Evaluation of Clinical Significance of Lymphovascular Space Invasion in Stage IA Endometrial Cancer

alwin shared this article with you from Inoreader Evaluation of Clinical Significance of Lymphovascular Space Invasion in Stage IA Endometrial Cancer Via Oncology CONCLUSION: LVSI was not a prognostic factor of not only stage IA endometrial cancer, but also stage IA low-grade cancer.PMID:34915516 | DOI:10.1159/000521382 (Source: Oncology) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Life and death of microglia: mechanisms governing microglial states and fates

alwin shared this article with you from Inoreader Life and death of microglia: mechanisms governing microglial states and fates Via Immunology Letters Immunol Lett. 2022 Apr 9:S0165-2478(22)00042-6. doi: 10.1016/j.imlet.2022.04.001. Online ahead of print.ABSTRACTRecent advances in genetic analysis and intensive research have revealed that microglial cells respond to external stimuli in various ways and adopt diverse states. Herein, we summarize the current knowledge on the possible microglial states during development, homeostasis, and perturbation. These states are characterized either by irreversible cellular changes, such as cell death and cellular senescence, or reversible alterations, triggered by temporary changes in the microenvironment. Subsequently, we discuss the modalities of the transcriptional and functional recovery of microglia from a molecular perspective. An understanding of (ir)reversible changes in their cellular fates... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Using Classical Test Theory to Determine the Psychometric Properties of the Deglutition Handicap Index

alwin shared this article with you from Inoreader Using Classical Test Theory to Determine the Psychometric Properties of the Deglutition Handicap Index Via Dysphagia AbstractThe Deglutition Handicap Index (DHI) is a self-report measure for patients at risk of oropharyngeal dysphagia on deglutition-related aspects of functional health status (FHS) and health-related quality of life (HR-QoL). The DHI consists of 30 items which are subsumed within the Symptom, Functional and Emotional subscales. The purpose of this study was to evaluate the psychometric properties of the DHI using Classic Test Theory according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria. A total of 453 patients with dysphagia with different aetiologies were recruited concurrently at two academic hospitals. Dysphagia was confirmed by fiberoptic endoscopic and/or videofluoroscopic evaluation of swallowing. In addition, a healthy con... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Investigation of the Effect of Radiotherapy Dose on Chewing and Swallowing Structures in Head and Neck Cancer Patients Treated with Concomitant Chemoradiotherapy

alwin shared this article with you from Inoreader Investigation of the Effect of Radiotherapy Dose on Chewing and Swallowing Structures in Head and Neck Cancer Patients Treated with Concomitant Chemoradiotherapy Via Dysphagia AbstractIntensity-modulated radiotherapy (IMRT) is a treatment method that is used in the treatment of head and neck cancers. Impairment of chewing and swallowing functions in the early and late periods of radiotherapy is frequent. Therefore, revealing the dose –effect relationship is important. The main purpose of this study is to investigate the dose–effect relationship between chewing and swallowing structures objectively via a standardized videofluoroscopy protocol. The study included 35 participants treated with chemo-IMRT. A videofluoroscopic swa llowing study (VFSS) was performed before IMRT, and 3 and 6 months after IMRT. VFSS results were scored according to the Modified Barium Swallow Impairment Profile (MBSImP) and the Penetration-Aspiration Scale (PAS). Maximum interinciso... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

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.

Expiratory Muscle Strength Training for Drooling in Adults with Parkinson ’s Disease

alwin shared this article with you from Inoreader Expiratory Muscle Strength Training for Drooling in Adults with Parkinson 's Disease Via Dysphagia This study explored the effect of an alter native therapy approach for drooling that aimed at improving the swallow, expiratory muscle strength training (EMST). Sixteen participants received EMST over a 6- to 8-week period. Measurements were taken pre- and post-training for drooling (Sialorrhea Clinical Scale for Parkinson's Disease; SCS-P D), swallowing, lip strength and peak cough flow. Measures of drooling, swallowing and peak cough flow were stable over pre-training assessments and improved following training (p  <  0.01). The most conservative estimate of the within-group change for SCS-PD was − 2.50 (95% confidence interval −  3.22 to −  1.22). No adverse effects were reported and participants gave high satisfaction ratings for the training. A programme of EMST ... 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.

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.

Clinical Outcomes and Patient Safety of Nasogastric Tube in Acute Stroke Patients

alwin shared this article with you from Inoreader Clinical Outcomes and Patient Safety of Nasogastric Tube in Acute Stroke Patients Via Dysphagia Discussion with family prior to insertion of NGT recorded in 46 (18.4%). There were 123 cases (49.2%) of aspiration pneumonia. There were 188 (75.2%) NGT associated complications: 67 patients (26.8%) had failed insertion, 31 required multip le attempts, 129 patients (51.6%) pulled out NGT, 107 patients (42.8%) had NGT placed in wrong positions and require reinsertion, 20 cases in the lung, 5 pneumothorax cases, 97 in the gastro oesophageal junction or hiatus hernias, 1 case of oesophageal ulceration, 37 coiled, kinked or resistance. 78 cases the tips were not seen on chest X-ray (CXR), gastrointestinal bleeding in 9 cases, epistaxis in 6 cases), 96 patients (38.4%) required restrain. There were 91 death (36.4%) with 73 patients occurring during hospital admission and a further 18 died with... 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.

Factors Associated with Food Form in Long-Term Care Insurance Facilities

alwin shared this article with you from Inoreader Factors Associated with Food Form in Long-Term Care Insurance Facilities Via Dysphagia We examined factors related to dietary intake status (food form) of long-term care facility (LTCF) residents to identify factors related to proper food form choice for older individuals requiring nursing care. We surveyed 888 residents from 37 LTCFs in Japan. We evaluated basic information (age, sex, body mass index [BMI]), food form (swallowing-adjusted diet class), Barthel Index (BI), Clinical Dementia Rating (CDR), simply evaluated eating and swallowing functions, the number of present/functional teeth, oral diadochokinesis, repetitive saliva swallowing test (RSST), and modified water swallowing test. To clarify factors associated with food form, participants who had good nutrition by oral intake were categorized into the dysphagic diet (DD) and normal diet (ND) groups. Multi-level anal... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Does Medialization Improve Swallowing Function in Patients with Unilateral Vocal Fold Paralysis? A Systematic Review

alwin shared this article with you from Inoreader Does Medialization Improve Swallowing Function in Patients with Unilateral Vocal Fold Paralysis? A Systematic Review Via Dysphagia The objective of this systematic review was to determine the impact of vocal fold medialization on dysphagia outcomes. Six electronic bibliographic databases and one clinical trial registry were searched on 3/13/2020. Our patient population were adult patients with verified UVFP that underwent vocal fold medialization. We limited review to prospective studies that had formal dysphagia assessment both before and after medialization. Nine studies met selection criteria (7 prospective case series and 2 prospective cohort studies) totaling 157 patients. The most common etiology of UVFP was iatrogenic (74/157; 47%). The majority of patients underwent injection augmentation (92/157; 59%), and the remaining underwent medialization thyroplasty. A variety of methods were used to assess changes in d... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.