safety and efficiency impairments between these populations in order to better understand whether differences may exist and guide clinical management...

Dysphagia in Robin Sequence can be present in varying degrees, requiring multidisciplinary management and specific swallowing assessment by a specialist. Most studies published to date have evaluated only respiratory outcomes, and the available evidence on the improvement of swallowing is questionable. To conduct a systematic review and meta-analysis of studies evaluating swallowing in children with Robin Sequence before and after airway clearance procedures. The research question was developed based on the PICO strategy...

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Peroral endoscopic myotomy (POEM) has demonstrated favorable short-term safety and efficacy in older adults, while a comprehensive understanding of the long-term outcomes were vague. We aimed to evaluate clinical outcomes in older adults' 5-year postop after undergoing POEM to treatment achalasia. Older adults from a single hospital who received POEM between January 2010 and January 2017 were analyzed. Older persons were reached to evaluate their symptoms at present and encouraged repeat examinations for objective follow-up...

Dysphagia occurs temporarily or permanently following esophageal replacement in at least half of the cases. Swallowing disorder, in addition to severe decline in the quality of life, can lead to a deterioration of the general condition, which may lead to death if left untreated. For this reason, their early detection and treatment are a matter of importance. Between 1993 and 2012, 540 esophageal resections were performed due to malignant tumors at the Department of Surgery, Medical Center of the University of Pécs...

The Swallow Disturbance Questionnaire (SDQ) is a screening tool developed to identify patients with Parkinson's Disease (PD) in need of objective swallowing evaluation. In a previous investigation, the SDQ did not predict abnormal airway protection on a videofluoroscopic swallowing study (VFSS). This investigation was undertaken to determine whether SDQ scores were more accurate when a global measure was used. The Dynamic Imaging Grade for Swallowing Toxicity (DIGEST) is a validated measure that provides a safety, efficiency, and total severity grade based on VFSS...

Simulation enables learners to practice new skills in a supportive environment. Largely driven by the COVID-19 pandemic, simulation via telepractice, i.e., telesimulation, has emerged. Viable delivery of telesimulation requires consideration of the adaptations needed to conduct simulation via telepractice. The aim of this study was to design and pilot test the feasibility of using telesimulation to provide training in infant feeding management. An iterative process was used across four phases: (1) simulation design, (2) telesimulation adaptations, (3) user testing, feedback, and modifications, and (4) user testing of modified simulation, feedback, and final modifications...

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Submental surface electromyography (sEMG) may provide information about the lingual-palatal pressure (LPP) during swallowing. However, the extent to which changes in age and LPP levels are reflected in different sEMG measures is unclear. This study aimed to understand the effects of age and different levels of submaximal LPPs on submental sEMG peak, average, and integrated values in healthy adults. Ninety community-dwelling healthy participants were categorized into three age groups (young: 20-39 years, middle age: 40-59 years, older: 60 ≥ years)...

Thickened feeds may be useful in supporting improved suck-swallow-breath coordination and airway protection in infants with dysphagia. Unfortunately, the stability of thickened feeds for infant formulas is unpredictable, which makes use of this strategy challenging. This study aimed to propose a set of Level 1 (slightly thick) recipes for Australian infant formulas/thickeners. A secondary aim was to test whether formula could be batch prepared. A set of powdered, ready-to-feed, and specialized formulas were mixed with two thickening products (Aptamil Feed Thickener® and Supercol®) and tested at 5-, 10-, 15-, 20-, 25-, 30-, and 45-min intervals using the International Dysphagia Diet Standardization Initiative (IDDSI) Flow Test...

Based on a large number of pre-existing documented electronic health records (EHR), we developed a machine learning (ML) algorithm for detection of dysphagia and aspiration pneumonia. The aim of our study was to prospectively apply this algorithm in two large patient cohorts. The tool was integrated in the hospital information system of a secondary care hospital in Austria. Based on existing data such as diagnoses, laboratory, and medication, dysphagia risk was predicted automatically, and patients were stratified into three risk groups...

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