Characterization of Esophageal and Sphincter Reflexes across Maturation in Dysphagic Infants with Oral Feeding Success vs Infants requiring Gastrostomy

Dysphagia ◽  
2021 ◽  
Author(s):  
Nancy Swiader ◽  
Kathryn A. Hasenstab ◽  
Vedat O. Yildiz ◽  
Sudarshan R. Jadcherla
Keyword(s):  
Oral Feeding ◽  
Feeding Success

DOZ047.34: Oral feeding attainment

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
K Hernandez ◽  
K Davidson ◽  
J Dargie ◽  
R Jennings ◽  
M Manfredi
Keyword(s):  
Esophageal Atresia ◽  
Genetic Diagnosis ◽  
Tube Feeding ◽  
Case Series ◽  
Oral Feeding ◽  
Retrospective Case ◽  
Genetic Syndrome ◽  
Feeding Success ◽  
Therapeutic Services

Abstract Aim A primary goal of esophageal atresia repair is to establish esophageal continuity to allow for swallowing of secretions, liquid, and food boluses. The transition to oral feeding and acquisition of oral sensorimotor skills following repair of long-gap esophageal atresia (LGEA) can be challenging. The timing of attaining full PO status (F-PO), without need for enteral tube feeding support, can vary greatly. A retrospective study was performed to identify predictors of oral feeding success in children with LGEA. Methods A retrospective case series was conducted with chart review of patients with a diagnosis of LGEA who underwent Foker process for staged repair from 2012 to 2017. Children with previous failed attempts at esophageal repair or other significant surgeries were excluded. Comparison was made between patients who achieved full PO status (F-PO) within the study follow-up period (minimum of one year postrepair) and those who did not. Results Twenty-three patients were included: twelve male and eleven female. Eight patients (35%) had an accompanying genetic diagnosis. Thirteen patients (57%) were born prematurely. Six patients (26%) were F-PO at 6 month post-repair; four of which were on an age appropriate diet without restrictions/modifications. Thirteen patients (57%) achieved F-PO by end of the study follow-up period while 43% required supplemental nutrition. Gestational age ≥ 37 weeks (P = 0.03), younger age at first PO trial (P = 0.013), shorter time between Foker 2 and first PO trial (P = 0.011), consistent PO intake at 6 months post-repair (P = 0.02), and fewer total number of airway/esophageal procedures within 1 year post-repair (P = 0.018) were found to be significantly associated with achieving F-PO. Total number of esophageal dilations within 2 years of esophageal repair and presence of a genetic syndrome were not significantly different between groups. Conclusion A majority of patients (57%) who undergo repair of LGEA via Foker process will progress to oral feeding; however, the timing of this progression is variable. Predictors of oral feeding success can be used to guide prognosis and identify patients at greatest need of therapeutic services.

scholarly journals Mechanisms and management considerations of parent-chosen feeding approaches to infants with swallowing difficulties: an observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sudarshan R. Jadcherla ◽  
Kathryn A. Hasenstab ◽  
Erika K. Osborn ◽  
Deborah S. Levy ◽  
Haluk Ipek ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Growth Velocity ◽  
Length Of Hospital Stay ◽  
Standard Of Care ◽  
Integrated Approach ◽  
Oral Feeding ◽  
High Resolution Manometry ◽  
Feeding Difficulties ◽  
Feeding Success ◽  
Feeding Therapy

AbstractVideofluoroscopy swallow studies (VFSS) and high-resolution manometry (HRM) methods complement to ascertain mechanisms of infant feeding difficulties. We hypothesized that: (a) an integrated approach (study: parent-preferred feeding therapy based on VFSS and HRM) is superior to the standard-of-care (control: provider-prescribed feeding therapy based on VFSS), and (b) motility characteristics are distinct in infants with penetration or aspiration defined as penetration-aspiration scale (PAS) score ≥ 2. Feeding therapies were nipple flow, fluid thickness, or no modification. Clinical outcomes were oral-feeding success (primary), length of hospital stay and growth velocity. Basal and adaptive HRM motility characteristics were analyzed for study infants. Oral feeding success was 85% [76–94%] in study (N = 60) vs. 63% [50–77%] in control (N = 49), p = 0.008. Hospital-stay and growth velocity did not differ between approaches or PAS ≥ 2 (all P > 0.05). In study infants with PAS ≥ 2, motility metrics differed for increased deglutition apnea during interphase (p = 0.02), symptoms with pharyngeal stimulation (p = 0.02) and decreased distal esophageal contractility (p = 0.004) with barium. In conclusion, an integrated approach with parent-preferred therapy based on mechanistic understanding of VFSS and HRM metrics improves oral feeding outcomes despite the evidence of penetration or aspiration. Implementation of new knowledge of physiology of swallowing and airway protection may be contributory to our findings.

scholarly journals SalivaryFOXP2expression and oral feeding success in premature infants: Table 1.

2015 ◽  
Vol 2 (1) ◽  
pp. a000554 ◽  
Author(s):  
Emily Zimmerman ◽  
Monika Maki ◽  
Jill Maron
Keyword(s):  
Premature Infants ◽  
Oral Feeding ◽  
Feeding Success

Oral Feeding Success

2019 ◽  
Vol 19 (1) ◽  
pp. 21-31 ◽  
Author(s):  
Thao T. Griffith ◽  
Aleeca F. Bell ◽  
Catherine Vincent ◽  
Rosemary White-Traut ◽  
Barbara Medoff-Cooper ◽  
...  
Keyword(s):  
Oral Feeding ◽  
Feeding Success

scholarly journals Non-Nutritive Sucking in the Preterm Infant

2018 ◽  
Vol 36 (03) ◽  
pp. 268-276 ◽  
Author(s):  
Kelsey Dewey ◽  
Amy Jacobsen ◽  
Joan Smith ◽  
Roberta Pineda
Keyword(s):  
Social Factors ◽  
Peak Pressure ◽  
Oral Feeding ◽  
Medical Complications ◽  
Feeding Success ◽  
Nutritive Sucking ◽  
Scale Scores ◽  
Postmenstrual Age ◽  
Relationship Of ◽  
The Relationship

Objective To identify the progression of non-nutritive sucking (NNS) across postmenstrual age (PMA) and to investigate the relationship of NNS with medical and social factors and oral feeding. Study Design Fifty preterm infants born at ≤32 weeks gestation had NNS assessed weekly starting at 32 weeks PMA with the NTrainer System. Oral feeding was assessed at 38 weeks PMA. Results There were increases in NNS bursts per minute (p = 0.005), NNS per minute (p < 0.0001), NNS per burst (p < 0.001), and peak pressure (p = 0.0003) with advancing PMA. Level of immaturity and medical complications were related to NNS measures (p < 0.05). NNS measures were not related to Neonatal Oral Motor Assessment Scale scores. Smaller weekly change in NNS peak pressure (p = 0.03; β = –1.4) was related to feeding success at 38 weeks PMA. Conclusion Infants demonstrated NNS early in gestation. Variability in NNS scores could reflect medical complications and immaturity. More stable sucking pressure across time was related to feeding success at 38 weeks PMA.

Morphological Characterization of Mycobacteriophage R1

1974 ◽  
Vol 32 ◽  
pp. 254-255
Author(s):  
B. L. Soloff ◽  
T. A. Rado
Keyword(s):  
Carbon Source ◽  
Stationary Phase ◽  
Growth Phase ◽  
Minimal Medium ◽  
Morphological Characterization ◽  
Logarithmic Growth Phase ◽  
Complete Lysis ◽  
Lysogenic Culture ◽  
Logarithmic Growth

Mycobacteriophage R1 was originally isolated from a lysogenic culture of M. butyricum. The virus was propagated on a leucine-requiring derivative of M. smegmatis, 607 leu−, isolated by nitrosoguanidine mutagenesis of typestrain ATCC 607. Growth was accomplished in a minimal medium containing glycerol and glucose as carbon source and enriched by the addition of 80 μg/ ml L-leucine. Bacteria in early logarithmic growth phase were infected with virus at a multiplicity of 5, and incubated with aeration for 8 hours. The partially lysed suspension was diluted 1:10 in growth medium and incubated for a further 8 hours. This permitted stationary phase cells to re-enter logarithmic growth and resulted in complete lysis of the culture.

AEM analysis of crystallization in Ti-based amorphous alloys

1983 ◽  
Vol 41 ◽  
pp. 270-271
Author(s):  
A.R. Pelton ◽  
A.F. Marshall ◽  
Y.S. Lee
Keyword(s):  
Magnetic Properties ◽  
Amorphous Alloys ◽  
Amorphous Materials ◽  
Isothermal Annealing ◽  
Amorphous Matrix ◽  
Nucleation And Growth ◽  
Current Interest ◽  
Amorphous Films ◽  
Electrical And Magnetic Properties

Amorphous materials are of current interest due to their desirable mechanical, electrical and magnetic properties. Furthermore, crystallizing amorphous alloys provides an avenue for discerning sequential and competitive phases thus allowing access to otherwise inaccessible crystalline structures. Previous studies have shown the benefits of using AEM to determine crystal structures and compositions of partially crystallized alloys. The present paper will discuss the AEM characterization of crystallized Cu-Ti and Ni-Ti amorphous films.Cu60Ti40: The amorphous alloy Cu60Ti40, when continuously heated, forms a simple intermediate, macrocrystalline phase which then transforms to the ordered, equilibrium Cu3Ti2 phase. However, contrary to what one would expect from kinetic considerations, isothermal annealing below the isochronal crystallization temperature results in direct nucleation and growth of Cu3Ti2 from the amorphous matrix.

Characterization of Coherent, Ordered Precipitates in Nickel-Base Alloys

1973 ◽  
Vol 31 ◽  
pp. 144-145
Author(s):  
B. H. Kear ◽  
J. M. Oblak
Keyword(s):  
Stable Phase ◽  
Nickel Base Superalloy ◽  
Alloy 718 ◽  
Commercial Alloy ◽  
Precipitate Morphology ◽  
Continuous Precipitation ◽  
Nickel Base ◽  
Base Superalloy ◽  
Strengthening Precipitate

A nickel-base superalloy is essentially a Ni/Cr solid solution hardened by additions of Al (Ti, Nb, etc.) to precipitate a coherent, ordered phase. In most commercial alloy systems, e.g. B-1900, IN-100 and Mar-M200, the stable precipitate is Ni3 (Al,Ti) γ′, with an LI2structure. In A lloy 901 the normal precipitate is metastable Nis Ti3 γ′ ; the stable phase is a hexagonal Do2 4 structure. In Alloy 718 the strengthening precipitate is metastable γ″, which has a body-centered tetragonal D022 structure.Precipitate MorphologyIn most systems the ordered γ′ phase forms by a continuous precipitation re-action, which gives rise to a uniform intragranular dispersion of precipitate particles. For zero γ/γ′ misfit, the γ′ precipitates assume a spheroidal.

The Use of Advanced Analytical Techniques for Characterization of the Chemical, Physical, and Crystallographic Nature of a Surface

1973 ◽  
Vol 31 ◽  
pp. 132-133 ◽  
Author(s):  
R. E. Herfert
Keyword(s):  
Surface Characterization ◽  
Analytical Techniques ◽  
X Ray Diffraction ◽  
Depth Of Penetration ◽  
X Ray ◽  
The Past ◽  
Transmission Electron ◽  
Scanning Electron

Studies of the nature of a surface, either metallic or nonmetallic, in the past, have been limited to the instrumentation available for these measurements. In the past, optical microscopy, replica transmission electron microscopy, electron or X-ray diffraction and optical or X-ray spectroscopy have provided the means of surface characterization. Actually, some of these techniques are not purely surface; the depth of penetration may be a few thousands of an inch. Within the last five years, instrumentation has been made available which now makes it practical for use to study the outer few 100A of layers and characterize it completely from a chemical, physical, and crystallographic standpoint. The scanning electron microscope (SEM) provides a means of viewing the surface of a material in situ to magnifications as high as 250,000X.

Skeletal elements of crinoid echinoderms: High-resolution structural and microanalytical results

1983 ◽  
Vol 41 ◽  
pp. 194-195
Author(s):  
D. F. Blake ◽  
L. F. Allard ◽  
D. R. Peacor
Keyword(s):  
High Resolution ◽  
Marine Invertebrates ◽  
Sea Urchins ◽  
Structural Features ◽  
Sea Stars ◽  
High Resolution Tem ◽  
Relationship Of ◽  
The Relationship ◽  
Insight Into

Echinodermata is a phylum of marine invertebrates which has been extant since Cambrian time (c.a. 500 m.y. before the present). Modern examples of echinoderms include sea urchins, sea stars, and sea lilies (crinoids). The endoskeletons of echinoderms are composed of plates or ossicles (Fig. 1) which are with few exceptions, porous, single crystals of high-magnesian calcite. Despite their single crystal nature, fracture surfaces do not exhibit the near-perfect {10.4} cleavage characteristic of inorganic calcite. This paradoxical mix of biogenic and inorganic features has prompted much recent work on echinoderm skeletal crystallography. Furthermore, fossil echinoderm hard parts comprise a volumetrically significant portion of some marine limestones sequences. The ultrastructural and microchemical characterization of modern skeletal material should lend insight into: 1). The nature of the biogenic processes involved, for example, the relationship of Mg heterogeneity to morphological and structural features in modern echinoderm material, and 2). The nature of the diagenetic changes undergone by their ancient, fossilized counterparts. In this study, high resolution TEM (HRTEM), high voltage TEM (HVTEM), and STEM microanalysis are used to characterize tha ultrastructural and microchemical composition of skeletal elements of the modern crinoid Neocrinus blakei.

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