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      Sintomas indicativos de disfagia em portadores de DPOC Translated title: Symptoms of dysphagia in patients with COPD

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          Abstract

          OBJETIVO: Identificar os sintomas indicativos de disfagia em indivíduos portadores de DPOC a partir de um questionário de autopercepção. MÉTODOS: Foram avaliados 35 indivíduos portadores de DPOC e 35 indivíduos sem a doença pareados por gênero e idade. O grupo de estudo foi avaliado quanto a gravidade da doença, sensação de dispneia, índice de massa corpórea (IMC) e sintomas de disfagia. O grupo controle foi avaliado quanto a IMC e sintomas de disfagia. RESULTADOS: Os sintomas mais frequentes de disfagia apresentados pelos participantes do grupo de estudo foram sintomas faríngeos/proteção de vias aéreas (p < 0,001), sintomas esofágicos/histórico de pneumonia (p < 0,001) e sintomas alimentares (p < 0,001). As seguintes variáveis apresentaram correlações positivas: VEF1 e IMC (r = 0,567; p < 0,001); sintomas faríngeos/proteção de vias aéreas e dispneia (r = 0,408; p = 0,015); e sintomas esofágicos/histórico de pneumonia e sintomas faríngeos/proteção de vias aéreas (r = 0,531; p = 0,001). Houve correlação negativa entre sintomas alimentares e IMC (r = -0,046; p < 0,008). CONCLUSÕES: Os resultados mostraram que os participantes com DPOC apresentaram sintomas de disfagia relacionados à fase faríngea e esofágica da deglutição; ao mecanismo de proteção das vias aéreas; ao histórico de pneumonia e aos sintomas alimentares.

          Translated abstract

          OBJECTIVE: To identify symptoms of dysphagia in individuals with COPD, based on their responses on a self-perception questionnaire. METHODS: The study comprised 35 individuals with COPD and 35 healthy individuals, matched for age and gender. The study group was assessed regarding COPD severity; sensation of dyspnea; body mass index (BMI); and symptoms of dysphagia. The control group was assessed regarding BMI and symptoms of dysphagia. RESULTS: The most common symptoms of dysphagia in the study group were pharyngeal symptoms/airway protection (p < 0.001); esophageal symptoms/history of pneumonia (p < 0.001); and nutritional symptoms (p < 0.001). Positive correlations were found between the following pairs of variables: FEV1 and BMI (r = 0.567; p < 0.001); pharyngeal symptoms/airway protection and dyspnea (r = 0.408; p = 0.015); and esophageal symptoms/history of pneumonia and pharyngeal symptoms/airway protection (r = 0.531; p = 0.001). There was a negative correlation between nutritional symptoms and BMI (r = -0.046; p < 0.008). CONCLUSIONS: Our results show that the individuals with COPD presented with symptoms of dysphagia that were associated with the pharyngeal and esophageal phases of swallowing, as well as with the mechanism of airway protection, a history of pneumonia, and nutritional symptoms.

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          Most cited references31

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          Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. American Thoracic Society.

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            Increased prevalence of gastroesophageal reflux symptoms in patients with COPD.

            To determine the prevalence of gastroesophageal reflux (GER) symptoms in patients with COPD and the association of GER symptoms with the severity of airways obstruction as assessed by pulmonary function tests (PFTs). Prospective questionnaire-based, cross-sectional analytic survey. Outpatient pulmonary and general medicine clinics at a Veterans Administration hospital. Patients with mild-to-severe COPD (n = 100) were defined based on American Thoracic Society criteria. The control group (n = 51) consisted of patients in the general medicine clinic without respiratory complaints or prior diagnosis of asthma or COPD. Both groups completed a modified version of the Mayo Clinic GER questionnaire. Compared to control subjects, a greater proportion of COPD patients had significant GER symptoms defined as heartburn and/or regurgitation once or more per week (19% vs 0%, respectively; p 50% of predicted (23% vs 9%, respectively; p = 0.08). In contrast, PFT results were similar among COPD patients with and without GER symptoms. An increased number of patients with COPD utilized antireflux medications, compared to control subjects (50% vs 27%, respectively; p = 0.008). The questionnaire demonstrated a higher prevalence of weekly GER symptoms in patients with COPD, as compared to control subjects. There was a trend toward higher prevalence of GER symptoms in patients with severe COPD; however, this difference did not reach statistical significance. We speculate that although GER may not worsen pulmonary function, greater expiratory airflow limitation may worsen GER symptoms in patients with COPD.
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              Temporal and durational patterns associating respiration and swallowing.

              This study obtained initial normative data on the temporal coordination of respiration and swallowing events in 12 young adults using a first-generation Respirodeglutometer. In addition, direction of airflow before and after deglutive apnea was obtained. Three swallows of two viscosities of bolus material were performed by each subject, yielding a total of 72 swallows. Qualitative and quanitative analyses were performed. Time of onset of submental surface electromyography and time of laryngeal movement were found to differ between males and females. Males began submental muscle contraction before females and laryngeal movement after females. Duration of deglutition apnea for all swallows was 0.75 +/- 0.14 sec. Expiration occurred before the deglutition apnea 93% of the time and after the deglutition apnea 100% of the time. A modal pattern of events obtained with the Respirodeglutometer was present in 42% of the swallows, and an additional 47% had only one event differ from that order.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                jbpneu
                Jornal Brasileiro de Pneumologia
                J. bras. pneumol.
                Sociedade Brasileira de Pneumologia e Tisiologia (São Paulo )
                1806-3756
                April 2011
                : 37
                : 2
                : 176-183
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                [2 ] Universidade de São Paulo Brazil
                [3 ] Universidade de São Paulo Brazil
                [4 ] Universidade de São Paulo Brazil
                [5 ] Universidade de São Paulo Brazil
                Article
                S1806-37132011000200007
                10.1590/S1806-37132011000200007
                53645bc0-acdb-4d8b-ae1d-7ad5aab1b0e5

                http://creativecommons.org/licenses/by/4.0/

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                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1806-3713&lng=en
                Categories
                RESPIRATORY SYSTEM

                Respiratory medicine
                Deglutition disorders,Pulmonary disease, chronic obstructive,Pathological conditions,signs and symptoms,Transtornos de deglutição,Doença pulmonar obstrutiva crônica,Condições patológicas,sinais e sintomas

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