scholarly journals Longitudinal Changes of Tongue Thickness and Tongue Pressure in Neuromuscular Disorders

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
George Umemoto ◽  
Shinsuke Fujioka ◽  
Hajime Arahata ◽  
Nobutaka Sakae ◽  
Naokazu Sasagasako ◽  
...  
Keyword(s):  
Neuromuscular Disorders ◽  
The Other ◽  
Tongue Pressure ◽  
Swallowing Function ◽  
Longitudinal Changes ◽  
Swallowing Dysfunction ◽  
The Relationship ◽  
Lateral Sclerosis

Abstract Background Swallowing dysfunction is related to major cause of adverse events and an indicator of shorter survival among patients with neuromuscular disorders (NMD). It is critical to assess the swallowing function during disease progression, however, there are limited tools that can easily evaluate swallowing function without using videofluoroscopic or videoendoscopic examination. Here, we evaluated the longitudinal changes in tongue thickness (TT) and maximum tongue pressure (MTP) among patients with amyotrophic lateral sclerosis (ALS), myotonic dystrophy type 1 (DM1), and Duchenne muscular dystrophy (DMD). Methods Between 2010 and 2020, TT and MTP were measured from 21 ALS, 30 DM1, and 14 DMD patients (mean ages of 66.9, 44.5, and 21.4 years, respectively) at intervals of more than half a year. TT was measured, by ultrasonography, as the distance from the mylohyoid muscle raphe to the tongue dorsum, and MTP was determined by measuring the maximum compression on a small balloon when pressing the tongue against the palate. Then we examined the relationship between these evaluations and patient background and swallowing function. Results Mean follow-up periods were 24.0 months in the ALS group, 47.2 months in the DM1group, and 61.1 months in the DMD group. The DMD group demonstrated larger first TT than the other groups, while the DM1 group had lower first MTP than the ALS group. The ALS group showed a greater average monthly reduction in mean TT than the DM1 group and greater monthly reductions in mean body weight (BW) and MTP than the other groups. Significant differences between the first and last BW, TT, and MTP measures were found only in the ALS group. Conclusions This study suggests that ALS is associated with more rapid degeneration of tongue function over several years compared to DMD and DM1.

scholarly journals Longitudinal Changes of Tongue Thickness and Tongue Pressure in Neuromuscular Disorders

2020 ◽  
Author(s):  
George Umemoto ◽  
Shinsuke Fujioka ◽  
Hajime Arahata ◽  
Nobutaka Sakae ◽  
Naokazu Sasagasako ◽  
...  
Keyword(s):  
Neuromuscular Disorders ◽  
The Other ◽  
Tongue Pressure ◽  
Swallowing Function ◽  
Longitudinal Changes ◽  
Swallowing Dysfunction ◽  
The Relationship ◽  
Lateral Sclerosis

Abstract Background: Swallowing dysfunction is related to major cause of adverse events and an indicator of shorter survival among patients with neuromuscular disorders (NMD). It is critical to assess the swallowing function during disease progression, however, there are limited tools that can easily evaluate swallowing function without using videofluoroscopic or videoendoscopic examination. Here, we evaluated the longitudinal changes in tongue thickness (TT) and maximum tongue pressure (MTP) among patients with amyotrophic lateral sclerosis (ALS), myotonic dystrophy type 1 (DM1), and Duchenne muscular dystrophy (DMD).Methods: Between 2010 and 2020, TT and MTP were measured from 21 ALS, 30 DM1, and 14 DMD patients (mean ages of 66.9, 44.5, and 21.4 years, respectively) at intervals of more than half a year. TT was measured, by ultrasonography, as the distance from the mylohyoid muscle raphe to the tongue dorsum, and MTP was determined by measuring the maximum compression on a small balloon when pressing the tongue against the palate. Then we examined the relationship between these evaluations and patient background and swallowing function.Results: Mean follow-up periods were 24.0 months in the ALS group, 47.2 months in the DM1group, and 61.1 months in the group. The DMD group demonstrated larger initial TT than the other groups, while the DM1 group had lower initial MTP than the ALS group. The ALS group showed a greater average monthly reduction in mean TT than the DM1 group and greater monthly reductions in mean BW and MTP than the other groups. Significant differences between the first and last BW, TT, and MTP measures were found only in the ALS group.Conclusions: This study suggests that ALS is associated with more rapid degeneration of tongue function over several years compared to DMD and DM1.

scholarly journals Swallowing function and the incidence of fever in older residents with special care needs: a one-year longitudinal prospective study

2020 ◽  
Author(s):  
Maya Izumi ◽  
Kazuo Sonoki ◽  
Yuko Ohta ◽  
Masayo Fukuhara ◽  
Masaharu Nagata ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Prospective Study ◽  
Proportional Hazards ◽  
The Body ◽  
Tongue Pressure ◽  
Care Needs ◽  
Swallowing Function ◽  
Kaplan Meier ◽  
Swallowing Dysfunction

Abstract Background Infectious diseases including aspiration pneumonia are the most frequent causes of fever, common in older residents of nursing homes. We investigated whether swallowing dysfunction was related to fever in such residents. Methods Older residents aged ≥ 65 years from three nursing homes were included in this prospective study conducted from July 2017 to May 2019. The follow-up period was 13 months. The outcome was fever incidence in relation to swallowing function. Baseline data on the activities of daily living, cognitive function, swallowing function, respiratory function, tongue pressure, and comorbidity conditions were collected. Dates on which the body temperature of participants was more than 37.5 °C during the follow-up period were also recorded. For statistical analysis, swallowing function assessed by the modified water swallow test (MWST) scores were used to divide the participants into three groups; scores ≤ 3, 4, and 5. Results A total of 52 participants [median age, 89.5 (67–104)] were enrolled. Kaplan-Meier analysis showed that the average periods until onset of fever in participants with MWST scores of ≤ 3, 4, and 5 were 8.0 (6.0–11.0), 10.0 (7.0–12.0), and 12.0 (10.0–13.0) months, respectively. Cox’s proportional hazards regression model revealed that participants with an MWST score ≤ 3 were at a higher risk of fever compared to those with an MWST score of 5 (hazards ratio 13.0, 95% confidence interval 1.9–87.6), adjusted with possible confounders. Conclusions Swallowing dysfunction correlated with the risk of fever in older residents of nursing homes.

A Decade of Disparities in Diabetes Technology Use and HbA1c in Pediatric Type 1 Diabetes: A Trans-Atlantic Comparison

2020 ◽  
Author(s):  
Ananta Addala ◽  
Marie Auzanneau ◽  
Kellee Miller ◽  
Werner Maier ◽  
Nicole Foster ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Technology Use ◽  
Hemoglobin A1c ◽  
Diabetes Technology ◽  
Design And Methods ◽  
Relationship Of ◽  
The Relationship ◽  
Pediatric Type 1 Diabetes

<b>Objective:</b> As diabetes technology use in youth increases worldwide, inequalities in access may exacerbate disparities in hemoglobin A1c (HbA1c). We hypothesized an increasing gap in diabetes technology use by socioeconomic status (SES) would be associated with increased HbA1c disparities. <p> </p> <p><b>Research Design and Methods: </b>Participants aged <18 years with diabetes duration ≥1 year in the Type 1 Diabetes Exchange (T1DX, US, n=16,457) and Diabetes Prospective Follow-up (DPV, Germany, n=39,836) registries were categorized into lowest (Q1) to highest (Q5) SES quintiles. Multiple regression analyses compared the relationship of SES quintiles with diabetes technology use and HbA1c from 2010-2012 and 2016-2018. </p> <p> </p> <p><b>Results: </b>HbA1c was higher in participants with lower SES (in 2010-2012 & 2016-2018, respectively: 8.0% & 7.8% in Q1 and 7.6% & 7.5% in Q5 for DPV; and 9.0% & 9.3% in Q1 and 7.8% & 8.0% in Q5 for T1DX). For DPV, the association between SES and HbA1c did not change between the two time periods, whereas for T1DX, disparities in HbA1c by SES increased significantly (p<0.001). After adjusting for technology use, results for DPV did not change whereas the increase in T1DX was no longer significant.</p> <p> </p> <p><b>Conclusions: </b>Although causal conclusions cannot be drawn, diabetes technology use is lowest and HbA1c is highest in those of the lowest SES quintile in the T1DX and this difference for HbA1c broadened in the last decade. Associations of SES with technology use and HbA1c were weaker in the DPV registry. </p>

scholarly journals Relationship between Oral Hypofunction and Sarcopenia in Community-Dwelling Older Adults: The Otassha Study

2021 ◽  
Vol 18 (12) ◽  
pp. 6666
Author(s):  
Yoshihiro Kugimiya ◽  
Masanori Iwasaki ◽  
Yuki Ohara ◽  
Keiko Motokawa ◽  
Ayako Edahiro ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Cross Sectional Study ◽  
Albumin Level ◽  
Community Dwelling ◽  
Tongue Pressure ◽  
Swallowing Function ◽  
Cross Sectional ◽  
Community Dwelling Older Adults ◽  
The Relationship

Oral hypofunction, resulting from a combined decrease in multiple oral functions, may affect systemic-condition deterioration; however, few studies have examined the association between oral hypofunction and general health among older adults. In this cross-sectional study, we examined the relationship between oral hypofunction and sarcopenia in community-dwelling older adults. We included 878 adults (268 men and 610 women, mean age 76.5 ± 8.3 years). Tongue coating index, oral moisture, occlusal force, oral diadochokinesis (/pa/,/ta/,/ka/), tongue pressure, mas-ticatory function, and swallowing function were evaluated as indicators of oral hypofunction. Grip strength, gait speed, and skeletal muscle mass index were measured as diagnostic sarcopenia parameters. The association between oral hypofunction and sarcopenia was examined via logistic regression using sarcopenia as the dependent variable. Oral hypofunction prevalence was 50.5% overall, 40.3% in men, and 54.9% in women. The prevalence of sarcopenia was 18.6% overall, 9.7% in men, and 22.5% in women. A logistic regression showed oral hypofunction, age, body mass index, higher-level functional capacity, and serum albumin level were significantly associated with sarcopenia. Sarcopenia occurred at an increased frequency in patients diagnosed with oral hypofunction (odds ratio: 1.59, 95% confidence interval: 1.02–2.47); accordingly, oral hypofunction appears to be significantly associated with sarcopenia.

scholarly journals Dysphagia in Perry Syndrome: Pharyngeal Pressure in Two Cases

2017 ◽  
Vol 9 (2) ◽  
pp. 161-167 ◽  
Author(s):  
George Umemoto ◽  
Yoshio Tsuboi ◽  
Hirokazu Furuya ◽  
Takayasu Mishima ◽  
Shinsuke Fujioka ◽  
...  
Keyword(s):  
Tube Feeding ◽  
Oral Intake ◽  
Normal Diet ◽  
Oral Feeding ◽  
Tongue Pressure ◽  
Normal Range ◽  
Swallowing Function ◽  
Pharyngeal Pressure ◽  
Swallowing Dysfunction ◽  
The Impact

Background: To investigate the impact of dysphagia in Perry syndrome (PS), an autosomal dominant parkinsonism caused by mutation of DCTN1, which is associated with hypoventilation, depression, and weight loss. Case Presentation: We used tongue pressure measurements and manofluorography to investigate swallowing function in 2 patients with PS. Case 1, a 60-year-old male showing parkinsonism, and case 2, a 49-year-old male admitted with pneumonia, were diagnosed as having PS based on the DCTN1 gene analysis. Case 1 showed a pharyngeal retention of the bolus on videofluorography (VF) and a few swallows were required for its passage into the esophagus. However, tongue pressure and manometry were within the normal range. This patient could eat a normal diet under supervision. Case 2 required artificial ventilation and tube feeding on admission. The VF image showed a slow transfer of the bolus, delayed swallow reflex, and pharyngeal retention of the bolus that required several swallows for its passage into the esophagus. The tongue pressure was within the normal range, but manometry showed a significant decrease in pressure at the hypopharynx and upper esophageal sphincter. The oral intake of the patients was limited to 2 cups of jelly per day. Conclusions: The investigation of swallowing dysfunction of 2 cases of PS showed that maintaining pharyngeal pressure within the normal range was very important for oral feeding success and prognosis.

Research meets practice

2016 ◽  
Vol 51 (3) ◽  
pp. 236-251 ◽  
Author(s):  
ZhaoHong Han
Keyword(s):  
Second Language ◽  
Second Language Acquisition ◽  
Language Acquisition ◽  
The Other ◽  
Research And Teaching ◽  
Research Findings ◽  
Instruction And Learning ◽  
The Relationship

At the recent CLTA-S2 conference, a spirited debate occurred between critics of second language acquisition (SLA) research and researchers who embraced it. Fascinating as it was, neither camp appeared to have convinced the other, but, more important, the debate left much of the audience flummoxed. In this paper, I intend to provide a follow-up, attempting to clarify a) the relationship between research and teaching in the context of Chinese as a second language (CSL), b) misunderstandings on the part of critics over research findings, and c) potential pitfalls in interpreting the SLA literature. My goal is to encourage, as well as contribute to, further communication between the two camps, for the ultimate good of CSL instruction and learning.

Comparing the Arrangements of Governance and Sustainable Development in OECD Countries: Coupled or Decoupled?

2019 ◽  
Vol 34 (1) ◽  
pp. 99-117
Author(s):  
Huh Taewook
Keyword(s):  
Sustainable Development ◽  
Oecd Countries ◽  
The Other ◽  
Type Analysis ◽  
Ideal Types ◽  
Type 3 ◽  
Relationship Of ◽  
The Relationship

This study attempts to analyze to what extent governance and sustainable development (SD) empirically appear compatible in the thirtyfive OECD countries through the fuzzy-set ideal type analysis, and identify which ideal types appear coupled or decoupled, and then reveal which countries belong to the coupled types or to the decoupled types. In short, twenty-two countries (including Sweden (fuzzy score, 0.953), Denmark (0.920), Finland (0.914), Norway (0.911) in Type 1 (G*S, ‘strong G-S coupled countries’); and Turkey (0.906), Greece (0.833), Mexico (0.828) in Type 4 (g*s, ‘lite g-s coupled countries’) are in line with the accepted conventions regarding the compatible relationship between governance and SD. On the other hand, the rest of thirteen countries (including USA (fuzzy score, 0.815), Luxembourg (0.721), Australia (0.660) in Type 2 (G*s, ‘G-s decoupled countries’); and Slovenia (0.728), France (0.644), Czech Rep. (0.625) in Type 3 (g*S, ‘g-S decoupled countries’) may indicate that the relationship of governance and SD is in fact experiencing tensions in the national contexts. These findings are characterized by the substance (of SD) and procedure (of governance) divide. Considering the results, this study focuses on the idea of reflexivity or reflexive capacity.

scholarly journals Traumatic Transient Herniation Concomitant with Tonsillar Hemorrhagic Contusion in a Child

2017 ◽  
Vol 5 (6) ◽  
pp. 771-773 ◽  
Author(s):  
Ahmet Öğrenci ◽  
Orkun Koban ◽  
Murat Ekşi ◽  
Onur Yaman ◽  
Sedat Dalbayrak
Keyword(s):  
Foramen Magnum ◽  
Type I ◽  
Tonsillar Ectopia ◽  
Chiari Type ◽  
Chiari Type I Malformation ◽  
Pediatric Age Group ◽  
Downward Displacement ◽  
The Relationship

Downward displacement of cerebellar tonsils more than 5 mm below the foramen magnum is named as Chiari type I malformation and named benign tonsillar ectopia if herniation is less than 3 mm. It does not just depend on congenital causes. There are also some reasons for acquired Chiari Type 1 and benign tonsillar ectopia/herniation. Trauma is one of them. Trauma may increase tonsillar ectopia or may be the cause of new-onset Chiari type 1. The relationship between the tonsil contusion and its position is unclear. We present a case of pediatric age group with tonsillar herniation with a hemorrhagic contusion. Only 1 case has been presented so far in the literature. A case with unilateral tonsil contusion has not been presented to date. We will discuss the possible reasons for taking the place of the tonsils to the above level of the foramen magnum in the follow-up period, by looking at the literature.

Functional Results after the Larynx Preserving Treatment of Laryngeal Cancer; suggestions for the follow-up

2019 ◽  
Vol 73 (3) ◽  
pp. 1-5
Author(s):  
Katarína Vlčková ◽  
Miroslav Tedla
Keyword(s):  
Laryngeal Cancer ◽  
Late Phase ◽  
Voice Quality ◽  
Functional Results ◽  
Post Treatment ◽  
Glottic Carcinoma ◽  
Swallowing Function ◽  
Key Words Laryngeal Cancer ◽  
Swallowing Dysfunction

Introduction: Laryngeal cancer and its treatment are associated with both short and long-term side effects, affecting laryngeal functions and having an impact on the quality of life. Material and methods: Retrospective analysis of the medical records of patients receiving surgical or non-surgical, larynx preserving treatment for laryngeal cancer. Results: After termination of the treatment, the highest proportion of patients with bad voice quality was in the glottic carcinoma group (both in early and late phase), with swallowing dysfunction in the transglottic carcinoma group. Compared to the situation before the treatment, the proportion of patients with impaired voice quality (bad voice quality and loss of voice) initially decreased among all groups (except for supraglottic carcinomas), and during the first post-treatment year either increased or hasn’t changed. The proportion of patients with no swallowing dysfunction increased in the supraglottic, subglottic and transglottic carcinoma groups. Discussion: We consider necessary the implementation of a standard pre- and post-treatment monitoring of the voice and swallowing function in the management of patients with laryngeal cancer. Key words laryngeal cancer, functional results, dysphonia, dysphagia, post-treatment follow-up

Sign in / Sign up

Export Citation Format

Share Document