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At least 847 records · Page 47Linked to original sources
PubMed1996

Intraamniotic deamino(D-Arg8)-vasopressin: prolonged effects on ovine fetal urine flow and swallowing.

OBJECTIVE: Fetal urine is the main source of amniotic fluid, and alterations in urine production have an impact on amniotic fluid dynamics. Intraamniotic arginine vasopressin is absorbed into fetal plasma, but fetal antidiuretic responses may be obscured by vasoconstrictor (V1 receptor) actions of arginine vasopressin. We determined the effects of intraamniotic administration of a specific V2 receptor agonist, deamino(D-Arg8)-vasopressin, on fetal plasma arginine vasopressin immunoreactivity, fetal urine output, and swallowing. STUDY DESIGN: Six chronically prepared pregnant ewes (129 +/- 1 days' gestation) received a single deamino(D-Arg8) (50 micrograms injection into the amniotic fluid with subsequent measurement of fetal plasma arginine vasopressin immunoreactivity, fetal urine flow and osmolality, and fetal swallowing. RESULTS: Within 30 minutes of deamino(D-Arg8)-vasopressin administration, fetal plasma arginine vasopressin immunoreactivity (4.5 +/- 0.5 to 76.4 +/- 21.9 pg/ml) and urine osmolality (135 +/- 13 to 285 +/- 43 mOsm/kg H2O) significantly increased and urine flow decreased (0.18 +/- 0.01 to 0.05 +/- 0.01 ml/kg per minute). After 48 hours urine flow remained reduced (0.08 +/- 0.03 mg/kg per minute) and osmolality remained elevated (399 +/- 18 mOsm/kg H2O). There were no changes in fetal swallowing, systolic (64 +/- 3 mm Hg) or diastolic (42 +/- 3 mm Hg) blood pressure, or heart rate (169 +/- 6 beats/min). CONCLUSIONS: Intraamniotic deamino(D-Arg8)-vasopressin administration evokes persistent fetal antidiuresis in the absence of arginine vasopressin-induced fetal cardiovascular effects or changes in fetal swallowed volume, indicating its suitability as a potential therapeutic agent in amniotic fluid volume disorders such as polyhydramnios.

Amniotic Fluid↗
PubMed2001

Tongue and jaw muscle activities during chewing and swallowing in freely behaving rabbits.

To study the function of the tongue and the coordination among jaw, tongue, and hyoid muscles during chewing and swallowing, we recorded the electromyographic activities from the masseter (Mas), digastric (Dig), mylohyoid (Myl), thyrohyoid (Thy), genioglossus (Gg) and styloglossus (Sg) muscles as well as jaw movement trajectories in the freely behaving rabbit. Three phases were identified in the chewing cycle (fast- and slow-closing and opening phases). The Gg (main tongue protruder) was active synchronously with the Dig during opening. The Sg (tongue retractor) showed two peaks in each cycle, one in the opening phase and the other in the closing phase. The latter may have a role in retracting the tongue during jaw closing. The co-contraction of the antagonists (i.e. Gg and Sg) during opening may contribute to shape the tongue to be appropriate to gather the foodstuff. In the swallowing cycle, five phases were identified, two in the closing phase and three in the opening phase. Regression analysis revealed that swallowing cycles had a longer cycle duration than that of the chewing cycles due to an extra phase (a pause) inserted in the opening phase, where there was a small co-activation in the jaw opening and closing muscles. The findings suggest that the swallowing center affects masticatory center in the central nervous system, and may also support the view that the masticatory burst timing begins with the Dig activities in the middle of the opening phase.

Animals↗
PubMed2002

Swallowing-like activity elicited in vitro in neonatal rat organ attached brainstem block preparation.

The purpose of this study was to induce swallowing in an in vitro neonatal rat brainstem preparation and to analyze the circuit. When we applied GABA(A) receptor antagonist (bicuculine methiodide, BIC) into the the nucleus tractus solitarius (NTS) in the organ attached brainstem preparation of neonatal (0-3 days after birth) rats, jaw closing movement, palatal lifting, and tongue peristalsis-like movement were seen, subsequent to elevation of the tip of the tongue and anterior movement of the larynx (closure of the trachea). The NTS has been proposed to be a critical locus for swallowing pattern generation in mammals. Electrical stimulation into the NTS or the vagal afferent nerve (X) following an application of BIC (10 microM) to the recording chamber initiated the same organ movement. This movement caused temporary inhibition of respiratory activity that was simultaneously recorded from the fourth cervical ventral nerve (C4). We were also able to elicit this activity in a whole organ (from lip to stomach, midline intact) preparation, whose oral cavity was filled with dye (pontamine sky-blue 3 mM, 50 microl), using each of the three types of stimulation. The esophagus, which was never stained by spontaneous respiratory movements, was stained only after the experimental stimulation. We concluded that the activity elicited was swallowing-like activity and the smallest circuit for swallowing pattern generation exists in this preparation.

Animals↗
PubMed1999

Effects of functional disruption of lateral pericentral cerebral cortex on primate swallowing.

Bilateral cold block of the intracortical microstimulation (ICMS)-defined swallow cortex markedly affected the ability of monkeys to carry out swallowing. Significant changes also occurred in swallow-related electromyographic (EMG) activity patterns. These findings provide further evidence that the lateral pericentral cortex plays a critical role in the initiation and regulation of swallowing in the primate.

Animals↗
PubMed1996

An objective assessment of speech and swallowing following free flap reconstruction for oral cavity cancers.

In this prospective study, eight consecutive patients underwent excision of oral cavity cancer and reconstruction with a microvascular free flap. Six patients had one pre- and two postoperative assessments of speech and swallowing at four to six weeks and four to six months respectively. One patient could not attend for the preoperative assessment and another for the first postoperative assessment. The speech assessment consisted of an intelligibility score and an articulation score. The swallowing assessment consisted of a videofluoroscopic examination. Five patients had an excellent postoperative speech assessment score, two had a moderate and one a poor result. Videofluoroscopy demonstrated minor swallowing problems preoperatively in one patient. Postoperatively, three patients had severe or moderate loss of control of bolus. Significant aspiration was detected in two and mild aspiration in one patient at the second postoperative assessment. The abnormalities of speech and swallowing were minor in the majority of the patients and the overall outlook was good. This information should be of value for preoperative counselling.

Adult↗
PubMed1977

Detection and grading of oesophageal varices by fibre-optic endoscopy and barium swallow with and without Buscopan.

Detection of oesophageal varices is important in the diagnosis of portal hypertension. We have, therefore, compared the results of fibre-optic endoscopy and barium swallow in 56 patients with chronic liver disease. Oesophageal varices were graded as small, moderate or gross by independent observers for each technique. In 12 patients varices were not detected by either method, and in six cases varices were detected by endoscopy when the barium swallow was negative. In 15 of the remaining 38 patients varices were found to be one grade larger at endoscopy than on barium swallow. Since it is possible that varices appear larger at endoscopy because of the Buscopan (hyoscine N-butyl bromide) used as a relaxant, we carried out barium examinations after Buscopan 20 mg i.v. in 23 of the patients. In eight cases varices were one grade larger after Buscopan than on the standard barium swallow, and in two were only detected after Buscopan had been given. Eight cases negative after Buscopan were also negative at endoscopy. Although emergency endoscopy has particular value in locating the site of bleeding in patients with portal hypertension and acute gastrointestinal haemorrhage, the results of the present study suggest that a barium meal with Buscopan is as accurate as endoscopy in the detection of oesophageal varices.

Butylscopolammonium Bromide↗
PubMedDate not supplied

Prevalence and nature of dysphagia in VA patients with COPD referred for videofluoroscopic swallow examination.

This retrospective study investigated the prevalence and nature of dysphagia in 78 male outpatients whose primary diagnosis was chronic obstructive pulmonary disease (COPD) and who were referred for modified barium swallow studies at the Veterans Affairs Medical Center (VAMC) in Tucson, Arizona, 1992-1995. Nearly 85% of these patients evidenced some degree of dysphagia, and laryngeal penetrations or aspirations were observed in 44 of them. Agreement between VAMC swallow assessments and those of a three-judge panel of certified speech-language pathologists supported the reliability and validity of the information extracted from VAMC records. The high percentage of silent laryngeal penetrations and aspirations observed in this sample suggests that COPD patient's respiratory status should be considered as well as overt symptoms of a swallowing disorder, such as coughing, in making referrals for video-fluoroscopic swallow studies for such patients.

Cough↗
PubMed1993

Swallowing disorders. Diagnosis and therapy.

Normal swallowing is a complex, rapid neuromuscular function. Causes for dysfunctional swallowing are protean. Appropriate workup includes a careful history, thorough physical examination of the head and neck, videofluorographic swallowing study, and when appropriate, manometry and endoscopy under anesthesia. Many swallowing problems are not easily curable or reversible, but most patients experience some improvement through the intensive efforts of a multidisciplinary team. The otolaryngologist-head and neck surgeon plays a key role in both evaluation of patients with dysphagia and in surgical intervention for selected cases of cricopharyngeal motor dysfunction and chronic aspiration.

Deglutition↗
PubMed2002

Swallowing and speech therapy after definitive treatment for laryngeal cancer.

As the trend in laryngeal cancer treatment shifts towards organ-conservation surgeries and organ-preservation protocols, patients will more often retain anatomy vital to communication and swallowing. Despite a conservative approach, results of treatment may have debilitating effects. Rehabilitation efforts are directed towards a return to functional, if not normal, status. Although there are predictable trends in voice and swallowing disorders of patients with laryngeal cancer, posttreatment dysphonia and dysphagia are diverse in presentation. Considering the significant diversity of this population, speech pathologists should work closely with otolaryngologists to determine the most appropriate treatment for each patient. As this article demonstrates, voice and swallowing therapy are necessary components of the rehabilitation process following treatment for head and neck cancers. As always, treatment is tailored to the specific individual and based on information obtained during a thorough evaluation by a speech pathologist. Fortunately, with the help of voice and swallowing therapy, many patients return to functional communication and oral feeding.

Antineoplastic Agents↗
PubMed1998

Anatomy and physiology of pediatric swallowing disorders.

The anatomy and physiology of the act of swallowing is complex. Because the swallowing mechanism matures with age, it is important to understand this maturation process from neonate to older child to appreciate the impact of this changing physiology on pediatric swallowing disorders. This article reviews the relevant anatomy, neurologic control mechanism, and physiology of swallowing in neonates and children.

Aging↗
PubMed1998

Swallowing therapy in adults.

Swallowing therapy can in many cases eliminate, and in nearly all cases, improve swallowing difficulty in adults. A wide variety of faciliatory and compensatory techniques are available to therapists who must be specially trained in such methods. In addition, swallowing therapy cannot be thought of as a series of "lessons" for a patient, but rather a management strategy using a multidisciplinary team, including the family of the patient. Efficacy studies are becoming available to evaluate the effectiveness of the many therapy methods available, and new techniques are constantly being developed and tested. The outlook for most adults with swallowing problems is thus optimistic for improvement.

Adult↗
PubMed1996

Evaluation of normal and abnormal hyoid bone movement during swallowing by use of ultrasound duplex-Doppler imaging.

We developed a new method to analyze normal and abnormal movements of the hyoid muscular region as an indicator of hyoid bone motion during swallowing using ultrasound duplex-Doppler imaging. Hyoid bone motion can be monitored by studying the Doppler shift spectra and B-mode images produced by ultrasound duplex imaging of the hyoid region muscular attachments. We can accurately determine swallowing duration and trajectory of hyoid bone movement. This procedure can assist in discriminating between normal and abnormal movements of the hyoid bone and the surrounding muscles during swallowing. This method appears to be a highly consistent measure. We suggest that Doppler spectrum analysis can be used for defining hyoid position and displaying accurate movement, which may be useful in the diagnosis of swallowing disorders.

Adult↗
PubMed1999

Relationship between the lingual-palatal contact duration associated with swallowing and maxillofacial morphology with the use of electropalatography.

To investigate the relationship between movement of the tongue during swallowing and malocclusion, the relationship between the lingual-palatal contact duration associated with swallowing and maxillofacial morphology was examined by electropalatography, cephalometric radiography, and dental casts. Seventy-one subjects (35 men and 36 women, 18 to 38 years of age) with normal occlusion or various types of malocclusion were used. Simple correlation analysis showed correlations between the time required for swallowing and the angles-FH-U1, L6-MP, FH-MP and Go-measured by lateral cephalometric radiography. In multiple regression analysis, five angles-FH-U1, L6-MP, FH-Occ, FH-SGna and NF-MP-measured by lateral cephalometric radiography were chosen as the independent variables, and significant regression equations and multiple correlation coefficient were obtained. It was concluded that the lingual-palatal contact duration associated with swallowing observed by electropalatography differs among persons; this is closely related to the maxillofacial morphology and significantly correlated with the measurement items representing the rotation of the lower jaw and inclination of upper incisors.

Adolescent↗
PubMedDate not supplied

Retinoic acid exposure on gestational days 11 to 13 impairs swallowing in rat offspring.

We have previously reported that exposure to 10 mg/kg of all-trans-retinoic acid (RA) daily on the 11th, 12th, and 13th days of rat gestation is lethal to all fetuses so exposed, due to an inability to suckle [R.R. Holson et al., Neurotoxicol Teratol 19 (1997) 347-353]. Because this lethal RA effect could be due to any of a variety of causes, from olfactory problems in locating the nipple to a motor problem in sucking or swallowing, we performed the following experiment. Albino dams were exposed to 10-mg/kg RA or vehicle daily over gestational days (GDs) 11 to 13. On the afternoon of GD 21 all pups were delivered by c-section. Tongue cannulae were inserted into the oral cavity of these offspring, and used to infuse a solution of condensed milk directly into the mouth. During and after each of four infusions, the behavioral response to the infusion (typically rolling and curling) was recorded. Controls responded well to this procedure, typically swallowing all milk so infused. In contrast, almost no RA-exposed neonates were able to swallow milk infused into the oral cavity. In such cases the milk simply dribbled out of the mouth, while the stomach was found to be empty at autopsy. However, the RA-treated animals did seem aware that milk was entering their mouths, because they showed a normal behavioral response to milk infusion. We conclude that GD 11-13 retinoid lethality is due to motor not sensory problems in the control of swallowing.

Animals↗
PubMed1998

[Children who swallow air].

UNLABELLED: Gas in the gut derives from swallowed air, intra-luminal production and diffusion from the blood. Excessive swallowed air may cause pathologic aerophagy. CASE REPORTS: This report describes four children aged from 3 to 12 years with pathologic aerophagy due to excessive air swallowing. One of them had a "Gas Bloat Syndrome". Clinical presentation was very incongruous. However, the clinical features were characteristic: abdominal distention increasing throughout the day, associated with visible and often audible air swallowing and excessive flatus. The questioning and clinical examination helped for diagnosing. Medical symptomatic treatment was associated with a psychotherapy approach. CONCLUSION: A better recognition of this condition might contribute towards earlier diagnosis.

Adolescent↗
PubMed2004

Canadian trial of sublingual swallow immunotherapy for ragweed rhinoconjunctivitis.

BACKGROUND: Sublingual swallow immunotherapy has been increasingly recognized as a safe and efficacious alternative to parenteral specific immunotherapy. OBJECTIVE: To determine the safety and efficacy of sublingual swallow immunotherapy ragweed allergen extract for rhinoconjunctivitis treatment starting just before and continuing through the ragweed pollen season. METHODS: This randomized, double-blind, placebo-controlled study was performed in children and adults with a documented history of allergic rhinoconjunctivitis during ragweed season at 9 Canadian allergy centers. Active treatment was standardized extract of ragweed allergen administered as sublingual swallow drops at increasing doses starting shortly before the pollen season and maintenance doses continued daily during the season. Primary efficacy variables were symptom and medication scores, and secondary variables included global evaluation of efficacy and immunologic measurements. RESULTS: Eighty-three patients were included in the safety analysis; 76 patients were included in the intent-to-treat analysis. Nine placebo recipients and 1 treatment recipient withdrew for lack of efficacy (P = .004). Nine patients in the treatment group withdrew because of adverse events, none serious (P = .003). Investigator evaluation of efficacy showed that significantly more patients improved and fewer deteriorated in the treatment group vs the placebo group (P = .047). Ragweed IgE and IgG4 levels increased significantly in treatment recipients vs placebo users (P < .001). Sneezing and nasal pruritus approached significant improvement in the treatment group vs the placebo group (P = .09 and .06, respectively). Quebec City experienced low pollen counts. Excluding Quebec City, significant improvement was seen for these 2 symptoms (P = .04). CONCLUSION: Sublingual swallow immunotherapy seems to be safe and efficacious for ragweed rhinoconjunctivitis even when started immediately before the ragweed pollen season.

Administration, Sublingual↗
PubMed2003

Integration of suck and swallow rhythms during feeding in preterm infants with and without bronchopulmonary dysplasia.

The aim of this study was to define quantitative measures for assessing the integration and maturation of suck and swallow rhythms in preterm infants as they relate to each other. Fourteen preterm infants (eight males, six females; gestational age range 26 to 32 weeks) with bronchopulmonary dysplasia (BPD) and an age-matched cohort of 20 infants (10 males, 10 females; gestational age range 26 to 33 weeks) without BPD were studied weekly from time of initiation of oral feeding using simultaneous recordings of nipple and pharyngeal pressure. The integration of suck and swallow rhythms was quantified by using the coefficient of variation (COV) of the suck-swallow dyad interval. Infants without BPD had a significant correlation between increasing postmenstrual age (PMA) and decreasing COV of the dyadic interval (increasing stabilization; r=0.45; p=0.008). In the non-BPD cohort 35 weeks or less PMA, the mean dyadic COV was 0.42 (SD 0.12) versus 0.34 (SD 0.09) in those more than 35 weeks PMA (p=0.039). In contrast, dyadic stability in infants with BPD was not correlated with PMA. Infants with BPD of more than 35 weeks PMA had less dyadic stability (0.45, SD 0.10) than did age-matched controls (p<0.001). Dyadic stability was also correlated with feeding efficiency in the non-BPD group (r=0.46;p=0.007) but not in the BPD cohort. Therefore, ontogeny of rhythmic suckle feeding can be described quantitatively in preterm infants, allowing comparison with at-risk populations. Infants with BPD do not follow predicted maturational patterns of suck-swallow rhythmic integration.

Analysis of Variance↗
PubMed2005

Comparison of clinical and videofluoroscopic evaluation of children with feeding and swallowing difficulties.

The objectives of this study were threefold: (1) to evaluate the accuracy of clinical evaluation compared with videofluoroscopic swallowing studies (VFSSs) in the detection of penetration and aspiration in children of age 0 to 15 years presenting with feeding and swallowing problems; (2) to assess the relationship between therapists' confidence ratings in making judgements about the presence or absence of penetration and aspiration, and the accuracy of their evaluation as confirmed by VFSSs; (3) to identify clinical predictors of penetration and aspiration during clinical evaluation of children with feeding and swallowing difficulties. We used a prospective study to evaluate the sensitivity, specificity, and positive and negative predictive values of a diagnostic clinical evaluation compared with VFSSs (criterion standard). Clinical evaluation and videofluoroscopy forms for oral motor and swallowing evaluation, which included potential indicators of aspiration, were designed for this project. Seventy-five children with feeding problems participated (33 females, 42 males; age range 0 to 14 years, mean 2 years; 62% of participants younger than 12 months). For fluids, clinical evaluation showed a sensitivity of 92% for aspiration. For solids, sensitivity for detecting aspiration was 33%. Analysis of the therapists' mean confidence ratings compared with the accuracy of their judgement demonstrated that when therapists were very sure that the child was aspirating or penetrating or not, they were correct. When the therapists were unsure, then the accuracy of prediction was not as good. Cough was the most significant predictor (p < 0.05) of fluid aspiration and penetration. We conclude that clinical evaluation with experienced clinicians can detect aspiration and penetration of fluids in children of varied ages and diagnoses, but that it is not accurate with solids.

Adolescent↗