The Experts below are selected from a list of 110757 Experts worldwide ranked by ideXlab platform
Yusaku Nakamura - One of the best experts on this subject based on the ideXlab platform.
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Rotigotine Transdermal Patch Improves Swallowing in Dysphagic Patients with Parkinson’s Disease
Dysphagia, 2015Co-Authors: Makito Hirano, Chiharu Isono, Hikaru Sakamoto, Shuichi Ueno, Susumu Kusunoki, Yusaku NakamuraAbstract:Abnormal swallowing, Dysphagia, is a potentially fatal symptom in Parkinson’s disease (PD) and is characterized by frequent silent aspiration, an unrecognized risk of suffocation and aspiration pneumonia. Several studies have reported that the injection of apomorphine, a dopamine agonist, alleviated Dysphagia in some patients with PD. The effects of other antiparkinson medications against Dysphagia remain controversial. Rotigotine is another dopamine agonist with non-oral administration, i.e., a transdermal patch. Its noninvasiveness seems to render this medicine even more suitable than apomorphine for dysphasic patients. However, no direct evidence has been reported. In the present retrospective open-label study, we for the first time objectively showed that rotigotine improved swallowing on videofluoroscopic examination in dysphagic patients with PD.
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rotigotine transdermal patch improves swallowing in dysphagic patients with parkinson s disease
Dysphagia, 2015Co-Authors: Makito Hirano, Chiharu Isono, Hikaru Sakamoto, Shuichi Ueno, Susumu Kusunoki, Yusaku NakamuraAbstract:Abnormal swallowing, Dysphagia, is a potentially fatal symptom in Parkinson's disease (PD) and is characterized by frequent silent aspiration, an unrecognized risk of suffocation and aspiration pneumonia. Several studies have reported that the injection of apomorphine, a dopamine agonist, alleviated Dysphagia in some patients with PD. The effects of other antiparkinson medications against Dysphagia remain controversial. Rotigotine is another dopamine agonist with non-oral administration, i.e., a transdermal patch. Its noninvasiveness seems to render this medicine even more suitable than apomorphine for dysphasic patients. However, no direct evidence has been reported. In the present retrospective open-label study, we for the first time objectively showed that rotigotine improved swallowing on videofluoroscopic examination in dysphagic patients with PD.
Sue Pownall - One of the best experts on this subject based on the ideXlab platform.
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Factors Associated with Risk of Stroke-Associated Pneumonia in Patients with Dysphagia: A Systematic Review
Dysphagia, 2019Co-Authors: Sabrina A. Eltringham, Karen Kilner, Melanie Gee, Ben D. Bray, Craig J. Smith, Karen Sage, Sue PownallAbstract:Dysphagia is associated with increased risk of stroke-associated pneumonia (SAP). However, it is unclear what other factors contribute to that risk or which measures may reduce it. This systematic review aimed to provide evidence on interventions and care processes associated with SAP in patients with Dysphagia. Studies were screened for inclusion if they included Dysphagia only patients, Dysphagia and non-Dysphagia patients or unselected patients that included dysphagic patients and evaluated factors associated with a recorded frequency of SAP. Electronic databases were searched from inception to February 2017. Eligible studies were critically appraised. Heterogeneity was evaluated using I ^2. The primary outcome was SAP. Eleven studies were included. Sample sizes ranged from 60 to 1088 patients. There was heterogeneity in study design. Measures of immunodepression are associated with SAP in dysphagic patients. There is insufficient evidence to justify screening for aerobic Gram-negative bacteria. Prophylactic antibiotics did not prevent SAP and proton pump inhibitors may increase risk. Treatment with metoclopramide may reduce SAP risk. Evidence that nasogastric tube (NGT) placement increases risk of SAP is equivocal. A multidisciplinary team approach and instrumental assessment of swallowing may reduce risk of pneumonia. Patients with impaired mobility were associated with increased risk. Findings should be interpreted with caution given the number of studies, heterogeneity and descriptive analyses. Several medical interventions and care processes, which may reduce risk of SAP in patients with Dysphagia, have been identified. Further research is needed to evaluate the role of these interventions and care processes in clinical practice.
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Factors Associated with Risk of Stroke-Associated Pneumonia in Patients with Dysphagia: A Systematic Review
Dysphagia, 2019Co-Authors: Sabrina A. Eltringham, Karen Kilner, Melanie Gee, Ben D. Bray, Craig J. Smith, Karen Sage, Sue PownallAbstract:Dysphagia is associated with increased risk of stroke-associated pneumonia (SAP). However, it is unclear what other factors contribute to that risk or which measures may reduce it. This systematic review aimed to provide evidence on interventions and care processes associated with SAP in patients with Dysphagia. Studies were screened for inclusion if they included Dysphagia only patients, Dysphagia and non-Dysphagia patients or unselected patients that included dysphagic patients and evaluated factors associated with a recorded frequency of SAP. Electronic databases were searched from inception to February 2017. Eligible studies were critically appraised. Heterogeneity was evaluated using I ^2. The primary outcome was SAP. Eleven studies were included. Sample sizes ranged from 60 to 1088 patients. There was heterogeneity in study design. Measures of immunodepression are associated with SAP in dysphagic patients. There is insufficient evidence to justify screening for aerobic Gram-negative bacteria. Prophylactic antibiotics did not prevent SAP and proton pump inhibitors may increase risk. Treatment with metoclopramide may reduce SAP risk. Evidence that nasogastric tube (NGT) placement increases risk of SAP is equivocal. A multidisciplinary team approach and instrumental assessment of swallowing may reduce risk of pneumonia. Patients with impaired mobility were associated with increased risk. Findings should be interpreted with caution given the number of studies, heterogeneity and descriptive analyses. Several medical interventions and care processes, which may reduce risk of SAP in patients with Dysphagia, have been identified. Further research is needed to evaluate the role of these interventions and care processes in clinical practice.
Shaheen Hamdy - One of the best experts on this subject based on the ideXlab platform.
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repetitive transcranial magnetic stimulation a novel approach for treating oropharyngeal Dysphagia
Current Gastroenterology Reports, 2016Co-Authors: Emilia Michou, Alicja Raginiszborowska, Masahiro Watanabe, Taha Lodhi, Shaheen HamdyAbstract:In recent years, repetitive transcranial magnetic stimulation, a technique used to produce human central neurostimulation, has attracted increased interest and been applied experimentally in the treatment of Dysphagia. This review presents a synopsis of the current research for the application of repetitive transcranial magnetic stimulation (rTMS) on Dysphagia. Here, we review the mechanisms underlying the effects of rTMS and the results from studies on both healthy volunteers and dysphagic patients. The clinical studies on Dysphagia have primarily focussed on Dysphagia post-stroke. We discuss why it is difficult to draw conclusions for the efficacy of this neurostimulation technique, given the major differences between studies. The intention here is to stimulate potential research questions not yet investigated for the application of rTMS on dysphagic patients prior to their translation into clinical practice for Dysphagia rehabilitation.
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Dysphagia in stroke patients
Postgraduate Medical Journal, 2006Co-Authors: S Singh, Shaheen HamdyAbstract:Swallowing musculature is asymmetrically represented in both motor cortices. Stroke affecting the hemisphere with the dominant swallowing projection results in Dysphagia and clinical recovery has been correlated with compensatory changes in the previously non-dominant, unaffected hemisphere. This asymmetric bilaterality may explain why up to half of stroke patients are dysphagic and why many will regain a safe swallow over a comparatively short period. Despite this propensity for recovery, Dysphagia carries a sevenfold increased risk of aspiration pneumonia and is an independent predictor of mortality. The identification, clinical course, pathophysiology, and treatment of Dysphagia after stroke are discussed in this review.
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explaining oropharyngeal Dysphagia after unilateral hemispheric stroke
The Lancet, 1997Co-Authors: Shaheen Hamdy, Rosie Crone, Qasim Aziz, David J. Hughes, Raymond Tallis, J C Rothwell, D G ThompsonAbstract:BACKGROUND: Oropharyngeal Dysphagia occurs in up to a third of patients presenting with a unilateral hemiplegic stroke, yet its neurophysiological basis remains unknown. To explore the relation between cortical motor function of swallowing and oropharyngeal Dysphagia, mylohyoid, pharyngeal, and thenar electromyographic responses to stimulation of affected and unaffected hemispheres were recorded in dysphagic and non-dysphagic patients. METHODS: The 20 patients studied had unilateral hemispheric stroke confirmed by computed tomography. Eight of them had associated swallowing difficulties. Electromyographic responses were recorded after suprathreshold transcranial magneto-electric stimulation of affected and unaffected hemispheres with a figure-of-eight coil. FINDINGS: Stimulation of the unaffected hemisphere evoked smaller pharyngeal responses in dysphagic patients than in non-dysphagic patients (mean 64 microV, median 48, interquartile range 44-86 vs 118 microV, 81, 73-150) (p < 0.02). With stimulation of the affected hemisphere, the pharyngeal responses were smaller than for the unaffected hemisphere but similar between the two patient groups (26 microV, 0, 0-48 vs 54 microV, 0, 0-80). Dysphagic and non-dysphagic patients showed similar mylohyoid and thenar responses to stimulation of the unaffected hemisphere as well as to stimulation of the affected hemisphere-unaffected mylohyoid (269 microV, 239, 89-372 vs 239 microV, 163, 133-307), thenar (572 microV, 463, 175-638 vs 638 microV, 485, 381-764); affected mylohyoid (60 microV, 41, 0-129 vs 96 microV, 0, 0-195); thenar (259 microV, 258, 0-538 vs 451 microV, 206, 8-717). INTERPRETATION: The findings indicate that Dysphagia after unilateral hemispheric stroke is related to the magnitude of pharyngeal motor representation in the unaffected hemisphere.
Makito Hirano - One of the best experts on this subject based on the ideXlab platform.
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Rotigotine Transdermal Patch Improves Swallowing in Dysphagic Patients with Parkinson’s Disease
Dysphagia, 2015Co-Authors: Makito Hirano, Chiharu Isono, Hikaru Sakamoto, Shuichi Ueno, Susumu Kusunoki, Yusaku NakamuraAbstract:Abnormal swallowing, Dysphagia, is a potentially fatal symptom in Parkinson’s disease (PD) and is characterized by frequent silent aspiration, an unrecognized risk of suffocation and aspiration pneumonia. Several studies have reported that the injection of apomorphine, a dopamine agonist, alleviated Dysphagia in some patients with PD. The effects of other antiparkinson medications against Dysphagia remain controversial. Rotigotine is another dopamine agonist with non-oral administration, i.e., a transdermal patch. Its noninvasiveness seems to render this medicine even more suitable than apomorphine for dysphasic patients. However, no direct evidence has been reported. In the present retrospective open-label study, we for the first time objectively showed that rotigotine improved swallowing on videofluoroscopic examination in dysphagic patients with PD.
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rotigotine transdermal patch improves swallowing in dysphagic patients with parkinson s disease
Dysphagia, 2015Co-Authors: Makito Hirano, Chiharu Isono, Hikaru Sakamoto, Shuichi Ueno, Susumu Kusunoki, Yusaku NakamuraAbstract:Abnormal swallowing, Dysphagia, is a potentially fatal symptom in Parkinson's disease (PD) and is characterized by frequent silent aspiration, an unrecognized risk of suffocation and aspiration pneumonia. Several studies have reported that the injection of apomorphine, a dopamine agonist, alleviated Dysphagia in some patients with PD. The effects of other antiparkinson medications against Dysphagia remain controversial. Rotigotine is another dopamine agonist with non-oral administration, i.e., a transdermal patch. Its noninvasiveness seems to render this medicine even more suitable than apomorphine for dysphasic patients. However, no direct evidence has been reported. In the present retrospective open-label study, we for the first time objectively showed that rotigotine improved swallowing on videofluoroscopic examination in dysphagic patients with PD.
Sabrina A. Eltringham - One of the best experts on this subject based on the ideXlab platform.
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Factors Associated with Risk of Stroke-Associated Pneumonia in Patients with Dysphagia: A Systematic Review
Dysphagia, 2019Co-Authors: Sabrina A. Eltringham, Karen Kilner, Melanie Gee, Ben D. Bray, Craig J. Smith, Karen Sage, Sue PownallAbstract:Dysphagia is associated with increased risk of stroke-associated pneumonia (SAP). However, it is unclear what other factors contribute to that risk or which measures may reduce it. This systematic review aimed to provide evidence on interventions and care processes associated with SAP in patients with Dysphagia. Studies were screened for inclusion if they included Dysphagia only patients, Dysphagia and non-Dysphagia patients or unselected patients that included dysphagic patients and evaluated factors associated with a recorded frequency of SAP. Electronic databases were searched from inception to February 2017. Eligible studies were critically appraised. Heterogeneity was evaluated using I ^2. The primary outcome was SAP. Eleven studies were included. Sample sizes ranged from 60 to 1088 patients. There was heterogeneity in study design. Measures of immunodepression are associated with SAP in dysphagic patients. There is insufficient evidence to justify screening for aerobic Gram-negative bacteria. Prophylactic antibiotics did not prevent SAP and proton pump inhibitors may increase risk. Treatment with metoclopramide may reduce SAP risk. Evidence that nasogastric tube (NGT) placement increases risk of SAP is equivocal. A multidisciplinary team approach and instrumental assessment of swallowing may reduce risk of pneumonia. Patients with impaired mobility were associated with increased risk. Findings should be interpreted with caution given the number of studies, heterogeneity and descriptive analyses. Several medical interventions and care processes, which may reduce risk of SAP in patients with Dysphagia, have been identified. Further research is needed to evaluate the role of these interventions and care processes in clinical practice.
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Factors Associated with Risk of Stroke-Associated Pneumonia in Patients with Dysphagia: A Systematic Review
Dysphagia, 2019Co-Authors: Sabrina A. Eltringham, Karen Kilner, Melanie Gee, Ben D. Bray, Craig J. Smith, Karen Sage, Sue PownallAbstract:Dysphagia is associated with increased risk of stroke-associated pneumonia (SAP). However, it is unclear what other factors contribute to that risk or which measures may reduce it. This systematic review aimed to provide evidence on interventions and care processes associated with SAP in patients with Dysphagia. Studies were screened for inclusion if they included Dysphagia only patients, Dysphagia and non-Dysphagia patients or unselected patients that included dysphagic patients and evaluated factors associated with a recorded frequency of SAP. Electronic databases were searched from inception to February 2017. Eligible studies were critically appraised. Heterogeneity was evaluated using I ^2. The primary outcome was SAP. Eleven studies were included. Sample sizes ranged from 60 to 1088 patients. There was heterogeneity in study design. Measures of immunodepression are associated with SAP in dysphagic patients. There is insufficient evidence to justify screening for aerobic Gram-negative bacteria. Prophylactic antibiotics did not prevent SAP and proton pump inhibitors may increase risk. Treatment with metoclopramide may reduce SAP risk. Evidence that nasogastric tube (NGT) placement increases risk of SAP is equivocal. A multidisciplinary team approach and instrumental assessment of swallowing may reduce risk of pneumonia. Patients with impaired mobility were associated with increased risk. Findings should be interpreted with caution given the number of studies, heterogeneity and descriptive analyses. Several medical interventions and care processes, which may reduce risk of SAP in patients with Dysphagia, have been identified. Further research is needed to evaluate the role of these interventions and care processes in clinical practice.