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Food Research International (Ottawa,... Jul 2024This study investigated the relationship between rheological properties, sensory perception, and overall acceptability in healthy young and old groups for dysphagia...
This study investigated the relationship between rheological properties, sensory perception, and overall acceptability in healthy young and old groups for dysphagia thickened liquids. Unflavored (UTL) and flavored (FTLP) thickened liquids were prepared using tap water or pomegranate juice at 10 different viscosity levels. The rheological properties were then evaluated via syringe flow test and line spread test (LST). When the apparent viscosity levels of UTL and FTLP were similar, the syringe test and LST results were also similar, indicating consistent flow behavior. Sensory perception evaluations showed that the young group better distinguished viscosity differences between stages compared to the old group. Regarding overall acceptability, the old group preferred samples with higher apparent viscosity than the young group. Principal component analysis and k-means cluster analysis were used to explore correlations between variables and classify thickened liquids into four groups. This can serve the foundation for standardized texture grades of dysphagia thickened liquids, considering rheological characteristics and sensory profiles.
Topics: Humans; Rheology; Viscosity; Deglutition Disorders; Young Adult; Female; Male; Adult; Aged; Taste; Taste Perception; Middle Aged; Beverages; Fruit and Vegetable Juices; Principal Component Analysis; Healthy Volunteers
PubMed: 38823884
DOI: 10.1016/j.foodres.2024.114511 -
Journal of Huntington's Disease May 2024Oropharyngeal dysphagia (OD) is a common symptom in Huntington's disease (HD) and is associated with severe health and psychosocial consequences. Different OD phenotypes...
BACKGROUND
Oropharyngeal dysphagia (OD) is a common symptom in Huntington's disease (HD) and is associated with severe health and psychosocial consequences. Different OD phenotypes are defined on the basis of characteristic patterns at fiberoptic endoscopic evaluation of swallowing (FEES), and they may vary during disease progression.
OBJECTIVE
To describe OD phenotypes in different HD stages and to analyze their association with neurological data and tongue pressure measurements.
METHODS
Twenty-four patients with HD at different stages of disease progression underwent a FEES. Data on penetration/aspiration, pharyngeal residue, and OD phenotypes were gained. Neurological examination was performed with the Unified Huntington's Disease Rating Scale (UHDRS). Patient Maximum tongue pressure (MTP) and tongue endurance were measured.
RESULTS
We confirmed that the occurrence of penetration/aspiration increased with disease duration and pharyngeal residue increased from 16.7% to 100% , respectively. The most common OD phenotypes were oropharyngeal dyspraxia (91.7% ), posterior oral incontinence (87.5% ), and delayed pharyngeal phase (87.5% ). These types of dysfunctions are already detectable in >80% of patients in the early disease stages. In more advanced stages, we also observed propulsion deficit (66.7% ), resistive issue (54.2% ), and protective deficit (37.5% ). Propulsion deficit was associated with higher disease stage, greater motor dysfunction (UHDRS-I), and lower MTP and tongue endurance (p < 0.05).
CONCLUSIONS
OD in HD results from a combination of different swallowing phenotypes. Early assessment of swallowing and periodical follow-ups are necessary to monitor OD severity and phenotypes and to revise diet recommendations.
PubMed: 38820019
DOI: 10.3233/JHD-231519 -
International Journal of Biological... Jun 2024κ-Carrageenan (κ-Car) is an important material for preparing food gels and hydrogels. However, κ-Car gel has issues with high hardness and low water-holding capacity....
κ-Carrageenan (κ-Car) is an important material for preparing food gels and hydrogels. However, κ-Car gel has issues with high hardness and low water-holding capacity. Modification strategy of micronization is proposed for the first time to explore its influence on texture properties and gelling process of κ-Car gel, and to investigate the feasibility of κ-Car as a food matrix with low strength. κ-Car undergoing 60 min of micronization, the d decreased by 79.33 %, S and V increased by 89.23 % and 95.27 %. The swelling rate and degree of gelling process increased significantly, and the microstructure changed from loose large pores to dense small pores resembling a "honeycomb". Importantly, the hardness of gel-60, Milk-60 and PNS-60 decreased by 72.52 %, 49.25 % and 81.37 %. In addition, WHC of gel-60, Milk-60 and PNS-60 was improved. IDDSI tests showed that κ-Car gels, milk gels and PNS gels can be categorized as level 6 (soft and bite-sized), except for PNS-60, which belongs to level 5 (crumbly and moist). Furthermore, the texture and bitter masking effect of milk gels and PNS gels were improved. In conclusion, this study demonstrated that micronization can be a novel approach to improve the gel properties of κ-Car, laying the groundwork for developing dysphagia foods.
Topics: Carrageenan; Gels; Deglutition; Milk; Animals; Hardness; Administration, Oral; Hydrogels
PubMed: 38815948
DOI: 10.1016/j.ijbiomac.2024.132708 -
Frontiers in Neurology 2024Dysphagia is a common complication in patients with cervical spinal cord injury (C-SCI) and can cause various pulmonary complications, such as aspiration pneumonia and...
INTRODUCTION
Dysphagia is a common complication in patients with cervical spinal cord injury (C-SCI) and can cause various pulmonary complications, such as aspiration pneumonia and mechanical airway obstruction increasing mortality and morbidity. This study evaluated the clinical factors that predict dysphagia in patients with traumatic and non-traumatic C-SCI.
METHODS
Ninety-eight patients with C-SCI were retrospectively enrolled in this study and were divided into those with and without dysphagia. Clinical factors such as age, sex, tracheostomy, spinal cord independence measure, pulmonary function test (PFT) including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FVC/FEV1, American Spinal Cord Injury Association score, Berg Balance Scale, and surgical approach were investigated retrospectively.
RESULTS
Multivariate logistic regression analysis revealed that FVC and the presence of tracheostomy were significantly correlated with dysphagia in patients with C-SCI ( < 0.05). FVC and the presence of tracheostomy are useful tools for detecting dysphagia in patients with C-SCI.
CONCLUSION
Considering the results of our study, early PFTs, especially FVC, in patients with C-SCI and early initiation of dysphagia management and treatment in patients with C-SCI and tracheostomy will be advantageous in lowering the mortality and morbidity due to pulmonary aspiration in these patients.
PubMed: 38813244
DOI: 10.3389/fneur.2024.1376171 -
Revista Da Escola de Enfermagem Da U S P 2024To understand caregivers' strategies for offering food to older adults with oropharyngeal dysphagia after dehospitalization.
OBJECTIVE
To understand caregivers' strategies for offering food to older adults with oropharyngeal dysphagia after dehospitalization.
METHOD
Qualitative research carried out with caregivers of older adults with oropharyngeal dysphagia, who were discharged after hospitalization at a university hospital in Bahia. Data collection was carried out between January and February 2023 through a semi-structured interview, whose data were organized based on content analysis and analyzed with the help of IRaMuTeQ software.
RESULTS
Three categories emerged: Caregivers' strategies for safely offering food to older adults with dysphagia; Caregiver strategies for oral hygiene for older adults; Recognition of continuity of speech therapy after dehospitalization.
CONCLUSION
Caregivers' strategies for offering food to older adults with oropharyngeal dysphagia were supported by tacit knowledge and effective care in the hospital-home transition.
Topics: Humans; Deglutition Disorders; Caregivers; Female; Male; Aged; Qualitative Research; Middle Aged; Oral Hygiene; Patient Discharge; Interviews as Topic; Speech Therapy; Aged, 80 and over; Hospitals, University; Brazil; Hospitalization
PubMed: 38808907
DOI: 10.1590/1980-220X-REEUSP-2023-0318en -
Sao Paulo Medical Journal = Revista... 2024The cause of oropharyngeal dysphagia in patients with coronavirus disease (COVID-19) can be multifactorial and may underly limitations in swallowing rehabilitation.
BACKGROUND
The cause of oropharyngeal dysphagia in patients with coronavirus disease (COVID-19) can be multifactorial and may underly limitations in swallowing rehabilitation.
OBJECTIVE
Analyze the factors related to dysphagia in patients with COVID-19 immediately after orotracheal extubation and the factors that influence swallowing rehabilitation.
DESIGN AND SETTING
A retrospective study.
METHODS
The presence of dysphagia was evaluated using the American Speech-Language Hearing Association National Outcome Measurement System (ASHA NOMS) scale and variables that influenced swallowing rehabilitation in 140 adult patients who required invasive mechanical ventilation for >48 h.
RESULTS
In total, 46.43% of the patients scored 1 or 2 on the ASHA NOMS (severe dysphagia) and 39.29% scored 4 (single consistency delivered orally) or 5 (exclusive oral diet with adaptations). Both the length of mechanical ventilation and the presence of neurological disorders were associated with lower ASHA NOMS scores (odds ratio [OR]: 0.80, 95% confidence interval [CI]: 0.74-0.87 P < 0.05; and OR: 0.13, 95% CI: 0.61-0.29; P < 0.05, respectively). Age and the presence of tracheostomy were negatively associated with speech rehabilitation (OR: 0.92; 95% CI: 0.87--0.96; OR: 0.24; 95% CI: 0.80--0.75), and acute post-COVID-19 kidney injury requiring dialysis and lower scores on the ASHA NOMS were associated with longer time for speech therapy outcomes (β: 1.62, 95% CI, 0.70-3.17, P < 0.001; β: -1.24, 95% CI: -1.55--0.92; P < 0.001).
CONCLUSION
Prolonged orotracheal intubation and post-COVID-19 neurological alterations increase the probability of dysphagia immediately after extubation. Increased age and tracheostomy limited rehabilitation.
Topics: Humans; COVID-19; Deglutition Disorders; Retrospective Studies; Male; Female; Middle Aged; Intubation, Intratracheal; Aged; Respiration, Artificial; SARS-CoV-2; Airway Extubation; Adult; Pandemics; Coronavirus Infections; Pneumonia, Viral; Betacoronavirus; Risk Factors; Aged, 80 and over
PubMed: 38808794
DOI: 10.1590/1516-3180.2022.0608.R3.14032024 -
Otolaryngologic Clinics of North America Aug 2024Older adults are projected to outnumber children aged under 18 years for the first time in United States history by 2034, according to Census Bureau projections. This... (Review)
Review
Older adults are projected to outnumber children aged under 18 years for the first time in United States history by 2034, according to Census Bureau projections. This will lead to significant increase in age-related disorders. One of the most important disorders that will increase in prevalence is dysphagia, as it leads to malnutrition, dehydration, aspiration pneumonia, and death. In this article, the physiology of dysphagia in the elderly, as well as the management options is discussed.
Topics: Humans; Deglutition Disorders; Aged; United States; Aging; Prevalence; Aged, 80 and over
PubMed: 38806319
DOI: 10.1016/j.otc.2024.03.006 -
Vestnik Otorinolaringologii 2024The article presents a case of pharyngeal dysphagia and obstructive sleep apnea syndrome caused by degenerative-dystrophic changes in the cervical spine with the...
The article presents a case of pharyngeal dysphagia and obstructive sleep apnea syndrome caused by degenerative-dystrophic changes in the cervical spine with the formation of large cervical osteophytes at the C3-C6 level. Osteophytes caused deformation of the posterior wall of the hypopharynx and narrowing of its lumen by 20-25% from the level of the arytenoid cartilages to the upper parts of the epiglottis. CT scan also showed the intervertebral disc heights lost, as well as osteophytes at the posterolateral margins of the vertebral bodies (disc osteophyte complex). Osteosclerosis in combination with facet arthrosis caused spinal and foraminal stenosis.
Topics: Humans; Cervical Vertebrae; Deglutition Disorders; Sleep Apnea, Obstructive; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 38805473
DOI: 10.17116/otorino202489021109 -
BMC Cancer May 2024This study aimed to assess the long-term effect of level IIb clinical target volume (CTV) optimisation on survival, xerostomia, and dysphagia in patients with...
Long-term follow-up of protective effects on salivary and swallowing structures and improvement of late xerostomia and dysphagia by level IIb optimisation in clinical target volume of nasopharyngeal carcinoma.
BACKGROUND
This study aimed to assess the long-term effect of level IIb clinical target volume (CTV) optimisation on survival, xerostomia, and dysphagia in patients with nasopharyngeal carcinoma (NPC).
METHODS
Clinical data of 415 patients with NPC treated with intensity-modulated radiotherapy between December 2014 and October 2018 were retrospectively analysed. The patients were categorised into modified and comparison groups. Late xerostomia and dysphagia were evaluated using Radiation Therapy Oncology Group/European Organisation for Research and Treatment of Cancer scoring. Survival analysis was performed using the Kaplan-Meier method. Differences in late toxicity and dose parameters between both groups were compared. Prognostic factors for survival and late toxicity were assessed using regression analyses.
RESULTS
Patients in the modified group developed late xerostomia and dysphagia less frequently than those in the comparison group did (P < 0.001). The mean dose (D) and V of parotid glands; D and V of submandibular glands; and D of sublingual glands, oral cavity, larynx, and superior, middle, and lower pharyngeal constrictor muscles were lower in the modified group than those in the comparison group (all P < 0.001). Both groups had no significant differences in overall, local recurrence-free, distant metastasis-free, or progression-free survival. The D of the parotid and sublingual glands was a risk factor for xerostomia. The D of the parotid and sublingual glands and middle pharyngeal constrictor muscle was a risk factor for dysphagia.
CONCLUSIONS
Level IIb optimisation in NPC patients who meet certain criteria specially the exclusion of positive retropharyngeal nodes treated with intensity-modulated radiotherapy has the potential to better protect the salivary and swallowing structures, decreasing the development of late radiation-induced xerostomia and dysphagia while maintaining long-term survival.
Topics: Humans; Deglutition Disorders; Male; Xerostomia; Female; Nasopharyngeal Carcinoma; Middle Aged; Radiotherapy, Intensity-Modulated; Retrospective Studies; Follow-Up Studies; Nasopharyngeal Neoplasms; Adult; Aged; Radiation Injuries; Deglutition; Salivary Glands; Radiotherapy Dosage; Prognosis; Young Adult
PubMed: 38802747
DOI: 10.1186/s12885-024-12391-7 -
Dysphagia May 2024This scoping review aimed to identify methodological procedures for acquiring and analyzing ultrasound images related to swallowing in adults and older adults. The... (Review)
Review
This scoping review aimed to identify methodological procedures for acquiring and analyzing ultrasound images related to swallowing in adults and older adults. The inclusion criteria were based on the PCC strategy (participants, concept, and context), as follows: population (adults and older adults), concept (ultrasound assessment), and context (swallowing assessment). The review included observational, experimental, descriptive, and analytical studies and excluded those that were not available in full, animal studies, in vitro studies, letters to the editor, errata, study protocols, and those that used ultrasound for purposes other than swallowing. There were no language and time restrictions. Two independent blinded professionals selected 81 articles that met the inclusion criteria from different databases. The most evaluated parameters included tongue morphology and movements, hyoid bone displacement, swallowing muscle area, and pharyngeal residue detection, such as pharyngeal wall mobility. They used convex and linear transducers (3 MHz to 8 MHz) positioned in the submental, laryngeal, and lateral regions of the neck. The subjects were seated and instructed to eat different food volumes and consistencies. The literature mapping showed that ultrasound is a promising diagnostic tool, helping clinicians understand swallowing disorders, as it provides static and dynamic images in different modes and positions. Also, patients receive real-time biofeedback of changes related to dysphagia.
PubMed: 38802587
DOI: 10.1007/s00455-024-10714-1