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Peter C. Belafsky - One of the best experts on this subject based on the ideXlab platform.
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Inflammatory Effects of Thickened Water on the Lungs in a Murine Model of Recurrent Aspiration
The Laryngoscope, 2020Co-Authors: Nogah Nativ-zeltzer, Rumi Ueha, Yuval Nachalon, Gabrielle Pastenkos, Clay Swackhamer, Gail M. Bornhorst, Maureen A. Lefton-greif, Johnathon D. Anderson, Peter C. BelafskyAbstract:Author(s): Nativ-Zeltzer, Nogah; Ueha, Rumi; Nachalon, Yuval; Ma, Betty; Pastenkos, Gabrielle; Swackhamer, Clay; Bornhorst, Gail M; Lefton-Greif, Maureen A; Anderson, Johnathon D; Belafsky, Peter C | Abstract: OBJECTIVE:Liquid thickeners are commonly recommended in individuals with dysphagia and Recurrent Aspiration as a strategy for pneumonia prevention. The goal of this study was to examine the effects of small amounts of aspirated liquid thickener on the lungs. STUDY DESIGN:Animal model. Prospective small animal clinical trial. METHODS:Adult Sprague Dawley rats (n = 19) were divided into two groups and underwent three intratracheal instillations of either xanthan gum-based nectar-thick water (0.1-0.25 mL/kg) or water-only control over the course of 8 days. Blood was collected from a peripheral vein on days 1 and 8 and submitted for complete blood count (CBC) analysis. Rats were euthanized 10 days after the last instillation, and the lungs were harvested. Histopathology was conducted on lung specimens by a blinded licensed veterinary pathologist and scored for evidence of lung injury and pneumonia. RESULTS:Fifteen animals (8 nectar-thickener group, 7 control group) survived until the endpoint of the study (day 18). Serum CBC did not show abnormalities at any timepoint in either group. Histological evidence of lung inflammation and edema were significantly greater in the nectar-thick group compared to controls (P l .05). Signs of inflammation included aggregates of foamy macrophages, expansion of bronchiolar lymphoid tissue, and large numbers of eosinophilic intraalveolar crystals. Histiocytic and neutrophilic pneumonia was noted in one animal that received thickened liquids. CONCLUSION:Recurrent Aspiration of small amounts of thickened water resulted in significant pulmonary inflammation in a murine model of Aspiration. Results of this study support the need for further investigation of liquid thickener safety and its efficacy in reducing the pulmonary complications of swallowing disorders. LEVEL OF EVIDENCE:NA Laryngoscope, 2020.
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Total laryngectomy for management of chronic Aspiration pneumonia in a myopathic dog.
The Canadian veterinary journal = La revue veterinaire canadienne, 2016Co-Authors: Karen M. Vernau, Stanley L. Marks, Maggie A. Kuhn, William T. N. Culp, G.d. Shelton, Siddiqui T, Rachel E. Pollard, Peter C. BelafskyAbstract:A 5-month-old female pit bull terrier dog evaluated for ataxia, progressive regurgitation, and Recurrent Aspiration pneumonia had markedly elevated creatine kinase activity, non-inflammatory generalized myopathy, and severe esophageal dysmotility. A narrow-field total laryngectomy was performed. The dog is doing well 30 months after surgery, and no longer has episodes of Aspiration pneumonia, despite intermittent regurgitation. This case represents the first application of total laryngectomy for the prevention of chronic Recurrent Aspiration pneumonia in the dog.
Jae Seung Kim - One of the best experts on this subject based on the ideXlab platform.
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H-type Tracheoesophageal Fistula Detected by Radionuclide Salivagram
Nuclear medicine and molecular imaging, 2012Co-Authors: Dong Yun Lee, Kyung Mo Kim, Jae Seung KimAbstract:Congenital H-type tracheoesophageal fistula is a rare anomaly in infants and the early diagnosis of this disorder is still a challenge to pediatricians due to scarcity, non-specific symptoms and lack of a single diagnostic examination. We report the case of a 3-month-old baby with choking and Recurrent Aspiration which finally turned out to be a tracheoesophageal fistula without esophageal atresia (H-type) by radionuclide salivagram (Fig. (Fig.11). Fig. 1 A 3-month-old baby girl with choking and Recurrent Aspiration was referred to our hospital for the surgical correction of an alleged laryngeal diverticulum. She was a full-term baby born by Cesarean section without any perinatal complication. One month ...
Jaime R. Lopez - One of the best experts on this subject based on the ideXlab platform.
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Botulinum Toxin Treatments for Sialorrhea Can Reduce Aspiration Related Hospitalizations (P03.027)
Neurology, 2013Co-Authors: Daniel Lai, Jaime R. LopezAbstract:OBJECTIVE: We demonstrate that Recurrent Aspiration symptoms in patients with sialorrhea can be effectively treated with botulinum toxin. BACKGROUND: Sialorrhea is a common symptom in many primary neurologic disorders which can affect the health of patients. Injection of botulinum toxin into the submandibular and parotid glands has been shown to significantly reduce saliva production in multiple studies for diverse study populations. DESIGN/METHODS: Our study is a retrospective review of 4 patients with clinically significant sialorrhea who were referred for botulinum toxin treatment due to Recurrent Aspiration pneumonia. Two patients received botulinum toxin A and two patients received botulinum toxin B. Injections occurred every 3-4 months. Primary outcome was hospitalization due to Aspiration pneumonia, pneumonitis or respiratory symptoms. RESULTS: Sialorrhea was subjectively reported to be improved for all patients. 2 patients9 outside medical records were available for analysis. Both patients had been treated with botulinum toxin A. Prior to treatment with toxin, patient 1 was hospitalized for respiratory symptoms an average of 17.8 days/year and patient 2 was hospitalized 25.6 days/year. Following treatment patient 1 was hospitalized 0.8 days/year and patient 2 was hospitalized 1.6 days/year. None of the patients reported adverse responses including dysphagia, respiratory insufficiency, or dry mouth. CONCLUSIONS: Botulinum toxin is a highly efficacious method for prevention of Aspiration pneumonia due to sialorrhea with few adverse effects. Botulinum toxin therapy can both improve quality of life for patients and limit hospitalization associated costs. Disclosure: Dr. Lai has nothing to disclose. Dr. Lopez has received personal compensation for activities with O2 MedTech as a consultant.
Dong Yun Lee - One of the best experts on this subject based on the ideXlab platform.
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H-type Tracheoesophageal Fistula Detected by Radionuclide Salivagram
Nuclear medicine and molecular imaging, 2012Co-Authors: Dong Yun Lee, Kyung Mo Kim, Jae Seung KimAbstract:Congenital H-type tracheoesophageal fistula is a rare anomaly in infants and the early diagnosis of this disorder is still a challenge to pediatricians due to scarcity, non-specific symptoms and lack of a single diagnostic examination. We report the case of a 3-month-old baby with choking and Recurrent Aspiration which finally turned out to be a tracheoesophageal fistula without esophageal atresia (H-type) by radionuclide salivagram (Fig. (Fig.11). Fig. 1 A 3-month-old baby girl with choking and Recurrent Aspiration was referred to our hospital for the surgical correction of an alleged laryngeal diverticulum. She was a full-term baby born by Cesarean section without any perinatal complication. One month ...
Nogah Nativ-zeltzer - One of the best experts on this subject based on the ideXlab platform.
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Inflammatory Effects of Thickened Water on the Lungs in a Murine Model of Recurrent Aspiration
The Laryngoscope, 2020Co-Authors: Nogah Nativ-zeltzer, Rumi Ueha, Yuval Nachalon, Gabrielle Pastenkos, Clay Swackhamer, Gail M. Bornhorst, Maureen A. Lefton-greif, Johnathon D. Anderson, Peter C. BelafskyAbstract:Author(s): Nativ-Zeltzer, Nogah; Ueha, Rumi; Nachalon, Yuval; Ma, Betty; Pastenkos, Gabrielle; Swackhamer, Clay; Bornhorst, Gail M; Lefton-Greif, Maureen A; Anderson, Johnathon D; Belafsky, Peter C | Abstract: OBJECTIVE:Liquid thickeners are commonly recommended in individuals with dysphagia and Recurrent Aspiration as a strategy for pneumonia prevention. The goal of this study was to examine the effects of small amounts of aspirated liquid thickener on the lungs. STUDY DESIGN:Animal model. Prospective small animal clinical trial. METHODS:Adult Sprague Dawley rats (n = 19) were divided into two groups and underwent three intratracheal instillations of either xanthan gum-based nectar-thick water (0.1-0.25 mL/kg) or water-only control over the course of 8 days. Blood was collected from a peripheral vein on days 1 and 8 and submitted for complete blood count (CBC) analysis. Rats were euthanized 10 days after the last instillation, and the lungs were harvested. Histopathology was conducted on lung specimens by a blinded licensed veterinary pathologist and scored for evidence of lung injury and pneumonia. RESULTS:Fifteen animals (8 nectar-thickener group, 7 control group) survived until the endpoint of the study (day 18). Serum CBC did not show abnormalities at any timepoint in either group. Histological evidence of lung inflammation and edema were significantly greater in the nectar-thick group compared to controls (P l .05). Signs of inflammation included aggregates of foamy macrophages, expansion of bronchiolar lymphoid tissue, and large numbers of eosinophilic intraalveolar crystals. Histiocytic and neutrophilic pneumonia was noted in one animal that received thickened liquids. CONCLUSION:Recurrent Aspiration of small amounts of thickened water resulted in significant pulmonary inflammation in a murine model of Aspiration. Results of this study support the need for further investigation of liquid thickener safety and its efficacy in reducing the pulmonary complications of swallowing disorders. LEVEL OF EVIDENCE:NA Laryngoscope, 2020.