New Radioprotective Device that can be Used for Fluoroscopic Exam: Possibility to Contribute to Staff Exposure Protection During VFSS

alwin shared this article with you from Inoreader New Radioprotective Device that can be Used for Fluoroscopic Exam: Possibility to Contribute to Staff Exposure Protection During VFSS Via Dysphagia AbstractThe videofluoroscopic swallowing study (VFSS) is a recognized standard diagnostic imaging technique that is used to investigate swallowing disorders and dysphagia. Patients were assessed in a seated posture on a chair or wheelchair. Using X-ray fluoroscopy, the state of patients ' swallowing was checked by eating and drinking according to the physician's instructions. VFSS procedures are prolonged, and VFSS staff members are exposed to radiation. Therefore, we evaluated original lead shielding device (OLSD) that can be attached to the handrail of a table and placed vertic ally. The OLSD has a lead-equivalent thickness of 0.3 mmPb, weighs about 6 kg, and has the dimensions 50 cm × 50 cm × 8.0 mm. We used a human phantom and a radiation survey meter with and without p... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cervical Vertebral Height Approximates Hyoid Displacement in Videofluoroscopic Images of Healthy Adults

alwin shared this article with you from Inoreader Cervical Vertebral Height Approximates Hyoid Displacement in Videofluoroscopic Images of Healthy Adults Via Dysphagia This study aimed to determine the validity and feasibility of a visual, anatomically scaled benchmark for judging complete hyoid displacement during a VFSS. The third and fourth cervical vertebral bodies (C3 and C4) lie at roughly the same vertical position as the hyoid body an d are strongly correlated with patient height. We hypothesized that anterior and superior displacement of the hyoid bone would approximate the height of one C3 or C4 body during safe swallows. Trained raters marked points of interest on C3, C4, and the hyoid body on 1414 swallows of adult patients w ith suspected dysphagia (n = 195) and 50 swallows of age-matched healthy participants (n = 17), and rated Penetration Aspiration Scale scores. Results indicated that the mean displacements of the hyoid bone were ... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reliability of Ultrasound Examination of Hyoid Bone Displacement Amplitude: A Systematic Review and Meta-Analysis

alwin shared this article with you from Inoreader Reliability of Ultrasound Examination of Hyoid Bone Displacement Amplitude: A Systematic Review and Meta-Analysis Via Dysphagia The objective of this study was to analyze the reliability of measuring hyoid bone displacement amplitude in swallowing with ultrasound. The systematic review encompassed five databases (MEDLINE, Scopus, EMBASE, Web of Science, Cochrane Library) and gray literature. There was no limitation of language or year of publication. The search/selection/extraction methodology was conducted by two authors blindly and independently, and differences were solved by a third rater. Th ree studies met the eligibility criteria: two of them analyzed the reliability in non-dysphagic populations and the other, in dysphagic patients. The transducer was positioned in the submandibular region in all studies. The authors were not clear about the training time to acquire and analyze ultras ound images. The meta-a... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Rare Case of Dysphagia with Palatal Tremor

alwin shared this article with you from Inoreader Message: Case Presentation A 77-year-old man with a known history of long-standing hypertension experienced a left cerebellar hemorrhage 9 months ago, then a right cerebellar hemorrhage 3 months prior to his presentation. The patient had noticeable dysphagia that required placing a nasogastric tube for nasal feeding. The standardized swallowing assessment revealed that he had an impairment in lip closure, head, and trunk control, pharyngeal reflex, as well as independent coughing. To observe the pathophysiological changes of the pharynx and larynx, a fiberoptic laryngoscope was inserted prior to the video fluoroscopic swallowing study (VFSS), which showed that there was no pathophysiological change. VFSS detected the rhythmic tremor of the soft palate and epiglottis, with residues displayed in the vallecula and pyriform sinuses. Magnetic resonance imaging (MRI) depicted bilateral long T2 signal shadows in the cerebellum, enlargement of the bilateral olivary nucleus, with a longer T2-weighted signal change. The T2 FLAIR image demonstrated an increased signal change, with the right inferior olivary nucleus (ION) obviously larger than the left. (Fig. 1) (9 months after the left cerebellar hemorrhage, 3 months after the right cerebellar hemorrhage). Fig. 1 figure 1 Axial T2 and FLAIR images: long T2 signal shadows were observed in the right cerebellum, and low-density circular shadows were observed around the lesion, with patchy long T2 signal changes in the left cerebellum. The area of the bilateral olivary nucleus was enlarged, with a longer T2-weighted signal change, and the T2 FLAIR image showed an increased signal change, the right ION was obviously larger than the left Full size image Diagnosis The patient presented with a palatal tremor (PT) after two episodes of cerebellar hemorrhage. MRI indicated bilateral hypertrophic degeneration of the olivary nucleus, especially on the left side. These findings taken together confirmed a diagnosis of hypertrophic olivary degeneration (HOD). HOD is a rare neurological condition characterized by trans-synaptic degeneration that occurs secondary to focal lesions disrupting the normal function of the afferent fibers to the ION as part of the dentate–rubro–olivary pathways (Guillain–Mollaret triangle, GMT) [1]. Possible etiologies for this condition include infarction, toxicosis, trauma, surgery, tumors, vascular malformations or hemorrhage. In this case, the patient developed HOD secondary to cerebellar hemorrhage [2]. Discussion GMT is composed of the contralateral dentate nucleus (DN), the ipsilateral red nucleus (RN) and the ipsilateral ION. DN, RN, and ION form an afferent and efferent loop pathway. The fibers from the DN are crossed by the superior cerebellar foot and reach the contralateral midbrain red nucleus. The red nucleus sends fibers descending through the central tegmental bundle to the ipsilateral ION for relay. The ION is then emitted from fibers passing through the cerebellar inferior foot (ICP) to the contralateral cerebellar cortex and projected onto the DN, constituting the complete GMT [2] (Fig. 2). Fig. 2 figure 2 Guillain–Mollaret triangle Full size image When the primary lesion is located within the cerebellum, contralateral ION degeneration occurs, which is due to the decussation of the dentate-rubral fibers. A unilateral lesion in a cerebellar hemisphere usually causes contralateral HOD, and only a rare number of cases of bilateral HOD have been described with lesions affecting a single cerebellar hemisphere [2]. HOD is characterized by enlargement and increased T2 hyperintense signal of the ION [3]. The classic clinical presentation associated with HOD is a PT [4] which was observed in this patient. Dentatorubral tremors and ocular myoclonus are other associated movement disorders [4], but were not observed in this case. This muscle tremor may affect the patient's peristalsis, which is manifested as an incomplete epiglottic closure during swallowing, food residues in the vallecula and pyriform sinuses, leading to penetration-aspiration, resulting in dysphagia. The exact pathogenesis of the tremor is not clear, but the currently accepted hypothesis involves the interruption of GABAergic descending inhibition of the dentate–olivary tract during de-afferentiation of the triangle [5]. We treated the patient with electric stimulation, vocal cord movement and airway protection training for dysphagia, but the results were not satisfactory. Previous literature reports indicated that the medical treatment of PT is unsatisfactory and is often ineffective. some patients may respond to medications such as valproic acid, carbamazepine, clonazepam, tryptophan, trihexyphenidyl, or levetiracetam [6]. This patient was treated sequentially with propranolol, clonazepam, and levetiracetam, but his symptoms persisted. Conclusion In this study, we report an unusual case of dysphagia following two episodes of cerebellar hemorrhage. Despite the fact that dysphagia after stroke is fairly common, the different etiologies and pathogenesis related to this condition should be identified, especially the rare causes of dysphagia. The patient is not responding well to treatment; thus, we need to follow up him for a long period of time to observe the changes in his condition. References Onen MR, Moore K, Cikla U, et al. Hypertrophic olivary degeneration: neurosurgical perspective and literature review. World Neurosurg. 2018;112:763–71. Article Google Scholar Wang H, Wang Y, Wang R, et al. Hypertrophic olivary degeneration: a comprehensive review focusing on etiology. Brain Res. 2019;1718:53–63. CAS Article Google Scholar Goto N, Kaneko M. Olivary enlargement: chronological and morphometric analyses. Acta Neuropathol. 1981;54(4):275–82. CAS Article Google Scholar Cosentino C, Velez M, Nuñez Y, et al. Bilateral hypertrophic olivary degeneration and Holmes tremor without palatal tremor: an unusual association. Tremor Other Hyperkinet Mov (NY). 2016;6:400. Article Google Scholar Walker G, Limaye K, Jankowitz BT, et al. Hypertrophic olivary degeneration after cerebellar hemorrhage. J Clin Neurosci. 2017;43:162–4. Article Google Scholar Diehl GE, Wilmes E. Etiology and clinical aspects of palatal myoclonus. Laryngorhinootologie. 1990;69(7):369–72. CAS Article Google Scholar Download references Author information Affiliations Department of Rehabilitation Medicine, Chengdu Second People's Hospital, No. 10 Qingyunnan Street, Jinjiang District, Chengdu, 610017, Sichuan, China Tao Xiang, Yingyue Yang & Juan Li Department of Neurology, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China Feng Wang Corresponding author Correspondence to Tao Xiang. Ethics declarations Conflict of interest We declare no conflicts of interest. Informed Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Reprints and Permissions About this article Verify currency and authenticity via CrossMark Cite this article Xiang, T., Wang, F., Yang, Y. et al. A Rare Case of Dysphagia with Palatal Tremor. Dysphagia 36, 758–760 (2021). https://doi.org/10.1007/s00455-020-10185-0 Download citation Received 15 July 2020 Accepted 24 August 2020 Published 03 September 2020 Issue Date August 2021 DOI https://doi.org/10.1007/s00455-020-10185-0 Share this article Anyone you share the following link with will be able to read this content: Get shareable link Provided by the Springer Nature SharedIt content-sharing initiative Download PDF Sections Figures References Case Presentation Diagnosis Discussion Conclusion References Author information Ethics declarations Additional information Rights and permissions About this article Advertisement Over 10 million scientific documents at your fingertipsSwitch Edition Academic Edition Corporate Edition Home Impressum Legal information Privacy statement California Privacy Statement How we use cookies Manage cookies/Do not sell my data Accessibility FAQ Contact us Affiliate program Not logged in - 141.255.95.55 Not affiliated Springer Nature © 2022 Springer Nature Switzerland AG. Part of Springer Nature. A Rare Case of Dysphagia with Palatal Tremor Via Dysphagia (Source: Dysphagia) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Characteristics of Dysphagia Based on the Type of ALS

alwin shared this article with you from Inoreader Characteristics of Dysphagia Based on the Type of ALS in Korean Patients Evaluated Using Videofluoroscopic Study: A Retrospective Analysis Via Dysphagia In this study, videofluoroscopic swallowing study (VFSS) results of bulbar and spinal onset ALS patients were compared. VFSS results and revised ALS Functional Rating Scale (ALSFRS-R) score were also analyzed to assess the correlation between dysphagia and functional status of patients. ALS patients with swallowing difficulties who underwent VFSS were recruited retrospectively. Two oral, seven pharyngeal, and two esophageal components of VFSS were evaluated. An ALSRFRS-R bulbar subtype score  <  9 was used to divide the groups with severe bulbar symptoms. Total 109 Korean ALS patients (39 bulbar vs 70 spinal) were included. Bulbar ALS patients exhibited a significantly longer oral transit time (OTT) then spinal ALS patients, especially in severe bulbar patients with low ALSRFRS-R bu... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Implementation of Pediatric Flexible-Endoscopic Evaluation of Swallowing: A Systematic Review and Recommendations for Future Research

alwin shared this article with you from Inoreader Implementation of Pediatric Flexible-Endoscopic Evaluation of Swallowing: A Systematic Review and Recommendations for Future Research Via Dysphagia DiscussionNone of the included studies showed good methodological quality and a significant amount of data were missing; the review still offers a systematic basis for future research to close the serious gap in the area of pediatric FEES. A proposal is made for a minimum requirement for pediatric FEES protocols in scientific studies. (Source: Dysphagia) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of Dysphagia in Motor Neuron Disease. Review of Available Diagnostic Tools and New Perspectives

alwin shared this article with you from Inoreader Evaluation of Dysphagia in Motor Neuron Disease. Review of Available Diagnostic Tools and New Perspectives Via Dysphagia AbstractOropharyngeal dysphagia (OD) is highly prevalent (up to 80%) in patients with motor neuron disease (MND), influencing the prognosis of the disease. The clinical assessment of dysphagia is complex. There are assessment scales and screening questionnaires, but they have not been tested in patients with MND. In a sample of 46 patients with MND, the sensitivity and specificity of the EAT-10 and SwalQoL questionnaires, as well as the ALS-SS and FOIS scales, were tested and compared to the gold standard technique (videofluoroscopy, VFS). The patients were stratified using the DOSSc variable according to the video fluoroscopic examination with (n = 37) or without (n = 8) signs of dysphagia, and the results were compared with the scores obtained in the dysphagia questionnaires. Non... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Brief Communication PD1-related Nephrotoxicity: Optimizing Its Clinical Management Through Histopathologic Features

alwin shared this article with you from Inoreader Brief Communication PD1-related Nephrotoxicity: Optimizing Its Clinical Management Through Histopathologic Features Via Journal of Immunotherapy Immune-related nephrotoxicity (ir-N) is a rare adverse event of immune-checkpoint(s) inhibitors (ICI) therapy and its clinical management is still debated. Among 501 consecutive ICI-treated patients at our Institution, 6 who developed an ir-N with clinical signs suggestive for an acute kidney injury underwent kidney biopsy. Histology showed an acute tubule-interstitial nephritis, simulating the scenario of acute T-cell–mediated kidney transplant rejection. Thus, the management of allograft kidney rejection routinely utilized at our clinic was implemented, leading to rapid renal function improvement. Histologic features supporting the definition of an immune-mediated acute kidney injury in ICI-treated patients may help optimizing the clinical management of ir-N. (Source: Journal of Immuno... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Are Bacteria Just Bystanders in the Pathogenesis of Inflammatory Jaw Conditions?

alwin shared this article with you from Inoreader Are Bacteria Just Bystanders in the Pathogenesis of Inflammatory Jaw Conditions? Via Journal of Oral and Maxillofacial Surgery It is unclear whether certain bacteria initiate the development of inflammatory jaw conditions, or whether these diseases create a milieu for dysbiosis and secondary colonization of indigenous flora. At present, there are no comparative studies on the types of bacteria that colonize different inflammatory jaw conditions. Accordingly, this study aims to identify and compare the types of bacteria isolated in osteomyelitis, osteoradionecrosis, and MRONJ. (Source: Journal of Oral and Maxillofacial Surgery) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Is the Er:YAG laser effective in reducing pain, edema and trismus after removal of impacted mandibular third molars? A meta-analysis.

alwin shared this article with you from Inoreader Is the Er:YAG laser effective in reducing pain, edema and trismus after removal of impacted mandibular third molars? A meta-analysis. Via Journal of Oral and Maxillofacial Surgery : Removal of impacted third molars, can be associated with complications such as pain, edema, trismus, that can increase the morbidity of this procedure. The purpose of this study is to determine whether the Er:YAG laser is effective in reducing pain, swelling and trismus compared to rotary instruments in removing impacted lower third molars (3 LM`s). (Source: Journal of Oral and Maxillofacial Surgery) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intraoperative flap warming: The novel use of a sterile cardiac forced warm air blanket for maintaining optimal flap perfusion.

alwin shared this article with you from Inoreader Intraoperative flap warming: The novel use of a sterile cardiac forced warm air blanket for maintaining optimal flap perfusion. Via Journal of Oral and Maxillofacial Surgery The two-team approach in major head and neck/reconstructive surgery can occasionally lead to delays between flap harvest and detachment, due to the complexity and length of the ablative procedure. In order to minimize the potential for flap cooling and the adverse impact on microcirculation, active warming can be beneficial.(1) Intraoperative flap warming to either maintain or improve circulation during free flap harvesting has been performed with a variety of passive and active techniques,(2) however limitations such as a lack of consistent temperature regulation, lack of sterility, inability to directly visualise the flap or the need for acquisition of new equipment for a niche area meant that an ideal solution was lacking. (Source: Journal of Oral and Maxillofacial Surgery) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Training the pronunciation of L2 vowels under different conditions: the use of non-lexical materials and masking noise

alwin shared this article with you from Inoreader Training the pronunciation of L2 vowels under different conditions: the use of non-lexical materials and masking noise Via Phonetica Phonetica. 2022 Apr 15. doi: 10.1515/phon-2022-2018. Online ahead of print.ABSTRACTThe current study extends traditional perceptual high-variability phonetic training (HVPT) in a foreign language learning context by implementing a comprehensive training paradigm that combines perception (discrimination and identification) and production (immediate repetition) training tasks and by exploring two potentially enhancing training conditions: the use of non-lexical training stimuli and the presence of masking noise during production training. We assessed training effects on L1-Spanish/Catalan bilingual EFL learners' production of a difficult English vowel contrast (/æ/-/ʌ/). The participants (N = 62) were randomly assigned to either non-lexical (N = 24) or lexical (N = 24) training and were fu... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.