Higher Risk Of Complications In Odynophagiaassociated Dysphagia In Amyotrophic Lateral Sclerosis [disfagia Associada á Odinofagia Na Esclerose Lateral Amiotrófica Pode Sugerir Maior Risco Para Complicaçes Pulmonares E Nutricionais]

Objective: This investigation aimed to identify associated factors with dysphagia severity in amyotrophic lateral sclerosis (ALS). Method: We performed a cross-sectional study of 49 patients with ALS. All patients underwent fiberoptic endoscopy evaluation of swallowing and answered a verbal questionnaire about swallowing complaints. The patients were divided into groups according to dysphagia severity. Results: Among the factors analyzed, only odynophagia was associated with moderate or severe dysphagia. Conclusion: Odynophagia was associated with moderate and severe dysphagia in ALS and suggests a high risk of pulmonary and nutritional complications.723203207Fattori, B., Grosso, M., Bongioanni, P., Assessment of swallowing by oropharyngoesophageal scintilography in patients with amyotrophic lateral sclerosis (2006) Dysphagia, 21, pp. 280-286Janzen, V.D., Hae, R., Hudson, A.J., Otolaryngologic manifestations of amyotrophic lateral sclerosis (1996) J Otolaryngol, 17, pp. 41-42Hadjikoutis, S., Wiles, C.M., Respiratory complications related to bulbar dysfunction in motor neuron disease (2001) Acta Neurol Scand, 103, pp. 207-213Oliveira, A.S.B., Pereira, R.D.B., Amyotrophic lateral sclerosis (ALS): Three letters that change the people's life (2009) Arq Neuropsiquiatr, 67, pp. 750-782O'toole, O., Traynor, B.J., Brennan, P., Epidemiology and clinical features of amyotrophic lateral sclerosis in Ireland between 1995 and 2004 (2008) J Neurol Neurosurg Psychiatry, 79, pp. 30-32Zoccolella, S., Beghi, E., Palagano, G., Analysis of survival and prognostic factors in amyotrophic lateral sclerosis: A population based study (2008) J Neurol Neurosurg Psychiatry, 79, pp. 33-37Ganzini, L., Johnston, W.S., Hoffman, W.F., Correlates of suffering in amyotrophic lateral sclerosis (1999) Neurology, 52, pp. 1434-1440Oliver, D., The quality of care and symptom control-the effects on the terminal phase of ALS/MND (1996) J Neurol Sci, 139 (SUPPL.), pp. S134-S136Chiò, A., Canosa, A., Gallo, S., Pain in amyotrophic lateral sclerosis: A population-based controlled study (2012) Eur J Neurol, 19, pp. 551-555Wilson, J.D., (1991) Harrison's Principles of Internal Medicine, p. 417. , 12th edition. New York: McGraw-HillVaiman, M., Eviatar, E., Surface electromyography as a screening method for evaluation of dysphagia and odynophagia (2009) Head Face Med, 5, pp. 1-11Brooks, B.R., El Escorial World Federation of Neurology criteria for the diagnosis of amyotrophic lateral sclerosis. Subcommittee on Motor Neuron Diseases/Amyotrophic Lateral Sclerosis of the World Federation of Neurology Research Group on Neuromuscular Diseases and the El Escorial "Clinical limits of amyotrophic lateral sclerosis" workshop contributors (1994) J Neurol Sci, 124 (SUPPL.), pp. S96-S107McEdo Filho, E.D., Gomes, G.F., Furkim, A.M., (2000) Manual de cuidados do paciente com disfagia, , São Paulo: LovisePontes, R.T., Orsini, M., Freitas, M.R.G., Antonioli, R.S., Nascimento, O.F.M., Alterações da fonação e deglutição na esclerose lateral amiotrófica: Revisão de literatura (2010) Rev Neurocienc, 18, pp. 69-73Thomas, C.K., Zijdewind, I., Fatigue of muscles weakened by death of motoneurons (2006) Muscle Nerve, 33, pp. 21-41Handy, C.R., Krudy, C., Boulis, N., Federici, T., Pain in amyotrophic lateral sclerosis: A neglected aspect of disease (2011) Neurol Res Int, 1, pp. 1-8Brettschneider, J., Kurent, J., Ludolph, A., Mitchell, J.D., Drug therapy for pain in amyotrophic lateral sclerosis or motor neuron disease (2008) Cochrane Database Syst Rev, 3, pp. CD005226Ertekin, C., Aydogdu, I., Yüceyar, N., Kiylioglu, N., Tarlaci, S., Uludag, B., Pathophysiological mechanisms of oropharyngeal dysphagia in amyotrophic lateral sclerosis (2000) Brain, 123, pp. 125-140Simmons, Z., Management strategies for patients with amyotrophic lateral sclerosis from diagnosis through death (2005) Neurologist, 11, pp. 257-270Garon, B.R., Engle, M., Ormiston, C., Reliability of the 3-oz water swallow test utilizing cough reflex as sole indicator of aspiration (1995) J Neurol Rehab, 9, pp. 139-143Pagnini, F., Lunetta, C., Banfi, P., Pain in amyotrophic lateral sclerosis: A psychological perspective (2012) Neurol Sci, 33, pp. 1193-1196Maessen, M., Veldink, J.H., van den Berg, L.H., Schouten, H.J., van der Wal Onwuteaka-Philipsen, B.D., Requests for euthanasia: Origin of suffering in ALS, heart failure, and cancer patients (2010) J Neurol, 257, pp. 1192-119

Dysphagia Progression And Swallowing Management In Parkinson's Disease: An Observational Study

Introduction: Dysphagia is relatively common in individuals with neurological disorders. Objective: To describe the swallowing management and investigate associated factors with swallowing in a case series of patients with Parkinson's disease. Methods: It is a long-term study with 24 patients. The patients were observed in a five-year period (2006-2011). They underwent Fiberoptic Endoscopic Evaluation of Swallowing, Functional Oral Intake Scale and therapeutic intervention every three months. In the therapeutic intervention they received orientation about exercises to improve swallowing. The Chi-square, Kruskal-Wallis and Fisher's tests were used. The period of time for improvement or worsening of swallowing was described by Kaplan-Meier analysis. Results: During the follow-up, ten patients improved, five stayed the same and nine worsened their swallowing functionality. The median time for improvement was ten months. Prior to the worsening there was a median time of 33 months of follow-up. There was no associated factor with improvement or worsening of swallowing. The maneuvers frequently indicated in therapeutic intervention were: chin-tuck, bolus consistency, bolus effect, strengthening-tongue, multiple swallows and vocal exercises. Conclusion: The swallowing management was characterized by swallowing assessment every three months with indication of compensatory and rehabilitation maneuvers, aiming to maintain the oral feeding without risks. There was no associated factor with swallowing functionality in this case series.8112430Crary, M.A., Adult neurologic disorders (2009) Dysphagia - clinical management in adults and children, pp. 72-98. , Elsevier/Mosby, St. LouisSchrag, A., Ben-Shlomo, Y., Quinn, N.P., Cross-sectional prevalence survey of idiopathic Parkinson's disease and parkinsonism in London (2000) BMJ, 321, pp. 21-22Rijk, M.C., Breteler, M.M., Graveland, G.A., Ott, A., Grobbee, D.E., Van Der Meche', F.G., Prevalence of Parkinson's disease in the elderly: the Rotterdam study (1995) J Neurol, 45, pp. 2143-2146Jankovic, J., Pathophysiology and assessment of parkinsonian symptoms and signs (2007) Handbook of Parkinson's disease, pp. 79-104. , Taylor and Francis Group LLC, New York, R. Pahwa, K. Lyons, W.C. Koller (Eds.)Potulska, A., Friedman, A., Krolicki, L., Spychala, A., Swallowing disorders in Parkinson's disease (2003) Parkinsonism Relat Disord, 9, pp. 349-353Felix, V.N., Corrêa, S.M.A., Soares, R.J., A therapeutic maneuver for oropharyngeal dysphagia in patients with Parkinson disease (2008) Clinics, 63, pp. 661-666Marik, P.E., Kaplan, D., Aspiration pneumonia and dysphagia in the elderly (2003) Chest, 124, pp. 328-336Manor, Y., Giladi, N., Cohen, A., Fliss, D.M., Cohen, J.T., Validation of a swallowing disturbance questionnaire for detecting dysphagia in patients with Parkinson's disease (2007) Mov Disord, 22, pp. 1917-1921Müller, J., Wenning, G.K., Verny, M., McKee, A., Chaudhuri, K.R., Jellinger, K., Progression of dysarthria and dysphagia in postmortem-confirmed Parkinsonian disorders (2001) Arch Neurol, 58, pp. 259-264D'Amelio, M., Ragonese, P., Morgante, L., Reggio, A., Callari, G., Salemi, G., Long-term survival of Parkinson's disease: a population-based study (2006) J Neurol, 253, pp. 33-37Schüpbach, M.W., Welter, M.L., Bonnet, A.M., Elbaz, A., Grossardt, B.R., Mesnage, V., Mortality in patients with Parkinson's disease treated by stimulation of the subthalamic nucleus (2007) Mov Disord, 22, pp. 257-261Crary, M.A., Treatment for adults (2009) Dysphagia: clinical management in adults and children, pp. 275-307. , Elsevier/Mosby, St. Louis, M.A. Crary, M.E. Groher (Eds.)Crary, M.A., Mann, G.D.C., Groher, M.E., Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients (2005) Arch Phys Med Rehabil, 86, pp. 1516-1520Miller, N., Noble, E., Jones, D., Burn, D., Hard to swallow: dysphagia in Parkinson's disease (2006) Age Ageing, 35, pp. 614-618Logemann, J.A., Blonsky, E.R., Boshes, B., Editorial: dysphagia in parkinsonism (1975) JAMA, 231, pp. 69-70Stroudley, J., Walsh, M., Radiological assessment of dysphagia in Parkinson's disease (1991) Br J Radiol, 64, pp. 890-893Bird, M.R., Woodward, M.C., Gibson, E.M., Phyland, D.J., Fonda, D., Asymptomatic swallowing disorders in elderly patients with Parkinson's disease: a description of findings on clinical examination and videofluoroscopy in sixteen patients (1994) Age Ageing, 23, pp. 251-254Miller, N., Allcock, L., Hildreth, A.J., Jones, D., Noble, E., Burn, D.J., Swallowing problems in Parkinson's disease: frequency and clinical correlates (2009) J Neurol Neurosurg Psychiatry, 80, pp. 1047-1049Baldeschi, M., Di Carlo, A., Rocca, W.A., Italian longitudinal study on aging Parkinson's disease and parkinsonism in a longitudinal study: two-fold higher incidence in men (2000) J Neurol, 55, pp. 1358-1363. , for ILSA Working GroupLogmann, J.A., Gensler, G., Robbins, J., Lindblad, A.S., Hind, J.A., Kosek, S., A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson's disease (2008) J Speech Lang Hear Res, 51, pp. 173-183Lorefält, B., Gránerus, A.K., Unosson, M., Avoidance of solid food in weight losing older patients with Parkinson's disease (2006) J Clin Nurs, 15, pp. 1404-1412Lo, R.Y., Tanner, C.M., Albers, K.B., Leimpeter, A.D., Fross, R.D., Bernstein, A.L., Clinical features in early Parkinson's disease and survival (2009) Arch Neurol, 66, pp. 1353-1358Auyeung, M., Tsoi, T.H., Mok, V., Cheung, C.M., Lee, C.N., Li, R., Ten years survival and outcomes in a prospective cohort of new onset Chinese Parkinson's disease patients (2012) J Neurol Neurosurg Psychiatry, 83, pp. 607-611Robbins, J., Gensler, G., Hind, J., Logemann, J.A., Lindblad, A.S., Brand, D., Comparison of two interventions for liquid aspiration on pneumonia incidence a randomized trial (2008) Ann Intern Med, 148, pp. 509-518El Sharkawi, A., Ramig, L., Logemann, J.A., Pauloski, B.R., Rademaker, A.W., Smith, C.H., Swallowing and voice effects of Lee Silverman Voice Treatment (LSVT(R)): a pilot study (2002) J Neurol Neurosurg Psychiatry, 72, pp. 31-36Hockstein, N.G., Samadi, D.S., Gendron, K., Handler, S.D., Sialorrhea: a management challenge (2004) Am Fam Physician, 69, pp. 2628-2634Russell, J.A., Ciucci, M.R., Connor, N.P., Schallert, N.T., Targeted exercises therapy for voice and swallow in persons with Parkinson's disease (2010) Brain Res, 1341, pp. 3-11Logemann, J.A., (1998) Evaluation and treatment of swallowing disorders, , Pro-Ed, Austin, TXMenezes, C., Melo, A., Does levodopa improve swallowing dysfunction in Parkinson's disease patients? 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Influence Of Smoking Isolated And Associated To Multifactorial Aspects In Vocal Acoustic Parameters [infuência Do Tabagismo Isolado E Associado A Aspectos Multifatoriais Nos Parâmetros Acústicos Vocais]

Introduction: Smoking affect voice quality in a long period of time, but other factors may compromise it, such as professional using of voice, habits, alcohol dependence and GERD. The aim was associate the influence of these factors on vocal parameters. Study design: Contemporary cohort study with cross-sectional. Materials and methods: Eighty adults of 35 to 60 years old had participated in this study, they had been divided into two groups, smokers (GF) and control (GC). There was application of questionnaire and voices were recorded. Praat software has been used for voice assessment and Man-Whitney, chi-square and logistic regression has been used for statistical analysis. Results: The GF had a higher incidence of alcohol dependence, coughing, throat clearing and professional voice using. Respecting to the acoustic parameters: noise-to-harmonic ratio (NHR), jitter and shimmer, the GF presented higher values. Relating these data to the questionnaire, it's noticed that female gender have influence over all acoustic parameters, GERD have influence over jitter and smoking can affect fundamental frequency, jitter, shimmer and NHR. Conclusion: Smoking interferes in acoustics parameters isolated and associated with alcohol dependence, GERD, cough, throat clearing, gender and professional using of voice. © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.8016067Geneva: World Health Organization (2007) World No Tobacco Day 2004 Materials, , http://www.who.int/tobacco/resour-ces/publications/wntd/2004/en, World Health Organization, [cited 01 Sep 2005] Available from, Accessed in 27/09/2011Rafferty, M.A., Fenton, J.E., Jones, A.S., The history, aetiology and epidemiology of laryngeal carcinoma (2001) Clin Otolaryngol, 26, pp. 442-446Sorensen, D., Horii, Y., Cigarrete smoking and voice fundamental frequency (1982) J Commun Dis, 15, pp. 135-144Duarte, J.L., de Faria, F.A.C., Ceolin, D.S., Cestari, T.M., de Assis, G.F., Efei-tos da inalação passiva da fumaça de cigarro sobre as pregas vocais de ratos (2006) Rev Bras Otorrinolaringol, 72, pp. 210-216Hashibe, M., Bofetta, P., Zaridze, D., Shangina, O., Szeszenia-Da-browska, N., Mates, D., Contribution of tobacco and alcohol to the high rates of squamous cell carcinoma of the supraglottis and glottis in central Europe (2007) Am J Epidemiol, 165, pp. 814-820Shiga, K., Tateda, M., Katagiri, K., Nakanome, A., Ogawa, T., Asada, Y., Distinct features of second primary malignancies in head and neck cancer patients in Japan (2011) Tohoku J Exp Med, 225, pp. 5-12Leon, X., Del Prado, M., Orus, C., Lopez, M., Barcia, J., Quer, M., In-fluence of the persistence of tobacco and alcohol use in the appearance of second neoplasm in patients with head and neck cancer. A case control study (2009) Cancer Causes Control, 20, pp. 645-652Cielo, C.A., Finger, L.S., Niehues, G.R., Deuschle, V.P., Siqueira, M.A., Disfonia organofuncional e queixas de distúrbios alérgicos e/ ou digestivo (2009) Rev CEFAC, 11, pp. 431-439Silverio, K.C.A., Gonçalves, C.G.O., Penteado, R.Z., Vieira, T.P.G., Libardi, A., Rossi, D., Ações em saúde vocal: Proposta de melhoria do perfl vocal de professores (2008) Pró-Fono, 20, pp. 177-182Fortes, F.S.G., Imamura, R., Tsuji, D.H., Sennes, L.U., Perfl dos pro-fssionais da voz com queixas vocias atendidos em um centro terciário de saúde (2007) Rev Bras Otorrinolaringol, 73, pp. 27-31Williams, N.R., Occupational groups at risk of voice disorders (2003) Occup Med (Lond), 53, pp. 456-460Velanovich, V., Gastroesophageal reflux disease and the airway essentials for the surgeon (2009) World J Gastrointest Surg, 1, pp. 8-10Mahieu, H.F., Review article: The laryngological manifestations of reflux diseasewhy the scepticism? 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Fortschritte der Medizin (1985) München, 13, pp. 469-478Machado, M.A.M.P., Aldrighi, J.M., Ferreira, L.P., Os sentidos atribuí-dos à voz por mulheres após a menopausa (2005) Rev Saúde Pública, 39, pp. 261-269Queija, D.S., Barros, A.P.B., Dedivitis, R.A., Corazza, V.R., Silva, V.F.C., Nishimoto, I.N., Avaliação laringoestroboscópica, perceptiva e computadorizada da voz de tabagistas do gênero masculino (2006) Rev Bras Cir Cabeça Pescoço, 35, pp. 93-96Figueiredo, D.C., Souza, P.R.F., Gonçalves, M.I., Biase, N.G., Análise per-ceptivo-auditiva computadorizada e laringológica da voz de adultos jovens fumantes e não fumantes (2003) Rev Bras Otorrinola-ringol, 69, pp. 791-799Behlau, M., (2001) Voz: O Livro Do Especialista, 1. , Rio de Janeiro: RevinterBoersma, P., Weenick, D., Praat Manual (2006) Phonetic Sciences Department, , http://www.fon.hum.uva.nl/praat/, Amsterdam: University of Amsterdam, [cited 27 Sept 2011]. 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