scholarly journals Videoradiographic analysis of how carbonated thin liquids and thickened liquids affect the physiology of swallowing in subjects with aspiration on thin liquids

2003 ◽  
Vol 44 (4) ◽  
pp. 366-372 ◽  
Author(s):  
M. Bülow ◽  
R. Olsson ◽  
O. Ekberg
Keyword(s):  
Transit Time ◽  
Thickened Liquids ◽  
Neurologically Impaired ◽  
Thickened Liquid ◽  
Significant Difference ◽  
Valuable Treatment ◽  
Pharyngeal Transit ◽  
Dysphagic Patients ◽  
Carbonated Liquids ◽  
Thin Liquids

Purpose: To analyze how carbonated thin liquids affected the physiology of swallowing in dysphagic patients. Material and Methods: 40 patients were analyzed; 36 were neurologically impaired. During a therapeutic videoradiographic swallowing examination the patients had to swallow liquids with the following consistencies three times: thin, thickened and carbonated. The liquids were given in doses of 3 × 5 ml. The swallows were analyzed regarding penetration/aspiration, pharyngeal transit time and pharyngeal retention. Results: Significant difference was found regarding penetration/aspiration when comparisons were made between thin liquid and carbonated thin liquid ( p<0.0001). Carbonated liquid reduced the penetration to the airways. The comparison between thin liquid and thickened liquid ( p<0.0001) showed significant less penetration with thickened liquids. Pharyngeal transit time was reduced both when comparing thin liquid with thin carbonated liquid ( p<0.0001) and thickened liquid ( p<0.0001). Pharyngeal retention was significantly reduced ( p<0.0001) with carbonated thin liquid compared to thickened liquid. The comparison of thin liquids and carbonated thin liquids showed p = 0.0013, thin and thickened liquids p = 0.0097. Conclusions: Carbonated liquids reduced penetration/aspiration into the airways, reduced pharyngeal retention and pharyngeal transit time became shorter. Therefore, carbonated liquids are a valuable treatment option for patients with penetration/aspiration. Thickened liquids may still be an option for patients who cannot tolerate carbonated liquids and liquids with this consistency are safer than thin liquids.

scholarly journals The influence of sour taste and cold temperature in pharyngeal transit duration in patients with stroke

2010 ◽  
Vol 47 (1) ◽  
pp. 18-21 ◽  
Author(s):  
Paula Cristina Cola ◽  
Ana Rita Gatto ◽  
Roberta Gonçalves da Silva ◽  
André Augusto Spadotto ◽  
Arthur Oscar Schelp ◽  
...  
Keyword(s):  
Transit Time ◽  
Oropharyngeal Dysphagia ◽  
Cold Temperature ◽  
Bolus Transit ◽  
Sour Taste ◽  
Positive Effects ◽  
Transit Times ◽  
Cold Food ◽  
Pharyngeal Transit ◽  
Dysphagic Patients

CONTEXT: The effect of sour taste and food temperature variations in dysphagic patients has not been entirely clarified. OBJECTIVE: To determine the effect of sour and cold food in the pharyngeal transit times of patients with stroke. METHODS: Patients participating in this study were 30 right-handed adults, 16 of which were male and 14 were female, aged 41 to 88 (average age 62.3 years) with ictus varying from 1 to 30 days (median of 6 days). To analyze the pharyngeal transit time a videofluoroscopy swallow test was performed. Each patient was observed during swallow of a 5 mL paste bolus given by spoon, totaling four different stimuli (natural, cold, sour and cold sour), one at a time, room temperature (22ºC) and cold (8ºC) were used. Later, the tests were analyzed using specific software to measure bolus transit time during the pharyngeal phase. RESULTS: The results showed that the pharyngeal transit time was significantly shorter during swallow of cold sour bolus when compared with other stimuli. Conclusion - Sour taste stimuli associated to cold temperature cause significant change in swallowing patterns, by shortening the pharyngeal transit time, which may lead to positive effects in patients with oropharyngeal dysphagia.

Use of Textured Thin Liquids in Patients With Dysphagia

2018 ◽  
Vol 27 (2) ◽  
pp. 827-835 ◽  
Author(s):  
Melissa M. Howard ◽  
Paul M. Nissenson ◽  
Lauren Meeks ◽  
Emily R. Rosario
Keyword(s):  
Patient Satisfaction ◽  
Pilot Study ◽  
Blood Urea Nitrogen ◽  
Retrospective Evaluation ◽  
Thickened Liquids ◽  
Dietary Recommendations ◽  
Normal Range ◽  
Laboratory Values ◽  
Dysphagic Patients ◽  
Thin Liquids

Purpose The goals of this article are to explore the use of textured thin liquids for dysphagic patients who require thickened liquids and to illustrate their impact on hydration and patient satisfaction. Method A retrospective evaluation of textured thin liquids was completed using patient data looking at laboratory values relevant to the detection of dehydration (blood urea nitrogen, creatinine, sodium) and patient satisfaction (using a clinician-generated questionnaire) on different modified liquid textures. In addition, the viscosity for all liquids was tested using a rheometer. Results Measurements show that the viscosity of the textured thin liquids examined in this pilot study are significantly lower than the viscosity of nectar-thick liquids and fall within the “thin” category as defined by the National Dysphagia Diet guidelines. Patients on honey- and nectar-thick liquids had laboratory values signifying dehydration, whereas those receiving the textured thin liquid consistency were within the normal range for all laboratory values. Importantly, when consuming textured thin liquids, patients reported significant improvement in their satisfaction related to their thirst. Conclusion The results of this pilot study highlight the consequences of common thickened liquid dietary recommendations and of the potentially beneficial clinical application of textured thin liquids for patients with dysphagia as well as the need for future prospective research.

A systematic review and meta-analysis of pneumonia associated with thin liquid vs. thickened liquid intake in patients who aspirate

2016 ◽  
Vol 31 (8) ◽  
pp. 1116-1125 ◽  
Author(s):  
Asako Kaneoka ◽  
Jessica M Pisegna ◽  
Hiroki Saito ◽  
Melody Lo ◽  
Katey Felling ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Publication Date ◽  
Inclusion Criteria ◽  
Thickened Liquids ◽  
Blind Review ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Safety Strategies ◽  
Clinical Register ◽  
Thin Liquids

Objective: To investigate whether drinking thin liquids with safety strategies increases the risk for pneumonia as compared with thickened liquids in patients who have demonstrated aspiration of thin liquids. Data sources: Seven electronic databases, one clinical register, and three conference archives were searched. No language or publication date restrictions were imposed. Reference lists were scanned and authors and experts in the field were contacted. Review methods: A blind review was performed by two reviewers for published or unpublished randomized controlled trials and prospective non-randomized trials comparing the incidence of pneumonia with intake of thin liquids plus safety strategies vs. thickened liquids in adult patients who aspirated on thin liquids. The data were extracted from included studies. Odds ratios (OR) for pneumonia were calculated from the extracted data. Risk of bias was also assessed with the included published trials. Results: Seven studies out of 2465 studies including 650 patients met the inclusion criteria. All of the seven studies excluded patients with more than one known risk factor for pneumonia. Six studies compared thin water protocols to thickened liquids for pneumonia prevention. A meta-analysis was done on the six studies, showing no significant difference for pneumonia risk (OR = 0.82; 95% CI = 0.05–13.42; p = 0.89). Conclusions: There was no significant difference in the risk of pneumonia in aspirating patients who took thin liquids with safety strategies compared with those who took thickened liquids only. This result, however, is generalizable only for patients with low risk of pneumonia.

scholarly journals Determining the Impact of Thickened Liquids on Swallowing in Patients Undergoing Irradiation for Oropharynx Cancer

2021 ◽  
pp. 019459982110104
Author(s):  
Carly E. A. Barbon ◽  
Douglas B. Chepeha ◽  
Andrew J. Hope ◽  
Melanie Peladeau-Pigeon ◽  
Ashley A. Waito ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Clinical Benefit ◽  
Oropharyngeal Cancer ◽  
Thickened Liquids ◽  
Current Standard ◽  
Oropharynx Cancer ◽  
Post Radiation ◽  
Thin Liquids ◽  
The Impact

The current standard for the treatment of oropharynx cancers is radiation therapy. However, patients are frequently left with dysphagia characterized by penetration-aspiration (impaired safety) and residue (impaired efficiency). Although thickened liquids are commonly used to manage dysphagia, we lack evidence to guide the modification of liquids for clinical benefit in the head and neck cancer population. The objective of this study was to assess the impact of slightly and mildly thick liquids on penetration-aspiration and residue in 12 patients with oropharyngeal cancer who displayed penetration-aspiration on thin liquid within 3 to 6 months after completion of radiotherapy. Significantly fewer instances of penetration-aspiration were seen with slightly and mildly thick liquids as compared with thin ( P < .05). No differences were found across stimuli in the frequency of residue. Patients with oropharyngeal cancers who present with post–radiation therapy dysphagia involving penetration-aspiration on thin liquids may benefit from slightly and mildly thick liquids without risk of worse residue.

scholarly journals The effect of resistant starch on colon function in humans

1990 ◽  
Vol 64 (2) ◽  
pp. 589-595 ◽  
Author(s):  
J. Tomlin ◽  
N. W. Read
Keyword(s):  
Transit Time ◽  
Resistant Starch ◽  
Bacterial Flora ◽  
Random Order ◽  
Observable Effect ◽  
Total Carbohydrate ◽  
Diet Supplements ◽  
Significant Difference ◽  
Dietary Period ◽  
The Difference

Starch that is resistant to human amylases forms during the cooking and subsequent cooling of some foods, and may therefore be a substrate for the bacterial flora of the colon. It is thus possible that resistant starch (RS) will affect colon function in a similar manner to non-starch polysaccharides. To test this theory, a group of eight volunteers took two diet supplements for 1 week each in a random order with a 1 week separation. One supplement comprised mainly 350 g Cornflakes/d and the other 380 g Rice Krispies/d, providing 10.33 and 0.86 g RS/.d respectively. The amounts of amylase-digestible starch, non-starch polysaccharides, total carbohydrate, energy, protein and fat were balanced between the two periods by giving small amounts of Casilan, wheat bran, butter and boiled sweets. The volunteers made faecal collections during day 3 to day 7 of each period. Whole-gut transit time was calculated using the continuous method. Stool consistency and ease of defaecation were assessed by the volunteers. All episodes of flatulence noticed were recorded in a diary, along with food intake. Serial breath hydrogen measurements were made at 15 min intervals for 8 h on day 1 of each supplement. Questionnaires regarding colon function were completed at the end of each dietary period. There were no significant differences in the stool mass, frequency or consistency, ease of defaecations, transit time or flatulence experienced during the two supplements (P > 0.05). Significantly more H2 (area under curve) was produced while eating Cornflakes than Rice Krispies (P < 0.05). The difference of 9.47 g RS/d between the two diets was over three times the calculated normal daily RS intake of 2.76 g/d. As the only significant difference observed was in the breath H2 excretion on day 1, we suggest that either RS is rapidly and completely fermented to end-products including H2 gas, which is subsequently excreted via the lungs and has little influence on colon function, or that bacterial adaptation removed any observable effect on faecal mass and transit time by day 3.

scholarly journals SWALLOWING IN PATIENTS WITH LARYNGITIS

2018 ◽  
Vol 55 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Isabela MODA ◽  
Hilton Marcos Alves RICZ ◽  
Lilian Neto AGUIAR-RICZ ◽  
Roberto Oliveira DANTAS
Keyword(s):  
Transit Time ◽  
Random Sequence ◽  
Acid Reflux ◽  
Bolus Transit ◽  
Normal Volunteers ◽  
Esophageal Ph ◽  
Solid Bolus ◽  
Oral Preparation ◽  
Pharyngeal Transit ◽  
Liquid Bolus

ABSTRACT BACKGROUND: Dysphagia is described as a complaint in 32% of patients with laryngitis. OBJECTIVE: The objective of this investigation was to evaluate oral and pharyngeal transit of patients with laryngitis, with the hypothesis that alteration in oral-pharyngeal bolus transit may be involved with dysphagia. METHODS: Videofluoroscopic evaluation of the swallowing of liquid, paste and solid boluses was performed in 21 patients with laryngitis, 10 of them with dysphagia, and 21 normal volunteers of the same age and sex. Two swallows of 5 mL liquid bolus, two swallows of 5 mL paste bolus and two swallows of a solid bolus were evaluated in a random sequence. The liquid bolus was 100% liquid barium sulfate and the paste bolus was prepared with 50 mL of liquid barium and 4 g of food thickener (starch and maltodextrin). The solid bolus was a soft 2.2 g cookie coated with liquid barium. Durations of oral preparation, oral transit, pharyngeal transit, pharyngeal clearance, upper esophageal sphincter opening, hyoid movement and oral-pharyngeal transit were measured. All patients performed 24-hour distal esophageal pH evaluation previous to videofluoroscopy. RESULTS: The evaluation of 24-hour distal esophageal pH showed abnormal gastroesophageal acid reflux in 10 patients. Patients showed longer oral preparation for paste bolus and a faster oral transit time for solid bolus than normal volunteers. Patients with laryngitis and dysphagia had longer preparation for paste and solid boluses, and a faster oral transit time with liquid, paste and solid boluses. CONCLUSION: A longer oral preparation for paste and solid boluses and a faster transit through the mouth are associated with dysphagia in patients with laryngitis.

Abstract 37: Increased Mean Transit Time and Blood Brain Permeability in Asymptomatic White Matter Lesions of Ischemic Origin

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Blake Dewey ◽  
Xiang Xu ◽  
Linda Knutson ◽  
Amod Jog ◽  
Jerry Prince ◽  
...  
Keyword(s):  
White Matter ◽  
Transit Time ◽  
Gray Matter ◽  
Mean Transit Time ◽  
White Matter Lesions ◽  
Lesion Volume ◽  
Dynamic Susceptibility ◽  
Automated Segmentation ◽  
Blood Brain ◽  
Significant Difference

Introduction: White matter lesions of presumed ischemic origin (WMH) have been associated with increased risk of stroke, cognitive and motor decline, and are a subject of public health research. Engineering new MRI pipelines allowing for determination of mean transit time (MTT), and blood brain barrier permeability (BBBP), within WMH lesions is required for long-term population-based studies of lesion progression in patients with dementia and vascular cognitive impairment. Methods: WMH lesion volumes in 24 asymptomatic individuals was determined using an automated segmentation methodology, S3DL, with manual correction to remove false positives. A double contrast injection scheme was used to measure both K trans using dynamic contrast enhanced (DCE) imaging and K 2 using dynamic susceptibility contrast (DSC) imaging which also provided perfusion-related measures. BBBP was measured as k 2 within segmented WMH lesions and compared with normal white and gray matter. Results: The mean transit time (MTT) was found to be significantly prolonged (8.11, p<0.001Wilcoxon Signed-Rank Test) in WMH lesions when compared to normal appearing white and gray matter. There was no significant difference in DCE-K trans (0.018, p=0.351) between the lesions and the white/gray matter. Permeability measured in the WMH lesions using the DSC-K 2 method was increased and was correlated withincreasing total WMH lesion volume (spearman correlation 0.44; p< 0.046). Conclusion: In this first study using an advanced WMH lesion automated segmentation pipeline, we measured DCE and DSC perfusion and permeability variables within WMH lesions and compared them to normal white and grey matter in healthy people. We observed increasing MTT, within WMH lesions as compared to unaffected white and gray matter. Using the DSC-K 2 method, BBBP was higher within WMH lesions in these asymptomatic people, and correlated with increasing total lesion volume.

Intraoperative flow profiles of arterial and venous bypass grafts to the left coronary territory

2019 ◽  
Vol 56 (1) ◽  
pp. 64-71 ◽  
Author(s):  
Sanaz Amin ◽  
Per Lav Madsen ◽  
Raphael S Werner ◽  
George Krasopoulos ◽  
David P Taggart
Keyword(s):  
Transit Time ◽  
Pulsatility Index ◽  
Artery Bypass ◽  
Diastolic Filling ◽  
Arterial Grafts ◽  
Venous Grafts ◽  
Flow Profiles ◽  
Significant Difference ◽  
Coronary Territory ◽  
Transit Time Flowmetry

Abstract OBJECTIVES The different mechanical and vasodilatory properties of arteries and veins may influence their flow profiles when used for coronary artery bypass grafting (CABG). This may be of significance when assessing the cut-off values for adequate flow. However, conduit-related flow differences are less examined. METHODS In a study of 268 patients, transit time flowmetry parameters of 336 arterial and 170 venous conduits all grafted to the left coronary territory were compared. With transit time flowmetry, the mean graft flow (MGF), pulsatility index, percentage of diastolic filling and percentage of backwards flow were measured. Conduit-related differences were further compared according to on- or off-pump CABG (ONCABG versus OPCABG) surgery. RESULTS Overall MGF and pulsatility index were comparable between arterial and venous grafts, but in arterial grafts, MGF was higher during ONCABG than during OPCABG (49.1 ± 35.3 ml/min vs 38.8 ± 26.6 ml/min; P = 0.003). Percentage of diastolic filling was higher in arterial grafts than in venous grafts (overall 71.0 ± 7.9% vs 63.7 ± 11.1%; ONCABG 69.9 ± 7.1% vs 63.9 ± 10.4%; OPCABG 71.9 ± 8.3% vs 63.4 ± 12.2%; all P < 0.001). Furthermore, percentage of backwards flow was higher in arterial grafts than in venous grafts in the overall (2.3 ± 3.2% vs 1.7 ± 3.2%, P = 0.002) and in the ONCABG (2.3 ± 3.2% vs 1.3 ± 2.5%, P < 0.001) cohorts. In venous grafts, percentage of backwards flow was lower during ONCABG versus OPCABG (1.3 ± 2.5% vs 2.6 ± 3.9%, P = 0.016). CONCLUSIONS No statistically significant difference was observed for MGF and pulsatility index between arterial and venous conduits. However, arterial grafts have significantly higher diastolic filling and backwards flow than venous grafts. Furthermore, arterial grafts have a significantly higher MGF in ONCABG versus OPCABG.

scholarly journals Effect of Anodal-tDCS on Event-Related Potentials: A Controlled Study

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Ahmed Izzidien ◽  
Sriharasha Ramaraju ◽  
Mohammed Ali Roula ◽  
Peter W. McCarthy
Keyword(s):  
Parietal Lobe ◽  
Event Related Potentials ◽  
Controlled Study ◽  
Oddball Paradigm ◽  
Anodal Tdcs ◽  
Neurologically Impaired ◽  
Double Blind ◽  
Significant Difference ◽  
Related Potentials ◽  
The Difference

We aim to measure the postintervention effects of A-tDCS (anodal-tDCS) on brain potentials commonly used in BCI applications, namely, Event-Related Desynchronization (ERD), Event-Related Synchronization (ERS), and P300. Ten subjects were given sham and 1.5 mA A-tDCS for 15 minutes on two separate experiments in a double-blind, randomized order. Postintervention EEG was recorded while subjects were asked to perform a spelling task based on the “oddball paradigm” while P300 power was measured. Additionally, ERD and ERS were measured while subjects performed mental motor imagery tasks. ANOVA results showed that the absolute P300 power exhibited a statistically significant difference between sham and A-tDCS when measured over channel Pz (p=0.0002). However, the difference in ERD and ERS power was found to be statistically insignificant, in controversion of the the mainstay of the litrature on the subject. The outcomes confirm the possible postintervention effect of tDCS on the P300 response. Heightening P300 response using A-tDCS may help improve the accuracy of P300 spellers for neurologically impaired subjects. Additionally, it may help the development of neurorehabilitation methods targeting the parietal lobe.

Influence of aging on oral-pharyngeal bolus transit and clearance during swallowing: scintigraphic study

1994 ◽  
Vol 266 (6) ◽  
pp. G972-G977 ◽  
Author(s):  
I. J. Cook ◽  
M. D. Weltman ◽  
K. Wallace ◽  
D. W. Shaw ◽  
E. McKay ◽  
...  
Keyword(s):  
Transit Time ◽  
Exposure Time ◽  
Normal Aging ◽  
Clearance Time ◽  
Time Activity ◽  
Bolus Transit ◽  
Transit Times ◽  
Scintigraphic Study ◽  
Pharyngeal Transit ◽  
Pharyngeal Clearance

The aim of the study was to determine the influence of normal aging on regional transit and the efficiency of bolus clearance during the oral and pharyngeal phases of swallowing. We compared scintigraphically derived oral-pharyngeal transit times and isotope clearance during swallowing in 21 healthy aged volunteers (mean age 68 +/- 8 yr) and 9 young controls (mean age 28 +/- 7.5 yr). Subjects swallowed 5- and 10-ml water boluses mixed with 30 MBq 99mtechnetium tin colloid. Oral and pharyngeal transit times, pharyngeal clearance time, and postswallow residual counts in each region were derived from time-activity curves. Pharyngeal residual counts were significantly greater in the aged than in controls (P = 0.0008), but age did not influence oral residual. Aging significantly prolonged oral transit time (P = 0.02), pharyngeal transit time (P = 0.0004), and pharyngeal clearance time (P = 0.0001). We conclude that normal impairs the efficiency of pharyngeal clearance during swallowing, prolongs scintigraphic measures of oral-pharyngeal transit, and increases the exposure time of the glottis to the swallowed bolus.

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