Browsing by Subject "dysphagia"
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(2021)Amyotrofinen lateraaliskleroosi (ALS) on etenevä, kuolemaan johtava, neurodegeneratiivinen sairaus, jolle tyypillistä on raaja-alkuinen lihasheikkous, lihasjäykkyys ja atrofia. Noin 25-30% potilaista sairastaa bulbaarialkuista tautia, jolle tyypillistä on puheentuoton ja nielemisen häiriöt. Taudin esiintyvyys Euroopassa on 4.1-8.2 tapausta 100 000 henkilövuotta kohden. Tämän tutkimuksen tavoitteena oli selvittää ensisijaisesti korva-, nenä- ja kurkkutaudeille hakeutuvien ALS-potilaiden ja erityisesti bulbaarista tautia sairastavien potilaiden tyypillinen oirekirjo, mahdollinen läheteviive ja taudin kulku sekä nielemisfunktiotutkimusten käyttökelpoisuus ja hoidon tulokset. Toissijainen tavoite oli selvittää parenteraalisen ravitsemuksen ja trakeostomian esiintyvyys koko potilasryhmässä. Tutkimusta varten kerättiin kaikki Helsingin ja Uudenmaan sairaanhoitopiirin diagnosoidut ALS-potilaat vuosilta 2010–2014, joita oli yhteensä 327, ja näistä 110 bulbaari-ALS-potilaita. Kaikista potilaista selvitettiin sukupuoli, taudin tyyppi ja kesto, tehdyt toimenpiteet, ja lisäksi bulbaarialkuista tautia sairastavilta nielemisfunktiotutkimuksiin, hengitys- ja nielemisoireiden alkuun, ensimmäiseen hoitokontaktiin, erikoislääkärikontaktiin sekä ensimmäiseen neurologikontaktiin liittyvää dataa. Aineisto analysoitiin käyttäen vakiintuneita tilastollisia menetelmiä. Tutkimuksessa selvisi, että korva-, nenä- ja kurkkutaudeille tyypillisesti hakeudutaan bulbaarialkuisen taudin tyyppioireiden takia. ALS-potilaiden hoitotulokset eivät merkittävästi riipu siitä, mille erikoisalalle potilas ensimmäisenä lähetetään. Lisäksi taudin insidenssi, hoitotulokset ja tehtyjen toimenpiteiden kumulatiivinen insidenssi vastaa kirjallisuuskatsauksessa ilmeneviä eurooppalaisia lukuja. Tutkimuksemme perusteella parenteraalinen ravitsemus näyttää parantavan bulbaarialkuista tautia sairastavan elinajan ennustetta, mutta hieman yllättäen huonontavan raaja-alkuista tautia sairastavan potilaan elinajan ennustetta. Tutkimus selkeyttää korva-, nenä- ja kurkkutautilääkäreille hakeutuvien potilaiden oirekuvaa ja selvittää ALS:n hoidon tilaa ja tuloksia Suomessa.
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(2017)Background: Fiberoptic endoscopic evaluation of swallowing (FEES) is an established non-invasive and radiation-safe evaluation method of the pharyngeal swallowing function. The focus is in the diagnosis of dysphagia, consideration of its treatment and in finding compensation techniques for impaired swallowing. We aimed at investigating the feasibility and outcome of FEES at our institution. Patients and Methods: The study group comprised all the 117 patients who had a FEES performed during the years 2011 and 2012 at the Department of Otorhinolaryngology – Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland. Results: Patients who were considered otherwise healthy prior to FEES presented significantly more often with globus symptoms compared with patients with a neurological disorder (p=0.009) or those diagnosed with a head and neck (HN) malignancy (p=0.011). Patients with a neurological disorder had significantly more aspiration (p=0.014), suffered more from swallowing initiation difficulties (p=0.031) and more often had a pneumonia (p<0.005) compared to the patients who had been considered healthy. Aspiration and pneumonia correlated with the underlying disease (r=0.382 p<0.005), as well as with the degree of dysphagia. Conclusions: FEES served well as a second-stage diagnostic tool for dysphagia in a multidisciplinary environment. Patients with no obvious underlying cause for dysphagia presented more often with globus, compared to patients with a diagnosed malignant tumour in the head and neck region, or with a neurological diagnosis. Aspiration, pneumonia and the degree of dysphagia correlated with the underlying cause of dysphagia.
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(2017)Background: Fiberoptic endoscopic evaluation of swallowing (FEES) is an established non-invasive and radiation-safe evaluation method of the pharyngeal swallowing function. The focus is in the diagnosis of dysphagia, consideration of its treatment and in finding compensation techniques for impaired swallowing. We aimed at investigating the feasibility and outcome of FEES at our institution. Patients and Methods: The study group comprised all the 117 patients who had a FEES performed during the years 2011 and 2012 at the Department of Otorhinolaryngology – Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland. Results: Patients who were considered otherwise healthy prior to FEES presented significantly more often with globus symptoms compared with patients with a neurological disorder (p=0.009) or those diagnosed with a head and neck (HN) malignancy (p=0.011). Patients with a neurological disorder had significantly more aspiration (p=0.014), suffered more from swallowing initiation difficulties (p=0.031) and more often had a pneumonia (p<0.005) compared to the patients who had been considered healthy. Aspiration and pneumonia correlated with the underlying disease (r=0.382 p<0.005), as well as with the degree of dysphagia. Conclusions: FEES served well as a second-stage diagnostic tool for dysphagia in a multidisciplinary environment. Patients with no obvious underlying cause for dysphagia presented more often with globus, compared to patients with a diagnosed malignant tumour in the head and neck region, or with a neurological diagnosis. Aspiration, pneumonia and the degree of dysphagia correlated with the underlying cause of dysphagia.
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(2023)Dysphagia, or difficulty swallowing, is a common condition in the elderly population that can lead to malnutrition and other health complications. Texture-modified food (TMF) has traditionally been used to address this issue, but they often lack the visual appeal and variety of regular food, which can impact the quality of life of individuals with dysphagia. 3D food printing technology offers a promising solution by allowing for the creation of customised and visually appealing food with modified textures, shapes, flavours and nutrient contents. In addition, fruit and vegetable (F&V) intake of individuals in residential aged care facilities (RACF) is considerably low, hence innovative solutions such as 3D food printing technology has potential to address some of these challenges and improve the provision of nutrient-dense foods in aged care settings. This report investigates the provision and consumption of F&V-based TM and 3D printed foods in RACF. The report explores 1) TMF provision and consumption in Australian RACF by a quantitative data analysis of food consumption data, 2) barriers and enablers in the current TMF provision and consumption while exploring the potential of 3D food printing to be an answer for better nutrition among residents, 3) the sensory acceptance of 3D printed food among RACF staff members and 4) modelling the use of 3D printed food in a current TM menu. The results of the study suggest that F&V consumption of RACF residents is below recommendations, although the intake is still considered adequate on average. The provision and consumption of F&V-based food were spread throughout the day, although there was great between-meal variation. The average total provision of vegetables, fruit and juice were 4.1, 0.7 and 1.2 respectively, whereas consumed amounts were lower: 3.6, 0.6 and 1.1 respectively. Interviewees disclosed 3D printed food to be acceptable, albeit there are multiple barriers for its implementation. 3D printed food has the potential to provide benefits for residents on a TM diet in RACF but was not considered timely or practical for the moment. In particular, 3D printed food was considered to be a promising technology to address the emerging challenges that aged care sector will face in the next decades, however, the technology and its implementation still require development and planning. Menu modelling demonstrated how easily F&V intake can be altered, yet its impact on the intake of nutrients need to be further researched. The study highlights that further research and development are needed to improve technical feasibility and practicality of 3D food printing in aged care settings. Overall, while F&V-based 3D printed food has potential benefits, there are significant challenges that need to be addressed before this technology can be widely adopted in RACF, and for it to be beneficial for the nutritional intake and quality of life of the residents.
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(2023)Dysphagia, or difficulty swallowing, is a common condition in the elderly population that can lead to malnutrition and other health complications. Texture-modified food (TMF) has traditionally been used to address this issue, but they often lack the visual appeal and variety of regular food, which can impact the quality of life of individuals with dysphagia. 3D food printing technology offers a promising solution by allowing for the creation of customised and visually appealing food with modified textures, shapes, flavours and nutrient contents. In addition, fruit and vegetable (F&V) intake of individuals in residential aged care facilities (RACF) is considerably low, hence innovative solutions such as 3D food printing technology has potential to address some of these challenges and improve the provision of nutrient-dense foods in aged care settings. This report investigates the provision and consumption of F&V-based TM and 3D printed foods in RACF. The report explores 1) TMF provision and consumption in Australian RACF by a quantitative data analysis of food consumption data, 2) barriers and enablers in the current TMF provision and consumption while exploring the potential of 3D food printing to be an answer for better nutrition among residents, 3) the sensory acceptance of 3D printed food among RACF staff members and 4) modelling the use of 3D printed food in a current TM menu. The results of the study suggest that F&V consumption of RACF residents is below recommendations, although the intake is still considered adequate on average. The provision and consumption of F&V-based food were spread throughout the day, although there was great between-meal variation. The average total provision of vegetables, fruit and juice were 4.1, 0.7 and 1.2 respectively, whereas consumed amounts were lower: 3.6, 0.6 and 1.1 respectively. Interviewees disclosed 3D printed food to be acceptable, albeit there are multiple barriers for its implementation. 3D printed food has the potential to provide benefits for residents on a TM diet in RACF but was not considered timely or practical for the moment. In particular, 3D printed food was considered to be a promising technology to address the emerging challenges that aged care sector will face in the next decades, however, the technology and its implementation still require development and planning. Menu modelling demonstrated how easily F&V intake can be altered, yet its impact on the intake of nutrients need to be further researched. The study highlights that further research and development are needed to improve technical feasibility and practicality of 3D food printing in aged care settings. Overall, while F&V-based 3D printed food has potential benefits, there are significant challenges that need to be addressed before this technology can be widely adopted in RACF, and for it to be beneficial for the nutritional intake and quality of life of the residents.
Now showing items 1-5 of 5