Dysphagia最新文献_第3页

Recovery of Swallowing Function and Prognostic Factors Associated with Exacerbation of Post-stroke Dysphagia. 脑卒中后吞咽困难加重与吞咽功能恢复及预后因素相关。

IF 3 3区医学

Dysphagia Pub Date : 2025-10-01 Epub Date: 2025-02-07 DOI: 10.1007/s00455-025-10804-8

Seung Jun Lee, So Young Lee, Min Kyun Sohn, Jongmin Lee, Deog Young Kim, Yong-Il Shin, Gyung-Jae Oh, Yang-Soo Lee, Min Cheol Joo, Min-Keun Song, Junhee Han, Jeonghoon Ahn, Young-Hoon Lee, Yun-Hee Kim, Won Hyuk Chang

{"title":"Recovery of Swallowing Function and Prognostic Factors Associated with Exacerbation of Post-stroke Dysphagia.","authors":"Seung Jun Lee, So Young Lee, Min Kyun Sohn, Jongmin Lee, Deog Young Kim, Yong-Il Shin, Gyung-Jae Oh, Yang-Soo Lee, Min Cheol Joo, Min-Keun Song, Junhee Han, Jeonghoon Ahn, Young-Hoon Lee, Yun-Hee Kim, Won Hyuk Chang","doi":"10.1007/s00455-025-10804-8","DOIUrl":"10.1007/s00455-025-10804-8","url":null,"abstract":"Post-stroke dysphagia is a common and debilitating complication affecting millions of people worldwide, often leading to malnutrition, pneumonia, and reduced quality of life. This study, an interim analysis of the Korean Study Cohort for Functional and Rehabilitation, aimed to identify long-term changes and predictive factors associated with post-stroke dysphagia at 3 years after stroke. A total of 4735 patients with acute first-ever stroke, including both ischemic and hemorrhagic subgroups, were followed, and dysphagia was assessed using the ASHA-NOMS scale. All the patients were then followed up for up to 36 months. The results showed significant improvements in dysphagia up to 12 months after stroke in the total and hemorrhagic stroke group, and the decline in swallowing function after 24 months in the total stroke and ischemic stroke groups was a novel finding. The hemorrhagic stroke group showed worsening dysphagia after 30 months. It is unclear whether patients who experienced worsening of swallowing function had other conditions, including new strokes, that might have contributed to this decline. Male gender, age at stroke, K-FAST at 7 days, ASHA-NOMS scale, mRS score at 3 months, and early comprehensive rehabilitation were identified as predictors of a decrease in the ASHA-NOMS score after 24 months. Additionally, the K-MBI score at 3 months post-stroke was found to be a significant factor influencing long-term improvements in swallowing function. These findings suggest that patients should be closely monitored for dysphagia beyond 24 months after stroke onset, as swallowing function may decline over time. During follow-up, it is essential to carefully consider the multiple factors associated with this decline.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"1092-1104"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of Active Interferential Current Stimulation on Swallowing Function in Patients with Dysphagia: A Cross-Sectional Study of Interferential Current Stimulation on Swallowing Function in Patients with Dysphagia: A Cross-Sectional Study. 主动干扰电流刺激对吞咽困难患者吞咽功能的影响：一项横断面研究

IF 3 3区医学

Dysphagia Pub Date : 2025-10-01 Epub Date: 2025-06-17 DOI: 10.1007/s00455-025-10853-z

Shinsuke Nagami, Masayuki Kouda, Katsuya Nakamura, Yuhei Kodani, Naoya Obama, Ayaka Yokozeki, Kazuhiro Wakamatsu, Masanori Hirobayashi

{"title":"Effects of Active Interferential Current Stimulation on Swallowing Function in Patients with Dysphagia: A Cross-Sectional Study of Interferential Current Stimulation on Swallowing Function in Patients with Dysphagia: A Cross-Sectional Study.","authors":"Shinsuke Nagami, Masayuki Kouda, Katsuya Nakamura, Yuhei Kodani, Naoya Obama, Ayaka Yokozeki, Kazuhiro Wakamatsu, Masanori Hirobayashi","doi":"10.1007/s00455-025-10853-z","DOIUrl":"10.1007/s00455-025-10853-z","url":null,"abstract":"Dysphagia is prevalent among elderly and neurologically impaired individuals, causing serious complications such as aspiration pneumonia. Interferential Current Stimulation (IFC), a non-invasive sensory method, may improve swallowing by reducing reflex latency. This study aimed to investigate the effects observed during active IFC stimulation of IFC on swallowing function using Laryngeal Elevation Delay Time (LEDT), Stage Transition Duration (STD), and Penetration-Aspiration Scale (PAS). Forty-six participants (ages 29-98) undergoing videofluoroscopic swallowing studies received IFC stimulation with electrodes bilaterally placed on the thyroid cartilage. Swallowing parameters were analyzed frame-by-frame using ImageJ software. LEDT measured the time from contrast arrival at the bottom of the piriform sinus to maximum laryngeal elevation. STD was the interval from oral bolus transit to pharyngeal swallow initiation. PAS assessed penetration and aspiration severity. LEDT significantly improved from baseline (median [IQR]: 0.15 [0.00-0.35] s) to 10 min during IFC stimulation (0.00 [0.00-0.19] s; p = 0.02, r = 0.46, 95% CI [0.11-0.76]). No significant changes were found in STD (STD1: p = 0.37; STD2: p = 0.37) or PAS scores (PAS1: p = 0.20; PAS2: p = 0.71). Responder analysis indicated substantial individual variability: approximately 70% improved in LEDT, while only 37-45% improved in STD. Higher responder rates were noted among participants with respiratory and cerebral disorders. IFC stimulation significantly shortened swallowing reflex latency (LEDT), suggesting its potential benefit for dysphagia rehabilitation. However, it did not significantly alter stage transition duration (STD) or penetration-aspiration safety (PAS). Further studies should explore long-term effects and optimal stimulation parameters.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"1263-1273"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Artificial Intelligence in Videofluoroscopy Swallow Study Analysis: A Comprehensive Review. 人工智能在视频透视吞咽研究分析中的应用综述。

IF 3 3区医学

Dysphagia Pub Date : 2025-10-01 Epub Date: 2025-02-17 DOI: 10.1007/s00455-025-10812-8

G Sanjeevi, Uma Gopalakrishnan, Rahul Krishnan Pathinarupothi, K Subramania Iyer

{"title":"Artificial Intelligence in Videofluoroscopy Swallow Study Analysis: A Comprehensive Review.","authors":"G Sanjeevi, Uma Gopalakrishnan, Rahul Krishnan Pathinarupothi, K Subramania Iyer","doi":"10.1007/s00455-025-10812-8","DOIUrl":"10.1007/s00455-025-10812-8","url":null,"abstract":"Videofluoroscopic Swallowing Study (VFSS) is considered the gold standard for diagnosing swallowing disorders, or dysphagia. However, the interpretation of VFSS is susceptible to human bias and subjectivity, resulting in significant inter- and intra-patient variability. In this context, artificial intelligence (AI) has emerged as a potentially valuable tool for physicians. This study reviews state-of-the-art research utilizing AI to analyze VFSS for the assessment of swallowing disorders and to support clinical decision-making. Our comprehensive analysis highlights substantial progress in areas such as pharyngeal phase detection, segmentation and identification of the bolus and hyoid bone, and penetration-aspiration detection. Despite these advancements, an end-to-end automated AI tool for VFSS analysis has yet to be developed. However, there is considerable potential for AI applications in areas like exploring the clinical relevance of segmented or tracked components and expanding the scope to include more upper aerodigestive components in the analysis. Additionally, we discuss the limitations of current research, including the lack of publicly available datasets, the need to address the generalizability of AI models, the integration of cutting-edge AI techniques, and the clinical implications for speech-language pathologists.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"1035-1048"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association Between the Intensity and Frequency of Swallowing Rehabilitation and Oral Intake at Discharge in Older Patients with Acute Post-stroke Dysphagia. 老年脑卒中后急性吞咽困难患者出院时吞咽康复的强度和频率与口服摄入的关系。

IF 3 3区医学

Dysphagia Pub Date : 2025-10-01 Epub Date: 2025-03-08 DOI: 10.1007/s00455-025-10809-3

Kota Ishizuka, Hayato Yamana, Kojiro Morita, Hiroki Matsui, Hiroyuki Ohbe, Kiyohide Fushimi, Hideo Yasunaga

{"title":"Association Between the Intensity and Frequency of Swallowing Rehabilitation and Oral Intake at Discharge in Older Patients with Acute Post-stroke Dysphagia.","authors":"Kota Ishizuka, Hayato Yamana, Kojiro Morita, Hiroki Matsui, Hiroyuki Ohbe, Kiyohide Fushimi, Hideo Yasunaga","doi":"10.1007/s00455-025-10809-3","DOIUrl":"10.1007/s00455-025-10809-3","url":null,"abstract":"This retrospective cohort study aimed to clarify the concurrent effects of intensity and frequency of early swallowing rehabilitation for post-stroke dysphagia. Using data from acute-care hospitals included in the Japanese Diagnosis Procedure Combination database between April 2020 and March 2021, we identified patients aged ≥65 years with dysphagia after acute stroke on admission who received swallowing rehabilitation within three days of hospitalization. Swallowing rehabilitation within seven days of hospitalization, starting from admission, was categorized into four types according to intensity (long/short per day) and frequency (high/low proportion of days performed). The primary outcomes were presence of dysphagia and recovery of total oral intake at discharge. Generalized estimating equations were used to assess the effects of rehabilitation intensity and frequency, adjusting for patient and hospital characteristics. Of the 4,669 patients with post-stroke dysphagia, 913 underwent swallowing rehabilitation within three days of hospitalization. The proportions of patients with dysphagia and total oral intake at discharge were 80% and 47%, respectively. The intensity and frequency of swallowing rehabilitation were not associated with dysphagia at discharge. Higher intensity or higher frequency was associated with total oral intake at discharge (odds ratio [95% confidence interval]:1.62 [0.93-2.81], 2.00 [1.11-3.60], and 2.75 [1.59-4.76] for low-intensity and high-frequency, high-intensity and low-frequency, and high-intensity and high-frequency groups, respectively). This nationwide study showed that the intensity and frequency of acute-phase swallowing rehabilitation were not associated with recovery from dysphagia after a stroke. However, they were associated with an improved oral intake at discharge.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"1132-1144"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Comparison of Quality of Life in Patients with Mild-Moderate Severity of Multiple Sclerosis with and without Dysphagia. 轻中度多发性硬化症伴与不伴吞咽困难患者的生活质量比较。

IF 3 3区医学

Dysphagia Pub Date : 2025-10-01 Epub Date: 2025-03-04 DOI: 10.1007/s00455-025-10811-9

Azam Rezatofighi, Majid Soltani, Seyed Mahmoud Latifi, Nastaran Majdinasab, Zohre Safari, Matin Varmazyar, Negin Moradi

{"title":"The Comparison of Quality of Life in Patients with Mild-Moderate Severity of Multiple Sclerosis with and without Dysphagia.","authors":"Azam Rezatofighi, Majid Soltani, Seyed Mahmoud Latifi, Nastaran Majdinasab, Zohre Safari, Matin Varmazyar, Negin Moradi","doi":"10.1007/s00455-025-10811-9","DOIUrl":"10.1007/s00455-025-10811-9","url":null,"abstract":"Multiple Sclerosis (MS) is a common chronic disease among young adults. It affects various aspects of Quality of Life (QOL). Dysphagia is a problem associated with neurological damage in MS patients. This study aimed to compare MS patients' QOL with and without dysphagia. This is a cross-sectional study performed on 40 patients with MS (20 with and 20 without dysphagia) selected from the MS Society members of Ahvaz, Iran. Research tools included the Persian version of Dysphagia in Multiple Sclerosis (DYMUS), Mini-Mental State Examination (MMSE), and Multiple Sclerosis Quality of Life-54 (MSQOL-54). The data were analyzed by SPSS software version 22 and the Mann-Whitney test. The results showed a significant difference in QOL score amongst patients with and without dysphagia. The QOL score of patients with dysphagia was significantly lower than patients without dysphagia. The main differences in the subscale of the QOL Index were mental component and physical activity. MS patients with dysphagia had lower QOL than patients without it. The results show that the quality of life of MS patients with dysphagia is lower than the quality of life of MS patients without dysphagia, and this issue includes different physical and mental aspects of the quality of life of these patients. According to the findings of this study, it seems that early referral of patients with MS to speech and language pathologists for the management of swallowing disorders in the early stages of the disease can be very important and help improve the wellbeing of these patients and their families.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"1156-1162"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development of a Screening Intervention for Dysphagia in Hospitalised Geriatric Patients. 对住院老年患者吞咽困难的筛查干预的发展。

IF 3 3区医学

Dysphagia Pub Date : 2025-10-01 Epub Date: 2025-01-30 DOI: 10.1007/s00455-025-10803-9

Anne Mette Schmidt, Helene Nørgaard Kristensen, Dorte Melgaard, Asger Roer Pedersen, Lene Mark, Charlotte Weiling Appel, Sofie Langergaard, Charlotte Overgaard

{"title":"Development of a Screening Intervention for Dysphagia in Hospitalised Geriatric Patients.","authors":"Anne Mette Schmidt, Helene Nørgaard Kristensen, Dorte Melgaard, Asger Roer Pedersen, Lene Mark, Charlotte Weiling Appel, Sofie Langergaard, Charlotte Overgaard","doi":"10.1007/s00455-025-10803-9","DOIUrl":"10.1007/s00455-025-10803-9","url":null,"abstract":"Prevalence of dysphagia is high in hospitalised geriatric patients, posing risks of complications including malnutrition, dehydration, aspiration, and pneumonia. These complications may lead to reduced daily functioning, frailty, prolonged hospital stays, readmissions, and mortality. Diagnosing dysphagia in geriatric patients is often challenging due to the complex health conditions of this patient group, and overall these patients are at risk of lack of continuity in patient pathways and unnecessary hospitalisations. Recognising the critical importance of prompt diagnosis and treatment of dysphagia, we developed a dysphagia screening intervention aligned with clinical guidelines and the political focus to improve patient pathways and reduce preventable hospitalisations. This article outlines the development process of a dysphagia screening intervention to geriatric patients (≥ 65 years) admitted to medical inpatient wards. We applied a theory-, evidence- and implementation-based approach combined with stakeholder involvement in adherence to the IdentifyiNg and assessing different approaches to DEveloping compleX intervention (INDEX) guidance, encompassing eleven actions. We developed a dysphagia screening intervention comprising a screening procedure (the 4 Questionnaire Test (4QT), the 30 ml water swallowing test, and an action algorithm) targeting the patient level. Moreover, we developed an implementation strategy (activities necessary for adequate delivery of the dysphagia screening procedure and activities supporting the delivery of the screening procedure) targeting health professionals and the organisational level. The dysphagia screening intervention is now ready for feasibility testing, promising improved health and healthcare services for hospitalised geriatric patients.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"1078-1091"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Super-Supraglottic Swallow Combined with Head Flexion Strengthens Laryngeal Closure. 超声门上吞咽配合头屈加强喉闭。

IF 3 3区医学

Dysphagia Pub Date : 2025-09-27 DOI: 10.1007/s00455-025-10891-7

Hiroko Kobayashi, Hitoshi Kagaya, Mao Ogawa, Keiko Aihara, Yoko Inamoto

{"title":"Super-Supraglottic Swallow Combined with Head Flexion Strengthens Laryngeal Closure.","authors":"Hiroko Kobayashi, Hitoshi Kagaya, Mao Ogawa, Keiko Aihara, Yoko Inamoto","doi":"10.1007/s00455-025-10891-7","DOIUrl":"https://doi.org/10.1007/s00455-025-10891-7","url":null,"abstract":"The super-supraglottic swallow (SSGS) improves laryngeal closure, and head flexion compensates for inadequate closure of the airway. These two procedures are typically utilized by speech-language pathologists for specific patient populations. This study compared the effect of the SSGS with head flexion (i.e., modified SSGS [mSSGS]) on laryngeal closure with that of usual swallowing and the SSGS in healthy individuals. Twenty-one healthy volunteers were instructed to swallow 4 ml of thin liquid barium in a sitting position during usual swallowing, SSGS, and mSSGS under X-ray fluoroscopy. The primary outcome was the distance between the epiglottis and arytenoid (DEA) at onset of the swallowing reflex. The secondary outcomes were DEA before onset of the swallowing reflex, the head flexion angle before and at onset of the swallowing reflex, and the Penetration-Aspiration Scale (PAS) score. The relative ease of performing the mSSGS compared with the SSGS was evaluated using a 7-point Likert scale. DEA at onset of the swallowing reflex was significantly shorter with mSSGS than with usual swallowing (P < 0.001) or the SSGS (P = 0.006). DEA before swallowing was also significantly shorter with the mSSGS than with usual swallowing (P < 0.001) and the SSGS (P = 0.006). PAS score was 1 in all trials. The median Likert score was 3, indicating that the SSGS was easier than the mSSGS. The findings suggest that the mSSGS maneuver enhances laryngeal closure more than the SSGS maneuver and usual swallowing.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Palpation as a Method To Predict Spatial Instrumental Hyolaryngeal Excursion Measures. 触诊作为预测空间仪器喉偏移测量的方法。

IF 3 3区医学

Dysphagia Pub Date : 2025-09-25 DOI: 10.1007/s00455-025-10880-w

Kelsey L Murray, Sarah H Szynkiewicz, Erin Kamarunas

{"title":"Palpation as a Method To Predict Spatial Instrumental Hyolaryngeal Excursion Measures.","authors":"Kelsey L Murray, Sarah H Szynkiewicz, Erin Kamarunas","doi":"10.1007/s00455-025-10880-w","DOIUrl":"https://doi.org/10.1007/s00455-025-10880-w","url":null,"abstract":"The purpose of this study is to determine if speech-language pathologists' (SLP) ratings of palpated hyolaryngeal excursion (pHLE) during a clinical swallow evaluation (CSE) are predictive of spatial measures of hyolaryngeal excursion determined by instrumentation (iHLE). Adults between the ages of 18-99 were recruited with a physician referral to complete a CSE and videofluoroscopy swallow study. Four SLP investigators completed ratings of pHLE palpation during a CSE. Spatial measures of hyoid peak elevation were taken from videofluoroscopy swallow studies. Statistical analyses included multiple linear regression to determine the best-fitting model to predict iHLE from palpated ratings. Data from 77 volunteers (44 female, mean age 71.6) were used for statistical analyses. The linear regression model indicated three significant predictors of superior (upward) hyoid peak position, including palpation, bolus consistency, and the number of swallows. There were no significant predictors of anterior (forward) hyoid peak position from the tested factors. The emergence of these significant predictors suggests that palpation may provide insight into superior HLE movements during a CSE. Next steps will be to determine if palpation improves SLPs' diagnostic accuracy and clinical decision-making during swallow assessment without instrumentation.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Pilot Study to Investigate the Effects of Bupivacaine Nasal Treatment in Palliative Care Patients with Swallowing Difficulty. 一项探讨布比卡因鼻腔治疗伴吞咽困难姑息治疗患者疗效的初步研究。

IF 3 3区医学

Dysphagia Pub Date : 2025-09-25 DOI: 10.1007/s00455-025-10890-8

Athma Prasanna, Chinmayee Anand, B S Sunitha, Praveen Prasannan, Priya Arjun, Shubhangi Upadhyay, Namrata Bankoti, Nagasuma Chandra

{"title":"A Pilot Study to Investigate the Effects of Bupivacaine Nasal Treatment in Palliative Care Patients with Swallowing Difficulty.","authors":"Athma Prasanna, Chinmayee Anand, B S Sunitha, Praveen Prasannan, Priya Arjun, Shubhangi Upadhyay, Namrata Bankoti, Nagasuma Chandra","doi":"10.1007/s00455-025-10890-8","DOIUrl":"https://doi.org/10.1007/s00455-025-10890-8","url":null,"abstract":"Dysphagia among end-of-life patients in palliative care is debilitating and requires symptomatic management. Current methods involving usage of IV fluids, total parenteral nutrition, intermittent oral liquid feeds, use of naso-gastric tubes or administration of nasal saline drops are inadequate in providing relief to the patient, warranting exploration of newer methods. At SSCHRC, a novel intervention of intranasal administration of Bupivacaine, a widely used anesthetic has been used successfully to treat end-of-life cancer patients, providing temporary relief for about half an hour with each administration, facilitating food and water intake. This study is aimed as a pilot to assess the feasibility of the study design in gathering molecular data on the effect of the treatment, especially on the mucin related pathways. Using throat swabs of patients, we obtained bulk RNAseq transcriptomes before and after the treatment. We analyze patterns of differential expression and use a genome-wide protein-protein interaction network approach to infer the affected pathways and processes. Our results indicate that the Bupivacaine treatment shows variation in gene expression in key genes and pathways that could potentially explain reduction in mucin secretion leading to relieving symptoms of dysphagia. It provides support for conducting a larger clinical study in order to study the effect in a larger cohort.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of Swallowing Function and Aspiration in Newly Diagnosed Head and Neck Cancer Patients. 初诊头颈部肿瘤患者吞咽功能及误吸的评价。

IF 3 3区医学

Dysphagia Pub Date : 2025-09-25 DOI: 10.1007/s00455-025-10888-2

Ping-Chia Cheng, Chia-Na Tusi, Yih-Chia Kao, Chi-Te Wang, Li-Jen Liao, Po-Wen Cheng, Wu-Chia Lo

{"title":"Evaluation of Swallowing Function and Aspiration in Newly Diagnosed Head and Neck Cancer Patients.","authors":"Ping-Chia Cheng, Chia-Na Tusi, Yih-Chia Kao, Chi-Te Wang, Li-Jen Liao, Po-Wen Cheng, Wu-Chia Lo","doi":"10.1007/s00455-025-10888-2","DOIUrl":"https://doi.org/10.1007/s00455-025-10888-2","url":null,"abstract":"Swallowing difficulties are common in head and neck cancer (HNC) patients, significantly affecting nutrition and quality of life. Early identification of risk factors is essential for timely intervention. A retrospective analysis of 244 newly diagnosed HNC patients was conducted. Swallowing function was assessed using the Penetration-Aspiration Scale (PAS) alongside subjective measures, including the Eating Assessment Tool (EAT-10) and Functional Oral Intake Scale (FOIS). PAS served as the gold standard for identifying aspiration risk factors. Aspiration events, defined as a PAS score of ≥ 6, varied by tumor site. The highest rate of aspiration events was observed in patients with hypopharyngeal cancers (35%), followed by oropharyngeal (24%), oral cavity (12%), and laryngeal cancers (11%). Notably, no aspiration events were identified in cases of nasopharyngeal carcinoma. Multivariate logistic regression analyses identify age, BMI and tumor site as independent predictors of aspiration. A prediction model was then created as follows: Score = (0.060 × Age) - (0.120 × BMI) + 1.587 (if tumor site is oral cavity) + 1.915 (if tumor site is oropharynx) + 2.425 (if tumor site is hypopharynx) + 0 (if tumor site is larynx, nasopharynx, or other sites) - 5.552. This model achieved an AUC of 0.78, with an optimal cutoff score of -2.15, yielding a sensitivity of 45%, specificity of 93%, and accuracy of 86% for predicting aspiration risk. This research highlights the multifactorial nature of dysphagia in HNC patients and introduces a predictive model for aspiration risk. Early identification of high-risk patients enables timely swallowing evaluations and interventions, improving safety and quality of life.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0