S169 – Radiation-Associated Dysphagia with Nasopharyngeal Carcinoma

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P132-P133
Author(s):  
Jeremy D. Meier ◽  
Rebecca Leonard ◽  
D Gregory Farwell ◽  
Peter C Belafsky
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Average Duration ◽  
Clinical Database ◽  
Swallowing Function ◽  
Age And Gender ◽  
Swallowing Dysfunction ◽  
And Gender ◽  
Maximal Average ◽  
Pharyngeal Constriction ◽  
Normal Controls

Objectives We have observed that patients with dysphagia after radiotherapy (RT) for nasopharyngeal carcinoma (NPC) have substantially worse swallowing function than patients treated with RT of other sub-sites. The purpose of this investigation was to describe swallowing dysfunction after RT for NPC and compare swallowing parameters to patients receiving RT for cancer from another site. Methods Fluoroscopic swallowing data of persons with dysphagia after RT for NPC was abstracted from a clinical database. Objective swallowing parameters were compared to age- and gender-matched normal controls and to cancer stage-matched patients treated with RT for oropharyngeal cancer (OPC). Results 13 patients with NPC were compared to 13 controls and 13 patients with OPC. The average duration from RT to fluoroscopic study was 74 months for NPC and 24 months for OPC (p=.06). 62% of NPC and 47% of OPC were gastrostomy tube-dependent. 92% of NPC patients aspirated or penetrated compared to 62% of OPC patients. The maximal average tolerated bolus was 10.6cc for NPC and 22.2cc for OPC (p<.02). Mean hyolaryngeal elevation was 4.02 (±1.27) for normals, 2.96 (±0.86) for OPC, and 2.45 (± 1.17) for NPC (p<.01). Opening of the pharyngoesophageal segment was lower than normal in both NPC and OPC. Pharyngeal constriction was 0.08 (±0.09) for normals, 0.40 (±0.24) for OPC and 0.45 (±0.27) for NPC (p<.001). Conclusions The data suggest that patients with dysphagia after radiotherapy for NPC present at a later date, have significantly less hyolaryngeal elevation, have weaker pharyngeal constriction, and cannot tolerate as large a bolus as patients treated with radiotherapy for OPC.

scholarly journals The Influence of a Vitrectomy on the Diurnal Intraocular Pressure

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Yong Woo Lee ◽  
Joon Mo Kim ◽  
Seong Hee Shim ◽  
Da Yeong Kim ◽  
Jeong Hun Bae ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Diurnal Fluctuation ◽  
Age And Gender ◽  
History Of ◽  
The Difference ◽  
And Gender ◽  
Diurnal Iop ◽  
Maximum Minimum ◽  
Normal Controls ◽  
Healthy Eyes

Purpose. To evaluate the diurnal intraocular pressure (IOP) in eyes after vitrectomy compared to that of healthy eyes.Methods. Twenty-one patients who had undergone vitrectomy and 21 age- and gender-matched normal controls were enrolled during the same period. We measured the diurnal IOP every two hours between 9 a.m. and 11 p.m. in all patients who were admitted for cataract surgery. Patients with a history of eye surgery (not including vitrectomy) or use of a medication that is associated with IOP were excluded. The IOP and ocular parameters of patients were compared with the same patients’ fellow healthy eyes and with normal eyes of age- and gender-matched controls.Results. There were no significant differences between vitrectomized eyes and normal fellow eyes with regard to all IOP parameters including the maximum, minimum, and IOP fluctuation values. Diurnal fluctuation of IOP (or the difference between the maximum and minimum IOP) was larger in vitrectomized eyes than it was in age- and gender-matched control eyes.Conclusions. Vitrectomy did not markedly affect the IOP. Although there were no severe complications after vitrectomy, the IOP fluctuation was wider in vitrectomized eyes than it was in normal eyes.

scholarly journals A Study of the Duration of Controlled Speech in Right Hemisphere of the Brain Damaged Male Participants

2021 ◽  
Vol 2 (2) ◽  
pp. 1-8
Author(s):  
Agniva Pal ◽  
Keyword(s):  
Right Hemisphere ◽  
Adult Males ◽  
Age And Gender ◽  
Linguistic Research ◽  
The Difference ◽  
Normal Males ◽  
And Gender ◽  
The Right ◽  
The Brain ◽  
Normal Controls

This is a neuro-linguistic research which compares Bangla speaking right hemisphere damaged (furthermore to be called RHD) male participants to age and gender matched normal males who have been selected from the same family as the right hemisphere damaged participants. RHD or right hemisphere damaged participants are those who have lesions or damages in the right hemisphere of the brain or both. This paper pertains to the understanding how a lesion or a damage in the right hemisphere can cause changes in the pattern of communication of adult males in the age group of 45 to 70. This paper discerns the difference in durations of controlled speech in RHD males compared to age and gender matched normal controls. It will be measured with the help a predetermined passage. A passage will be played to them, using a media player (to make sure everyone listens to the same recording, ruling out chances of error there) and then they will be asked to repeat the same passage, as much as they can remember. In this research, we will be looking at the time they would take to narrate the whole passage without missing out on anything.

Electroconvulsive therapy clinical database: Influence of age and gender on the electrical charge

2017 ◽  
Vol 10 (3) ◽  
pp. 143-148 ◽  
Author(s):  
Javier Salvador Sánchez ◽  
Mónica Delia David ◽  
Aurora Torrent Setó ◽  
Montserrat Martínez Alonso ◽  
Maria J. Portella Moll ◽  
...  
Keyword(s):  
Electroconvulsive Therapy ◽  
Electrical Charge ◽  
Clinical Database ◽  
Age And Gender ◽  
And Gender

scholarly journals Renal Dysfunction in Prediabetes: Confirmed by Glomerular Hyperfiltration and Albuminuria

2021 ◽  
Author(s):  
Alagilawada S. Shilpasree ◽  
Vidya S. Patil ◽  
Manjunath Revanasiddappa ◽  
Vijayetha P. Patil ◽  
Deepti S. Ireshnavar
Keyword(s):  
Odds Ratio ◽  
Renal Damage ◽  
Early Stage ◽  
Glomerular Hyperfiltration ◽  
P Value ◽  
Age And Gender ◽  
Asymptomatic Patients ◽  
And Gender ◽  
The Impact ◽  
Normal Controls

Abstract Objectives Prediabetes is defined as an intermediate state of hyperglycemia with glucose levels above normal but below the diagnostic cutoff of diabetes mellitus. Prediabetes is considered as an important risk factor for the development of diabetes and complications associated with diabetes. Since glomerular hyperfiltration (elevated GFR) and albuminuria represent early and reversible stages of kidney damage seen in patients with type 2 diabetes, we aim to assess the impact of hyperglycemia in prediabetic range on renal functions measured by estimated GFR and urine albumin excretion (UAE). Materials and Methods The study included 1,031 patients aged 30 to 70 years, attending regular health checkup. Patients were grouped as normal, prediabetes, and diabetes according to the American Diabetic Association (ADA) criteria based on fasting blood sugar and hemoglobin A1c (HbA1c). Further, the patients were grouped into multiple subgroups based on age and gender. UAE was measured by using immunoturbidimetric method, and GFR was estimated by chronic kidney disease epidemiology collaboration (CKD EPI) equation. Statistical Analysis Prevalence of hyperfiltration (estimated glomerular filtration rate above the age and gender specific 95th percentile), and albuminuria in prediabetes and diabetes was compared with normal controls. Odds ratio and 95% confidence interval were calculated by using logistic regression analysis to predict the occurrence of hyperfiltration in prediabetes and diabetes. Analysis of variance followed by post hoc comparison was done to assess the significance of difference, and p-value < 0.05 was considered statistically significant. Results Prevalence of hyperfiltration was more in prediabetes and diabetes compared with normal controls, and it increased with surging HbA1c level that was shown as higher odds ratio for hyperfiltration in both the groups. UAE was more in the prediabetes and diabetes group when compared with normal controls, but the difference was significant only in diabetes. Conclusion Since glomerular hyperfiltration represents an early and reversible stage of renal damage manifesting before the appearance of albuminuria, elevated GFR can be used to identify asymptomatic patients with intermediate hyperglycemia having high risk of developing nephropathy in the future. Prediabetes represents a window of opportunity to initiate preventive strategies at an early stage before the occurrence of significant renal damage.

scholarly journals The Relationships Between Radiation Dosage and Long-term Swallowing Kinematics and Timing in Nasopharyngeal Carcinoma Survivors

Dysphagia ◽  
2021 ◽  
Author(s):  
Dai Pu ◽  
Victor H. F. Lee ◽  
Karen M. K. Chan ◽  
Margaret T. Y. Yuen ◽  
Harry Quon ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Radiation Dosage ◽  
Intensity Modulated Radiation Therapy ◽  
Concurrent Chemotherapy ◽  
Swallowing Function ◽  
Pharyngeal Constriction ◽  
The Relationship ◽  
Higher Doses ◽  
Inferior Pharyngeal Constrictor

AbstractThis study aimed to investigate the relationship between intensity-modulated radiation therapy (IMRT) dosimetry and swallowing kinematic and timing measures. Thirteen kinematic and timing measures of swallowing from videofluoroscopic analysis were used as outcome measures to reflect swallowing function. IMRT dosimetry was accessed for thirteen swallowing-related structures. A cohort of 44 nasopharyngeal carcinoma (NPC) survivors at least 3 years post-IMRT were recruited. The cohort had a mean age of 53.2 ± 11.9 years, 77.3% of whom were male. There was an average of 68.24 ± 14.15 months since end of IMRT; 41 (93.2%) had undergone concurrent chemotherapy. For displacement measures, female sex and higher doses to the cricopharyngeus, glottic larynx, and base of tongue were associated with reduced hyolaryngeal excursion and pharyngeal constriction, and more residue. For timing measures, higher dose to the genioglossus was associated with reduced processing time at all stages of the swallow. The inferior pharyngeal constrictor emerged with a distinctly different pattern of association with mean radiation dosage compared to other structures. Greater changes to swallowing kinematics and timing were observed for pudding thick consistency than thin liquid. Increasing radiation dosage to swallowing-related structures is associated with reduced swallowing kinematics. However, not all structures are affected the same way, therefore organ sparing during treatment planning for IMRT needs to consider function rather than focusing on select muscles. Dose-response relationships should be investigated with a comprehensive set of swallowing structures to capture the holistic process of swallowing.

scholarly journals Swallowing in Parkinson Patients versus Healthy Controls: Reliability of Measurements in Videofluoroscopy

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Laura W. J. Baijens ◽  
Renée Speyer ◽  
Valéria Lima Passos ◽  
Walmari Pilz ◽  
Nel Roodenburg ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Interrater Reliability ◽  
Matched Control ◽  
Healthy Controls ◽  
Swallowing Function ◽  
Age And Gender ◽  
Control Subjects ◽  
Healthy Control ◽  
And Gender

Objective. To determine and describe the pathophysiological aspects of oropharyngeal swallowing in patients with Parkinson's disease more accurately, a pilot study of qualitative as well as quantitative parameters of swallowing was performed using videofluoroscopy (VFS).Methods. Ten patients with a diagnosis of idiopathic Parkinson's disease having dysphagic complaints and ten healthy age- and gender-matched control subjects underwent a standardized videofluoroscopic swallowing protocol. Information on the swallowing function was derived from temporal, spatial, and descriptive visuoperceptual parameters. Intra- and interrater reliability was calculated.Results. No significant differences were found between Parkinson patients and healthy control subjects for the majority of the reliable variables.Conclusions. It was concluded that swallowing function seemed to be preserved in the early stages of Parkinson's disease. Furthermore, the reliability of many quantitative as well as qualitative swallowing parameters proved insufficient, raising questions about the interpretation of study outcomes in videofluoroscopy.

In Normal Controls, Both Age and Gender Affect Coagulability as Measured by Thrombelastography

2010 ◽  
Vol 110 (4) ◽  
pp. 987-994 ◽  
Author(s):  
Wilfried W. Roeloffzen ◽  
Hanneke C. Kluin-Nelemans ◽  
Andre B. Mulder ◽  
Nic J. Veeger ◽  
Lotte Bosman ◽  
...  
Keyword(s):  
Age And Gender ◽  
And Gender ◽  
Normal Controls

Functional Anatomy Underlying Pharyngeal Swallowing Mechanics and Swallowing Performance Goals

2019 ◽  
Vol 4 (4) ◽  
pp. 648-655
Author(s):  
William G. Pearson ◽  
Jacline V. Griffeth ◽  
Alexis M. Ennis
Keyword(s):  
Functional Anatomy ◽  
Neuromuscular Control ◽  
Upper Esophageal Sphincter ◽  
Performance Goals ◽  
Laryngeal Elevation ◽  
Port Closure ◽  
Swallowing Dysfunction ◽  
Hyoid Movement ◽  
Pharyngeal Swallowing ◽  
Pharyngeal Constriction

Purpose Rehabilitation of pharyngeal swallowing dysfunction requires a thorough understanding of the functional anatomy underlying the performance goals of pharyngeal swallowing. These goals include the safe and efficient transfer of a bolus through the hypopharynx into the esophagus. Penetration or aspiration of a bolus threatens swallowing safety. Bolus residue indicates swallowing inefficiency. Several primary mechanics, or elements of the swallowing mechanism, underlie these performance goals, with some elements contributing to both goals. These primary mechanics include velopharyngeal port closure, hyoid movement, laryngeal elevation, pharyngeal shortening, tongue base retraction, and pharyngeal constriction. Each element of the swallowing mechanism is under neuromuscular control and is therefore, in principle, a potential target for rehabilitation. Secondary mechanics of pharyngeal swallowing, those movements dependent on primary mechanics, include opening the upper esophageal sphincter and epiglottic inversion. Conclusion Understanding the functional anatomy of pharyngeal swallowing underlying swallowing performance goals will facilitate anatomically informed critical thinking in the rehabilitation of pharyngeal swallowing dysfunction.

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