No abstract available.
Deglutition Disorders*

No abstract available.
Deglutition Disorders*

No abstract available.
Deglutition Disorders*

No abstract available.
Deglutition Disorders*

There were critical limitations to dysphagia services in Malaysia with speech-language pathologists’ (SLPs) reported lacking skills and confidence in managing the disorder. This study examined the impact of providing professional development training in dysphagia management. Aims were to determine if: (1) delivery of a training series enhances SLPs knowledge in dysphagia management, (2) knowledge translated into improved clinical skills and (3) clinicians’ perception of their knowledge, skills and confidence improved post-training. The study used a single cohort pre- and post-test research design and involved nine Malaysian SLPs. Participants underwent assessment at pre- and immediately post-training and again at one month post-training. At each assessment level, knowledge and skills were assessed via a written examination and observational assessment of clinical performance respectively. Visual analogue scales were used to measure clinician’s perceptions of knowledge, skills and confidence. The training model involved four consecutive; 4-hour week-end workshops with opportunity to apply new knowledge and develop networking in clinical practice in the weekdays between each session. Significant (p < 0.05) improvements in knowledge and clinical skills were observed immediately post- and at one month after training. Clinician’s perceptions of knowledge, skills and confidence were also significantly higher immediately post- and at one month post-training. The current 4-week structured professional development model was found to be effective in enhancing SLPs’ knowledge and skills in dysphagia management and improving their perceptions and confidence. The findings highlight the benefits that can be achieved through well designed professional development programs.
Deglutition Disorders

A 64-year-old man presented with prolonged history of intermittent dysphagia with sensation of food sticking at his upper chest. Physical examination was unremarkable, and an upper endoscopy did not reveal the underlying cause. On computed tomography scan of thorax, an aberrant right subclavian artery was seen coursing posterior to the esophagus resulting in external compression, which is a typical radiological feature of Dysphagia Lusoria. The pathophysiology, clinical features, imaging features and updated treatment modalities of this rare disease are discussed.
Deglutition Disorders

The etiology, diagnosis, and treatment of mysthenia gravis is discussed; and a case involving the muscles of phonation and deglutition, admitted into the North General Hospital, Manila on January 30, 1947, is presentedThe use and value of the prostigmin test as a confirmatory diagnostic test was demonstrated on the basis of the chemical mediation theory of transmission of nerve impulse to effector muscle. The prostisin is assumed to inhibit the action of cholinesterase in splitting acetylcholine by hydrolysis into choline and acetic acid, thus allowing the acetylcholine to remain at the myoneural junction and making possible the efficient transmission of nerve impulseLikewise, treatment using prostigmin is based on the same premise. The amount of the drug necessary varies greatly. The initial and maintenance doses of prostigmin depend on the individual case. The amount given is just enough to bring relief, and it is calculated after an observation study period. Three other drugs are mentioned in the treatment--ephedrine sulfate, potassium chloride, and guanidine hydrochloride; but their use has been overshadowed by prostigminThe role of thymectomy in the treatment of myasthenia gravis has been gaining headway in the past few years. Statistics presented by advocates of this form of therapy, although meager, are rather encouraging. However, more time, experience, and investigate work will be required before the exact causal association between myasthenia gravis and thymus pathology can be determined and the value of thymectomy ascertainedPregnancy is said to make the condition of myasthenia gravis patients worse. Some workers, for this reason advise longer spacing of gestation or even advocate total prevention of pregnancy in severe cases. In those afflicted case with concomitant malarial infection, it is not amiss here to point out that quinine should not be given in treating the latter disease, lest the quinine may aggravate the former condition.(Summary)
Thymectomy, Deglutition

Puffs of air were administered to the face of 102 normal Filipino children between 0-36 months to determine the presence or absence of, and age parameters for, the Santmyer swallow reflex. Visual observation and surface EMG recordings were used to detect the responses in 3 trials per subject. subjects who responded were less than 24 months of age or possibly neurologically or developmentally disturbed; those who did not were older than 9 months of age or asleep. Variable responses were elicited between 10-23 months of age. The statistically significant differences among the three groups established age parameters slightly different from those set by the Santmyer study, and the seemingly inhibitory effect of sleep on the reflex was noted. (Sum)
Epidemiology, Deglutition

Pediatric dysphagia comes from disturbances in swallowing process, which has 'preparatory phase', 'oral phase', 'pharyngeal phase', and 'esophageal phase', and mainly the causes are neuro-muscular discoordination. It is necessary to recognize clinical manifestation if they have accompanied organic disorder and diagnose accurately. Videofluoroscopic study evaluation is a valuable method to find out abnormal swallowing mechanism at each phases. Treatment should be diagnosis specific, and multidisciplinary team approach is desirable. We can use various behavioral techniques to facilitate normal swallowing mechanism including conditioning of oral and pharyngeal structures, bolus manipulation, postural compensation, and adaptive feeding utensils. Important point is that the diagnosis and treatment for pediatric dysphagia should not be delayed because children are under development.
Child ; Compensation and Redress ; Deglutition ; Deglutition Disorders ; Humans

OBJECTIVE: To investigate the inter-rater agreement for the clinical dysphagia scale (CDS). METHOD: Sixty-seven subjects scheduled to participate in a video-fluoroscopic swallowing study (VFSS) were pre-examined by two raters independently within a 24-hour interval. Each item and the total score were compared between the raters. In addition, we investigated whether subtraction of items showing low agreement or modification of rating methods could enhance inter-rater agreement without significant compromise of validity. RESULTS: Inter-rater agreement was excellent for the total score (intraclass correlation coefficient (ICC): 0.886). Four items (lip sealing, chewing and mastication, laryngeal elevation, and reflex coughing) did not show excellent agreement (ICC: 0.696, 0.377, 0.446, and kappa: 0.723, respectively). However, subtraction of each item either compromised validity, or did not improve agreement. When redefining 'history of aspiration' and 'lesion location' items, the inter-rater agreement (ICC: 0.912, 0.888, respectively) and correlation with new videofluoroscopic dysphagia score (PCC: 0.576, 0.577, respectively) were enhanced. The CDS showed better agreement and validity in stroke patients compared to non-stroke patients (ICC: 0.917 vs 0.835, PCC: 0.663 vs 0.414). CONCLUSION: The clinical dysphagia scale is a reliable bedside swallowing test. We can improve inter-rater agreement and validity by refining the 'history of aspiration' and 'lesion location' item.
Deglutition ; Deglutition Disorders ; Humans ; Mastication ; Reflex ; Stroke