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      International Journal of COPD (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on pathophysiological processes underlying Chronic Obstructive Pulmonary Disease (COPD) interventions, patient focused education, and self-management protocols. Sign up for email alerts here.

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      Oral and pharyngeal bolus transit in patients with chronic obstructive pulmonary disease

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          Abstract

          Background

          Patients with respiratory diseases, such as chronic obstructive pulmonary disease (COPD), may have swallowing dysfunction.

          Objective

          The aim of this investigation was to evaluate the oral and pharyngeal phases of swallowing in patients with COPD.

          Methods

          We studied 16 patients with clinical manifestations and pulmonary function tests diagnosis of COPD (mean age: 68 years) and 15 nonsmoking healthy volunteers (mean age: 65 years) with normal pulmonary function tests. All subjects were submitted to clinical and videofluoroscopic evaluation of swallowing. Each subject performed in duplicate swallows of 5 mL and 10 mL of liquid bolus, paste bolus, and a solid bolus.

          Results

          In general, the duration of the events of the pharyngeal phase of swallowing was longer in COPD patients than controls. The difference was significant in the laryngeal vestibular closure, hyoid movement, and pharyngeal transit with swallows of both volumes of liquid bolus; in oral–pharyngeal transit with 5 mL paste bolus; and in pharyngeal and oral–pharyngeal transit with solid bolus. The difference between the duration of maximal laryngeal elevation and the duration of pharyngeal transit was higher in control subjects than in patients with COPD.

          Conclusion

          The results suggested that patients with COPD have a longer pharyngeal swallowing phase than normal subjects, which is associated with a decrease in the difference between the duration of maximal laryngeal elevation and the duration of pharyngeal transit.

          Most cited references21

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          SAS for Mixed Models

          The indispensable, up-to-date guide to mixed models using SAS®. Discover the latest capabilities available for a variety of applications featuring the MIXED, GLIMMIX, and NLMIXED procedures in this valuable edition of the comprehensive mixed models guide for data analysis, completely revised and updated for SAS®9. The theory underlying the models, the forms of the models for various applications, and a wealth of examples from different fields of study are integrated in the discussions of these models: random effect only and random coefficients models split-plot, multilocation, and repeated measures models hierarchical models with nested random effects analysis of covariance models spatial correlation models generalized linear mixed models nonlinear mixed models Professionals and students with a background in two-way ANOVA and regression and a basic knowledge of linear models and matrix algebra will benefit from the topics covered. Includes a free CD-ROM with example SAS code!
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            A penetration-aspiration scale.

            The development and use of an 8-point, equal-appearing interval scale to describe penetration and aspiration events are described. Scores are determined primarily by the depth to which material passes in the airway and by whether or not material entering the airway is expelled. Intra- and interjudge reliability have been established. Clinical and scientific uses of the scale are discussed.
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              Reference spirometric values using techniques and equipment that meet ATS recommendations.

              Forced expiratory volumes and flows were measured in 251 healthy nonsmoking men and women using techniques and equipment that meet American Thoracic Society (ATS) recommendations. Linear regression equations using height and age alone predict spirometric parameters as well as more complex equations using additional variables. Single values for 95% confidence intervals are acceptable and should replace the commonly used method of subtracting 20% to determine the lower limit of normal for a predicted value. Our study produced predicted values for forced vital capacity and forced expiratory volume in one second that were almost identical to those predicted by Morris and associates (1) when the data from their study were modified to be compatible with the back extrapolation technique recommended by the ATS. The study of Morris and colleagues was performed at sea level in rural subjects, whereas ours was performed at an altitude of 1,400 m in urban subjects. Either the present study or the study of Morris and co-workers, modified to back extrapolation, could be recommended for predicting normal values.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                International Journal of COPD
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove Medical Press
                1176-9106
                1178-2005
                2015
                05 March 2015
                : 10
                : 489-496
                Affiliations
                Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
                Author notes
                Correspondence: Roberto Oliveira Dantas, Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, 14049-900, Ribeirão Preto, São Paulo, Brazil, Tel +55 16 3602 2457, Fax +55 16 3602 0229, Email rodantas@ 123456fmrp.usp.br
                Article
                copd-10-489
                10.2147/COPD.S74945
                4356708
                25784795
                1e886059-0e3d-4ce0-90f1-2ff96232d2bb
                © 2015 Cassiani et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

                The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Respiratory medicine
                copd,videofluoroscopy,oral–pharyngeal transit,swallowing,deglutition
                Respiratory medicine
                copd, videofluoroscopy, oral–pharyngeal transit, swallowing, deglutition

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