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Iranian Journal of Neurology Oct 2018Dysphagia is the most prevalent sign of multiple sclerosis (MS) which can reduce the quality of life and augment mortality in the final stages of MS. We presented a... (Review)
Review
Dysphagia is the most prevalent sign of multiple sclerosis (MS) which can reduce the quality of life and augment mortality in the final stages of MS. We presented a systematic review to estimate the prevalence of dysphagia in general and separately for each evaluation method (subjective and objective), and to analyze the causes of this rampant disease. Cross-sectional and prospective cohort studies were reviewed and scientific proofs were evaluated consistent with the pre-specified levels of certainty. Twenty-two articles entered the meta-analysis phase; the estimation of the general prevalence of dysphagia in MS-affected patients was 43.33% related to all the 22 studies. Moreover, the estimate of the prevalence via the subjective (16 studies) and objective (6 studies) methods were 37.21% and 58.47%, respectively. This study obtained the prevalence rate of dysphagia in patients affected by MS globally, yet there was infinite statistical society and limited methodological quality. Thus, more extensive studies are required for a better understanding of the global epidemiology regarding dysphagia in MS.
PubMed: 31210903
DOI: No ID Found -
Cancer Treatment and Research... 2023Radiation-induced oral mucositis (RIOM) is one of the common toxic reactions from ionizing radiation and normal tissue injuries as a complication of radiation therapy... (Review)
Review
Radiation-induced oral mucositis (RIOM) is one of the common toxic reactions from ionizing radiation and normal tissue injuries as a complication of radiation therapy and chemotherapy. Radiation therapy is an option for the treatment of head and neck cancer (HNC). The use of natural products is an alternative therapy for RIOM. This review aimed to describe the effectiveness of natural-based products (NBPs) in reducing the severity, pain score, incidence, oral lesion size, and other symptoms such as dysphagia, dysarthria, and odynophagia. This systematic review follows the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Pubmed, ScienceDirect, and Ebscohost-CINAHL Plus databases were used for article searches. The inclusion criteria were studies published from 2012 to 2022 with full text available, in English, a study in humans, and a Randomized Clinical Trial (RCT) that evaluate the effect of NBPs therapy in RIOM patients diagnosed with HNC. This study's population was HNC patients who had oral mucositis after receiving radiation or chemical therapy. The NBPs were manuka honey, thyme honey, aloe vera, calendula, zataria multiflora, Plantago major L., and turmeric. Eight of the twelve included articles showed significant effectiveness against RIOM in various parameters, such as a decrease in severity, incidence rate, pain score, oral lesion size, and the other symptoms of oral mucositis such as dysphagia and burning mouth syndrome. This review concludes that NBPs therapy is effective for RIOM in HNC patients.
Topics: Humans; Deglutition Disorders; Head and Neck Neoplasms; Radiation Injuries; Randomized Controlled Trials as Topic; Stomatitis
PubMed: 37209466
DOI: 10.1016/j.ctarc.2023.100720 -
Prevalence of and Risk Factors for Dysphagia in the Community Dwelling Elderly: A Systematic Review.The Journal of Nutrition, Health & Aging 2016This review clarifies current information regarding the prevalence of and risk factors associated with dysphagia (swallowing disorders) in the community dwelling elderly... (Review)
Review
OBJECTIVES
This review clarifies current information regarding the prevalence of and risk factors associated with dysphagia (swallowing disorders) in the community dwelling elderly (CDE). A better understanding of prevalence and characteristics of dysphagia in the CDE will help to determine the scope of this problem. Understanding the scope of dysphagia is a critical first step towards early identification, management, and prevention of dysphagia related morbidities in the CDE.
METHODS
Studies identified from multiple electronic databases (MEDLINE (Pubmed), PsychInfo, Google Scholar, EBSCO, PROQUEST, Web of Science and WorldCat dissertations and theses) evaluating prevalence and risk factors for dysphagia in the CDE were reviewed. Data from all eligible studies were abstracted by the first author and independently reviewed by two raters, using the Newcastle-Ottawa scale (NOS).
RESULTS
15 studies (n = 9947 participants) were eligible for inclusion. Studies included were all observational: 14 cross-sectional and 1 prospective cohort. Significant heterogeneity was observed in methodology among studies of dysphagia in the CDE. The average NOS study quality rating was 4.54 points (SD: 0.9), with a mode of 4 points (range 3-6). Only 6 of the 15 studies were identified as high quality research studies, with a mean of 5.33 points (SD: 0.47). Among reviewed studies, the prevalence of swallowing difficulty in the CDE ranged from 5% to 72%. However, the average prevalence of dysphagia estimated from the 6 high quality studies was 15%. Reported risk factors associated with dysphagia include advancing age; history of clinical disease; and physical frailty, including reduced ability to carry out activities of daily living.
CONCLUSION
Research on dysphagia in CDE is modest and consists mostly of observational studies with diverse methodology. However, prevalence rate of 15% from the high quality research suggests a significant public health impact of this impairment. Identification of specific risk factors that cause dysphagia in the CDE is premature, given the rigor of published studies. Future research efforts should focus on developing a valid definition and assessment of dysphagia in this population before clarifying causative risk factors.
Topics: Aged; Aging; Cohort Studies; Cross-Sectional Studies; Deglutition Disorders; Humans; Prevalence; Prospective Studies; Risk Factors
PubMed: 27709229
DOI: 10.1007/s12603-016-0712-3 -
International Journal of Environmental... Oct 2022The purpose of this review is to investigate the relationship between oral health status and oropharyngeal dysphagia (OD) in older people and to collect a list of oral... (Review)
Review
The purpose of this review is to investigate the relationship between oral health status and oropharyngeal dysphagia (OD) in older people and to collect a list of oral health indicators that can enable carers and health professionals to screen for risk of dysphagia in older people during oral examinations. A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P 2015) guidelines. The analysis methods and inclusion criteria were documented in a protocol published in the Prospective International Register of Systematic Reviews (PROSPERO) under the registration number CRD42020140458. A total of 19 articles published between 2002 and 2020 were retained by the search criteria for the qualitative synthesis. Eighteen studies demonstrated at least one positive association between an oral health component (dental, salivary and/or muscular) and dysphagia. This review highlights that oral health and OD are associated but was not able to determine causality. The lack of scientific evidence could be explained by the observational approach of the majority of the studies and the irrelevant choice of oral health indicators. A relationship may exist between oral health and dysphagia, but this review highlights the lack of valid and standardized oral health indicators that would be needed to assess the impact of oral health on the overall health status of individuals.
Topics: Aged; Humans; Deglutition Disorders; Meta-Analysis as Topic; Oral Health; Prospective Studies
PubMed: 36294196
DOI: 10.3390/ijerph192013618 -
Physiology & Behavior Feb 2018Many studies evaluate dysphagia in elderly patients and compare their swallowing to younger controls to assess the degree of swallowing impairment. Previous research... (Review)
Review
Many studies evaluate dysphagia in elderly patients and compare their swallowing to younger controls to assess the degree of swallowing impairment. Previous research suggests that changes should be expected in swallowing due to aging, and these changes need to be considered when performing swallowing assessments. A systematic review was conducted to elucidate the timing of swallowing in healthy. A comprehensive multiengine literature search was conducted to find articles studying swallowing in the healthy elderly, which yielded 22,852 articles of which 11 were judged to be relevant. Only articles using videofluoroscopy as an assessment method for swallowing timing were included. The articles underwent detailed review for study quality and data extraction. The eleven studies contained data for 32 different parameters, and 10 of the 11 studies compared elderly subjects to a younger group. Timing measures from the studies were compiled for analysis. In general, bolus transit times do not appear to change with age. Of note, elderly subjects tended to have a significantly delayed swallow response times and longer duration of upper esophageal sphincter opening. Results showed a large degree of variability across studies for each of the timing measures. Confidence intervals for timing in healthy older participants were computed across studies. Potential sources of variation were identified, including methodological, stimulus-related and participant-related sources. The results suggests that aging affects only a few very specific swallowing timing parameters, and many parameters appear to be unaffected by aging. Therefore, significant differences from a young reference sample should be interpreted as dysphagia rather than normal changes due to aging.
Topics: Age Factors; Aged; Aged, 80 and over; Aging; Deglutition; Humans; Middle Aged; Reaction Time
PubMed: 29101012
DOI: 10.1016/j.physbeh.2017.10.023 -
The Cochrane Database of Systematic... Dec 2022Laparoscopic Heller's cardiomyotomy (LHC) is the preferred treatment of achalasia. It improves dysphagia by dividing muscles of the lower oesophageal sphincter, but this... (Review)
Review
BACKGROUND
Laparoscopic Heller's cardiomyotomy (LHC) is the preferred treatment of achalasia. It improves dysphagia by dividing muscles of the lower oesophageal sphincter, but this intervention can result in debilitating gastro-oesophageal reflux symptoms in some patients. To prevent these reflux symptoms, most surgeons add a fundoplication to Heller's cardiomyotomy, but there is no consensus regarding this or the type of fundoplication which is best suited for the purpose.
OBJECTIVES
To assess how the addition of a fundoplication affects postoperative reflux and dysphagia in people undergoing LHC and compare the different types of fundoplications used in combination with LHC to determine which is better at controlling reflux without worsening the dysphagia.
SEARCH METHODS
We searched three databases (CENTRAL, MEDLINE and Embase) on 31 October 2021 and trial registers to identify all published and unpublished randomised controlled trials (RCTs) in any language, comparing different fundoplications used in combination with LHC to treat achalasia. We also included RCTs where LHC with a fundoplication is compared with LHC without any fundoplication.
SELECTION CRITERIA
We only included RCTs which recruited adult participants with achalasia undergoing LHC with minimal hiatal dissection. We excluded non-randomised studies or studies involving paediatric participants. We also excluded studies where the procedure was done by open surgery and where circumferential hiatal dissection of the oesophagus was carried out, unless it was necessary to reduce a hiatus hernia or to facilitate a Toupet or Nissen fundoplication.
DATA COLLECTION AND ANALYSIS
Two review authors independently identified studies to be included, assessed risk of bias using the Cochrane RoB 1 tool, and extracted the data. We calculated the risk ratio (RR) with 95% confidence interval (CI) using both fixed-effect and random-effect models with Review Manager (RevMan) software.
MAIN RESULTS
We included eight studies in this review, with a total of 571 participants with an average age of 45 years (range 33.5 to 50). LHC without any fundoplication was performed in 65 (11.3%) participants, 298 (52.1%) had Dor fundoplication, 81 (14.1%) had Toupet fundoplication, 72 (12.6%) had Nissen's fundoplication, and 55 (9.6%) participants had angle of His accentuation. Three studies with a total of 143 participants compared LHC + Dor to LHC without fundoplication. We found that the evidence is very uncertain as to whether the addition of a Dor fundoplication made any difference to the outcome of postoperative pathological acid reflux (RR 0.37, 95% CI 0.07 to 1.89; I = 56%; 2 studies, 97 participants; very low-certainty evidence) and uncertain for severe postoperative dysphagia (RR 3.00, 95% CI 0.34 to 26.33; I = 0%; 3 studies, 142 participants; low-certainty evidence). Three studies with 174 participants compared LHC + Dor to LHC + Toupet. The evidence suggests that there may be little to no difference in the outcomes of postoperative pathological acid reflux (RR 0.75, 95% CI 0.23 to 2.43; I = 60%; 3 studies, 105 participants; low-certainty evidence) and severe postoperative dysphagia (RR 0.78, 95% CI 0.19 to 3.15; I = 0%; 3 studies, 123 participants; low-certainty evidence) between the two interventions, but the certainty of the evidence is low. One study with 138 participants compared LHC + Dor to LHC + Nissen. Nissen fundoplication caused increased severe postoperative dysphagia (RR 0.19, 95% CI 0.04 to 0.83; 1 study, 138 participants; high-certainty evidence) when compared to Dor fundoplication. This study did not show a difference in postoperative pathological acid reflux (RR 4.72, 95% CI 0.23 to 96.59; 1 study, 138 participants; low-certainty evidence), but the certainty of evidence is low. One study with 110 participants compared LHC + Dor with LCH + angle of His accentuation, and reported that severe postoperative dysphagia was similar between the two interventions (RR 1.56, 95% CI 0.27 to 8.95; 1 study, 110 participants; moderate-certainty evidence), with moderate certainty of evidence. This study did not report on postoperative pathological acid reflux.
AUTHORS' CONCLUSIONS
When LHC was performed with minimal hiatal dissection, we were very uncertain whether the addition of a Dor fundoplication made a difference in controlling postoperative reflux, and we were uncertain if it increased the risk of severe postoperative dysphagia. There may be little to no difference in the outcomes of postoperative pathological acid reflux or severe dysphagia between Dor and Toupet fundoplications when used in combination with LHC, but the certainty of the evidence is low. Nissen (total) fundoplication used in combination with LHC for achalasia increased the risk of severe postoperative dysphagia. The angle of His accentuation and Dor fundoplication had a similar effect on severe postoperative dysphagia when combined with LHC, but their effect on postoperative pathological acid reflux was not reported.
Topics: Adult; Child; Humans; Middle Aged; Margins of Excision; Heller Myotomy; Esophageal Achalasia
PubMed: 36478353
DOI: 10.1002/14651858.CD013386.pub2 -
Neural Plasticity 2021Dysphagia is a common sequelae after stroke. Noninvasive brain stimulation (NIBS) is a tool that has been used in the rehabilitation process to modify cortical... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dysphagia is a common sequelae after stroke. Noninvasive brain stimulation (NIBS) is a tool that has been used in the rehabilitation process to modify cortical excitability and improve dysphagia.
OBJECTIVE
To systematically evaluate the effect of NIBS on dysphagia after stroke and compare the effects of two different NIBS.
METHODS
Randomized controlled trials about the effect of NIBS on dysphagia after stroke were retrieved from databases of PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP, and CBM, from inception to June 2021. The quality of the trials was assessed, and the data were extracted according to the . A statistical analysis was carried out using RevMan 5.3 and ADDIS 1.16.8. The effect size was evaluated by using the standardized mean difference (SMD) and a 95% confidence interval (CI).
RESULTS
Ultimately, 18 studies involving 738 patients were included. Meta-analysis showed that NIBS could improve the dysphagia outcome and severity scale (DOSS) score (standard mean difference (SMD) = 1.44, 95% CI 0.80 to 2.08, < 0.05) and the water swallow test score (SMD = 6.23, 95% CI 5.44 to 7.03, < 0.05). NIBS could reduce the standardized swallowing assessment (SSA) score (SMD = -1.04, 95% CI -1.50 to -0.58, < 0.05), the penetration-aspiration scale (PAS) score (SMD = -0.85, 95% CI -1.33 to -0.36, < 0.05), and the functional dysphagia scale score (SMD = -1.05, 95% CI -1.48 to -0.62, < 0.05). Network meta-analysis showed that the best probabilistic ranking of the effects of two different NIBS on the DOSS score is rTMS ( = 0.52) > tDCS ( = 0.48), the best probabilistic ranking of the SSA score is rTMS ( = 0.72) > tDCS ( = 0.28), and the best probabilistic ranking of the PAS score is rTMS ( = 0.68) > tDCS ( = 0.32).
CONCLUSION
Existing evidence showed that NIBS could improve swallowing dysfunction and reduce the occurrence of aspiration after stroke, and that rTMS is better than tDCS. Limited by the number of included studies, more large-sample, multicenter, double-blind, high-quality clinical randomized controlled trials are still needed in the future to further confirm the results of this research.
Topics: Deglutition Disorders; Humans; Network Meta-Analysis; Randomized Controlled Trials as Topic; Stroke; Transcranial Direct Current Stimulation
PubMed: 34777497
DOI: 10.1155/2021/3831472 -
Clinical Nutrition ESPEN Dec 2023Malnutrition is a common problem among patients with head and neck cancer and can have adverse effects on overall health and treatment outcomes. Nutritional and physical...
BACKGROUND/SCOPE
Malnutrition is a common problem among patients with head and neck cancer and can have adverse effects on overall health and treatment outcomes. Nutritional and physical prehabilitation are potential strategies to optimize the nutritional status of these patients. This systematic review aimed to identify and describe prehabilitative interventions that can promote an improvement in nutritional status.
METHODS
A systematic review of the literature was conducted in the databases PubMed/Medline, Embase, CINAHL, Scopus and on the platform Web of Science and in Cochrane Library. The selected studies concern adults with head and neck tumours, not malnourished at the time of diagnosis, who undergo nutritional or physical prehabilitation.
RESULTS
Out of 1369 results, 7 studies were included. Multimodal prehabilitation interventions that combine nutritional counseling, oral nutritional supplements, and swallowing exercises to prevent dysphagia have shown positive outcomes in maintaining caloric intake, body weight, swallowing ability, and a reduced incidence of fibrosis in the upper gastrointestinal tract, as well as improving quality of life.
CONCLUSION
Despite the limited number of clinical studies available in the literature, the results suggest that nutritional and physical prehabilitation interventions have a positive effect on the nutritional status and clinical outcomes of patients with head and neck cancer, helping mitigate the risk of malnutrition and improve general well-being.
Topics: Adult; Humans; Preoperative Exercise; Quality of Life; Nutritional Status; Malnutrition; Head and Neck Neoplasms
PubMed: 38057023
DOI: 10.1016/j.clnesp.2023.10.033 -
Journal of Parkinson's Disease 2023Swallowing impairment, including altered physiology and aspiration, occur across the progression of Parkinson's disease (PD). The phase of respiration during which a... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Swallowing impairment, including altered physiology and aspiration, occur across the progression of Parkinson's disease (PD). The phase of respiration during which a swallow is initiated has been linked to swallowing impairment and aspiration in cohorts with dysphagia following stroke and head and neck cancer treatment, but has been understudied in PD. If similar findings are shown in individuals with PD, the implications for swallowing assessment and treatment are significant.
OBJECTIVE
The aim of this systematic review and meta-analysis of literature was to examine respiratory-swallow coordination measures and potential implications on swallowing physiology in individuals with PD.
METHODS
An extensive search of 7 databases (PubMed, EMBASE, Central, Web of Science, ProQuest Dissertations & Theses, Scopus, and CINAHL) with predetermined search terms was conducted. Inclusion criteria were individuals with PD and the use of objective evaluations of respiratory-swallow coordination.
RESULTS
Of the 13,760 articles identified, 11 met the inclusion criteria. This review supports the presence of atypical respiratory swallow patterning, respiratory pause duration and lung volume at swallow initiation in individuals with PD. The meta-analysis estimated an occurrence of 60% of non-expiration-expiration and 40% of expiration-expiration respiratory phase patterns surrounding swallowing.
CONCLUSION
Although this systematic review supports the occurrence of atypical respiratory-swallow coordination in individuals with PD, the evidence is limited by the variability in the methods of data acquisition, analysis, and reporting. Future research examining the impact of respiratory swallow coordination on swallowing impairment and airway protection using consistent, comparable, and reproducible methods and metrics in individuals with PD is warranted.
Topics: Humans; Parkinson Disease; Deglutition; Deglutition Disorders; Respiration
PubMed: 37393516
DOI: 10.3233/JPD-230057 -
The Cochrane Database of Systematic... Mar 2021This review has been withdrawn because it has been split into the following reviews: 'Pharmaceutical interventions for Barrett's oesophagus' and 'Endoscopic... (Meta-Analysis)
Meta-Analysis
This review has been withdrawn because it has been split into the following reviews: 'Pharmaceutical interventions for Barrett's oesophagus' and 'Endoscopic interventions for Barrett's oesophagus'.
Topics: Adenocarcinoma; Barrett Esophagus; Catheter Ablation; Esophageal Neoplasms; Gastroesophageal Reflux; Humans; Laser Coagulation; Photochemotherapy; Precancerous Conditions; Randomized Controlled Trials as Topic
PubMed: 33661543
DOI: 10.1002/14651858.CD004060.pub3