检索结果-重庆医科大学图书馆

The surgical management of motility disorders

Dysphagia 1993年第2期8卷 135-145页

作者： Feussner, H. Kauer, W. Siewert, J.R. Chirurgische Klinik und Poliklinik Technischen Universität München München 80 8000 Ismaninger Straße 22 Germany

Surgical treatment is either the therapy of choice or a facultative procedure in various types of esophageal motility disorders. In achalasia, cardiomyotomy, frequently combined with fundoplasty, achieves good or excellent results in >80% of cases, and is, therefore, advised in cases when pneumostatic dilatation fails. Diverticulectomy and myotomy of the upper or lower esophageal sphincter are proven procedures to treat cervical and epiphrenic diverticula, leading to good/excellent results or at least an improvement in more than 95%. If, exceptionally, parabronchial diverticula require therapy, they should be excised transthoracically. Cervical myotomy is indicated in cases of cervical achalasia, when sufficient pharyngeal propulsion is preserved. In systemic diseases like scleroderma reflux induced complications may require surgical intervention in medically intractable cases. In these rather few cases, subtotal gastrectomy with a Roux-en-Y anastomosis is advised. In patients suffering from diffuse esophageal spasm or symptomatic "nutcracker" esophagus, extended esophageal myotomy can relieve symptoms. If a clear diagnosis is provided, about 75% of patients will have an improvement of symptoms. © 1993 Springer-Verlag New York Inc.

关键词： deglutition deglutition disorders Esophageal motility Surgical therapy

来源：

springerlink期刊评论

在线全文

springerlink期刊

学校读者我要写书评

暂无评论

Usefulness of Prophylactic Percutaneous Gastrostomy Placement in Patients with Head and Neck Cancer Treated with Chemoradiotherapy

引用

DYSPHAGIA 2016年第1期31卷 84-89页

作者： Moleiro, Joana Faias, Sandra Fidalgo, Catarina Serrano, Miguel Dias Pereira, A. Inst Portugues Oncol Lisboa Dept Gastroenterol Rua Prof Lima Basto P-1099023 Lisbon Portugal

Chemoradiotherapy (CRT) has evolved as the preferred organ preservation strategy in the treatment of locally advanced head and neck cancer (HNC). This approach increases malnutrition, and thus, establishing a direct enteral feeding route is essential. To evaluate the usefulness of prophylactic percutaneous endoscopic gastrostomy (PEG) in HNC patients receiving definitive CRT, we performed a prospective evaluation of HNC patients over a 6-month period. Patients and tumor characteristics, nutritional status 30 days after PEG insertion and technique complications were evaluated. We also assessed the long-term PEG usage. Forty-seven PEGs were placed and only 2 patients did not use it. The mean time of PEG use was 131 days (4-255) and mean duration of exclusive utilization was 71 days (4-180). On 30th day after procedure, 34/45 (76 %) patients had lost weight, but only 10/45 (22 %) patients had lost more than 10 % of their initial weight. The most frequent complications were minor peristomal infections, which were correlated with protonpump inhibitor use before PEG placement (OR 3.91, 95 % CI 1.01-15.2, and p = 0.049). One year later, 19 % of patients in remission continue needing PEG. Enteric nutritional support is essential during and after CRT in HNC patients. Most patients lost weight even with PEG. One-fifth of patients in remission required long-term PEG utilization.

关键词： Percutaneous endoscopic gastrostomy Enteral nutrition Head and neck cancer Malnutrition Peristomal infection deglutition deglutition disorders

来源：

springerlink期刊 SCIE 评论

在线全文

学校读者我要写书评

暂无评论

Correlation between the severity of critically ill patients and clinical predictors of risk for bronchial aspiration

引用

JORNAL BRASILEIRO DE PNEUMOLOGIA 2016年第2期42卷 114-120页

作者： de Medeiros, Gisele Chagas Sassi, Fernanda Chiarion Zambom, Lucas Santos Furquim de Andrade, Claudia Regina Univ Sao Paulo Fac Med Hosp Clin Div FonoaudiolInst Cent Sao Paulo SP Brazil Univ Sao Paulo Fac Med Dept Fisioterapia Fonoaudiol & Terapia Ocupac Sao Paulo SP Brazil Univ Sao Paulo Fac Med Disciplina Emergencias Clin Sao Paulo SP Brazil

OBJECTIVE:To determine whether the severity of non-neurological critically ill patients correlates with clinical predictors of bronchial aspiration.;METHODS:We evaluated adults undergoing prolonged orotracheal intubation (> 48 h) and bedside swallowing assessment within the first 48 h after extubation. We collected data regarding the risk of bronchial aspiration performed by a speech-language pathologist, whereas data regarding the functional level of swallowing were collected with the American Speech-Language-Hearing Association National Outcome Measurement System (ASHA NOMS) scale and those regarding health status were collected with the Sequential Organ Failure Assessment (SOFA).;RESULTS:The study sample comprised 150 patients. For statistical analyses, the patients were grouped by ASHA NOMS score: ASHA1 (levels 1 and 2), ASHA2 (levels 3 to 5); and ASHA3 (levels 6 and 7). In comparison with the other patients, those in the ASHA3 group were significantly younger, remained intubated for fewer days, and less severe overall clinical health status (SOFA score). The clinical predictors of bronchial aspiration that best characterized the groups were abnormal cervical auscultation findings and cough after swallowing. None of the patients in the ASHA 3 group presented with either of those signs.;CONCLUSIONS:Critically ill patients 55 years of age or older who undergo prolonged orotracheal intubation (≥ 6 days), have a SOFA score ≥ 5, have a Glasgow Coma Scale score ≤ 14, and present with abnormal cervical auscultation findings or cough after swallowing should be prioritized for a full speech pathology assessment.

关键词： Aspiration deglutition deglutition disorders Intensive care units Intratracheal Intubation Pneumonia

来源： SCIE 评论

在线全文

SCIE

学校读者我要写书评

暂无评论

Brief Report: How Do Patients With Newly Diagnosed Systemic Lupus Erythematosus Present? A Multicenter Cohort of Early Systemic Lupus Erythematosus to Inform the Development of New Classification Criteria

引用

ARTHRITIS & RHEUMATOLOGY 2019年第1期71卷 91-98页

作者： Mosca, Marta Costenbader, Karen H. Johnson, Sindhu R. Lorenzoni, Valentina Sebastiani, Gian Domenico Hoyer, Bimba F. Navarra, Sandra Bonfa, Eloisa Ramsey-Goldman, Rosalind Medina-Rosas, Jorge Piga, Matteo Tani, Chiara Tedeschi, Sara K. Doerner, Thomas Aringer, Martin Touma, Zahi Univ Pisa Pisa Italy Brigham & Womens Hosp 75 Francis St Boston MA 02115 USA Harvard Med Sch Boston MA USA Univ Toronto Inst Hlth Policy Management & Evaluat Toronto ON Canada Scuola Super Sant Anna Pisa Italy Azienda Osped San Camillo Forlanini Rome Italy Univ Kiel Kiel Germany Univ Hosp Schleswig Holstein Kiel Germany Univ Santo Tomas Manila Philippines Univ Sao Paulo Hosp Clin HCFMUSP Fac Med Sao Paulo Brazil Northwestern Univ Feinberg Sch Med Chicago IL 60611 USA AOU Univ Clin Cagliari Cagliari Italy Charite Univ Med Berlin Berlin Germany Deutsch Rheuma Forschungszentrum Berlin Germany Univ Med Ctr Dresden Germany Tech Univ Dresden Fac Med Carl Gustav Carus Dresden Germany

Objective Systemic lupus erythematosus (SLE) presents with nonspecific signs and symptoms that are also found in other conditions. This study aimed to evaluate manifestations at disease onset and to compare early SLE manifestations to those of diseases mimicking SLE. Methods Academic lupus centers in Asia, Europe, North America, and South America collected baseline data on patients who were referred to them during the previous 3 years for possible SLE and who had a symptom duration of SLE and those diagnosed as having SLE-mimicking conditions. Diagnostic performance of the 1997 American College of Rheumatology (ACR) SLE classification criteria and the 2012 Systemic Lupus International Collaborating Clinics (SLICC) SLE classification criteria was tested. Results Data were collected on 389 patients with early SLE and 227 patients with SLE-mimicking conditions. Unexplained fever was more common in early SLE than in SLE-mimicking conditions (34.5% versus 13.7%, respectively;P < 0.001). Features less common in early SLE included Raynaud's phenomenon (22.1% versus 48.5%;P < 0.001), sicca symptoms (4.4% versus 34.4%;P < 0.001), dysphagia (0.3% versus 6.2%;P < 0.001), and fatigue (28.3% versus 37.0%;P = 0.024). Anti-double-stranded DNA, anti-beta(2)-glycoprotein I antibodies, positive Coombs' test results, autoimmune hemolytic anemia, hypocomplementemia, and leukopenia were more common in early SLE than in SLE-mimicking conditions. Symptoms detailed in the ACR and SLICC classification criteria were significantly more frequent among those with early SLE. Fewer patients with early SLE were not identified as having early SLE with use of the SLICC criteria compared to the ACR criteria (16.5% versus 33.9%), but the ACR criteria demonstrated higher specificity than the SLICC criteria (91.6% versus 82.4%). Conclusion In this multicenter cohort, clinical manifestations that could help to distinguish early SLE from SLE-mimicking conditions were identified. These findings may aid in

关键词： deglutition disorders DIAGNOSIS AUTOIMMUNE hemolytic anemia RAYNAUD'S disease SYSTEMIC lupus erythematosus diagnosis SJOGREN'S syndrome diagnosis FATIGUE LEUCOPENIA GLYCOPROTEIN analysis AGE factors in disease COOMBS' test DIAGNOSTIC errors DNA LONGITUDINAL method MEDICAL cooperation RESEARCH SYSTEMIC lupus erythematosus SYMPTOMS

来源： SCIE ebsco(ASP/aph) 评论

在线全文

学校读者我要写书评

暂无评论

Fiberoptic endoscopic documentation of the high incidence of aspiration following extubation in critically ill trauma patients

引用

DYSPHAGIA 1998年第4期13卷 208-212页

作者： Leder, SB Cohn, SM Moller, BA Yale Univ Sch Med Otolaryngol Sect Commun Disorders CtrDept Surg New Haven CT 06504 USA Univ Miami Sch Med Dept Surg Div Trauma & Surg Crit Care Miami FL USA Yale Univ Sch Med Dept Surg Sect Trauma & Crit Care New Haven CT 06510 USA

The purpose of this study was to investigate the incidence of aspiration following extubation in critically ill trauma patients. This prospective pilot study included 20 consecutive trauma patients who required orotracheal intubation for at least 48 hours. All subjects underwent a bedside transnasal fiberoptic endoscopic evaluation of swallowing at 24 +/- 2 hr after extubation to determine objectively aspiration status. Aspiration was defined as the entry of a blue dyed material into the airway below the level of the true vocal folds, with silent aspiration occurring in the absence of any external behavioral signs such as coughing or choking. Aspiration was identified in 9 of 20 (45%) subjects and 4 of these 9 (44%;) were silent aspirators. Therefore, silent aspiration occurred in 20% of the study population. Eight of the 9 (89%) aspirating subjects resumed an oral diet from 2-10 days (mean, 5 days) following extubation. All subjects had no evidence of pulmonary complications. It was concluded that trauma patients after orotracheal intubation and prolonged mechanical ventilation have an increased risk of aspiration. An objective assessment of dysphagia to identify aspiration may reduce the likelihood of pulmonary complications after extubation.

关键词： aspiration silent aspiration fiberoptic endoscope trauma orotracheal intubation extubation deglutition deglutition disorders

来源：

springerlink期刊 SCIE 评论

在线全文

学校读者我要写书评

暂无评论

Oropharyngeal Dysphagia Phenotypes Across Huntington's Disease Stages: Endoscopic Findings and Tongue Pressure Analysis

引用

JOURNAL OF HUNTINGTONS DISEASE 2024年第2期13卷 225-235页

作者： Pizzorni, Nicole Ciammola, Andrea Pirola, Chiara Nanetti, Lorenzo Castaldo, Anna Poletti, Barbara Mariotti, Caterina Schindler, Antonio Univ Milan Dept Biomed & Clin Sci ViaGB Grassi 74 I-20154 Milan Italy Ist Auxol Italiano IRCCS Dept Neurol & Lab Neurosci Milan Italy Unit Med Genet & Neurogenet Dept Diagnost & Technol Fdn IRCCS Ist Neurol Carlo Besta Milan Italy Univ Milan Dept Oncol & Hemato Oncol Milan Italy

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.

关键词： Huntington's disease deglutition disorders disease progression tongue

来源：评论

学校读者我要写书评

暂无评论

Palliation of patients with dysphagia due to advanced esophageal cancer by endoscopic injection of cisplatin/epinephrine injectable gel

引用

GASTROINTESTINAL ENDOSCOPY 2002年第5期56卷 644-651页

作者： Harbord, M Dawes, RFH Barr, H Giovannini, M Viens, P Eysselein, V Mishra, L Orenberg, EK Bown, SG UCL Royal Free & Univ Coll Med Sch Natl Med Laser Ctr Inst Surg Studies London W1W 7EJ England Dept Gen Surg Gloucester England Cranfield Univ Gloucestershire Royal Hosp Trust Postgrad Med Sch Gloucester England Inst J Paoli I Calmettes Med Oncol Unit F-13009 Marseille France Harbor UCLA Med Ctr Dept Med Div Gastroenterol Torrance CA 90509 USA Matrix Pharmaceut Inc Profess Serv Dept Fremont CA USA Vet Affairs Med Ctr Dept Med Washington DC 20422 USA

Background: The aim of therapy for advanced esophageal cancer is relief of dysphagia with minimal treatment-related morbidity. This study assessed the efficacy of endoscopic intratumoral injection of cisplatin/epinephrine gel to relieve obstruction and improve swallowing. The gel is designed to minimize diffusion of active drug away from the tumor injection site. Methods: Patients with inoperable esophageal cancer and dysphagia caused by exophytic esophageal tumor underwent up to 6 weekly endoscopic injections of the gel. Response was documented objectively (exophytic tumor volume, lumen size, dysphagia grade) and subjectively (achievement of treatment goal). Results: Twenty-four patients were treated. Primary evaluation criteria for 18 evaluable patients were as follows: dysphagia grade improved in 4 (duration 30 to 45 days) and stabilized in 11;lumen patency improved in 6 (duration 29 to 56 days) and stabilized in 10;exophytic tumor volume decreased in 8 (duration 29 to 114 days). Eight patients felt that their ability to swallow improved. One patient with intramural and exophytic tumor developed a tracheoesophageal fistula, possibly related to treatment. Other complications were tolerable and self-limited. No nephrotoxicty or severe nausea/vomiting typical of systemic administration of cisplatin occurred. Conclusions: Endoscopic injection of cisplatin/epinephrine gel is a straightforward procedure with standard equipment and techniques, which can provide palliation for patients with exophytic malignant tumors of the esophagus. Assessment of this method in conjunction with other therapeutic options such as brachytherapy is warranted.

关键词： Gels deglutition disorders Neoplasms Injections Cisplatin

来源： SCIE

ElsevierScienceDirec... 评论

在线全文

学校读者我要写书评

暂无评论

A Systematic and a Scoping Review on the Psychometrics and Clinical Utility of the Volume-Viscosity Swallow Test (V-VST) in the Clinical Screening and Assessment of Oropharyngeal Dysphagia

引用

FOODS 2021年第8期10卷 1900-1900页

作者： Riera, Stephanie A. Marin, Sergio Serra-Prat, Mateu Tomsen, Noemi Arreola, Viridiana Ortega, Omar Walshe, Margaret Clave, Pere Consorci Sanitari Maresme Hosp Mataro Gastrointestinal Motil Lab Mataro 08304 Catalunya Spain Univ Autonomous Barcelona Dept Surg & Morphol Sci Cerdanyola Del Valles 08193 Catalunya Spain Hosp Badalona Germans Trias & Pujol Dept Pharm Badalona 08916 Catalunya Spain Consorci Sanitari Maresme Hosp Mataro Res Unit Mataro 08304 Catalunya Spain Ctr Invest Biomed Red Enfermedades Hepat & Digest Mataro 08304 Catalunya Spain Trinity Coll Dublin Dept Clin Speech & Language Studies Dublin 8PVW G5 Ireland

(1) Background: The volume-viscosity swallow test (V-VST) is a clinical tool for screening and diagnosis of oropharyngeal dysphagia (OD). Our aims were to examine the clinical utility of the V-VST against videofluoroscopy (VFS) or fiberoptic endoscopic evaluation of swallow (FEES) and to map the V-VST usage with patients at risk of OD across the years since it was described for the first time, carrying a systematic and a scoping review. (2) Methods: We performed both a systematic review (SR) including studies that look at the diagnostic test accuracy, and a scoping review (ScR) with articles published from September 2008 to May 2020. Searches were done in different databases, including PubMed and EMBASE from September 2008 until May 2020, and no language restrictions were applied. A meta-analysis was done in the SR to assess the psychometric properties of the V-VST. Quality of studies was assessed by Dutch Cochrane, QUADAS, GRADE (SR), and STROBE (ScR) criteria. The SR protocol was registered on PROSPERO (registration: CRD42020136252). (3) Results: For the diagnostic accuracy SR: four studies were included. V-VST had a diagnostic sensitivity for OD of 93.17%, 81.39% specificity, and an inter-rater reliability Kappa = 0.77. Likelihood ratios (LHR) for OD were 0.08 (LHR-) and 5.01 (LHR+), and the diagnostic odds ratio for OD was 51.18. Quality of studies in SR was graded as high with low risk of bias. In the ScR: 34 studies were retrieved. They indicated that V-VST has been used internationally to assess OD's prevalence and complications. (4) Conclusions: The V-VST has strong psychometric properties and valid endpoints for OD in different phenotypes of patients. Our results support its utility in the screening and clinical diagnosis and management of OD.

关键词： oropharyngeal dysphagia deglutition disorders volume-viscosity swallow test screening diagnosis sensitivity specificity V-VST systematic review swallowing disorders

来源： SCIE MultidisciplinaryDig...

在线全文

学校读者我要写书评

暂无评论

Oral cancers: supportive care issues

引用

PERIODONTOLOGY 2000 2011年第1期57卷 118-131页

作者： Murphy, Barbara A. Gilbert, Jill

The article focuses on the treatment for oral cancers, its clinical impact and prevention. It says that head and neck cancers can be treated with radiation-based therapy but poses adverse acute and late toxicities including mucositis, dysphagia, and xerostomia leading to a decreased quality of life. It states that radiation-induced salivary gland dysfunction and xerostomia can be prevented using cytoprotective agents and tissue-sparing radiation therapy.

关键词： ORAL cancer -- Treatment HEAD & neck cancer -- Treatment deglutition disorders QUALITY of life SALIVARY glands -- Diseases PREVENTION RADIOTHERAPY

来源： SCIE 评论

在线全文

SCIE

学校读者我要写书评

暂无评论

Validity and Reliability of an Arabic Version of MD Anderson Dysphagia Inventory (MDADI)

引用

DYSPHAGIA 2021年第4期37卷 946-953页

作者： Alsubaie, Hemail M. Sayed, Suhail, I Alsini, Albaraa Y. Alkaff, Haddad H. Margalani, Osama A. Abu-Zaid, Ahmed Abu-Suliman, Omar A. Alherabi, Ameen Z. Alghamdi, Saeed A. Saleh, Essam Alessa, Mohammad A. Abdelmonim, Sherif K. King Abdullah Med City Dept Otolaryngol Head & Neck Surg Mecca Saudi Arabia Alhada Armed Forces Hosp Dept Otolaryngol Head & Neck Surg At Taif Saudi Arabia Umm Al Qura Univ Coll Med Mecca Saudi Arabia King Faisal Specialist Hosp & Res Ctr Dept Otolaryngol Head & Neck Surg Jeddah Saudi Arabia Alfaisal Univ Coll Med Dept Surg Riyadh Saudi Arabia Univ Tennessee Ctr Hlth Sci Coll Grad Hlth Sci Dept Pharmacol Memphis TN 38163 USA Alexandria Univ Fac Med Alexandria Egypt Ain Shams Univ Fac Med Cairo Egypt

Dysphagia is a common adverse event among head and neck (H&N) cancer patients. We aimed, for the first time, to validate the Arabic version of the MD Anderson Dysphagia Inventory (MDADI) among 82 Saudi Arabian patients with H&N cancer. We followed established validation guidelines and translated the 20-item MDADI using the forward-backward method. Our results revealed 100% feasibility. Test-retest reliability demonstrated acceptable interclass correlation coefficients (ICC) for the subscale domains (emotional = 0.973, physical = 0.971, and functional = 0.956) and composite score (ICC = 0.984). The Cronbach's alpha coefficients for the emotional, functional, and physical subscales were 0.937, 0.825, and 0.945, respectively (composite score = 0.975). We confirmed concurrent validity by demonstrating significant correlations between the domains of the Arabic MDADI and European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Head and Neck Module (QLQ-H&N35). Our study validated the Arabic version of the MDADI among H&N cancer patients from Saudi Arabia.

关键词： Dysphagia HRQOL Psychometric validation Quality of life Swallowing deglutition deglutition disorders

来源：

springerlink期刊 SCIE 评论

在线全文

学校读者我要写书评

暂无评论

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

核心刊收录

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

核心刊收录

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

请选择保存的检索档案：

请选择收藏分类：