Effects of a Sour Bolus on Oropharyngeal Swallowing Measures in Patients With Neurogenic Dysphagia

1995 ◽  
Vol 38 (3) ◽  
pp. 556-563 ◽  
Author(s):  
Jeri A. Logemann ◽  
Barbara Roa Pauloski ◽  
Laura Colangelo ◽  
Cathy Lazarus ◽  
Masako Fujiu ◽  
...  
Keyword(s):  
Lemon Juice ◽  
Bolus Volume ◽  
Neurogenic Dysphagia ◽  
Stroke Group ◽  
Pharyngeal Swallow ◽  
Group 2 ◽  
Sour Bolus ◽  
Swallow Therapy ◽  
Group 1 ◽  
Volume Effects

This study examines the effects of a sour bolus (50% lemon juice, 50% barium liquid) on pharyngeal swallow measures in two groups of patients with neurogenic dysphagia. Group 1 consisted of 19 patients who had suffered at least one stroke. Group 2 consisted of 8 patients with dysphagia related to other neurogenic etiologies. All patients were selected because they exhibited delays in the onset of the oral swallow and delays in triggering the pharyngeal swallow on boluses of 1 ml and 3 ml liquid barium during videofluoroscopy. Results showed significant improvement in oral onset of the swallow in both groups of patients and a significant reduction in pharyngeal swallow delay in Group 1 patients and in frequency of aspiration in Group 2 patients with the sour as compared to the non-sour boluses. Other selected swallow measures in both subject groups also improved with the sour bolus. Volume effects were present but not as consistently as in prior studies. Implications for swallow therapy are discussed.

scholarly journals Clinical Safety and Efficacy of Ablation for Atrial Fibrillation Patients With a History of Stroke

2021 ◽  
Vol 8 ◽  
Author(s):  
Zi-liang Song ◽  
Shao-hui Wu ◽  
Dao-liang Zhang ◽  
Wei-feng Jiang ◽  
Mu Qin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Safety ◽  
Safety And Efficacy ◽  
Linear Lesions ◽  
Significant Difference ◽  
Stroke Group ◽  
History Of ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objectives: To evaluate the clinical safety and efficacy of radiofrequency catheter ablation for atrial fibrillation patients with a history of stroke.Methods and Results: A total of 116 symptomatic, drug-refractory AF patients with a history of stroke, and 1:2 matched patients without a history of stroke were enrolled. Of these, 28 cases occurred stroke within 3 months (Group 1), 88 cases with stroke history longer than 3 months (Group 2), and 232 cases without stroke (Group 3). PVI was performed in all patients, extended to ablation of linear lesions ablation. The periprocedural stroke rates and other procedure-related in-hospital complications did not differ significantly among the three groups. The maintenance rate of SR after the procedure showed no significant difference (p = 0.333), 52.7, 66.4, and 70.7% in Group 1, 2, and 3, respectively. Furthermore, the comparison between a history of stroke and those without it were also shown no significant difference (p = 0.351).Conclusions: Radiofrequency ablation for AF patients occurred stroke, even within 3 months is safe and effective, without higher periprocedural complication rate and recurrence rate.

scholarly journals PASSIVE VERTICALIZATION IN PATIENTS WITH SYMPTOMATIC PRECEREBRAL STENOSЕS IN ACUTE STROKE

2013 ◽  
Vol 19 (6) ◽  
pp. 449-457
Author(s):  
V. A. Sorokoumov ◽  
I. A. Voznyuk ◽  
A. V. Polyakova ◽  
A. Y. Polushin
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Autoregulation ◽  
Reduction Rate ◽  
Tilt Table ◽  
Increased Risk ◽  
Stroke Group ◽  
Group 2 ◽  
Design And Methods ◽  
Brachiocephalic Arteries ◽  
Group 1

stenoses of precerebral arteries, to determine predictors of the complications of verticalization in order to perform a more differentiated approach to the implementation of the protocol to ensure the safety of the process. Design and methods. The study included 50 patients with hemispheric ischemic stroke. Group 1 (n = 30) included patients without hemodynamically signiicant stenoses of the brachiocephalic arteries (BCA), group 2 (n = 20) included patients with hemodynamically signiicant stenoses of the BCA. Verticalization was carried out on a tilt-table «Vario-Line» («Beka») on the 1, 2, 3, 4, 5 and 14 day from the onset of the disease. Results. In group 2 an earlier decline in the rate of cerebral blood low (CBF), as well as the re-reduction rate of the CBF during the session of verticalization were detected. During the interruption between the sessions, indicators of autoregulation recovered more slowly in patients from group 2. Moreover, the cerebral autoregulation indicators were decreased during the course of verticalization, by 14 day only a quarter of these patients had a ratio of 10 % overshoot.Conclusions. Patients with hemodynamically signiicant stenoses of symptomatic BCA need to use a special regimen of verticalization that would appear «gentle» in order to prevent the complications of verticalization. Assessment of cerebral blood low autoregulation by the overshoot factor can help to identify patients with the increased risk of complications.

scholarly journals Ten-year long-term outcomes of conventional and eversion carotid endarterectomy. Multicenter study

2021 ◽  
Vol 26 (12) ◽  
pp. 4742
Author(s):  
Yu. V. Belov ◽  
A. N. Kazantsev ◽  
R. A. Vinogradov ◽  
A. V. Korotkikh ◽  
V. V. Matusevich ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Endarterectomy ◽  
Long Term Outcomes ◽  
Patch Angioplasty ◽  
Long Term Follow Up ◽  
Stroke Group ◽  
Group 2 ◽  
Group 1

Aim. To analyze the immediate and long-term outcomes of eversion and conventional carotid endarterectomy (CE) with patch angioplasty.Material and methods. For the period from February 1, 2006 to September 1, 2021, the present retrospective multicenter open comparative study included 25106 patients who underwent CE. Depending on the technique of operation, the following groups were formed: group 1 (n=18362) — eversion CE; group 2 (n=6744) — conventional CE with patch angioplasty. The long-term follow-up period was 124,7±53,8 months.Results. In the hospital postoperative period, the groups were comparable in incidence of all complications: lethal outcome (group 1: 0,19%, n=36; group 2: 0,17%, n=12; p=0,89; odds ratio (OR) =1,1; 95% confidence interval (CI) =0,57- 2,11); myocardial infarction (MI) (group 1: 0,15%, n=28; group 2: 0,13%, n=9; p=0,87; OR=1,14; 95% CI=0,53-2,42); stroke (group 1: 0,33%, n=62; group 2: 0,4%, n=27; p=0,53; OR=0,84; 95% CI=0,53-1,32); bleeding with hematoma formation (group 1: 0,39%, n=73; group 2: 0,41%, n=28; p=0,93; OR=0,95; 95% CI=0,61-1,48); internal carotid artery (ICA) thrombosis (group 1: 0,05%, n=11; group 2: 0,07%, n=5, p=0,9; OR=0,8; 95% CI=0,28-2,32). In the long-term follow-up, the groups were comparable only in MI incidence: group 1: 0,56%, n=103; group 2: 0,66%, n=45; p=0,37; OR=0,84; 95% CI=0,59-1,19. All other complications were more frequent after conventional CE with patch angioplasty: all-cause death (group 1: 2,7%, n=492; group 2: 9,1%, n=616; p<0,0001; OR=0,27; 95% CI=0,24-0,3); lethal ischemic stroke (group 1: 1,0%, n=180; group 2: 5,5%, n=371; p<0,0001; OR=0,17; 95% CI=0,14-0,21); non-lethal ischemic stroke (group 1: 0,62%, n=114; group 2: 7,0%, n=472; p<0,0001; OR=0,08; 95% CI=0,06-0,1); ICA restenosis >60%, requiring re-revascularization (group 1: 1,6%, n=296; group 2: 12,6%, n=851; p<0,0001; OR=0,11; 95% CI=0,09-0,12). Thus, the composite endpoint (lethal ischemic stroke + non-lethal ischemic stroke + MI) after conventional CE with patch angioplasty was more than 6 times higher than this parameter of eversion CE: group 1: 2,2%, n=397; group 2: 13,2%, n=888; p<0,0001; OR=0,14; 95% CI=0,12-1,16.Conclusion. Conventional CE with patch angioplasty is not prefer for cerebral revascularization in the presence of hemodynamically significant ICA stenosis due to the high prevalence of deaths, stroke, and ICA restenosis in the long-term follow-up.

Biomechanics of failed deglutitive upper esophageal sphincter relaxation in neurogenic dysphagia

2002 ◽  
Vol 283 (1) ◽  
pp. G16-G26 ◽  
Author(s):  
Rohan B. H. Williams ◽  
Karen L. Wallace ◽  
Galib N. Ali ◽  
Ian J. Cook
Keyword(s):  
Biomechanical Properties ◽  
Upper Esophageal Sphincter ◽  
Zenker’S Diverticulum ◽  
Bolus Volume ◽  
Neurogenic Dysphagia ◽  
Zenker's Diverticulum ◽  
Pharyngeal Swallow ◽  
Extrapyramidal Disease ◽  
Esophageal Sphincter ◽  
Ues Opening

Our aims were to examine the etiology and biomechanical properties of the nonrelaxing upper esophageal sphincter (UES) and the relationship between UES opening and failed relaxation. We examined the relationships among swallowed bolus volume, intrabolus pressure, sagittal UES diameter, the pharyngeal swallow response, and geniohyoid shortening in 18 patients with failed UES relaxation, 23 healthy aged controls, and 15 with Zenker's diverticulum. Etiology of failed UES relaxation was 56% medullary disease, 33% Parkinson's or extrapyramidal disease; and 11% idiopathic. Extent of UES opening ranged from absent to normal and correlated with preservation of the pharyngeal swallow response ( P = 0.012) and geniohyoid shortening ( P = 0.046). Intrabolus pressure was significantly greater compared with aged controls ( P < 0.001) or Zenker's diverticulum ( P < 0.001). The bolus volume-dependent increase in intrabolus pressure evident in controls was not observed in failed UES relaxation. The nonrelaxing UES therefore displays a constant loss of sphincter compliance throughout the full, and potentially normal, range of expansion during opening. Adequacy of UES opening is influenced by the degree of preservation of the pharyngeal swallow response and hyolaryngeal traction. In contrast, the stenotic UES displays a static loss of compliance, only apparent once the limit of sphincter expansion is reached.

scholarly journals Implantation of a long biological patch in classical carotid endarterectomy for extended atherosclerotic lesions. Long-term outcomes

2021 ◽  
Vol 23 (1) ◽  
pp. 112-124
Author(s):  
A. N. Kazantsev ◽  
M. A. Chernyavsky ◽  
R. A. Vinogradov ◽  
V. N. Kravchuk ◽  
D. V. Shmatov ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Long Term Outcomes ◽  
Atherosclerotic Lesions ◽  
Long Term Follow Up ◽  
Stroke Group ◽  
Group 2 ◽  
Death Group ◽  
Group 1

Objective: to analyze the in-hospital and long-term outcomes of classical carotid endarterectomy (CEE) in extended atherosclerotic lesions in comparison with the outcomes of this operation in local atherosclerotic plaque (AP). Materials and Methods. This study, which lasted from January 2010 to December 2020, included 148 patients with extended AP and hemodynamically significant internal carotid artery (ICA) stenosis. The term “extended” was understood as a hemodynamically significant lesion ≥ 5 cm long. These patients made up Group 1. Group 2 was formed over the same period of time from 632 patients with hemodynamically significant stenosis <5 cm long. In both cohorts, CEE with repair of the reconstruction zone with a diepoxide-treated xenopericardial patch was performed. Long-term follow-up was 71.4 ± 45.6 months. Results. The groups were comparable in terms of frequency of in-hospital complications: death (group 1: 0.67%, n = 1; group 2: 0.5%, n = 3; p = 0.74; OR = 1.42; 95% Cl 0.14-13.6), myocardial infarction (MI) (group 1: 0.67%, n = 1; group 2: 0.5%, n = 3; p = 0.74; OR = 1.42; 95% CI 0.14-13.6), ischemic stroke (group 1: 0%; group 2: 0.5%, n = 3; p = 0.91; OR = 0.6; 95% CI 0.03-11.8), combined endpoint (death + MI + stroke) (group 1: 1.35%, n = 2; group 2: 1.4%, n = 9; p = 0.74; OR = 0.94; 95% CI 0.2-4.43). The groups were also comparable in terms of frequency of long-term complications: death (group 1: 2.0%, n = 3; group 2: 2.05%, n = 13; p = 0.76; OR = 0.98; 95% CI 0.27-3.5), MI (group 1: 2.7%, n = 4; group 2: 2.4%, n = 15; p = 0.95; OR = 1.14; 95% CI 0.37-3.49), ischemic stroke (group 1: 5.4%, n = 8; group 2: 5.2%, n = 33; p = 0.9; OR = 1.03; 95% CI 0.46-2.29), ICA occlusion and restenosis (group 1: 12.8%, n = 19; group 2: 13.3%, n = 84; p = 0.99; OR = 0.96; 95% CI 0.56-1.63), combined endpoint (death + MI + stroke) (group 1: 10.1%, n = 15; group 2: 9.6%, n = 61; p = 0.98; OR = 1.05; 95% CI 0.58-1.91). Analysis of survival graphs revealed no significant intergroup differences for all types of complications (lethal outcome: p = 0.56; MI: p = 0.73; stroke/mini-stroke: p = 0.89; ICA restenosis/occlusion: p = 0.82; combined end point: p = 0.71). Their increase was uniform in both groups. However, more than half of all ICA restenoses and occlusions were visualized in the first 6 months after CEE. Conclusion. Implantation of a long patch (≥ 5 cm) is not characterized by increased incidence of restenosis and all adverse cardiovascular events during in-hospital and long-term follow-up.

scholarly journals Efek Perendaman Air Jeruk Nipis dan Air Jeruk Lemon pada Kekasaran Permukaan Semen Ionomer Kaca

2018 ◽  
Vol 7 (2) ◽  
pp. 11
Author(s):  
Rosalina Tjandrawinata ◽  
Andreas Julianto
Keyword(s):  
Surface Roughness ◽  
Mineral Water ◽  
Glass Ionomer Cement ◽  
Lemon Juice ◽  
Lime Juice ◽  
Significant Difference ◽  
Food And Beverage ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The surface of Glass Ionomer Cement (GIC) restoration changes because of mastication forces, shear force, other functional forces, and also tooth brushing process. Things that can also change the surface of GIC restoration is kind of food and beverage consumption, such as in Indonesia, lime and lemon juice are usual beverage, and mixed in food. The purpose of this study is to determine the changes in surface roughness of GIC restoration due to lime and lemon juice immersion. Three groups GIC sample, each of ten samples were 5 mm in diameter and 2.5 mm in height. Group 1 was immersed in mineral water (as control) for 10 days. In 10 days, Group 2 was immersed in lime juice, each day 9 times @ 15 minutes and brushed with soft toothbrush for 9 times @ 3 minutes. Similar way with group 2, 10 samples of group 3 was immersed in lemon juice. Samples immersed in mineral water show changes in surface roughness of 0.977+0.503 μm, while samples immersed in lime juice show 4.267+1.489 μm, and samples immersed in lemon juice show 4.293+1.311 μm. One way ANOVA test shows significant differences among the samples (p<0.05). Post hoc Tukey test shows significant difference (p<0.05) between group 1 and group 2 and between group 1 and group 3. However, there is no significant difference between group 2 and group 3 (p>0.05). Conclusion, lime juice and lemon juice cause changes in the surface roughness of GIC more than mineral water.

scholarly journals PASSIVE VERTICALIZATION IN PATIENTS WITH SYMPTOMATIC PRECEREBRAL STENOSЕS IN ACUTE STROKE

2013 ◽  
Vol 19 (5) ◽  
pp. 449-457
Author(s):  
V. A. Sorokoumov ◽  
I. A. Voznyuk ◽  
A. V. Polyakova ◽  
A. Y. Polushin
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Autoregulation ◽  
Reduction Rate ◽  
Tilt Table ◽  
Increased Risk ◽  
Stroke Group ◽  
Group 2 ◽  
Design And Methods ◽  
Brachiocephalic Arteries ◽  
Group 1

stenoses of precerebral arteries, to determine predictors of the complications of verticalization in order to perform a more differentiated approach to the implementation of the protocol to ensure the safety of the process. Design and methods. The study included 50 patients with hemispheric ischemic stroke. Group 1 (n = 30) included patients without hemodynamically signiicant stenoses of the brachiocephalic arteries (BCA), group 2 (n = 20) included patients with hemodynamically signiicant stenoses of the BCA. Verticalization was carried out on a tilt-table «Vario-Line» («Beka») on the 1, 2, 3, 4, 5 and 14 day from the onset of the disease. Results. In group 2 an earlier decline in the rate of cerebral blood low (CBF), as well as the re-reduction rate of the CBF during the session of verticalization were detected. During the interruption between the sessions, indicators of autoregulation recovered more slowly in patients from group 2. Moreover, the cerebral autoregulation indicators were decreased during the course of verticalization, by 14 day only a quarter of these patients had a ratio of 10 % overshoot.Conclusions. Patients with hemodynamically signiicant stenoses of symptomatic BCA need to use a special regimen of verticalization that would appear «gentle» in order to prevent the complications of verticalization. Assessment of cerebral blood low autoregulation by the overshoot factor can help to identify patients with the increased risk of complications.

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

The influence of continuous local wound infusion on postoperative pain in patients undergoing transfemoral amputation

VASA ◽  
2015 ◽  
Vol 44 (5) ◽  
pp. 381-386 ◽  
Author(s):  
Christian Uhl ◽  
Thomas Betz ◽  
Andrea Rupp ◽  
Markus Steinbauer ◽  
Ingolf Töpel
Keyword(s):  
Pain Management ◽  
Pilot Study ◽  
Local Anaesthetic ◽  
Phantom Pain ◽  
Transfemoral Amputation ◽  
Postoperative Wound ◽  
Stump Pain ◽  
Management Protocol ◽  
Group 2 ◽  
Group 1

Abstract. Summary: Background: This pilot study was set up to examine the effects of a continuous postoperative wound infusion system with a local anaesthetic on perioperative pain and the consumption of analgesics. Patients and methods: We included 42 patients in this prospective observational pilot study. Patients were divided into two groups. One group was treated in accordance with the WHO standard pain management protocol and in addition to that received a continuous local wound infusion treatment (Group 1). Group 2 was treated with analgesics in accordance with the WHO standard pain management protocol, exclusively. Results: The study demonstrated a significantly reduced postoperative VAS score for stump pain in Group 1 for the first 5 days. Furthermore, the intake of opiates was significantly reduced in Group 1 (day 1, Group 1: 42.1 vs. Group 2: 73.5, p = 0.010; day 2, Group 1: 27.7 vs. Group 2: 52.5, p = 0.012; day 3, Group 1: 23.9 vs. Group 2: 53.5, p = 0.002; day 4, Group 1: 15.7 vs. Group 2: 48.3, p = 0.003; day 5, Group 1 13.3 vs. Group 2: 49.9, p = 0.001). There were no significant differences between the two groups, neither in phantom pain intensity at discharge nor postoperative complications and death. Conclusions: Continuous postoperative wound infusion with a local anaesthetic in combination with a standard pain management protocol can reduce both stump pain and opiate intake in patients who have undergone transfemoral amputation. Phantom pain was not significantly affected.

Abnormal Haemostasis and Blood Viscosity in Malignant Hypertension

1984 ◽  
Vol 52 (03) ◽  
pp. 253-255 ◽  
Author(s):  
C Isles ◽  
G D O Lowe ◽  
B M Rankin ◽  
C D Forbes ◽  
N Lucie ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Viscosity ◽  
Renal Damage ◽  
Antithrombin Iii ◽  
Plasma Viscosity ◽  
Malignant Hypertension ◽  
Fibrin Deposition ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

SummaryWe have previously shown abnormalities of haemostasis suggestive of intravascular coagulation in patients with malignant hypertension, a condition associated with retinopathy and renal fibrin deposition. To determine whether such abnormalities are specific to malignant hypertension, we have measured several haemostatic and haemorheological variables in 18 patients with malignant hypertension (Group 1), 18 matched healthy controls (Group 2), and 18 patients with non-malignant hypertension (Group 3) matched for renal pathology, blood pressure and serum creatinine with Group 1. Both Groups 1 and 3 had increased mean levels of fibrinogen, factor VIIIc, beta-thrombo- globulin, plasma viscosity and blood viscosity (corrected for haematocrit); and decreased mean levels of haematocrit, antithrombin III and platelet count. Mean levels of fast antiplasmin and alpha2-macroglobulin were elevated in Group 1 but not in Group 3. We conclude that most blood abnormalities are not specific to malignant hypertension; are also present in patients with non-malignant hypertension who have similar levels of blood pressure and renal damage; and might result from renal damage as well as promoting further renal damage by enhancing fibrin deposition. However increased levels of fibrinolytic inhibitors in malignant hypertension merit further investigation in relation to removal of renal fibrin.

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