The Quality of Life in Citizens with Oropharyngeal Dysphagia-A Cross-Sectional Study

Dysphagia is a risk factor that impaires an individual’s experience of mealtimes. Few studies contribute to the knowledge on the health-related quality of life (HRQoL) of citizens with oropharyngeal dysphagia (OD) living independently. The aim of this study involves evaluating the HRQoL in citizens living independently and suffering from OD. This cross-sectional study was performed in seven municipalities in Denmark between March 2019 and December 2020. The 90 citizens included (54% female, mean age 76.6 years (SD 0.8)) were ≥18 years, as well as diagnosed with OD using the volume-viscosity swallow test and Minimal Eating Observation Form version II. The Dysphagia Handicap Index-DK, Barthel 20, and European Quality of Life-5 Dimensions were fulfilled. Of the participating citizens, 66% of them needed additional time to eat, 64% coughed while eating, and 58% coughed while drinking. Additionally, 60% reported having a dry mouth, 62% needed to drink to succeed with swallowing foods, and 57% had to swallow multiple times. About one-third felt embarrassed when eating with others. They could not enjoy eating in the same manner as they had previously, and/or felt handicapped or limited. OD was shown to have had a high impact on the QoL in citizens with OD living independently. Focus is needed on xerostomia, as well as on the psychological aspects pertainings to mealtimes for citizens with OD

Eosinophilic oesophagitis in Denmark:Population-based incidence and prevalence in a nationwide study from 2008 to 2018

BACKGROUND: Eosinophilic oesophagitis (EoE) is a chronic immune‐mediated or antigen‐mediated oesophageal disease characterised by symptoms related to oesophageal dysfunction and eosinophil‐predominant inflammation. OBJECTIVE: We aimed to estimate the incidence and prevalence of EoE in Denmark during the period 2008–2018. METHODS: Based on data from nationwide registers we identified cases of EoE using two definitions: a broad definition based solely on oesophageal biopsies registered in the Danish Pathology Register and a narrow definition also including symptoms of oesophageal dysfunction registered in the Danish National Patient Registry. The annual incidence and prevalence were standardised by sex and age in 5‐year intervals to the 2013 study population. RESULTS: From 2008 to 2011, the standardised incidence of EoE was stable, but from 2011 to 2018 it increased from 3.9 (95% CI 3.3–4.4) to 11.7 (95% CI 10.8–12.6) per 100,000 person‐years. Similar temporal trends were observed when using the narrow EoE definition. The increase in incidence was most pronounced in men and in individuals above 40 years of age. In children, the EoE incidence was a fourth of the incidence in adults aged 40–64 years: 4.4 (95% CI 3.2–5.6) versus 17.6 (95% CI 15.7–19.5) per 100,000 person‐years. The EoE incidence varied substantially across the five regions in Denmark. Overall, the biopsy rate as well as the proportion of oesophageal biopsies with detected eosinophilia increased during the study period. CONCLUSION: This study of the entire population of Denmark during the period 2008 to 2018 shows that the incidence and prevalence of EoE is not yet plateauing and that EoE could be severely underdiagnosed, especially in children

Effect of Chin Tuck against Resistance Exercise in Citizens with Oropharyngeal Dysphagia-A Randomised Controlled Study

Oropharyngeal dysphagia (OD) impacts the safety and efficacy of the swallowing function. The aim was to uncover the effect of chin tuck against resistance (CTAR) exercises compared to standard care in relation to the swallowing function in citizens with OD. Ninety-two citizens (46% male, median age 78 years (IQR 71, 84)) with OD confirmed by the Volume-Viscosity Swallow Test and/or Minimal Eating Observation Form version II were randomised to standard care with the addition of CTAR daily for six weeks or standard care only. The participants were included from seven Danish municipalities from March 2019 to October 2020. A nonsignificant effect on dysphagia of CTAR training combined with standard care versus standard care alone was documented. Both CTAR training combined with standard care and standard care alone had a significant effect on the swallowing function in citizens with OD, with the best effect in the group receiving CTAR training combined with standard care. A significant effect compared to baseline was observed in all participants (p = 0.03) after 12 weeks. Participants in both groups had a significant reduction in problems with manipulating food in the mouth (p = 0.005), swallowing (p = 0.005), and chewing (p = 0.03) but an increased appetite (p = 0.01). The reported quality of life scored with DHI-DK was significantly improved in both groups

The incidence of eosinophilic oesophagitis in 2007-2017 among children in North Denmark Region is lower than expected

BACKGROUND: In North Denmark Region (NDR), the incidence of Eosinophilic Oesophagitis (EoE) among adults has increased following a new biopsy protocol in 2011, whereas data on the incidence of EoE among children is lacking. AIMS: To describe the incidence of EoE in children aged 0–17 in NDR as well as diagnostic delay, clinical manifestations, treatment and complications. METHODS: This retrospective, register-based DanEoE cohort study included 18 children diagnosed with EoE between 2007–2017 in NDR. Medical files were reviewed with attention to symptoms, reason for referral, disease progress, treatment, symptomatic and histological remission as well as diagnostic delay. RESULTS: The median incidence per year (2007–2017) was 0.86/100,000 children in NDR aged 0–17 years. The median diagnostic delay among children was four years and six months. Sixty percent presented with food impaction at first hospital visit. After initial treatment, only one of 18 children achieved symptomatic and histologic remission and had a long-term treatment plan. CONCLUSIONS: The calculated incidence among children was lower compared to similar studies. Combined with poor remission rates and lack of follow-up, it is likely that EoE is an underdiagnosed and insufficiently treated disease among children in NDR. Our findings suggest that more knowledge concerning EoE in children could lead to a higher incidence, shorter diagnostic delay and more effective treatment

Can protein and energy enriched soups be a tool in the nourishment of hospitalised patients in Denmark? A quality-development study

  Baggrund: Patienters fødevare- og smagspræferencer ændres ofte med stigende alder og sygdom. Dette studie har till formål at undersøge proteinberigede supper som et alternativ eller supplement til standard protein drikke hos svært syge danske patienter.     Metode: Forbedringsmodellen (Plan-Do-Study-Act cycle) er anvendt til at evaluere de berigede supper og inkluderede tre sessioner (session 1-3). Session 1) 18 svært syge patienter indlagt mere end 24 timer på Regions Hospital Nordjylland fik i vilkårlig rækkefølge serveret 6 forskellige proteinberigede supper (0,1-0,2 dl) med og uden topping og skulle efterfølgende bedømme supperne på en VAS-skala. Session 2) Borgere med kronisk obstruktive lungelidelse (KOL) deltog i et gruppeinterview om fødevarepræferencer ved svær sygdom i hjemmet eller under indlæggelse. Session 3) Supperne blev modificeret ud fra erfaringer fra session 1-2 og testet igen på en tilsvarende patientgruppe som i session 1, som evaluerede supperne ud fra en 5-punkts Likert skala med ansigter.   Resultater: Session 1: I session 1 kunne størstedelen af data ikke indhentes på grund af at patienter 1) faldt i søvn, 2) ikke kunne anvende VAS skalaen, 3) oplevede manglende smags- og lugtesans, 4) ikke kunne tygge eller anvende ske. I session 2 foretrak deltagerne i gruppeinterviewene varme måltider, tyk konsistens og at det krævede begrænset energi at spise måltidet samt at der ikke indgik nødder. I session 3 var det muligt at indhente pålidelige resultater. Gennemsnitsscoren for kærnemælks-, tomat- og kartoffelsuppe var henholdsvis 4,7, 3,8 og 4,2 ud af 5. Tyk og sød suppe var det foretrukne valg. Konklusion: Studiet viste, at svært syge patienter oplevede det var vanskeligt at holde sig vågne under måltiderne, føre maden til munden, de var stakåndede, udmattede af at tygge og manglede smags- og lugtesans.  Protein- og energiberigede supper er tilfredsstillende og blev rangeret højt på smagsoplevelse. Fremadrettet virker proteinberigede supper i små portioner som en god mulighed for at imødekomme mange af de problemer disse patienter oplever

Ændrede stuegangsrutiner på de akutte sengeafsnit på Aalborg Universitetshospital har medført hurtigere afvikling af stuegangen og reduceret crowding trods samme antal læger - Et organisatorisk studie

Titel: Ændrede stuegangsrutiner på de akutte sengeafsnit på Aalborg Universitetshospital har medført hurtigere afvikling af stuegangen og reduceret crowding trods samme antal læger - Et organisatorisk studie Baggrund: Det stigende antal akutte patienter i Danmark har medført vanskeligheder med at få afviklet stuegang i Akutafdelingerne. På Kolding Sygehus har man med succes ændret stuegangsorganiseringen, så stuegangen afvikles hurtigere og lægerne derefter kan hjælpe med modtagelse af nye patienter.   Formål: at undersøge, om erfaringerne fra Kolding kan overføres til andre akutmodtagelser.   Metode: I to uger blev næsten alle læger i Akutafdelingen sat til at gå stuegang. Efterhånden som nye patienter ankom i Modtagelsen op ad dagen, blev lægerne kaldt fra stuegang ned til Modtagelsen en ad gangen. Der blev sendt spørgeskemaer ud til alle sygeplejersker i de to akutmedicinske sengeafsnit og alle læger mhp. at måle effekten.  Resultat: Ud af 51 besvarelser svarede 84 % ”Ja” (43, heraf 25 læger) til at arbejdsgangene fra projektugerne skulle indføres permanent. Andelen af dage, hvor sengeafsnittene var afviklet før kl. 13, steg fra 48% til 79 % (p=0.03). Andelen af læger, der ”ofte” eller ”altid” kunne nå stuegang inden lægekonference øgedes fra 14% til 82 % selvom konferencen blev rykket fra kl. 12 til kl. 11 (p< 0.001). Andelen af læger, der efter stuegang kunne hjælpe med i Modtagelsen med nye patienter øgedes fra 38 % til 77 % (p<0.001). Af koordinerende læger i Modtagelsen vurderede 64 % at varigheden af crowding blev nedsat.   Konklusion: Selvom projektugerne medførte en stor organisatorisk forandring, viste det sig at være en fordel for både læger og sygeplejersker. Forbedring sås både ved hurtig afvikling af stuegang og flere læger i Modtagelsen i crowding perioder. Metoden har potentiale og kan med fordel afprøves i andre Akutafdelinger med tilsvarende organisation.